OptumRx
Reviews and Complaints

So here's yesterday's episode in a nutshell.
I ordered Lynestra 2 weeks ago. 1 week later got recorded message, there will be 6-7 day delay. No problem, I had enough. Following week they leave message, they been trying to reach Dr. and haven't heard back. I ran out of medication that night. I called and told them if they would have left that message the first time I would of called Dr. to get on it. I thought it was a delivery or supply problem. Yesterday I called them to tell them I've ran out of med. been awake since 3:00 am having symptoms from stopping suddenly. They instruct me to call Dr. for an emergency 7 day refill. Dr. called in script to local pharmacy. Pharmacy called Optum rx twice. They were told by Optum, they can't figure out how to do an over ride. The pharmacy called me, they can't spend anymore time on the phone with this Co. Remember, the pharm. has to make these calls to Optum all day for other customers with same issus's. They have a lot of customers that work for State of NJ that got stuck using Optum. I called Optum, spoke to Sup. I was given a # that only the pharmacy could call. They called 1 more time waiting on hold then told again by the 3rd person. Can't figure out how to do over ride. I called Optum 5 th, time and Sup, I explain the whole day's events and ask her why can't 3 people figure out how to do an over ride. She assured me they do know how and that she was gonna call the pharmacy and get this done by end of day. it's already 6:00 pm now. She said she would call me back to let me know it's completed. Never got a call back. The State of NJ need's to cancel this contract and go back to Express Scripts. But that probably won't happen, because it's all about saving money. The state doesn't care about it's employee's and their families. I'm sure Christie made some back door deal on his way out.
Follow the money trail.

My order was placed by my doctor. There was an issue with one item, so I asked for it to be removed that same week. The remaining order has been stuck in processing for another 5 days for medication that I need to survive. I've talked to about 3 customer service reps who continue to tell me nothing more can be done to push the order. I explained to them how I need one medication on the order ASAP. I've spoken to 1 manager who assured me they would rush the order. Then, I receive an email stating the order has been cancelled. Every person I talk to tells me how they can't do anything more. Why is no one taking the initiative to say "Yes, we can help you and I'll do all I can to help." Why is no one taking the initiative to do whatever needs to be done to the order to move it? I don't know how their system works - the company does! If you need to split the order, remove items, whatever, just get it done! I have been clear that I need the one medication most and will pay to have it rushed or whatever. But, no, still stuck in processing. BASIC customer service. I hate that my company switched my insurance and I have to use OptumRx. If I had a choice, I would NEVER use OptumRx.

I received a prescription on Monday morning from my doctor. I took the prescription to CVS pharmacy to be filled. It's Friday evening and my prescription has yet to be filled. I have spoken to Optum Rx Customer Service 6 times over the week, as well as my doctor's office. I have been given the wrong information several times only to be discounted and changed by another representative. My doctor has called your company numerous times only to receive varying and incorrect information about what was required to get the prescription filled. The doctor sent 3 Prior Authorizations. We sent numerous blood test results per your representatives only to be denied over, and over again. It is absolute insanity that a patient has to jump through hoops to get a prescription filled. By Tuesday morning, when my doctor's office opens, it will have be 8 days that I have gone without my medication. And I am not certain that this issue will be resolved on Tuesday either. It is shameful that it takes more than a week to get a prescription filled in the United States of America. It's sad and despicable that a patient has to suffer due to under qualified personnel, and big company roadblocks. I simply want to get my medication, and hopefully help someone else from experiencing what I have experienced with your organization.

OPTUM RX completely botched take over of prescription plan for State of NJ Employee's and Teachers

In Dec 2017 I received notice that they would be cutting back my pain mdse in Jan.

I called them and was told to call back in Jan to see if I was approved for the amount of the dose I have been on for 7 years.

I called Jan 4, was told to have Capital Health send over the script marked Urgent so there would not be a problem refilling Jan.21.

Cap. Health did as requested. A few day's later I called to check with Optum if everything was complete. They have no records. I call Cap. H and they sent again. Rinse and repeat. Optum still has nothing.

Jan 22, my doctor sends script to Pharmacy, they call Optum and Optum would not approve.

Today I called Optum and I'm told New law went into effect now they need to speak with Dr, personally. They said he called they would fill it today.

I sent my Dr. text and he was in Boston but called them because he knows the trouble I have been having with them.

Dr. gave me rep. name and case#. He also called Pharmacy and said it should be ok now. Pharmacy called Optum for approval and now, 1 hour later and they say the script has been terminated and we need to start process all over again.

So I call back Optum they pull up case # given by Paul Riviera to my Dr, and there is no record of my Dr calling.

The pharmacy said it's not just me, they are screwing up everyone's scripts.

They should have worked more closely with Primary's so there would be a smooth transition.

If your haveing similar problems call the Board of Pharmacist, Attorney General and NJ state emplyee benefits. Tell them to cancel contract with Optum.

P.S. I have a feeling Christie has something to do with this.

Follow the money trail.

This is the most unorganized company I have ever dealt with. They can not get their stories straight. Everytime you call you get a different person who says something totally different. I have spent two days trying to get my medication filled even spoke with supervisors and still can't get it fixed. I call back get someone else have to explain everything again because they do not log nothing in their system to tell the next person what is going on. Then this person tells you something different. This company needs to be shut down and retrained or shut down all together. Each call has been a minimal of 45 mins up to 130 mins. I have lost track on how many times I have called. This place needs to be shut down. Especially if the supervisors don't know what they are doing. This is people's medications. Medications that are not safe to not come off of. They are playing a dangerous game.

I needed a PA for a medication (no big) I called for a status and they told me it was canceled the day it started (by this point I'm out of meds) I was told I could get a 5 day "emergency" supply at full co-pay. I called back to get said supply and was then told the pharmacy had to call. The pharmacy called and was told that wasn't possible. Later I get a PA approval but it still won't go through because they approved the dose and not the frequency. But this point it's 5pm on Friday my doctor is gone for the day and I've been a week without my medication. Fast forward to Monday doctor calls and tell me the PA was denied and we have to do a written appeal. They were told to mark it urgent and we would get a response in 72 hours. Now I'm waiting to see what happens.

My daughter had been diagnosed with insulin dependent Type 1 Diabetes. She sticks her body at least 4 times a day for insulin and 10-13 times per day for blood sugar checks due to frequent exercise and management. A PA was sent by our doctor on November the 17th for a Dexcom to prevent her from having to stick needles in her body so many times per day. Since that time we have been given nothing but trouble from Optum. EVERY SINGLE TIME we call Optum, we are given a different story. Once she was "not on insulin" so it was declined. Once it was "we don't have all the pieces to the PA" so it was declined. Once it was "we have two weeks to make that decision" and told us the PA was sent on a different day, which it was not. Once it was declined because "we didn't need a PA"! We have had the Dexcom Rep, the Walgreens supply company, and our doctors trying to resolve this issue and we are getting no where! My daughter needs your help! My daughter needs security in knowing her blood sugar isn't going to bottom out in the middle of the night and her have a seizure or worse! This is very important...to her, us, and her medical care. I do not understand the problem and lack of care and consideration here. My daughter's name is Kinley Corder.

I am a highly-active online/Internet/App user for various aspects of both my professional and personal life- work, personal banking, professional meetings, entertainment viewings, gaming, shopping, bill pay, Facebook, Instagram- you get it!
Like most of the world, interfacing with people at local stores and banks to accomplish many things is diminishing b/c of these technological advances. Most changes like this are of great convenience and save both me and the businesses time and money. All good things.

The exception to this overall societal improvement is dealing with the OptumRx online pharmacy. For over 6 months, I have been trying to refill my own medicines via their mail order prescription service. I have had to use this mail in service at the requirement of my employer for nearly 7+ years. It had been ok; however, the train derailed at some point this year.

I logged in to refill my meds in early Spring (April 30th). My medicine chest had somehow been converted from all mail in scripts to local pharmacy only. In trying to use the tool within the Optum website to switch them back, I somehow launched a request to my Doctor to ask for new scripts. I didn't need new scripts. I had plenty of refills left. So, my Doctor called me and I had to explain.
I had to contact Optum myself at this point, so I attempted to use their click to call feature (where you put in your # and it calls you right now or in a few minutes). It repeatedly dialed then hung up on me. I tried several times. Having no success, I clicked on the "contact us" link only to find that it put me in an endless circle of the click to chat option and showed no phone listing rather it only showed a mailing address. I googled their contact info and dialed to them.

When I reached the OptumRx Rep, he told me they were having website problems, apologized and that they could see them as mail in and they ordered them for me. I was irritated as all heck, but chalked it up to this day and age and moved on.

Fast forward to end of June- GROUND HOG DAY
same thing. scripts were only showing as local pharmacy and 2 were not showing at all. Tried click to chat- CLICK. Looked up their 800 and called them. Guy says oh we are aware of the issue, IT is looking at it, please be patient...same shtick. I had them find my missing scripts that they could see and I got refills ordered.

Today is November 30th. Yesterday, I got an email notice that I was due for a refill (I turned those on to remind myself using the tricky little thing called the website when it was working so I could avoid contacting them and just do it myself)...see how well that has worked

I log in and TAH DAH... now I have NO scripts at all showing on my medicine page-NONE; click to chat doesn't work; go find number in google, call them, the gal says...we are aware of the problem. I can see your meds I can refill them..and I said, that's great...thanks...can you tell me: what are you being told about the horrific website and medicine cabinet problems that have been going on for over 6 months. what rhetoric have they scripted (ha no pun intended) for you to say to us when we call in? do they have a clue or is it an intentional way to frustrate and anger their clients and drive more calls into the agents that they pay to be online? what's the deal...

awkward stumbling mumbling swallowing and she said...

they are working on it is all we have been told.

I'm angry bc I can't self serve and I am forced by my employer to use this service b/c I tried to use local pharmacies and I got threatened with letters telling me if I refill maintenance meds at local pharmacies that my medical insurance will be canceled. WHAT A JOKE OF A SERVICE!

I have been using OptumRX mail-in services for several years and never had a complaint until this year. I called them a month ago to transfer the above prescription from CVS to them. They claim that my doctor's office never responded to their faxes which is not true. Not only did they respond to the faxes, but they called OptumRx 3 times to have the prescription filled. When I called OptumRX to check on the status of the prescription, they claimed that my doctor's office never called the prescription in. This is not true. My thoughts are that Optum never responded to the voice mail messages that my doctor's office left and that Optum's representatives were negligent in following up to those voice mail messages because they really don't respond to voice mails. This is not acceptable and no way to deal with their customers. In other words, are Optum's representatives doing their job?

I have been on the same medication since 2008. When I refilled it thru OPTUMRX mail order, I was sent a pill vastly different in color and shape. There wasn't a picture of the pill on their website or their APP. All of my other medications had pictures. Had to call OPTUMRX and talk to several people who were rude and unprofessional. This company should not be allowed to get by with this. My trust level with them is so low that I had to call and talk to these people to ensure this was the correct medication.

Can't someone do something,

I have been going through optums mail services for over 4 years and have been treated terrible every time. I have been lied to by multiple customer service reps, pharmacists, and supervisors. I have never receive my prescriptions on time which they have left me at least a week or more without important medications because they say they are being sent out and then never do. I have complained to supervisors and have been hung up on multiple times and have been called derogatory names because of my orientation. Once they finally send my last prescription I will NEVER use OptumRx ever again because no one seems to make it right.

For almost two months, I have unable to access my order on the OptumRx website. They tell me it's a known issue, IT is working on it, but nada, nuttin, zilch as far as progress.

There is no communication between OptumRx and the customer. I placed my regular order, but they could not fill one item. However they didn't tell me and despite regular calls, I still don't have the item. I resorted to getting the medication at a local pharmacy.

The customer service is horrible. The agents who answer the phone are polite, but don't give reasonable answers. I had to be connected to a supervisor in order to get better service.

My father died on 13 August 2017. As a result, I've been working closely with my Mother (the surviving spouse) to ensure her health care coverage and attendant benefits are all in place and correct given my Dad's death. He was the primary with my Mom as a dependent when he was alive.

We had gone to great lengths to get everything sorted out with the Social Security Administration, Medicare, Optum Rx, EPIC including several faxes, emails, and phone calls. To complicate matters, when trying to renew the Rx for Xarelto, the cost had gone up significantly.

After another series of calls, one lasting over two hours, we were able to determine that the rise n cost was due to my Mom having moved into the donut hole - which we understood. We went head and paid for the Xarelto refill and were assured that not only was everything in order at Optum with my Mom's coverage, that they would put a 'rush' on the refill since my Mom was on her last four tablets.

More ten days later with no Xarelto delivered, and my Mom in a panic having been without her pills for five days, we called Optum yet again. This time were told that the order taken over the two-hour phone call didn't go through (we received no notification of any kind), and that we had to place it again. Needless to say, we were furious.

We ended up getting an interim refill of seven days, but even that was difficult as my Mom doesn't drive, and there are very few people available to get her the medication since the pharmacy doesn't deliver. Hence, the Optum Rx Mail Order service. It allows my Mom to get her medications cost and time-effectively. Except when it doesn't.

My complaint highlights what happened when we called distraught at not having received the meds. We were told many things: the order number, where the drugs were coming from, that Optum was a large company with many departments, that each person I spoke with "understood" my issue. Not only was the info shared irrelevant, it was clear that no one "understood" what was happening with my Mom. Further, blaming all the other players (insurance, my Mom's doctor, etc) was lame and plain wrong. The only issue was that they had screwed up badly leaving an 80-yr old in a panic about her medication. They couldn't own the issue, not did they solve it well.

Eventually, my Mom did get her order filled, but it was more than two weeks later and after a lot of stress and anxiety, not to mention tons of phone calls, and interim measures that we had to take care of since Optum couldn't do their job right even the one time.

I am quite upset and my Mom is now paranoid about their ability to get it right going forward.

We are done with optumrx and will be posting nothing but negative feedback.
Date of incident - the past 4 years! Most recent 10/30 - 11/7.

We changed insurance as my wife lost her job and we went straight to medicare part d. Not withstanding the issues we had just getting the prescriptions into optumrx system, then they were put on hold due to a "secondary insurance" which there wasn't. We had a 3 way call with optumrx, aarp medicare and myself and it was "supposed to be cleared up" I was told that I would get the medications by monday 11/6.
Fine - so next day 11/1 we called optum rx again (Because they've been so reliable in the past) to verify processing and was told "yes it's being processed and there is a rush so you'll get them monday 11/6" I even said to make it overnight.
Called on monday to find out again that they were on hold as they had to contact the doctor's office (What?!?! Same meds for 4 years are you kidding?) so that delayed it even further. At this point I am out of medication and in pain.
Again called optumrx today 11/7 - spoke with a rep then a pharmacist who got nasty and said "you'll get them the 15th" then hung up on me.
My wife got on the phone at that point and called back and spoke w/yvonne customer rep lead, asked to transfer to her boss "candice" who could not be reached, she asked to speak to "candice" boss "randy who also could not be connected. She then said to speak to a pharmacist and was able to reach"mary beth"who tried to help out and worked on it. Then rec'd a call back from mary beth who stated that the hard copies of prescriptions had to be sent out from their office to california for filling (What?!?! This is the first time this has happened) she was attempting to push it through and would call back later - my wife asked just to have the hard copies sent back and was told that would take longer than getting them filled so she said ok just get them filled and overnighted back. My wife called a few hours later and spoke with"israel"an agent who was difficult to deal with and said the same thing and my wife had to get pushy and s/w yet another pharmacist"julie"and told her just to mail the hard copies back to us and we'll go through walgreens going forward.
This is unacceptable! I am out of my meds and in pain and there is a chance i'm going to end up in the emergency room due to the sheer incompetence of this stupid mail order pharmacy.
Also - for the icing on the cake - we were told 5 completely different stories of why there was a hold up. We are involving medicare now to help us out.
Pathetic and will never use or support optumrx again!
My wife is a rn as well as an him specialist and at this point is considering an attorney for"bad faith" on optumrx's part.

My ex husband and I are being double billed every three months for the same prescription. This has been going on, since he and i split up last september 2016. He doesn't care. He said he doesn't care if I get billed. This is taken out of my checking. I called OptumRx. They will not do anything for me. I am furious. Its is a small amount, but that is not the point. What is my recourse?

I have been trying to get on the OptumRx website to order my mom's medication for over a month. Each time I try to get on, it gives me the following error:

Error: Our records indicate you don't have access to OptumRx. If you think you are getting this message in error, please call the number on the back of your Member ID card so we can assist you further.

I clear the cache on my computer and then it tells me that it doesn't recognize the machine I am trying to logon from and sends me a one-time confirmation code. When I put that in, and re-enter my id and password, I get the same error. I have contacted OptumRx about this and they send me a link to reset my password. I get the same error! They said they would contact the IT people and get it resolved...crickets!

I called again today [protected]) and the representative said she would file a case with the IT people and put it as a tier II, and that someone would call me within 48 hours. This is very frustrating and it has been happening since OptumRx began using 'Healthsafe ID'. You would think someone would work out all the bugs before implementing a new process. I wish I had the CEO's phone number because I'm sure he wouldn't be happy with this lack of customer service!

I was promised my prescription would be filled on Friday and I would receive a Saturday delivery. I called several times to confirm this. At about 11:30 pm, I received an email saying that my order was on its way, only to find out that my order was processed AFTER UPS picked up all packages. So now my order is sitting in OptumRx facility where it will sit for 3 days until UPS picks it up on Monday. And I paid for overnight shipping. This is so very frustrating because its not the first time that I have been lied to by your reps. This always ends the same way, I don't get my medicine, just an apology. The lying/missinformation has got to stop. I am done talking to supervisors and reps. I will take
my complaint to corporate. This is not right.

Last week my husband was notified that his insurance was cut. So i called to find out what happened, because i had mailed payment and knew there was no reason to have cancelled. Called and spoke to 2 different people because the first one disconnected me. The first one told me it was because i did not submit proof of residency before the deadline which i had sent in about a month prior. The second girl informed me that it was not the case but the reason he got cut was because he had not selected a plan. A month prior i had to call to submit my new enrollment because the website was not allowing me to, so after being approved the employee told me that i could only select a plan starting Nov 1st. So much to my suprise when i did call and they tell me this is the reason why, i was not a happy camper and then they told me i could be reinstated until November 1st. And i told them that it wasn't my fault or problem and they need to resolve it ASAP because my husband was not feeling well. So i asked to speak to a supervisor and was placed on hold for about 45 min and then was told that the supervisor was too busy on another call and couldn't talk to me but told the girl that i could pay a month in advance and i would be reinstated come Tuesday. So i paid it and was told to call back on Tuesday. Tuesday came and i call and they tell me it hasn't been reinstated yet to try back tomorrow. Tomorrow comes and i call back and was disconnected again after the person told me they would look into it. And i call back again and get this girl with a really bad attitude who tells me that i cannot be reinstated. So i told her i needed to speak to a supervisor and of course they are not available, and they will give me a call back. This is not something you play with someone's health insurance. Its like they are selling cars and not insurance, there was no legitimate reason for them to cut the insurance and yet they did.

Have been trying for over a month to refill scrips via their horrible website. I go though checkout and it looks like order is accepted, but nothing comes. New HealthID login doesnt work so getting back in to check on order is next to impossible. Refill price shown on screen varies -- first it came up over $300. After logging in and out multiple times on different days, it finally came up correctly $9.00. By the time i got through to phone service, i was already out of meds. They offered to send scrps to a local pharmacy, but i would have to pay their super inflated so-called "retail price".

This company is a disgrace!

My son has a disorder known as Phenylketonuria or PKU. To survive he must have a medical formula. His entire life that formula has been covered through my insurance until your company began coverage for TDCJ. I am requesting what legal reason your company is using to deny my son his medical needs?
Per the Texas Department of Insurance, insurance companies are required to cover Phenylketonuria and Inborn errors of amino acid or urea organic acid metabolism as well as the formula the persons who have these disorders requires.
RxBIN 610494
RxPCN 9999
RxGRP ERSTX
ISSUER [protected]
ID [protected]
Name Coby Brewer
Product your company is claiming is not covered is Phenex-2 Amino Acid-Modified Medical Food