To take care of your child’s health, you need to know how to fill prescriptions for supplies and equipment. Some may be filled at a local pharmacy. When your child needs special supplies, a lot of them, or equipment that is not at your pharmacy, a durable medical equipment (DME) company can fill the prescription.
Your insurance may require you to use a specific supplier (pharmacy or DME company).
It is best to call or check your insurance company’s website in advance to know what to do.
Before filling a prescription
Find out if:
- Your insurance covers the cost of the supplies and equipment.
- You can get what you need from a local pharmacy or if you need to go to a DME company.
- You need pre-approval or “prior authorization” to order things. If something the doctor orders is not covered, the pharmacy or DME may call your child’s doctor to change the item to one similar. The doctor’s office may need to call the insurance company to help you get the items approved.
- You or your child’s doctor need to fill out a special order form.
- You need to pay for part of the cost of the supplies each time you get them or part of the cost to use the equipment. This is called a “co-pay.”
- Certain brands or generic supplies are allowed. If available, generic supplies and equipment work the same way as brand name equipment but will cost less.
- Your insurance lets you arrange for automatic refills or if you need to call each time or go online to order more.
- If you can have your order delivered to your home or you will need to pick it up.
For supplies, find out if:
- A limited amount of supplies can be ordered each time.
- They can be refilled for several months or for an entire year without a new prescription each time.
For equipment, find out if:
- The insurance company limits the time that you are allowed to keep the equipment. Ask how to arrange to keep the equipment longer.
- There is a choice to rent or buy the equipment and which option is better.
- The DME company will contact your child’s doctor to verify if the equipment is still needed when the prescription runs out. If your child no longer needs the equipment, you may need to call the supplier to arrange to return it.
To fill a prescription
- The doctor usually sends prescriptions for supplies or equipment electronically to the pharmacy or DME company. Sometimes, you may be given a written prescription.
- When you first get the prescription, read the label and know the different parts.
- Check to see if all the things that your child needs is on the prescription label (Picture 1, page 2).
- Check to see how much is ordered and how many refills there are. Refills let you get supplies each month without asking the doctor to write a new prescription when it is time to order more.
- Prescriptions for small amounts of supplies can often be filled at your local pharmacy. Sometimes a private, local pharmacy can fill a prescription for larger amounts, including refills.
- If your insurance will not pay for what is ordered, ask the supplier if you can arrange a payment plan.
To refill and renew a prescription
- You can get refills until there are no more allowed by the prescription. After one year, the doctor will need to write a new prescription.
- If refills are not sent automatically, you may need to call the supplier’s toll free number or go to their website to place the order.
- Try to refill a prescription at least 5 to 7 days before running out.
- If the label says NO REFILLS, plan ahead. Call your child’s doctor to get a new prescription at least 14 days or longer before you run out. If the prescription can be sent electronically, tell the doctor where to send it.
- It may take a few days for the doctor’s office to return your call and write a new prescription. Allow 7 days to have it ready for you to pick up, be mailed to you, or sent electronically to the supplier.
- The doctor may request that you schedule an appointment for your child before renewing any prescription.
- To stop getting supplies automatically, call the company or go to their website to make the change.
How to transfer a prescription
If you need to change pharmacies or DME company, they may need to call the old supplier. Keep a list of what things are needed to help the new supplier help you. Your child’s doctor will most likely need to write a new prescription.
Other helpful tips
- When you go to your child’s doctor, bring the name and contact information for the pharmacy or DME company that you will use and any forms that you or the doctor must fill out.
- Always have your prescription insurance card with you when you go to the pharmacy
or DME company.
- When you receive any equipment or supplies from a DME company, save the packing slip. The packing slip will have information needed to order more of the same equipment or supplies in the future. Bring the packing slip and a list of things that you need to your child’s doctor’s appointments.
Medical Supplies and Equipment (DME Company)