Mail-Order or Retail? Finding the Best Refill Option

When managing long-term prescriptions, choosing between mail-order and retail pharmacy options can impact both convenience and cost. Retail pharmacies typically offer 30- and 90-day supplies of medication. A 30-day supply is more common for new prescriptions, while 90-day refills are often available for medications used to manage chronic conditions.

Mail-order pharmacies provide a convenient option for receiving prescriptions, as they are closed-door facilities that ship medications directly to your home. These pharmacies often work in partnership with a pharmacy benefit manager (PBM) to streamline service and manage costs. They are typically set up to supply 90-day prescriptions, which are shipped directly to your home.

❕Using a mail-order service that doesn’t have a contract with your insurer's PBM could result in coverage issues.

📫 Time and Money Savings with Mail-Order

Having prescriptions delivered through a mail-order pharmacy can save both time and money, especially for maintenance medications, by eliminating regular trips to the pharmacy and offering cost savings through bulk purchases, such as 90-day supplies.

These larger quantities are often more cost-effective than 30-day supplies at a retail pharmacy, as they typically reduce the per-dose cost. Additionally, many insurance plans provide lower copays or discounted rates for prescriptions filled via mail order, further enhancing savings.

📋 Retail Refill Limitations & 90-Day Supply Requirement

Many insurance plans do have retail refill limitations, especially for maintenance medications (those taken regularly for chronic conditions). Some plans allow only a few 30-day refills at retail pharmacies before requiring a switch to a 90-day supply through mail order or a preferred retail pharmacy for better rates.

This setup often offers cost advantages and is aimed at improving adherence to long-term treatments.

💊 Refills for Controlled Medications

Controlled medications are subject to strict regulations, often limiting refills to 30 days and restricting their availability for 90-day supplies through mail-order services. Some mail-order pharmacies may not deliver controlled substances due to the stringent regulations and specific requirements involved in handling these medications. Additionally, not all mail-order pharmacies are authorized to deliver controlled substances because of regulatory and compliance restrictions.

📌To explore your options, we recommend the following steps:

• Check with your pharmacy: Visit their website or contact their customer service to confirm if they deliver controlled substances and whether it complies with state regulations.
• Consult your healthcare provider: They may have insights or recommendations on mail-order services that handle controlled substances.
• Review your state regulations: Some states have specific rules that could affect mail-order delivery of these medications.

💡 Best Practices for Refill Types

For short-term or immediate medications, retail pharmacies are often the best choice, as they provide on-the-spot service. For ongoing prescriptions, however, transitioning to a 90-day mail-order supply can reduce refill hassle and potentially save money. Comparing costs, checking your insurance coverage, and consulting with your provider can help you determine the most suitable and budget-friendly option for your healthcare needs.

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