Are compounded prescriptions covered by insurance?

Some health insurance plans cover compounded medications. Check with your insurance company to see if you have coverage. Many pharmacies are able to bill insurance companies directly for compounded medications. If unable to bill your insurance company, your compounding pharmacist may provide you with a claim form to submit to your insurance company to reimburse you directly, Depending on the nature of the product, these medications may be just as affordable as your conventional prescriptions. Pharmacies are also willing to work with patients who wish to pay out-of-pocket on pricing.

 

How does my medical provider play a role in compounding?

Many medical providers are aware of the practice of compounding, and they work with your local compounding pharmacy to provide the right compounded medication for you. Talk to your pharmacist or doctor today if you feel that a compounded prescription may be a better way to manage a health condition for you or your family member.

 

What is “compounding”?

In general, compounding is a practice in which a licensed pharmacist, upon a physicians' prescription order, combines, mixes, or alters ingredients of a drug to create a medication tailored to the needs of an individual patient. A health care provider will prescribe a compounded drug when commercially available products do not meet your needs. Preparing a paste or suspension from crushed tablets is one example of compounding. Likewise, adding flavoring to a medications is also compounding.

 

What makes compounded medications different from commercially available medications?

Mass-produced, commercially available drugs are manufactured by drug companies for the general population with no specific patient in mind. Compounded medications are ordered by a physician, individually prepared by a compounding pharmacy and made specifically for your unique medical needs.

 

Does a compounding pharmacist have special training?

All pharmacists are taught in pharmacy school how to properly compound medications, and many compounding pharmacist have advanced training after pharmacy school graduation.

 

Is a prescription required for a compounded medication?

Yes, a prescription order from a physician is required for the pharmacist to compound your medication to meet your specific needs.

 

Can a regular pharmacy compound my prescription?

A compounding pharmacy ensures the quality of its products by using specialized equipment, high grade chemicals and advanced techniques. Other pharmacies generally do not have the time, equipment, chemicals, or specialized training and techniques to appropriately prepare your customized medications.

 

 

 

 

Reviewed: September 23, 2014

Updated: September 23, 2014

Reviewed by: Beth Bolt, RPh

Source: RxWiki

Managing Editor: Anyssa Garza, PharmD