When you try to get a new prescription filled and your pharmacy tells you “your doctor has to authorize this prescription,” chances are they are mistaken. A prescription is the only “authorization” a pharmacy needs to dispense a medication. What the pharmacy usually means is that your insurance company is refusing to pay for the medication. The pharmacy wants your doctor to argue with the insurance company. The problem is, initiating insurance authorization should be done by the pharmacy. Your doctor doesn’t have access to your insurance company’s computer systems, phone and fax lines, forms, and formulary lists. The pharmacy does. Caremark, one of the largest pharmacy insurers in the country, describes the process thus: “The pharmacist is provided with the Caremark toll-free number to call and start the PA process.” We often include prior authorization information on our prescriptions so that the pharmacy can complete the process without even having to contact us. When the pharmacy needs more information, they can always call us and we will re-send the prescription with that information included.
[Editor’s note 25May2018: The state changed the law, and now we have a standard form on which we can request prior authorization. It is no longer entirely up to the pharmacy. We do need to know the fax number for your pharmacy benefit management company, which should be on your insurance card.]
If your pharmacy refuses to fill your prescription, consider doing the following:
Change pharmacies. Often the problem is that huge “big box” pharmacies are overburdened and don’t have the resources to do their job. Many smaller, independent pharmacies will handle the process for you. Many deliver, so they’re even more convenient than the behemoth on the corner. A list of area independent pharmacies is attached. For generic medications, we’ve seen a twenty-fold difference in price for identical medications from two different pharmacies. Sometimes a discount pharmacy’s cash price will be even less than your copay.
Contact your insurance company yourself. We’ll gladly give you a letter explaining that the medication is medically necessary. Don’t let them deflect responsibility by saying “your pharmacy or doctor has to call us.” Make them explain to you why they are refusing to pay for medically necessary care.
Make an appointment with us. It isn’t free, but gives us the time to interface between you and your insurance company. Often the insurance companies refuse to pay for even a medically necessary medication. If you can’t pay for it yourself, we will have to discuss if there are suboptimal but lower-cost alternatives.
We work hard to keep our prices as low as possible. If we have to donate our time to make life easier for multimillion dollar pharmacies and insurers, we will have to raise our rates. That wouldn’t be good for anyone.
–DrR
Independent Pharmacies
This list is derived from a directory published by the late Manor Drug Store. We can’t vouch for these pharmacies, and the list is now out of date, but it’s a start.
Advantage Pharmaceuticals
4351 Pacific Street
Rocklin CA 95677
916-630-4960
Aids For Daily Living
2551 Warren Dr
Rocklin CA 95677
916-624-0900
Anderson Bros Florin Square Leader Pharmacy
2374 Florin Road
Sacramento CA 95822
916-428-3794
Anderson Bros Town & Country Leader Pharmacy
2900 Fulton Ave
Sacramento CA 95821
916-489-3638
Auburn Drug Co
815 Lincoln Way
Auburn CA 95603
530-885-6524
Blue Star Pharmacy
3811 Florin Road #28
Sacramento CA 95823
916-422-9861
Broadway Long Term Care Pharmacy
3330 Broadway
Sacramento CA 95817
916-452-8022
California Pharmacy
9550 Micron Ave Suite D
Sacramento CA 95827
916-362-5400
Cardinal Health
201 Lathrop Way Suite D
Sacramento CA 95815
916-648-2192
Chapa-De Indian Health Program
1350 E Main Street
Grass Valley CA 95945
530-477-8545
Demartini Spring Hill Pharmacy
102 Catherine Lane
Grass Valley CA 95945
530-273-2268
Dokimos’ East Main Leader Pharmacy
640 E Main Street Suite 2
Grass Valley CA 95945
530-274-0100
Family Discount Pharmacy
5830 Jameson Court Suite B
Carmichael CA 95608
916-481-6900
Folsom Medical Pharmacy
1300 E Bidwell Street Suite 105
Folsom CA 95630
916-983-4900
Folsom Leader Pharmacy
9545 Folsom Blvd #7
Sacramento CA 95827
916-364-9900
Greater Sacramento Pharmacy
2288 Auburn Blvd Suite 102
Sacramento CA 95821
916-564-9888
Innovative Compounding Pharmacy
820 Wales Dr Suite 3
Folsom CA 95630
916-984-9222
Kim Leader Pharmacy #1
5026 Fruitridge Road #3
Sacramento CA 95820
916-392-3488
Kim Leader Pharmacy #2
7248 South Land Park Dr Suite 116
Sacramento CA 95831
916-399-0757
Knott’s Leader Pharmacy
4819 J Street
Sacramento CA 95819
916-455-3068
Laguna Medical Pharmacy
9390 Big Horn Blvd Suite 110
Elk Grove CA 95758
916-684-9922
Mai Pharmacy Store #2
7240 E Southgate Dr #A
Sacramento CA 95823
916-393-5961
Main Leader Drug
3685 Taylor Road
Loomis CA 95650
916-652-7265
Mar Care Pharmacy
811 Grand Ave Suite A2
Sacramento CA 95838
916-922-4512
Mason Pharmacy
4600 47th Ave #110
Sacramento CA 95824
916-428-7677
North Highland Leader Pharmacy
5600 Watt Ave
North Highlands CA 95660
916-332-4420
Pacific West Pharmacy
4363 Pacific Street
Rocklin CA 95677
916-632-7560
Parkside Pharmacy Compounding & Wellness Center
4404 Del Rio Road
Sacramento CA 95822
916-452-2200
Pharm Med Services
2129 Hacienda Way Suite J
Sacramento CA 95825
916-487-4488
Physicians Building Pharmacy
3701 J St
Sacramento CA 95816
916-452-3454
Professional Village Pharmacy
1701 Professional Dr
Sacramento CA 95825
916-483-3455
Pucci’s Leader Pharmacy
2821 J Street
Sacramento CA 95816
916-442-5891
River City Pharmacy
5491 Carlson Dr
Sacramento CA 95819
916-454-0444
Sacramento Medical Park Leader Pharmacy
5270 Elvas Ave Suite D
Sacramento CA 95819
916-739-1513
Sacto Pharmacy
5033 Stockton Blvd
Sacramento CA 95820
916-454-0168
Saigon Pharmacy
6665 Stockton Blvd #6
Sacramento CA 95823
916-393-f071
Sierra Compounding Pharmacy
3126 Professional Dr #150
Auburn CA 95603
530-889-9970
Sierra Compounding Pharmacy
1101 Maidu Dr #200
Auburn CA 95603
530-823-5200
Skyridge Pharmacy
601 Auburn Folsom Road
Auburn CA 95603
530-885-3739
South Sacramento Leader Pharmacy
5385 Franklin Blvd Suite 1
Sacramento CA 95820
916-452-0247
Than Thuy Leader Pharmacy
6830 Stockton Blvd #160
Sacramento CA 95823
916-391-7210
Thu Pharmacy
6171 Stockton Blvd #185
Sacramento CA 95824
916-395-0352
Timberlake Leader Pharmacy
8100 Timberlake Way Suite A
Sacramento CA 95823
916-760-2470
Valley Pharmacy Of Sacramento
7600 Hospital Dr Suite A
Sacramento CA 95823
916-423-2098