Early Refills

[rnb5972]

I am curious of how many days BEFORE your refill date can you get your script filled.  I live in Virginia and use Rite Aid pharmacy

[Jean59]

Just to let you know, I got my new script and it was filled.  Also yesterday I got news from the State that effective January 2015 they are changing my insurance.  Here we go again!!!  I will probably have to get all new preapprovals and also get a new referral for me to see my pain specialist.  Also have to go for a CT scan and my PCP had to pull teeth to get the doctor of my current insurance to approve.  I am also in the middle of getting Physical Therapy.  I don't know about the transferring from one State Insurance to another State Ins.,  but I pray I don't have to go through the preapprovals of my meds again, just when I got everything fixed. Ugh!!!

[philnoir]

Good for you.

Good luck with it.

[Jean59]

Just contacted my pharmacy, yes they will not fill it tomorrow, but they did say if she wrote it different like 2 instead of 3, different mg. then it would not be a problem.  The amount would differ also, giving me enough to carry me through till next month.  Since it is the same medication, but different mg's is okay.  Still giving the doctor time to do a preapproval before the 26th of this month.  Then if he wants to change me back to the original mg. he can do that next month.  Thank you for all your help, you were dead on with your information.  

[philnoir]

Jean, unfortunately, if the Rx is for a presciption opioid analgesic, like Vicodin, OxyContin, or morphine, the pharmacist is not allowed to give you a partial fill.

Yes, you lost me, but let me go over the rules.

- Prescriptions must be for 30 days only if covered by insurance / medicare. Some insurance allows 90 day Rx but never for controlled medications.

- Sched II (CII) medications cannot have refills, and cannot be partially filled. This class now includes all the opioid pain medications. (Actually, they can be partially filled at the pharmacist's discretion within 72 hours, but you won't find a pharmacist who will do it anymore. They're all afraid of losing their license to dispense.)

You're going to have to catch up somehow so that the two-week prior authorization cycle doesn't put you into opioid withdrawal.

If you indeed have to get a prior authorization every month, you and your doc are going to have to get creative. If the prior auth cycle is two weeks, perhaps your doc can give you a two-week script that you pay out of pocket, start the prior auth process, and you fill the 30 day script after the two week processing period.

Then you'll still have to call your doc two weeks before your next appointment to get them to start the prior auth process again.

I can't believe you're the only person on Medicare in your state that has this problem. This has to have been worked out so that patients don't go into withdrawal every month.

If your doc has other pain patients in this situation, then she knows how to manage it.

[Jean59]

Thank you for getting back to me.  I told my doctor to remember that I was up for preapproval again at the end of this month and that is why she moved up the refill date.  He said the pharmacy would probably give me a partial fill, but the script says a full script.  I don't think it said "Not to Fill before" and I feel that the insurance won't pay for another full script because I do have two weeks left, but he said they would give me a partial fill to last me till the second week of Dec.  I am so confused!!!  I think what I need to do is have the doc write a script for a specific amount like 40 since I have taken 50. That is the only way my script would last until the second week of Dec. giving the doc/pharm enough time to get another 3 month approval so I don't have to do an emergency fill. Do you think they would approve an amount of 40 pills that would carry me into the next month?  Changing my due date from the 26th to the 12th?  The 12th is also the due date of my short term meds.  I would like to get the both of them on or around the same day as I have been on this schedule for years until I got on the State Ins. which screwed up my due dates.  I will be talking with the pharm this week, I will let you know what they say, but I truly believe the script will have to be rewritten for a certain amount to be added to what I already have to make it a 30 day script.  Did I lose you?  Please I am interested in what you think?

[philnoir]

Preapproval date is different from fill date.

Generally, preapprovals (or prior authorizations) are good for a length of time, 6 months, one year, etc.

This is probably why your doc wrote the Rx 2 weeks early. When doctors write early, they usually include a Do Not Fill Before date.

Because your medication is a CII controlled substance, the rules on when you can fill, and how many days dose you can receive are restrictive. I doubt if you would be able to get 1-1/2 month supply when you fill your Rx.

I understand your fear of running out -- this is a big problem for people like us who are maintained on long-term opioid therapy.

Stay in touch with your pharmacy or whomever has submitted the request for pre-approval, so there are no surprises when it is time to fill the Rx. If the state is again slow in the pre-approval, notify your doctor's office of the situation, as if they do not come through on time, he may be willing to write an emergency Rx for a  few days worth of medication until some bureaucrat gets your paperwork in order.

I'm hoping the can generate an approval in less than 10 working days.

Best wishes.