It doesn't occur often, but it may happen - a pharmacist may refuse to fill your prescription. Just because you show a prescription doesn't mean that it automatically gets filled. The pharmacist may decide not to issue the drugs you require for several reasons.
Thankfully, most of these circumstances can be remedied or avoided entirely. Here are some reasons your pharmacist may decline your prescription and what you can do about it.
Why Pharmacists Might Refuse to Fill a Prescription
The prescription isn't complete or is unreadable
- The requirements vary from state to state, but generally, your prescription needs to have:
- Full identification details, including your full name and address
- The name, dosage, strength, and quantity of the medication
- A signature of the prescribing officer and your healthcare provider
- Date of issue and directions for use
If any of these are missing or unreadable (including the specific requirements for your state), then the pharmacist may not fill the prescription. Prescriptions for controlled substances, such as ones that can cause addiction, may require additional information before they are completed.
Your insurance provider rejected your prescription
Sometimes, your insurer may decline to cover your prescription because:
- It requires prior authorization (PA)
- The pharmacy is out-of-network
- The medication isn't included in your coverage
- You have exceeded either your insurance coverage or the number of refills allowed for that medication
If your insurance company doesn't cover the medication costs and you can't pay out of pocket (usually more expensive), your prescription won't be filled.
The medicine you need is out of stock
This is unlikely for commonly used drugs but may occur if your prescription requires rarely-used or costly medication. Medication can also be out of stock due to an ongoing drug shortage, or it may be no longer in production. Your pharmacist will let you know if it is on the way or is unavailable.
What Can You Do to Avoid Unfilled Prescriptions?
Check your prescription to ensure it is complete. If anything is missing, let your healthcare provider know before you go to the pharmacy to avoid delays. Ensure you also carry the necessary identification and insurance documents on your trip to the pharmacy.
If your medicine requires prior authorization (PA), ask your healthcare provider early enough and ensure it is still valid when you go for the medication. If the PA is rejected and you need different medications, contact your healthcare provider for a new prescription.
You can also call ahead at the pharmacy to check if the medication you need is available. If there is a shortage, you can keep track of supply at the American Society of Health-System Pharmacists (ASHP) or the FDA's websites.
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