I have been trying for two days now to get my mom's pain medication refilled. She's only got one more dose left. They have so many automatic prompts for "controlled substances" in the pharmacy and clinic computer systems that it keeps tossing out the refill request.

I swear it would probably be easier for me to walk across the street to the high school and ask a student if he could score me some opioids !!!!!!!

It would be faster. I am trying to refill an asthma med and it is taking an act of god, I have 3 doses left and they are still making me wait two more days.

Can't imagine if I were trying to get pain meds. I would probably have to die in the pharmacy line.



Edited 2 time(s). Last edit at 04/17/2018 12:17PM by sbg.

With respect to asthma meds (and others with variable dosing): The problem is a lack of understanding on the part of you and the pharmacy. Every time the pharmacy fills a prescription, if there is an insurance company involved, they need to ascribe some duration for that fill. Usually the time allotment is not determined by the insurance company, and the pharmacy people make a guess. Usually they say it is for 30 days. This practice gives the insurers some level of control over their payouts. Remember that they are paying for most of the cost of your meds.

The pharmacy should be able to easily rectify the situation. All they need to do is reverse the last fill transaction, put in a new duration, and rerun that fill. Pharmacies do this all the time. Creams and ointments are a problem almost every time, for obvious reasons. So talk to your pharmacy to see about reversing the billing and reprocessing the fill.

One thing that the pharmacy/insurance company cannot control is changes to your dosing per new instructions from your doctor. If the doctor tells you to take one pill daily, and you get 30 pills, then of course the pharmacy will call that a 30 day supply. If after 20 days your doctor tells you to take two pills a day, the pharmacy and insurer have no way to know that part. So you will have to arrange for your doctor to write a new official prescription with the new dose.

It may be possible with non-controlled meds for the doctor to say "as needed" on the prescription, in which case the pharmacy still has to guess on the duration. But the rules for controlled substances are much more strict, and are set by the US DEA and not by your insurance company. The pharmacist can tell you exactly what the law says, but remember that the decision is made by your elected representatives and not by the guy or girl in the white coat.

Remember, remember that your insurance company is doing you a favor. You are always 100% free to pay for the meds out of your own pocket, in which case time limits on non-controlled meds are nonexistent. You can get as many non-controlled pills or inhalers as you want at any time if you pay for them yourself. You signed the contract with your insurance company. You asked the pharmacist to ask the insurance company to pay the bulk of the costs. And you probably voted for the public servants who set the rules for prescription insurance companies. So the first place to look for redress is in the mirror.

>>Remember, remember that your insurance company is doing you a favor.

My insurance company is not "doing me a favor." It is providing a service for which I (along with my employer) have paid dearly.

I've gotten a hard time for refilling items (for my pet) that I pay full price for because it's "too soon to refill the prescription." Bear in mind that my vet has given me a year's worth of refills with no restrictions. But I still get a hard time.

summer Wrote:
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> I've gotten a hard time for refilling items (for
> my pet) that I pay full price for because it's
> "too soon to refill the prescription."


I may not know the whole story, but I'm 99% sure that the person you talked to at the pharmacy simply does not understand the rules. There is absolutely no restriction on how you allocate your purchases of meds you buy on your own dime. You can absolutely buy the whole year's worth at one time, or you can buy one pill every day, or you can do anything in between. Any pharmacist person who says otherwise simply does not know what they are talking about.

As for the suitability of an insurance model for medical coverage: IMO, it is an unsuitable model. Insurance means you pay a set of investors, who use your money to make more money with the possibility that sometime they may have to pay you a whole lot of money. It works for life and car coverage, because everybody tries real hard not to smash their car or get killed. But medical coverage is much different. Everybody wants to use the services so they can stay healthy and not have to impose on their life insurance company. So they take every opportunity they can to draw on the funds from their health insurers. Yes, I know health insurance companies get rich. But IMO a different coverage model would make a whole lot more sense.

And as for all those legal limitations: remember that that is what the American public has chosen. Trust me, pharmacists hate having to be narcotics cops.

Mom's doctor came through for us and put a rush on her pain killers. Just gave Mom her bedtime pill. These things are not refillable by the patient so we have to go through this silly routine, contacting the doctor every time she runs low. That's why I give them to her myself because the skilled care nurses wait until the very last minute to call the doctor for refills. If it's a weekend or the doctor is out of town, Mom has to go without for days before she gets them. I anticipate them running out and get the refills before she is completely out if I do it myself.

I suppose the nurses think I'm doing something fishy with the pills since I'm not using them and their pharmacy to get the refills any more.

I'm glad you (and your Mom) got the pills, Pooped.

I agree with you, that the necessary steps shouldn't be as difficult as they are.

(My experience is from hospice, and both times--for my aunt, and then for my father--hospice just automatically delivered what was needed, WHEN it was needed. I had not a single problem getting their meds for them during both of those situations. Going through what you are going through would have been really difficult for me back then.)



Edited 1 time(s). Last edit at 04/18/2018 01:32AM by Tevai.

Im so glad your mom got her pills. Really. Forgive my rant. It wadnt directed at you rather the state legislature which knows more about my medical condition than my doctor or I.

I'm glad she has you to look out for her.

I posted about them saying I tried to pick up gabapentin 3 days early. I was in that area of town. I live in Hyrum, which is far South in Cache Valley. The hospital is on the North end of Logan. It is a pain to go pick up one prescription at a time. We have to go to the hospital pharmacy. Gabapentin isn't a controlled substance, but insurance doesn't like you to refill more than a week before.

I need to get in to my doctor and get my prescriptions refilled all at the same time.

BUT I'm in search for a new doctor. She has joined some group called MDMVP (look it up on google if you want to be shocked). I can stay her patient if I will pay her $1650 a year out of pocket and she will still be using my insurance when I visit. That way I can see her as often as I want and she'll have less patients. That way she can have 300 patients instead of the 2500 she supposedly has now. I go see her twice a year, so I really need to see her more often. AND when I had shingles, I had to go see her every 10 days for my pain meds. I never had any problem getting in to see her and I didn't even have to pay that extra $1650, and I'm sure she made a lot of money off me as my shingles lasted over a year. I can't stand to see a doctor a lot. She's only called or sent me letters over 20 times in the past 2 months.

Healthcare is ridiculous.

You get refills. Wow. They legislated that of existence for us. You have to go to the doctor every 28 days. You getpee tested every 3 months and if you freeze up, they swab you. God help you if you lose a pill or come up short. And when they automatically get cut down, you can commit suicide. No joke. And god help you if your pain clinic closes because theyll stick their thumbs up their butts and say but we were doing what the law told us to do, we tried to get him an appointment but we were booked. No one sends a flower to your funeral.

I lived this nightmare i feel for anybody in chronic pain and is on pain meds every day. One mess up and you get cut off and you are in a bad situation. This is the main reason i am getting all my injuries fixed so i don't have to deal with pain management anymore.