Some insurance plans will allow you to fill at your retail pharmacy for a few months (usually 3 months) and then will require you to get the prescription for that same medication filled at their mail order facility.  If you’re like most of us, we are usually unaware of the specifics of the requirements and then are told the bad new when we try to fill (or pick up) our prescriptions only to see that the price is very high.  What this means is that you’ll have to get a new prescription for a 3 month supply and send it to the mail order facility to be filled.  It usually will cost less to get it through a mail order pharmacy, but most don’t like the hassle of having to mail a prescription and then waiting for it to be filled and then mailed back.  While you’re waiting for your prescription, some plans will allow a 5 to 7 day supply to be filled at your retail pharmacy.  There are other insurance that don’t have this option so you’ll have to pay our to pocket for the pills you need until you get your prescriptions filled by mail; this can certainly be expensive for some medications.   You should read over the specifics of your plan or give your insurance a call.

What are my options when my medication requires prior authorization?

Prior authorization usually requires that your doctor’s office contact your insurance company to try to initiate a process that will determine whether or not the insurance company will pay for the medication.

When you are awaiting prior authorization for your medication, you have the option to purchase a few days worth of medication so you don’t be without it.  Since there is a chance that the doctor may have to change the medication before the insurance will pay for it, the pharmacies usually don’t loan out medications in this situation.  As the patient, you should check in with your doctor’s office regarding the status of a prior authorization.