![]() ![]() For example, many pharmacies don’t typically fill controlled substance prescriptions more than 2 days early the specific number of days varies by pharmacy. When it comes to controlled substances, states and individual pharmacies also have restrictions regarding how often you can refill them. These are enforced by insurance companies to make sure you’re taking your medication as directed, and not filling prescriptions too frequently. When you ask your pharmacist for an emergency refill, you might encounter what pharmacies and insurers refer to as a “ refill too soon” restriction. Your pharmacy has closed unexpectedly and you need to pick up your medication at a different pharmacy. You forgot to pack your medication before leaving for a trip. You need a backup supply of your medication.Ī natural disaster, such as a flood, has destroyed or damaged your medication. Reasons you might need an emergency refill include: ![]() If for whatever reason you need an emergency prescription refill, there are ways that a pharmacist can help handle this. How can I get an emergency prescription refill? If your insurer tells you it’s “too soon” to refill your prescription, your pharmacist or healthcare provider can often work with you to make sure you’re able to access your necessary medications. This is typically the case for controlled substance medications. And depending on the type of medication and the state you’re in, paying out-of-pocket for an early refill may not be allowed by law. In some cases, you may be out of refills and need to ask your healthcare provider for a new prescription. When you’re out of your medication under a quantity limit and you need more, you may need to pay out-of-pocket (without insurance coverage). These laws vary by location, so it’s best to ask your pharmacist for details regarding your state’s regulations. For example, Colorado limits people to a 7-day supply of an opioid if they haven’t filled an opioid prescription from the same prescriber in the past year. For example, an insurance plan may only cover 18 tablets of sumatriptan (Imitrex) every 30 days.įor some medications with serious side effects, like opioids, some plans, states, and pharmacies may only cover a few days’ worth for first-time prescriptions. Plans can also work in month time frames. ![]() So if you get a 30-day supply, you’ll only get 30 tablets. For example, your plan may cover one tablet of atorvastatin (Lipitor) per day. Plans can implement a day-to-day quantity limit. However, these changes are most commonly seen at the start of a plan’s coverage year. This means the amount your plan covers can change from one refill to the next. And quantity limits can change at any time. Different quantity limits apply to different medications. Generally speaking, insurance plans will review clinical and FDA literature, as well as economic data, to decide how much of a medication they will cover in a certain time period. Prescription refill rules: quantity limits and refills too soon Let’s dive into how to navigate your plan’s policies, so you can still get the medications you need. These rules require you to wait a certain amount of time between refills of a prescription.īut what happens if you lose a prescription? Or what if you’re out of refills and can’t get a hold of your healthcare provider for a new prescription? Well, you should know there are ways to obtain an emergency prescription refill in many cases. Insurance providers can also set prescription refill rules for medications. Quantity limits define how much of a medication you can fill during a specific time period, but they can be a hassle. As with other forms of coverage restrictions, insurance plans use quantity limits to help ensure patient safety and control healthcare costs. ![]()
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