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Supply Prescription
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Supply Prescription
Has anyone ever encountered an issue getting a prescription for their ostomy supplies? I am unable to get any of my doctors to provide me with a prescription. I used to use my surgeon who gave me my ostomy in 2014 but they have since retired and their office will no longer provide my prescription. They said I should have had my PCP give me the prescription long ago since they only did surgery and no follow up. I asked my PCP to give me a prescription and they refused stating they do not care for my ostomy and to see my GI physician. My GI has also retired and their office new physician refuses to give me a prescription and I should contact my surgeon who did my hernia repair. I contacted the surgeon and they refused as well since they are a general surgeon and did not give me the ostomy. I am at a loss at what my next options should be. I have no idea why a doctor would refuse to provide a prescription since they obviously know I need supplies. It’s not like I am selling them on the black market to make money.
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Shamrock4806
- Posts: 519
- Joined: 2024-02-22 13:00:22
Re: Supply Prescription
Why would you need a prescription for ostomy supplies?
The only one I can think of is Medline Marathon and if your still needing that then you might be doing something wrong or not healing properly or something.
The only one I can think of is Medline Marathon and if your still needing that then you might be doing something wrong or not healing properly or something.
I get knocked down, but I get up again
You're never gonna keep me down...
You're never gonna keep me down...
Re: Supply Prescription
I am fully healed. The supplies are the pouch, barrier ring, wafer, adhesive remover spray and wipe. I get my supplies from Byram Healthcare and need to renew my prescription on a yearly basis.
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Shamrock4806
- Posts: 519
- Joined: 2024-02-22 13:00:22
Re: Supply Prescription
What I found on prescription requirements
In the U.S., ostomy supplies (e.g. pouches, skin barriers) are treated as “durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).” To get coverage from Medicare or many insurers, you generally need a written order or prescription from a treating physician.
Many hospital and ostomy-care patient guides state that ostomy supplies “need a prescription” from a physician in order to be covered by insurance.
In Europe, ostomy appliances are also commonly “prescribed and customised” via the health system or payers in many countries.
The degree to which a prescription is strictly required (versus optional, or enforced only for reimbursement) probably varies by jurisdiction (country, state, province) and health care system.
It is common in many developed health systems that a physician’s authorization is required to access ostomy supplies under insurance or public coverage.
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What you can do if your prescribing doctor has retired and others are deferring
This is a frustrating situation, but there are steps you can try. Here are suggestions (some more promising than others, depending on your local laws, health system, and provider willingness):
1. Obtain your medical records / surgical history
Request your records from your former surgeon’s office or hospital (even if the surgeon retired, the hospital or clinic may maintain records).
In many jurisdictions, patients have a legal right to access their medical records (or at least relevant portions).
With documentation of the surgery, you can show that an ostomy exists, its type, etc., which strengthens the case for needing ongoing supplies.
2. Find an ostomy nurse / WOCN (Wound, Ostomy, Continence Nurse)
These specialized nurses sometimes have established relationships with providers and suppliers and may assist in securing prescriptions or convincing physicians to authorize them.
They often understand the logistics and justification (e.g. medical necessity), which helps when asking a provider to write the order.
3. Go to a specialist (gastroenterologist, colorectal surgeon, urologist)
Sometimes a specialist, even if not originally involved, may agree to “take over” care of your ostomy (or at least to evaluate you) and prescribe needed supplies.
When approaching them, bring your surgical records, photos of your stoma, prior supply list, and any documentation you have.
4. Talk to your supply vendor / DME supplier
Some suppliers are familiar with these situations and may help facilitate or communicate with providers.
They may be able to submit a request for “continuation” or “refill” based on past history.
Some have clinicians or liaisons who can help persuade a provider or review documentation.
5. Write a letter to a new provider
Prepare a concise but well-documented letter summarizing: your surgery, stoma type/location, what supplies you use and how often, complications or skin issues, prior prescription, and the necessity of continuation.
Present that to a physician and ask them to evaluate and authorize the supply prescription.
6. Appeal to your insurer / payer
If your insurer denies coverage due to lack of a prescription, you may be able to appeal, providing your medical records, documentation of your medical need, and statements from ostomy nurses or suppliers.
Some insurers have exceptions or “medical necessity override” routes.
7. Involve a patient advocacy organization
Ostomy associations (in your country) may have resources, legal advice, and help in advocating for access.
They may know doctors willing to help or past cases similar to yours.
8. Check regulatory/medical board / health authority rules
Sometimes there are laws or regulations requiring covered medical supplies to be accessible, even if the originally prescribing physician is unavailable.
You can check with your health department, medical licensing board, or ombudsman to see whether a new provider has a legal or professional obligation to continue care (if you establish a physician-patient relationship).
9. As a last resort, pay out of pocket temporarily
If no provider will sign the prescription, you might purchase needed supplies without coverage (if possible) just to maintain your health, while continuing to seek a permanent solution.
---
If you tell me which country (or state/province within a country) you are in, I can try to dig into the local laws and help you strategize more specifically.
- ChatGPT
In the U.S., ostomy supplies (e.g. pouches, skin barriers) are treated as “durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).” To get coverage from Medicare or many insurers, you generally need a written order or prescription from a treating physician.
Many hospital and ostomy-care patient guides state that ostomy supplies “need a prescription” from a physician in order to be covered by insurance.
In Europe, ostomy appliances are also commonly “prescribed and customised” via the health system or payers in many countries.
The degree to which a prescription is strictly required (versus optional, or enforced only for reimbursement) probably varies by jurisdiction (country, state, province) and health care system.
It is common in many developed health systems that a physician’s authorization is required to access ostomy supplies under insurance or public coverage.
---
What you can do if your prescribing doctor has retired and others are deferring
This is a frustrating situation, but there are steps you can try. Here are suggestions (some more promising than others, depending on your local laws, health system, and provider willingness):
1. Obtain your medical records / surgical history
Request your records from your former surgeon’s office or hospital (even if the surgeon retired, the hospital or clinic may maintain records).
In many jurisdictions, patients have a legal right to access their medical records (or at least relevant portions).
With documentation of the surgery, you can show that an ostomy exists, its type, etc., which strengthens the case for needing ongoing supplies.
2. Find an ostomy nurse / WOCN (Wound, Ostomy, Continence Nurse)
These specialized nurses sometimes have established relationships with providers and suppliers and may assist in securing prescriptions or convincing physicians to authorize them.
They often understand the logistics and justification (e.g. medical necessity), which helps when asking a provider to write the order.
3. Go to a specialist (gastroenterologist, colorectal surgeon, urologist)
Sometimes a specialist, even if not originally involved, may agree to “take over” care of your ostomy (or at least to evaluate you) and prescribe needed supplies.
When approaching them, bring your surgical records, photos of your stoma, prior supply list, and any documentation you have.
4. Talk to your supply vendor / DME supplier
Some suppliers are familiar with these situations and may help facilitate or communicate with providers.
They may be able to submit a request for “continuation” or “refill” based on past history.
Some have clinicians or liaisons who can help persuade a provider or review documentation.
5. Write a letter to a new provider
Prepare a concise but well-documented letter summarizing: your surgery, stoma type/location, what supplies you use and how often, complications or skin issues, prior prescription, and the necessity of continuation.
Present that to a physician and ask them to evaluate and authorize the supply prescription.
6. Appeal to your insurer / payer
If your insurer denies coverage due to lack of a prescription, you may be able to appeal, providing your medical records, documentation of your medical need, and statements from ostomy nurses or suppliers.
Some insurers have exceptions or “medical necessity override” routes.
7. Involve a patient advocacy organization
Ostomy associations (in your country) may have resources, legal advice, and help in advocating for access.
They may know doctors willing to help or past cases similar to yours.
8. Check regulatory/medical board / health authority rules
Sometimes there are laws or regulations requiring covered medical supplies to be accessible, even if the originally prescribing physician is unavailable.
You can check with your health department, medical licensing board, or ombudsman to see whether a new provider has a legal or professional obligation to continue care (if you establish a physician-patient relationship).
9. As a last resort, pay out of pocket temporarily
If no provider will sign the prescription, you might purchase needed supplies without coverage (if possible) just to maintain your health, while continuing to seek a permanent solution.
---
If you tell me which country (or state/province within a country) you are in, I can try to dig into the local laws and help you strategize more specifically.
- ChatGPT
I get knocked down, but I get up again
You're never gonna keep me down...
You're never gonna keep me down...
Re: Supply Prescription
PDX_Mike - I can't believe your doctors are so uncooperative. I can't even imagine what their problem is for this no big deal situation.
AFAIK all they need to do is sign the form the supply co. faxes them with the list of ostomy items and fax it back. My PCP of many years who used to do this also retired but I recently saw a nurse practitioner at my new GI doc's office for some issues and she said she will take care of it when the time comes....
AFAIK all they need to do is sign the form the supply co. faxes them with the list of ostomy items and fax it back. My PCP of many years who used to do this also retired but I recently saw a nurse practitioner at my new GI doc's office for some issues and she said she will take care of it when the time comes....
Ileostomy due to UC - 50 odd years
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Shamrock4806
- Posts: 519
- Joined: 2024-02-22 13:00:22
Re: Supply Prescription
I've been buying my supplies out of pocket because I have just catastrophic insurance with a $7000 deductible and haven't had a need to use it for the last year or so and I spend about $5000, so it didn't make sense.
Unfortunately my reasonably affordable tax credit ACA appears to be on the current administratives agenda about allowing them to expire so I don't know what I'm going to do and I certainly don't like using Medicaid any, nor the unreliable insurance supplied ostomy sources as often the orders are incomplete or some other hassle.
Now this requiring a prescription business just means more unnecessary doctors visits and I've moved so now I have to establish all new ones.
Unfortunately my reasonably affordable tax credit ACA appears to be on the current administratives agenda about allowing them to expire so I don't know what I'm going to do and I certainly don't like using Medicaid any, nor the unreliable insurance supplied ostomy sources as often the orders are incomplete or some other hassle.
Now this requiring a prescription business just means more unnecessary doctors visits and I've moved so now I have to establish all new ones.
I get knocked down, but I get up again
You're never gonna keep me down...
You're never gonna keep me down...
Re: Supply Prescription
My general Surgeon’s office sent a message to my GI doctor that it is their responsibility to provide prescriptions for my ostomy supplies, so i need to wait and see what they say. I have developed a small hernia and will see if my surgeon wants to see me. Hopefully i will hear back next week about my prescription issue.
Re: Supply Prescription
My general Surgeon’s office sent a message to my GI doctor that it is their responsibility to provide prescriptions for my ostomy supplies, so i need to wait and see what they say. I have developed a small hernia and will see if my surgeon wants to see me. Hopefully i will hear back next week about my prescription issue.
Re: Supply Prescription
I hate to use bad words, PDX_Mike....but I might have to - if my docs were pulling this s--- on me, I would be exceptionally angry. If I were you, I would have your ostomy supply company send faxes to all your different docs and hope to get one back. When my doc retired, his office gave me a big pile of my old records and I found the form from my ostomy supply co - it listed the items I was ordering and he signed it and faxed it back....no big deal and certainly no visit necessary....best of luck to you!!
Ileostomy due to UC - 50 odd years
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22Sunpuperwolf22
- Posts: 48
- Joined: 2025-09-05 19:04:23
Re: Supply Prescription
PDX_Mike,
My Gastroenterologist that I had was prescribing my ostomy supplies and suddenly when I was having problems with my skin and required additional supplies temporarily due to major leaks that required a prescription under Medicare's allowable, he refused. So I left his office, and didn't have a Gastroenterologist for around 5 years. My primary doctor took over the prescription, with no problems, and when he retired, I decided to go back to the same Gastroenterologists office and the older doc had retired, so I got another doctor from the same office, at the end of 2024, and she is one of the best, most thorough, most knowledgeable doctors I have ever had. She easily took over my prescription, without any hesitation, even after being a brand new patient that she wasn't familiar with. All she requires is that I see her yearly in person and then she updates my prescription. Are you happy with your current Gastroenterologist, or do you think having a different physician might be warranted?
My Gastroenterologist that I had was prescribing my ostomy supplies and suddenly when I was having problems with my skin and required additional supplies temporarily due to major leaks that required a prescription under Medicare's allowable, he refused. So I left his office, and didn't have a Gastroenterologist for around 5 years. My primary doctor took over the prescription, with no problems, and when he retired, I decided to go back to the same Gastroenterologists office and the older doc had retired, so I got another doctor from the same office, at the end of 2024, and she is one of the best, most thorough, most knowledgeable doctors I have ever had. She easily took over my prescription, without any hesitation, even after being a brand new patient that she wasn't familiar with. All she requires is that I see her yearly in person and then she updates my prescription. Are you happy with your current Gastroenterologist, or do you think having a different physician might be warranted?
Re: Supply Prescription
My GI doctor who i liked has retired and I was assigned a different GI from the office. The new GI is refusing to prescribe me supplies. I think I will look for a new GI doctor.
Re: Supply Prescription
I cannot understand your new doc's problem - what is the BFD? If you don't know what that means, I can't write it out here...lol....PDX_Mike wrote: 2025-09-27 14:35:44 My GI doctor who i liked has retired and I was assigned a different GI from the office. The new GI is refusing to prescribe me supplies. I think I will look for a new GI doctor.
Is there a higher up person in the office to talk to...or else certainly find another doc....Plus If there is any place on their website for a review you can give them a bad one....
Ileostomy due to UC - 50 odd years
Re: Supply Prescription
I encountered this problem when I started using Medicare (prior, I paid out of pocket and bought without a script, from SB Medical Stoma Bags, which tends to have lower prices than others and sells direct to the customer). The need for a prescription for me was purely financial, as Medicare requires it to cover supplies. My PCP said my GI doc should write the prescription. I haven't had a GI in 25 years - my ileostomy is more than 50 years old. For me, it helped that I made a list of the products I used, including frequency of need ( like 10-20 pouches and wafers /month ), and drafted a sample letter of medical necessity for the doctor. I also assured her that I would not expect her to deal with ostomy-related problems other than occasional severe dehydration (she had done that already--by sending me to the ER). I tried to be kind while talking to her.Sometimes doctors get so busy and are so stressed and pressured to get on to the next thing or patient, they don't see the obvious.