Still have questions?
Why isn't my medication covered?
There are several reasons why a medication may not be covered:
- It is experimental or new.
- Your doctor prescribed it for a use that is not recognized by the U.S. Food and Drug Administration or other professional medical organizations.
- It was given to you in a doctor’s office (example: a measles vaccine). Mediations given in a doctor’s office are not covered under your pharmacy benefits. Your medical plan may provide coverage.
- What you thought was a medication is actually a medical device. For example, a glucose monitor is a device, not a medication. Your medical plan may provide coverage.
- There are over-the-counter medications that work the same way.
- Your specific pharmacy plan may not include certain drugs.
- Research shows that the drug is not for safe for some people.
You can buy any drug your doctor prescribes, even if it is not covered by your plan. You will have to pay the full cost if the drug is not covered.
If you are denied coverage for a medication, talk to your doctor. He or she can advise you on the best steps to take.
How do I find out if I can take another drug in place of one that’s not covered?
Talk to your doctor about other possible drugs. You can also call Member Services at the number on your ID card.
What are generic drugs?
Generic drugs contain the same active ingredients in the same amounts as the brand-name drugs and work the same way. They are proven to be just as safe and effective as brand-name drugs. So they have the same risks and benefits as brand-name drugs do. However, generic drugs typically cost less. When appropriate, your doctor may decide to prescribe a generic drug, or allow the pharmacist to substitute a generic drug.
A generic drug is the same as a brand-name drug in:
- Dosage
- Safety
- Strength
- Quality
- The way it works
- The way it is taken
- The way it should be used
Compared with brand-name drugs, generic drugs may:
- Be a different color, shape or size
- Have different fillers, binders, coloring agents and flavorings (these are called “inactive ingredients”)
What can I do at the pharmacy to get the generic version of a drug?
Most pharmacies can substitute a generic drug for a brand-name drug. In fact, many will make the switch automatically, unless your state law says they can’t.
However, your doctor may have written “DAW” on your prescription. This stands for “dispense as written.” It means that the pharmacy can’t give you a generic drug without calling your doctor for approval. Doctors may write DAW if they believe the generic drug is not right for you.
What is compounding, and why is it necessary?
Compounding is the creation of a pharmaceutical preparation—a drug—by a licensed pharmacist to meet the unique needs of an individual patient (either human or animal) when a commercially available drug does not meet those needs. A patient may not be able to tolerate the commercially available drug, the exact preparation needed may not be commercially available, or a patient may require a drug that is currently in shortage or discontinued. The U.S. Pharmacopeia Convention (USP) formally defines compounding as “the preparation, mixing, assembling, altering, packaging, and labeling of a drug, drug-delivery device, or device in accordance with a licensed practitioner’s prescription, medication order, or initiative based on the practitioner/patient/ pharmacist/compounder relationship in the course of professional practice.”
Following are a few examples of how a compounding pharmacist can customize medications based upon a doctor’s prescription to meet a patient’s needs:
- Customize strength or dosage.
- Flavor a medication (to make it more palatable for a child or a pet).
- Reformulate the drug to exclude an unwanted, nonessential ingredient, such as lactose, gluten, or a dye to which a patient is allergic.
- Change the form of the medication for patients who, for example, have difficulty swallowing or experience stomach upset when taking oral medication.
Compounding pharmacists can put drugs into specially flavored liquids, topical creams, transdermal gels, suppositories, or other dosage forms suitable for patients’ unique needs. Compounding does not include making copies of commercially available drug products, as this is not allowed by law.
Do you deliver?
Please call 703.479.7642 to speak with a patient care coordinator for delivery options.
Do you accept insurance?
YES WE DO! We accept most prescription insurances including Medicare Part D. We do our best to have your medication covered. An expert Patient Care Coordinator will handle the entire billing process on your behalf.
Can I order a new prescription online for in-store pickup?
You can order new prescriptions for home delivery online, but if you want to pick up your new prescription at Adkoa pharmacy you will need to bring the paper prescription to the store or have your health care provider call it in. However, you can order your prescription refills online for in-store pickup.
Can I cancel or edit an order submitted for in-store pickup?
Once you’ve submitted a prescription refill request for in-store pickup, any changes you need to make are best done by phone to the Adkoa Pharmacy where you requested the prescription be available for pickup.
How can I check the status of my prescription for home delivery?
When you place your order online, we will send you a shipping confirmation email containing a tracking number and a link to the package carrier’s website to track the progress of your order. Please note that it may take up to 24 hours for the tracking number to take effect.