Your local pharmacy can be a confusing and often frustrating place to navigate. Along the way, you might have questions or run into situations where you feel unsure. Who do you talk to? What do you say? Why is the needle so big this time? Manufacturers might make changes to, or stop manufacturing your usual medication. You may need to switch to a generic brand, or your usual supplies might go out of stock. There may be confusion about an updated administration method if you switch from injection to gel. Your pharmacy may be unfamiliar with the injection supplies required. 

Instead of being caught off guard, you can be prepared to deal with these situations. At Plume, we want you to feel confident and empowered walking into that pharmacy, so let’s discuss this together!

Step 1: Get in touch 

Once your provider sends your prescription order to your local pharmacy, it is the pharmacy’s responsibility to fill the order in a timely manner. We do not physically send the medications to the pharmacy. Your provider creates a prescription order for your pharmacy to fill using their own inventory. After your provider has sent your prescription to your local pharmacy, you may get notified via phone, email, or pharmacy app notification that your medication is ready for pick-up. However, please note that your pharmacy may not always notify you even if something is ready. Additionally, when you are getting low on your medication, you want to make sure a refill is ready before you run out. Attaching refills to a prescription order tells the pharmacy that your provider is okay with them continuing to fill your prescription. This is helpful when you are close to the end of your medication supply. Learn more about what refills are here.

In both scenarios of having a new prescription and needing to refill a current prescription, the first step is to contact your pharmacy. We don’t want you experiencing any delays, so we suggest that you go straight to the source and contact a human being at the pharmacy first. Taking this step before you run out of medication will provide enough time for any bumps in the process to get smoothed out before your current supply of medication is gone.

The best way to do that is to call the pharmacy directly. You may also go to the pharmacy in person and speak to a staff person directly, but this may not be the most accessible option for some folks.  Avoid the automated options to go straight to “refill” because this sends an automatic refill request to the pharmacy based on what is already in their system. Additionally, avoid going straight to “check prescription status” because if there is any delay or clarification needed regarding your prescription (dose adjustment, stock issue, etc), you will need to speak to someone directly regardless to learn more information. Instead, select the option that allows you to talk to the pharmacist. This will direct your call to someone on the pharmacy staff and get an accurate status. 

NOTE: For folks on testosterone, avoiding the automated refill option is especially important.  Controlled substances like testosterone limit the amount of refills allowed on each prescription order. Instead, your provider will send new prescriptions more frequently to ensure you do not run out. When a new prescription is sent, it generates a new prescription number associated with the order. When you request to refill your prescription, you are requesting to refill an old prescription order with a different/outdated prescription number. Your refill will be automatically denied or told you are awaiting prescriber approval. This will happen even if you have medication orders actively on file at the pharmacy. The wires do not cross within the pharmacy’s system, so you can be trying to refill an old prescription all while you have a new order waiting for you. That is why it is best to always contact the pharmacy directly and speak to someone to get the most accurate information and to ensure no further action needs to be taken from us.

Step 2: Ask them to fill your prescription

Congratulations, you made it to the next step! Now that you have contacted the pharmacy, here are some things you can say when you talk to the pharmacist if you are refilling a current medication:

“I’m calling to refill a prescription I have on file.”

“I have some refills left on a prescription that I would like to fill.”

“I’m running low on a prescription. Can you check to see if I have any refills left?"


Here are some things you can say when you talk to the pharmacist if you are checking the status of a new prescription:


“My provider ordered a new prescription for me and I want to check the status of it.” 

“My provider prescribed me [MEDICATION NAME] today and I want to see when it will be ready for pick up”


At this point, you will review your medications on file with your pharmacist. They will inform you which medications are available to be (re)filled, which medications are not currently in stock, any barriers to filling your prescription, and anything else you need to know regarding your medications. Your pharmacist will give you an estimated day and time to pick up your medications. Plan to do so at that time! Many pharmacies send an automated notification via text or robo-call that will tell you when you can pick up your medication. Make sure you are subscribed to this option so you don’t have to call the pharmacy every time you need to pick up your medication.

If you are an active member and need a new prescription order, your pharmacist should contact Plume directly. In this case, please let us know so we can be extra on top of things and reach out to them first! You can do this by sending a message to your Plume care team in the Spruce app. Your message might look something like this:

“Hi, I spoke to my pharmacist at [ADDRESS] and they said they need a new order for my [PRESCRIPTION NAME].”

Step 3: Picking up your prescription

When your prescription is ready, get your photo ID and head over to the pharmacy! Remember, your medication will not be ready for pick up if you do not initiate the refill first. For gender-affirming medications, there are often additional steps a pharmacist must take before completing the refill. They cannot just take the medication off the shelf and give it to you. Please make sure you have asked them to refill it and received confirmation that your medication is ready before heading over!

Once you arrive, tell the pharmacist at the counter you are there to pick up your medication. They will ask for your (legal) name and date of birth. They may also ask for your photo ID. BEFORE YOU PAY FOR YOUR MEDICATION, CHECK TO MAKE SURE IT IS CORRECT! Look closely at your prescription label! Does everything look right to you? Most prescription labels will include the following:


☐  Pharmacy contact information - name address and phone number
☐ Your legal name
☐ Prescription number
☐ Your physician's name (who ordered the medication)
☐ Name of medication
☐ Expiration date
☐ Number of refills allowed by your physician
☐ Directions on how to take the medication

When you look at the medication container, does it have the right label on it? Do you have the correct quantity and type of injection supplies? Has anything changed? Everything from mistakes to incorrect substitutions are possible at the pharmacy (they’re people too, and no system is perfect). Always check your medication before you pay for it. Don’t skip this step!

Once you pay for the medication, there is no returning it, even if things are incorrect. If you aren’t sure, you can open your Spruce app to check. Your Plume provider will have messaged you the description of your prescription order, so you can ensure that everything matches Questions to ask include: 

☐  Is my hormone dose correct? 
☐ Is my uptake method correct? (tablets, patches, gel, injectable)
☐ Is the quantity the pharmacist gave me correct?

If you inject, ask yourself:

☐ Do I have all of the correct injection supplies: the syringe, injection needle, and draw-up needle all detachable to each other? 
☐ Are the needle gauges and lengths correct?

Not sure what to look for? Check out our All About Injections article for a more in-depth review on understanding injection supplies! 

If you do notice that something looks off, go ahead and tell the pharmacy! Some things you can say include:

“I think I was prescribed [NAME OF MEDICATION] but I was given this instead. Do you have the supplies I need in stock?”  

“I actually am supposed to get [NAME OF MEDICATION] and I don’t think these substitutes will work. Can we order what my provider prescribed?”

Extra pro tip: If you keep getting the wrong injection supplies from the pharmacy, bring an example with you so that you can show the pharmacist. Keep a label (or a picture of the label) from your correct prescription. This will help you confirm that you’re getting what you need. You can even show your materials to the pharmacy team if further explanation is needed. 

If you feel confused about injection supplies, no worries! Take a closer look by visiting our article All About Injections for a more in-depth breakdown of injection supplies, including the anatomy of a syringe, Leur-Lock vs Leur-Slip syringes, and more.

Step 4: Celebrate!

And you’re done! Congratulations on getting your medication! We know how stressful the pharmacy can be, so please reach out to us if you find yourself at the pharmacy with an immediate concern or issue. We want to help! You can reach out to us via Spruce and mark your message “Urgent”. “Urgent” messages are specifically for folks experiencing time-sensitive concerns that require action from your Care Team, such as clarifying questions from your pharmacy so they release your medication (we kindly ask please do not use the “urgent” button for general questions). 

NOTE: This information is most relevant if you receive prescriptions from your local pharmacy. If you would like to switch to our delivery pharmacy, learn how to do so here.