Getting Medicines After Leaving the Hospital

It is important that your child keeps taking their medicine as prescribed after they leave the hospital. Below are tips on how to get your child's medication from a pharmacy in your home community.

Steps for filling a prescription

First, check your pharmacy insurance to know which pharmacies and medicines are covered. Some insurance companies may require or recommend a specific pharmacy or mail-order pharmacy.  

Choose a pharmacy that you would like to use. Try to use the same pharmacy for all prescriptions. This helps your pharmacists make sure your medicines are safe to take together. 

Have the following information ready to give the pharmacy: 

• Your child's prescription. Your doctor may send it directly to your pharmacy. Or you might need to provide a paper prescription. 
• Your child's name, birth date, address, phone number, and drug allergies 
• Your pharmacy insurance card. It may be different from your health insurance card.

Be prepared to pay a co-pay or deductible. You will need to pay the difference if your insurance does not cover the entire cost of the medicine. 

Picking up your medicine

Ask how and when you should pick up the medicine. You can also ask if delivery is an option.

Most pharmacies will only hold the medicine for a certain amount of time after the prescription is filled. If you do not pick up the medicine within a certain number of days, the pharmacy may return it to its supply. If this happens, you may need to ask for the prescription again.

Before you leave the pharmacy, double-check that you have received the:

• Correct person's medicine: Look for your child's name on the prescription label.
• Correct medicine: Make sure it is the medicine you were expecting.
• Correct dose: Check that the instructions match what your health care provider told you. This will ensure that you give the medicine correctly.

If you have questions about your medicines, talk to your pharmacist. Ask questions if a medicine looks different from normal or if the instructions are different than what you are used to seeing.

Refilling a prescription

Your child may need to take medicine for weeks, months, or longer. If so, your health care provider will arrange for the pharmacy to provide a new supply of medicine on a specific schedule, such as every 30, 60, or 90 days. This is called a "refill."

How to tell if a medicine has refills 

To find out if your child's medicine allows refills, look at the most recent medicine bottle. The number of refills is on the prescription label. Look for the word "refill" on the label. The number of refills will be next to that word.  

How to get a refill 

Some pharmacies may offer refills through a website, mobile app, or by phone. Your pharmacy can help you with these options. 

When you have 3–5 days of medicine left, contact the pharmacy and have this information ready: 

• Your child's name and date of birth 
• Name of the medicine 
• Strength or dose of the medicine 
• Prescription (Rx) number 

If you do not have refills remaining 

If you do not have refills available, most pharmacies can send a request to your health care provider's office. But you should also tell your provider's office that you need refills. Let them know how many doses of medicine you have left and if you need a refill right away. You may need to schedule an office visit with your health care provider before you can get a refill. 

If you have questions about refilling a prescription, talk to your care team or local pharmacist. 

Common pharmacy terms

When getting your child's medicines, you may hear some common pharmacy terms. Understanding what these words mean can help you feel more confident when talking with your doctor, pharmacist, or insurance company.

Prescription drug: A medicine that requires an order from a health care provider (prescription).

Over-the-counter medication: A medicine that can be bought without a prescription. Most insurance plans do not cover these medicines. Examples include Tylenol^®, Miralax^®, or Benadryl^®.

Brand name medication: A medicine marketed by a specific drug name and manufacturer. When medicines are new to the market, only one company makes them. 

Generic medication: A medicine that contains the same active ingredient as the brand name medication. These medicines are as safe and effective as the brand names but usually cost less.

Co-pay: Depending on your pharmacy benefits, your insurance may not pay the entire price of your medicine. Your co-pay is the amount you need to pay.

Deductible: The amount you must pay each year before your insurance company will begin to pay. Some insurance plans do not have a deductible but might require co-pays.

Pharmacy insurance card: This is sometimes called a drug benefit card. It is important to know what type of insurance you have and if medicines are covered. Depending on your insurance type, this card may be the same as your medical insurance card or a different card. 

Formulary: Also known as "preferred drug list." This is a list of medicines that are preferred by your insurance company. Your medical team can help you learn which medicines are covered by your insurance.

Exclusion: A medicine or service not covered by your insurance.

Prior authorization/precertification: Not all medicine is routinely covered by insurance. Sometimes your health care provider or pharmacy must explain why your child needs a specific medicine. If your medicine requires prior authorization, work with your doctor, pharmacy, and insurance company to make sure the medicine is covered by insurance.

Quantity limitations: Limits placed on the amount of medicine you may get at one time. These limits make sure that you cannot take more medicine than your health care provider recommends. 

Controlled substance: A medicine placed in a special group by the government because it could be abused. Certain laws apply to these kinds of medicines.

Specialty medications: Medicines taken for complex conditions. These drugs often need more monitoring and cost more.

Specialty pharmacy: A pharmacy that sells specialty medicines.

Questions to ask your care team

• What medicines will my child need to take at home, and for how long?
• Which pharmacy do you recommend, and can all prescriptions be filled there?
• How do I get refills for these prescriptions, and what should I do if I run out?
• Will my insurance cover these medicines, or does it need special approval?
• Who should I contact if I have questions or problems with my child's medicine at home?

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