Prescription Questions

Feel free to use the Ask the Pharmacist Form if your question is not answered below

(Q) What if my physician will not write for natural bioidentical hormone replacement therapy (bHRT)?

After you have completed a patient consultation and have our recommendations for bHRT, we will assist you in finding a physician in your general area if your physician is not open to writing bHRT.

(Q) Will my insurance pay for natural HRT?

70-75% of the time most insurance companies will allow us to fill your prescription or we can assist you in filling out a manual form from your insurance provider, so that you can be reimbursed for the prescription. After you receive a prescription from your doctor, we can determine if your insurance will cover compounded natural/bioidentical HRT prescriptions by faxing us a copy of your insurance card (front and back). Please include your name, phone number, date of birth, and what you are requesting on the fax. We will call you and update you on the status of your insurance coverage.

(Q) What is the cost for a bioidentical hormone replacement prescription?

The cost varies depdending on the dosage form, the number of hormones combined in one vehicle or if each hormone is a separate prescription and the dose of the hormone. In general, the cost averages $25-$60 per hormone. However, keep in mind, many times your insurance will cover your prescription and you will be responsible for only a copay.

(Q) Can I get my prescriptions filled every month without calling in?

Yes. However, in order to do this, we ask that you complete the Auto-Refill Authorization Form found in the FAQ section. All you would need to do is complete and sign the form and mail or fax it to us. Upon receipt, we will set up your refills according to the frequency requested. Please be sure you keep in mind to allow for shipping and authorization from your doctor if needed.

(Q) How are orders shipped?

We recommend shipping via UPS Ground for $7.75 per shipment within the continental US. For quicker service, we also offer 2nd&3rd Day Air as well as Overnight service. We can mail packages in situations where a street address is not available, but do not recommend it because if the package is lost in the mail there is no way to track its movement. We do not guarantee mailed shipments.

(Q) How can I get free shipping?

Effective 09/02/07, to receive free standard shipping (UPS Ground Service) on your next order, order any combination of a total 4 compounded prescriptions and/or supplements. Each supplement must be over $10.00 to qualify. Free shipping only applies to current order submitted. The price for ground shipping cannot be applied to any expedited shipping cost (2nd Day, 3rd Day or Overnight service). Free shipping only applies if the order is eligible for processing within time frame noted.

(Q) What if I change my mind about wanting my medication? Can I return it for a refund?

Bellevue Pharmacy has a "No return policy" on all custom compounded medications. Once a medication has left the pharmacy by any method, the cost of the medication will not be refunded, and cannot be accepted for re-use. All medications are custom compounded to your doctor’s exact specifications for you.

When a patient requests an automatic refill on a scheduled time frame, the medication is also non-returnable. We require a one-week notification of any change in medications, shipping address, or billing information. Once you notify Bellevue Pharmacy of any change, every attempt will be made to stop the preparation and shipping of your medication. If your order has already been shipped from Bellevue Pharmacy, it is non-returnable and no refund will be issued.

(Q) When I login to become a user, is any of my personal medical information stored and available online?

No, your information is secure in a completely separate prescription management system.

(Q) What is my copayment?

Your copayment is a fixed dollar amount that you pay for a prescription, generally ranging between $5 and $45. BPS does not set the amount of your copayment or know it in advance. Your employer and health insurance provider do. The insurance provider (and you and your employer through the insurance premiums you both pay) makes up the difference between the copayment and the actual cost of the drug.

(Q) What is my deductible?

Your deductible is a specified amount of money (e.g., $200) that you must pay during a given period (usually a year) before your health plan pays anything. You should know your deductible and to keep track of out-of-pocket expenses. The pharmacy has no way of knowing your deductible or when it has been met.

(Q) What is my coinsurance?

Your coinsurance is a specific percentage (usually 20 percent) of the cost of a prescription you are required to pay. Your health insurance pays the remainder.

(Q) What is my formulary?

Your formulary is a list of drugs that your insurance provider, usually through a pharmacy benefit manager (PBM), prefers that you use. Drugs on the formulary may or may not be the medications that your physician believes are best. Manufacturers of "preferred" drugs often give your PBM a rebate if their medication is on the formulary's preferred list.

(Q) What is a non-formulary drug?

This is a drug that is not on the formulary. The drug may not be covered at all or may require a higher copayment or coinsurance percentage. The final cost depends on the member's benefit and is set by the insurance provider

(Q) Can my formulary change?

Yes. Your PBM has the power to change the formulary. When a change to your formulary occurs, your PBM will generally notify you through the mail. Make sure that you have a copy of your formulary.

(Q) What is a prior authorization?

This means that your PBM will approve the medication for coverage only after certain conditions are met. Your doctor will need to contact your PBM and provide information on the medical reasons for prescribing the medication. It may take 24 to 48 hours to receive approval from your PBM before BPS can fill your prescription.

(Q) Why are prior authorizations required on certain drugs?

The prior authorization process is used to determine medical necessity, ensure patient safety, promote preferred drugs, and to keep drug costs to your employer down.

(Q) What do you mean when you "process the billing of my prescription"?

BPS must enter your prescription into our computer and then transmit a request to your PBM asking them to pay for the drug. Your PBM tells us if you are eligible, what it will pay, and how much you must pay. The PBM also tells BPS the quantity of medication the pharmacist is allowed to give you. Most PBMs refuse to let a pharmacy dispense more than a 30 day supply.

(Q) I'm going on vacation, and will need an extra supply of my medication. What should I do?

Some PBMs allow occasional "vacation overrides" while some do not. If you have a choice of insurance plans, this might be an important question to ask. If your PBM allows vacation overrides, you should call it in several days in advance. Always allow several days for the administration of vacation override requests.

(Q) Did I get brand or generic?

Most insurance requires that you fill the prescription with the generic, or encourages you by telling the pharmacy to charge a lower co-payment. The generic drug is the same medication as the brand product, but is not made by the original manufacturer and has a different appearance. Most pharmacies will ask you what you would like. If not asked, make sure that you tell your pharmacist if you would like the brand or the generic.