Like medical insurance, having a dedicated pharmacy is good; having more than one is confusing. Right now, I am getting my medications from three different pharmacies. There is a reason for this madness. My “regular” pharmacy is a Sav-On inside the local Albertsons. I used to get most of my medications there since it was close by and very responsive. They also have an iOS app that is very minimal, but good for viewing prescriptions and ordering refills. Since COVID hit, I can order my refills and have them mail my medications to me directly from the app. When a prescription is set for long term (no dosage changes), I can switch to the mail order pharmacy preferred by my work insurance. There I can get a three-month supply for the price of one co-pay, saving some money and hassle of monthly reorders. Finally, I still have some prescriptions at UCLA Pharmacy. After transplant, they re-prescribed all my medications, including existing ones so most of the active prescriptions are still from UCLA doctors. Additionally, even though I am getting most refills at the mail order pharmacy, only UCLA takes Medicare Part B for anti-rejection medications, forcing me to get my tacrolimus refills there. The prednisone is common and cheap enough that I am not worried about insurance mix-ups, but the tacrolimus is somewhat expensive, and do not want to order it with my work insurance just to have them reject it later because I still have Medicare. Confusing, right?
This almost became a huge problem last weekend. Since I take so many tacrolimus pills daily (six), it is hard to tell how many days of supply I have left just by looking at the pill bottle. Anyway, I started filling my weekly pill dispenser and ran out of tacrolimus. I was told to never miss a dose of the anti-rejection medication so of course I was worried. I tried to refill online, but it did not allow me to select the mail option at UCLA. I ended up leaving a voice message and then called them in person Tuesday to ask them to mail out. Luckily, I received the package Friday afternoon, having only three pills left.
Earlier this afternoon, I just put in some more refills. One was for the Lokelma, which was previously filled at my local pharmacy. The mail order savings is not that great, only $30 over three months, and since there were no refills, the pharmacy needs to contact UCLA for authorization. Likewise, I was running low on prednisone. Since I wanted a three month refill and there was none left on the prescription, I had to log in to UCLA’s online system and request a refill from the transplant doctors, and to send to the mail order pharmacy. It is like each prescription has its own special handing rules to get filled and paid by insurance. I probably need to create a file in Excel or something to keep track.
Life with chronic diseases 