Amy asked
My doctor called in my medicine and I usually get it toward the end of month. My insurance is United Health and they say I can fill the prescription on Wednesday. That is too late for me and was wondering if I could fill it early.
Answer
The answer as to whether or not you can get your prescription filled early depends on many factors, most notably is the reason as to why it needs to be filled early. The answer also varies on whether or not you are paying out of pocket (i.e. "cash") or are going through an insurer. The majority of early fill issues deal with going through an insurer or when the early fill is for a controlled substance.
Below, we will go through some common situations.
You Want To Fill Early For Convenience
This commonly occurs. Perhaps you only travel to the store once a week. Maybe you want to sync up all the fills of your medications for a one time pickup. Regardless of the reason, many times insurance companies will fill about one week early on a monthly fill or up to a few weeks early on 90 day refill. Every insurance company varies slightly in terms of how early they will allow you to fill. Your pharmacy will be able to transmit an electronic claim to your insurance company and get you an exact fill date if you require.
Be aware that most insurance companies calculate refill dates over the life of the medication, meaning you cannot consistently get it filled early. For example, if you filled your medication 7 days early one month, the insurance company may only allow you to refill the medication on the day that it is due, since they already allowed an early fill.
If the prescription is a controlled substance, the rules are much more strict. Every state has different laws. New York for example, allows people to have up to a 7 day 'extra' supply on hand. Many pharmacies however, have stricter guidelines and may only fill a few days early or only allow a fill on the day the prescription is due. Often times, the prescribing practitioner will notify the pharmacy of the allowable fill date on controlled substances. If you have a valid reason for needing a controlled substance early, your physician can contact the pharmacy and ask that it be filled early. If the reason is valid and within the confines of the law, the pharmacy should be able to fill the prescription.
Vacation/Leaving Out Of Town
In these cases, if a patient needs a medication early, they (or their pharmacy) can contact their health insurance and ask for a vacation override. Many insurances allow one override per year, in case a patient has to travel and may not be able to get to a pharmacy where they are going.
If the medication is a controlled/scheduled substance, you typically cannot get the prescription filled early unless there are some extenuating circumstances. Even if you could get an override from the insurance company, the pharmacy may not want to take on the responsibility of filling it early. This is up to the discretion of the pharmacy or the pharmacy's policies/handbook.
If the pharmacy will not fill the controlled substance early, ask your doctor to write a prescription that may be filled when you are due at your new location.
You Lost Your Prescription
If you lost your prescription and are soon due for a refill, your pharmacy may loan you a one to two day supply to reach your refill date. This isn't recommended however since you will always be "early" on your subsequent refills. In cases of lost prescriptions, it would be beneficial to contact your insurance company to see if they cover lost prescriptions. If they do not, you may have to pay out of pocket.
You Are Out Of Refills But Are Continuing Therapy
This happens more often than it should. Sometimes prescriptions aren't sent over to the pharmacy soon enough from the doctor or your pharmacy may have forgotten to send a refill request for you. If you are a few days short on your medication for some reason, many pharmacies will give you a 3 day emergency supply until you can get a new prescription from your doctor. Depending on the pharmacy, some will deduct this emergency quantity supply from your next refill, some will charge, others will give it without deducting or charging.
If the medication is not controlled, and your insurance denies the emergency refill, you always have the option for paying cash for the quantity that you need to keep you consistent on your medication until insurance covers it.
