1. Will I always get the medication my doctor prescribed?

2. How do I know if I didn’t get what I was prescribed?

3. What should I do if I didn’t get the medication my doctor prescribed?

4. I don’t have insurance and can’t afford my prescriptions. Are there any resources available to help me with the costs?

5. Why are my out-of-pocket costs so high for my prescriptions?

6. What happens if my health insurance plan only covers one medication for my condition, but I need a different one?

7. Are there coupons or discounts available for the medication I’m taking?

8. I need to fill, refill or renew a prescription. How can I do that?

9. I need to order a new prescription or insurance card. How can I do that?

10. I’m interested in sharing my prescription process story. How will it be used?

 

Not always. Many factors help determine what medication you will get from your pharmacy. Additionally, several parties are involved in the decision-making process including you, your doctor or other healthcare professional, your health insurance company and several others. You can learn more about how prescriptions are processed and filled on this site.
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In most cases, the pharmacist or the mail-order pharmacy filling your prescription should tell you if the medication they give you is a substitute. However, this isn’t always the case. Before you pay for your medication, you should check to confirm it is the medication you were prescribed. If you don’t remember the name of the medication you were prescribed, ask the pharmacist to look up the prescription for you. If you received your prescription in the mail, call the customer service number provided by the mail-order pharmacy. You can also look at the pills when you open them for the first time. Are they a different color or shape than usual? Then you may follow up with your pharmacist or mail-order pharmacy to find out why.
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Before paying for your prescription at a pharmacy, you should ask the pharmacist why you received a different prescription and if your doctor authorized the change. It is important that you check the prescription to confirm it is correct before paying because you may not be able to return it for a refund. You can also call the customer service number provided by a mail-order pharmacy to ask the same questions. If your doctor did not authorize the switch, ask your doctor’s office to contact the pharmacy directly. You can also take these steps to ensure you get the same medication you were prescribed:

Ask your doctor to mark “medically necessary,” “may not substitute” or “dispense as written” on all of your prescriptions or electronic prescriptions. This helps to ensure your pharmacist will check with you and your doctor before any substitutions are made.
Ask your pharmacist to add a statement to your records that you do not want any medications substituted unless you and your doctor approve.
Call your health insurance company when you receive the prescription to confirm the medication is covered by your plan.
At the pharmacy counter, check your prescription before paying to confirm it is the same medication you were prescribed.
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Yes. Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage get the medicines they need – free of charge. Many patients will get their medications at no cost or at discounted prices. Visit Partnership for Prescription Assistance or call 1-888-4PPA-NOW (1-888-477-2669) to get started. You can also visit the same site to access information on state and corporate prescription assistance programs and drug savings cards.
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The out-of-pocket cost for a prescription is determined by many factors, including what your health insurance and prescription benefit plan are required to cover, what your co-pay requirement is under your prescription insurance plan, what your insurer agrees to pay a pharmaceutical company for each medication, and what Medicare and Medicaid agree to pay for specific drugs.

To determine what your insurance company will cover and what out-of-pocket costs you could face, you should:

Review your plan’s details, called a formulary, to see what drugs are covered and what the cost is to you.
Identify if a co-pay is required for your prescriptions and the cost for each of your prescriptions – different prescriptions may have different co-pay amounts.
Ask your health insurance company if they require prior authorization, which means they will need to approve certain medications before the pharmacist will dispense them. If the insurance company does not give this approval, they will not provide coverage for the medication.
Determine if your plan will require you to try and fail on one or more medications before getting to the medication prescribed by your doctor.

There are several resources available if you are struggling to pay out-of-pocket costs for a drug your doctor prescribed. Visit Partnership for Prescription Assistance or call 1-888-4PPA-NOW or 1-888-477-2669 to learn more.
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Your health plan may cover additional options, including the medication your doctor prescribed, at a higher out-of-pocket cost. If your health insurance company wants you try a medication not prescribed by your doctor, contact your doctor’s office to appeal the decision.

Learn more about why a health insurance plan may request this and how prescriptions are processed and filled.
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Some pharmaceutical companies help offset patient out-of-pocket costs by offering co-pay assistance programs and co-pay vouchers on their medicines. Visit Partnership for Prescription Assistance or call 1-888-4PPA-NOW or 1-888-477-2669 to learn more, or speak with your doctor to see if co-pay vouchers are available for your prescriptions.
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If you have questions about filling or refilling your prescription, contact your pharmacist, the company that manages your prescription benefits or health insurance company directly. If you need to renew a prescription, you must contact your doctor’s office directly to make the request. Prescription Process cannot process any requests regarding your prescription. We are not affiliated with any personal accounts, insurance companies, prescription benefits management company or healthcare providers.
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You must contact your insurer or pharmacy benefits manager directly to get prescription or insurance cards. If you do not have the correct contact information and receive health benefits through your employer, you may be able to contact your employe’’s benefits department to get this information. Prescription Process cannot process these requests and is not affiliated with any insurance companies, prescription benefits management company, healthcare providers or personal accounts.
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Prescription Process wants to hear from you about the challenges you or someone you know may have faced while trying to get your prescription. If you’re willing to share your experience with others, we ask you to submit your story on our Share Your Story page. Once we receive your submission, someone from Prescription Process will contact you before posting to confirm you authorize the public use of your story. From there, Prescription Process will post your story using your first name and the first initial of your last name. Someone from Prescription Process may contact you at a later date to find out if you are willing to share your story as part of a broader public education effort. However, your story will never be used without your direct permission.
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