Prescriptions are given by doctors because they are supposed to reflect a needs based assessment of a person. They're different than picking up ibuprofen at the market--they are a specially written order for your body. So if your doctor is just writing up these orders without any questions or assessment, I recommend you find a new doctor.
As prescriptions are intended to be tailored to YOUR needs, it is important to know some key information about prescriptions and how they can work for your benefit.
- Prescriptions tell insurance/medical coverage what medications are necessary for condition management/prevention
- Prescriptions are specific orders that are going to keep down long term medical costs for you as an individual--thus, programs are motivated to cover them. If something does not have a prescription, it is written off as 'unimportant' and thus unnecessary to cover. Always check into prescriptions if you have coverage--even prescribed ibuprofen can save you money.
- Many people seem to think that the limits their insurance puts on quantity of their medication is fixed. Generally, this is not the case. These limits (like including placebos in birth control for coverage) are intended to fulfill general needs. If your needs differ from what you are initially told, ask your doctor to personalize your prescription. If insurance resists, ask your doctor communicate with insurance regarding your needs. For example, I skip placebos in hormones and take the medication non-stop, because it is too dangerous for my body to go through a menstrual cycle. My doctor just had to write this into my prescription. For a patch I use, the doctor had to justify my needs.
- Medical coverage will try to cut costs--it is their job and what they do best. If they are trying to prevent you from getting a medication you need however, keep pushing. Ask you doctor to push and push as well. Often, insurances will request you 'try' alternatives before paying for the more effective medication. You can speed this process up with communication with your provider.
- Providers are used to fighting with insurance for the best medication for their patients. If you ask for help, they will give it and will be experienced with the process. If they refuse you, find another doctor. A doctor should always put patient health first.
- Many brand name medications provide discount cards to ease the financial burden their cost may cause (this is called skimming the market, making it cheaper for those willing to jump through hoops). The cards take a bit to set up but are generally easy to use. Most pharmacies can help you with the process if you feel overwhelmed.
- If a medication is not working or not working well enough or is not in high enough quantity, ask your doctor for alternative options. If prescribed medications were one size fits all, they would not require prescriptions. Do not be afraid to voice problems, concerns, and needs. You can work with your doctor and insurance to get what you need. NEVER settle for a medication that does not fit your needs. There is almost always another alternative worth trying.
Thank you for reading and for those of you that asked these questions this past week. I particularly want to voice these options to women with endometriosis--you can get birth control/hormones custom fitted to your needs, paid for by insurance, as long as you are willing to PUSH! Best of luck to everyone and I hope you have read something of use!