How do I request a medication refill?

Contact your pharmacy to see if you have any refills available before reaching out to your provider through the Patient Portal to request a refill. It takes up to 72 hours to process a refill request.

Do all messages I send through the portal become part of my medical record?

Yes. Any messages you send through the Patient Portal become part of your legal, HIPAA-protected medical record and cannot be altered or deleted. Do not send messages that you don’t want part of this permanent record.

I put in a refill request, why haven’t you done it yet?

There are several possible reasons for this. 1) It takes up to 72 hours to process a refill request. 2) It could be that we sent the prescription to your pharmacy but your insurance is requiring an extra step called prior authorization which is a very time consuming barrier for our staff to overcome for you. 3) It could be that we sent the prescription to your pharmacy but the medication is not in stock in which case they will order it or direct you to a different pharmacy. 4) It could be that the requested a refill too soon and you have refills remaining on the previous prescription.

If it has been more than 72 hours since your request or you are running out of medication prior to 72 hours, and you’ve contacted the pharmacy and are unable to fill your prescription, please call our front desk and let us know so we can follow up on your request.

How many refills can I get on a medication?

It depends on the medication. For controlled substances, like testosterone and stimulants for ADHD, refill amounts are limited by federal and state regulations. For example, prescribers can at most send a 90 day supply on a prescription for testosterone, and stimulants can only be prescribed for a max of 30 days. Estrogen and anti-androgen medications are not controlled substances and prescribers can write prescriptions for up to a year at a time. Also, Massachusetts law allows patients to get a year of birth control pills at once with only one trip to the pharmacy. However, providers must also balance your health and safety and there are some situations in which it isn’t good practice to give a year of refills.

The pharmacy says that I can’t get my refill, why?

This happens when: 1) you requested the refill too early and the pharmacy thinks you should have meds left, 2) the number of refills on your prescription has run out and your prescriber needs to write a new prescription, 3) your insurance is refusing to pay for the medication (in which case, the script is valid but the coverage is not and you need to pay out of pocket to get the medication or call the insurance company to try to fight the denial).

Can I get a refill more than once in a 30 day period?

Typically no, unless the prescription amount was written for less than 30 days. Example: a 14 day prescription with 1 refill = 1 month of meds. However, there is something called an emergency override that the pharmacy can occasionally do for lost or stolen medications. The key word for this is occasional, and it usually doesn’t apply to controlled substances. If your prescriber changes the dose of your medication, you can fill it as a new prescription within 30 days of the previous refill.

Can I get medications without using my insurance?

Yes, if you have a valid prescription you can pay out of pocket for it without using your insurance. This is especially helpful for cheaper medications such as oral estradiol or spironolactone.

Do I have to have a prescription for medication?

To obtain prescription medication legally in the US, you must have a prescription from a healthcare provider. You can get medication that is classified as “over the counter” without a prescription. This includes Plan B (emergency contraception) and a progestin-only birth control pill called the O pill.

Why can’t I get a new prescription without a visit to my provider?

For health and safety reasons, providers will likely want to see you before writing a new prescription or sending more refills. Reasons for this may include: 1) it has been a while since you were seen by a provider and they want to make sure your health is stable, 2) requests for changes in dosing or medication types usually require a detailed conversation with a provider, 3) you are on a controlled substance and there are federal guidelines about how often you need be seen by your prescriber.

Can I get an IUD or other long-acting contraceptive method?

Yes, in Massachusetts our health insurance covers contraceptives including IUDs, Nexplanon, permanent sterilization, and other methods. If the providers at Transhealth are not able to provide a specific type of contraception for you, we can refer you to other providers in our area who can do this for you.

What options are there for long acting gender-affirming hormone therapy?

Puberty blocker options include Lupron, Triptodur, and Eligard (1 month, 3 month, or 6 month injections administered in office) and Supprelin (implant placed in arm as an in-office procedure that lasts roughly 2 years).

Testosterone options include Testopel (implantable testosterone pellets inserted roughly every 3 months as an in-office procedure) and Aveed (long-acting testosterone injection administered in-office; first two doses are a month apart and subsequent doses are every 10 weeks).

Currently there are no options for long acting estrogen