Refill Too Soon

"Refill too soon" is a rejection message the pharmacy gets when a claim is submitted before enough of the previous fill's days' supply has been used up. Most plans allow a refill once 75 to 80 percent of the days have passed, so a 30-day prescription filled on the first of the month is usually refillable around the 23rd. Try on the 15th and the pharmacy's screen says refill too soon, and the claim does not pay.

The rule exists to stop stockpiling and to stop the plan from paying for medicine that is not being taken. It also catches a lot of ordinary life. You are leaving on a three-week trip. You dropped a bottle in the sink. The doctor raised your dose from one tablet to two, so the old supply now runs out in half the time, but the plan still thinks you have two weeks left. Each of these has a fix, called an override, which the pharmacist can request from the plan by phone with a reason code: vacation supply, lost medication, dose change. Plans allow a vacation override once or twice a year and a lost-medication override rarely. Controlled substances have tighter rules and a dose change usually needs a new prescription from the doctor.

The takeaway: if you hear "refill too soon," do not leave without asking for the override. Tell the pharmacist why, and if it is a dose change, have the doctor send a new prescription with the new directions so the days' supply is recalculated.