FAQ: Managing prescriptions during COVID-19
I’ve always filled my prescriptions at the MIT Pharmacy; what should I do now?
With MIT Medical temporarily restructuring its service model in response to the COVID-19 pandemic, we are asking healthy patients to avoid MIT Medical — including the MIT Pharmacy. Our goal is to limit possible exposure to illness by preventing healthy people from coming into contact with ill patients within our building.
What other options do I have for getting my prescriptions?
If you are enrolled in an MIT-sponsored employee health plan or in the MIT Student/Affiliate Extended Insurance Plan, you can ask to have your prescriptions sent to a local pharmacy for pick-up. For members of the MIT Traditional and MIT Choice Health plans, copayments for medications filled outside of MIT Medical’s pharmacy are always charged at the participating Express Scripts Pharmacy copay amount.
If you’re enrolled in an MIT-sponsored employee health plan, you also have the option of getting your medications in the mail through Express Scripts.
How do I transfer a prescription from the MIT Pharmacy to a local pharmacy?
The easiest way to do that is through the HealthELife patient portal. Log on to HealthELife, click on “Prescriptions” at the top of the page, and then check off the prescriptions you would like to refill. In the “Additional comments” field at the bottom of the page, put the pharmacy name, address, and phone number. You’ll get a response indicating that your provider has been instructed to send the prescription to the outside pharmacy and/or that a prescription renewal has been requested if any prescription has no remaining refills.
Alternatively, you can make that request by contacting the provider who prescribed the medication — either through the HealthELife patient portal or by calling their office directly.
In either case, you will have to check with the outside pharmacy to find out when your prescription is ready for pick up.
How do I transfer a prescription from the MIT Pharmacy to the Express Scripts mail-order service?
To sign up for the mail-order service, visit express-scripts.com. Some of your prescriptions may already be available through Express Scripts mail order — click on the “prescriptions” tab to find out. Transfer additional prescriptions to Express Scripts by contacting your prescribing clinician; ask the clinician to send an up-to-90-day prescription to Express Scripts.
Alternatively, you can set up your Express Scripts account by calling 1-866-454-7118, or by visiting express-scripts.com, registering online, and printing out, completing, and mailing the home-delivery form.
Note that it can take between two and three weeks to get your first prescription in the mail. Make sure you have a three-week supply of any current prescription medication that you want to start getting through the Express Scripts mail-order service.
Once you are enrolled with the Express Scripts mail-order service, you can use the HealthELife patient portal to request refills and renewals, just as you would for a prescription that is going to an outside retail pharmacy.
I’m still on campus; can I continue to use the MIT Pharmacy?
Yes. Though we are generally discouraging this option, if you are still on campus, you can continue to pick up your prescriptions at the MIT Pharmacy. To order prescription refills for pick-up here, use the pharmacy’s automated refill request line at 617-253-0202. Have your prescription number handy, because you will need it when requesting a refill.
I’ve heard that my insurance may allow me to get early refills on maintenance medications. What does that mean, and what’s a “maintenance medication?”
A “maintenance medication” is one that you take every day — or at some other, regular interval on an on-going basis. A medication that you take only once in a while or “as needed” would not be considered a maintenance medication. Maintenance medications are often medications that an individual would take to control a chronic condition such as high blood pressure, diabetes, or hypothyroidism.
An “early refill” means that you will be able to fill prescriptions for these medications earlier than normal for the same copay. Usual insurance rules generally do not allow you to get a refill until you have used up 75 percent of the previous quantity dispensed — in other words, 68 days’ worth of a 90-day supply or 22 days’ worth of a 30-day supply. The MIT Pharmacy and retail pharmacies in the Express Scripts network can use a special insurance override to fill these prescriptions earlier than normal (based on the 75%-used definition). Early refills can be obtained only from retail pharmacies, not through the Express Scripts mail-order service.
Are there exceptions to “early refill” of maintenance medications?
Yes, controlled substances are the exception. If you are taking a maintenance medication that is a controlled substance, you’ll need to follow the usual rules for refills. The typical rule is that controlled substances can be filled three days early based on all previous cumulative fills, or seven days early if the provider expressly states on the prescription that an early refill is allowed.
I have a prescription that I currently fill monthly. Can I start getting a larger amount at one time?
Possibly, but keep reading for some exceptions and caveats.
In general, with the exception of mental health prescriptions and controlled substances, the prescribed quantity of a medication can be changed to a three-month supply. In fact, if there are adequate refills remaining on a prescription, the MIT Pharmacy can change the quantity to a 90-day supply at the same time they transfer the prescription to a local pharmacy. Your provider can also write a new prescription that specifies a 90-day supply.
When it comes to mental health prescriptions and controlled substances, the amount that can be dispensed at one time depends on the medication and DEA classification:
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Schedules IV or V medications (benzodiazepines, used to treat anxiety or insomnia, such as tramadol or zolpidem) can be filled for three months if the prescription is specifically written for that quantity
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Schedule III medications (testosterone products) are limited to 30 days, but prescriptions can be written with up to five refills.
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Schedule II medications (opioid narcotics and most stimulants, like Adderall and Ritalin) can be handled a few different ways, depending on the specific medication. ADD/ADHD medications may be written for up to a 60-day supply if the provider specifies “for ADD or ADHD” on the prescription. Alternatively, the provider can write three prescriptions for 30-day supplies of ADHD stimulants or three prescriptions for 28-day supplies of chronic opioids on the same date, as long as the provider specifies a “do not fill until” date on two of the three.
The caveat on increased quantities is that your insurance may not agree to pay for a larger quantity of certain medications. This means that if you wanted a 90-day supply of such medications — and if the pharmacist was allowed to dispense that amount — you would need to pay out of pocket, at the full retail price, for any quantity of medication in excess of the amount your insurance will cover.
What should I do if I run into a problem filling a prescription at a retail pharmacy or need information about what my insurance will cover?
Contact your insurance company by using the customer-service phone number on the back of your insurance ID card.
What happens when this is all over?
When MIT Medical resumes normal operations, you can go back to using the MIT Pharmacy as normal. Any prescription that you’ve switched to a retail pharmacy or mail-order service can be easily switched back.
