Behind the glass at your national chain pharmacy exists a world of long periods of boredom punctuated by extremely busy periods of stress, angry and illogical patients in Xanax withdrawal, and screaming babies with fevers. The typical pharmacist has grown accustom to a sedentary life of sitting in chairs with occasionally helping patients with problems of the insurance variety. While we may think our job is to make time go by as quickly as possible, there are constantly issues that go unresolved and leave patients without medication. Placing too much trust in your local pharmacy can also be dangerous for your health, and though rare, errors are made that can compromise your health. There are however simple steps that patients can take to ensure everything is done correctly every time you fill a prescription. Whether it be the pharmacy’s fault or not, there are also ways to resolve insurance denials with little effort.
1) Do not trust the expiration date on your prescription bottle. Unless you are given the exact bottle delivered to us by the manufacturer, you may as well be guessing as to when your medication actually expires. While expired medication may not not worry some, the effectiveness of your medication decreases with each passing day the tablet or capsule is expired. With hundreds of bottles of medication being delivered to pharmacies every week, it is easy to overlook the expiration date of medication. Safety is our first priority for patients, but some things do slip through the cracks. If you have a condition which requires a precise medication and strength, ask the pharmacist to show you the bottle where the medication originated. Self verifying the expiration date only takes a second, and gives you the confirmation you need to trust the effectiveness of your prescription.
2) Do not pay full price for an insurance denial. If an expensive medication is denied by your health insurance company, ask your pharmacist to perform a prior authorization while you wait. Waiting in the pharmacy is crucial for this process to be successful. A prior authorization is simply a form that is sent to your insurance company and doctor’s office that can force your insurance company to pay for your medication. This process usually takes up to ten days (or never) depending on the pharmacy. However, I have personally pushed this process to be completed in under 10 minutes. Make sure that your doctor or his/her staff is prepared to answer the call from your insurance company. Once your doctor or staff says the magic words, “medically necessary”, you are on your way to paying your regular copay for your medication. The alternative is waiting ten days for a rejection from your insurance company for a prior authorization that may or may not have been done in a correct and timely manner. Some pharmacist may try to brush off this request, but the fact is we are legally required to assist you in getting your medication. Anything else can be considered unprofessional, irresponsible, and possibly grounds for malpractice. Do not get pushed around by anyone when it comes to your health.
3) All generics are not created equal. Insurance companies push generics due to their low cost, but every person reacts differently to medication. There are some medications for conditions like epilepsy and thyroid issues that react differently than their brand named counterparts for some patients. Even the same generic medication made by different manufactures can have a different effect on the same person. While the chemical structure of the medication may be the same, the way it is synthesized and concentrated differs from company to company. Small differences between medications can make all the difference for a patient. If one generic does not work for you, ask for a different malefactor. If no generics work, you always have the option (under federal law) to substitute for the brand name version. Many patients experience a change in their health when a generic becomes available for their medication, but are unaware that they do not have to take the generic medication.
4) Ask for a loaner when needed. If you for some reason run out of medication (that is a non-controlled medication such as Xanax or Hydrocodone) your pharmacist has the option to give you up to a three day loaner supply to hold you over until your doctor is contacted for a refill. This loaner supply also goes for situations when you are out of town and forgot to pack your medication if you do have a refill somewhere in the United States, though you may have to pay for the three day supply in this circumstance. Many pharmacist do not extend the offer because they fear taking a loss for the pharmacy, but simply asking is often all a patient needs to do.
5) Take advantage of transfer gift cards! We will give you a gift card for a transfer in almost any situation. If you are in a large national chain pharmacy, at least. When gift cards popular for transfer prescriptions in 2005 there were many restrictions placed as to how they were to be given out. These restrictions no longer exist since we have been notified not to argue with customers in this situation. Instead of a pharmacy district manager personally replying to complaints on transfer gift cards, most pharmacies simply give them out. There may be nice pharmacy staff that will give you a gift card automatically, but most hope you don’t ask. Ask for the gift card, they exist to facilitate a transfer which benefits the pharmacy more than giving out a thirty dollar gift card. The pharmacy makes a fortune from insurance companies, you shouldn’t feel guilty or timid for taking advantage of a program created for the patient.