OptumRx
Reviews and Complaints

DATE 05/16/2022

My doctor recommended Synvisc 1injection for my bone-on-bone knees. Optum RX denied the Synvisc and would only approve Euflexxa which is 3 injections per knee instead of one. This meant I would have to take 6 days off of work instead of 2 and I would have to go through 6 painful injections instead of 2. I went around and around with Optum to please just approve what my doctor recommended. They would not budge, went with the injection they recommended because I was desperate. After one injection my knee pain got worse and my doctor did not want to do the other injections. Now I am in more pain and back where I started and now in debt $400 for a medication that was not recommended, did not work, made my condition worse and I was unable to even receive all of the injections. I told Optum RX that I wanted to dispute or appeal the bill. They were very rude and unaccommodating. I have researched many complaints where Optum is acting as physicians and recommending what they want to pay for instead of what your doctor recommends. This seems unethical and unsafe for sick or injured people.

I only have one prescription with Optum, Rasuvo injections 25 mg. I have been receiving this same medication monthly for over 3 years. I placed me refill order for September 2022 online. Nothing changed with the prescription. My address has not changed. My credit card for the co-pay is on file as it has been for 3.5 years. There is absolutely no reason my order should have been held up or delayed in any way.

I have a missed call from Optum on 9.16.22. Then, Optum had the audacity to call me asking to start to fill my other prescriptions via an inbound call on 9.20.22. I told them I was not interested in transferring prescriptions to them until I received my medication. I had to drop for a meeting. I called back on 9.21.22 and spent 15 mins more asking where the medication was. I was told I had a co-pay card on file that had expired. I have never used a co-pay card for this medication. They told me they would ship the medication to arrive Sept 24.

Today I called the number I have in my phone and got yet another rep who wants to talk to me about moving my other prescriptions. I demanded to know where my existing prescription was. She had to transfer me to customer service but instead transferred me to the automated system. I had to call back and speak to a rep who told me my refill date was Oct 3. I asked to speak to a supervisor. The supervisor offered to send me a 3 month supply overnight.

My Rheumatologist just took my blood mid-September. My inflammation is the highest it has ever been. Without the medication, my hands become stiff my fatigue gets worse, all of which prevent me from working. Optum's failure to provide one medication on a routine basis has led to a decline in my health.

My name is William Hoffman, 1047 Limestone Ln, Columbia, TN 38401.

On 8/9/2022 I received a 90 day supply of home delivery Humalog Kwikpens. I neither ordered nor setup for automatic order this prescription. The week before this delivery I received a notice of impending refill. I call OptumRx customer service and was assured that the mistake had been caught and the Humalog prescription would not be refilled. Yet on 8/9/2022 the refill is delivered to my doorstep. To further compound OptumRx's error this refill order was also denied by my physician and that denial was also ignored.

I am worn out managing these mistakes.

Should another unauthorized refill occur I will return the product and expect a full refund. If this poor service continues I will be forced to move my prescription refills to another provider.

Sincerely,

William Hoffman

[protected]

As you can see by all the other 1 star reviews, this company sucks. All they care about is profit. They could careless about the patient(s).

I'm a type 2 diabetic. I shouldn't use steroids so I asked about another alternative. They cover no alternatives... Zero!

Every time I get a cortisone shot, my glucose goes off the chart for a few weeks.

It's truly amazing that people are forced to use this company.

This is a quote from Healthcare Finance. "Optum is a behemoth in the health care industry, reaping profits for parent company United Health."

all of the criteria has been meet for this medication.

HTN, hypothyroidism, increased cholesterol class 3 obesity.

lifestyle / diet changes have been documented along counseling having a gym membership, plus the fact that antidepressants are to cause weight gain. the fact I have a good support system.

I have also loss 6 LBS using samples of Saxenda

I will not stop until this is over turned.

My husband is an employee of CHI Franciscan Virginia Mason. We have heath care through "Commonspirit" and Optum RX is our Prescription provider. We are only allowed to get our prescriptions through the Franciscan Mail order Pharmacy in Gig Harbor, WA. The problem with this, is that this pharmacy is no bigger than my living room, and they are not able to provide prescriptions in a timely manner. 3 times in the last few months, my husband and I have run out of medications that are either needed to breathe (literally) or have horrible side effects if stopped abruptly. (My husband is an asthmatic, with 2 different steroid inhalers). Most recently, My provider sent the Franciscan pharmacy a prescription on June 21st. On Monday, June 27th, I called the pharmacy to see if they had processed my prescription (an antidepressant). They had received it several days prior, but had not processed it. I informed the tech that I would be running out of my medicine on July 1st, but she assured me she would RUSH it, and I would have it by then. Friday the 1st came, but my prescription did not. Not only was I out of medication, but everything was closed for the holiday weekend. I couldn't even get samples. I had headaches, nausea, dizziness all weekend - my holiday weekend. I called on Monday to verify what date the medication was mailed out, and it had not even been mailed. I drove to the location in person, and picked up the medication. Prior to this, I had a nasal spray for allergies prescribed, and it took me over 2 months to get my first prescription. This is unacceptable. We do not have a choice, and we if the pharmacy cannot provide the services, then we should be allowed to go elsewhere.

In addition, I keep receiving intrusive letters about my prescription history, stating I am not regularly refilling my prescriptions, and giving me "Tips" for managing my medicine. This is not their business. I am an adult, and can manage my medication. The meds that were not refilled were actually discontinued by my doctor. This is insulting and unnecessary. When I called to have me taken off this mailing list, they said that they couldn't, because it is automatically computer generated.

We received a prescription for my husband that cost $290 which was automatically deducted from my bank account. We returned the drugs which they received in June 21st. On July 1st I called since we hadn’t received our refund yet. I was told it was being processed and the money would be in our account on Friday. It’s now Tues July 5th and still no refund. Called again today and was given the runaround. $290 is a lot of money when you live on SS Disability. I’m so incredibly frustrated with Optum and especially their customer service. If I had the option to change mail order companies I would, but unfortunately it’s the company my insurance uses. I just want our damn money back.

May the 21st i send a prescription to Optum Rx, and up to date i don't received, any prescription, there left me a massage at the email, and told me there will call me back in a few min. or email me back, but never did call me or email me, if there don't want to do any business, why simple don't send the prescription back to me, it really sad to have companies like that, who don't care about anyone, now i need the prescription, and i don't have it

Franz Colli

My company is a self-pay health benefits company who contracts with UMR to Masbate our health, dental, and pharmacy claims. For employees and members dependents who have immunosuppressive therapy needs, OptumRx repeatedly denies members from access to Tier 3 drugs and drugs from specific drug manufacturers, and pharmacy distributors. This includes drugs that are listed as generic at times. The Prior Authorization process is actually a series of gates to force the doctor and the patient into a financially beneficial course of treatment for OptumRx/UMR/UHC. UHC justifies this through their ever changing formulary schedule and corporate doctors who are paid by UHC and who never treat or examine the member patient. To modify and govern OptumRx, who has a large class action suit filed against them currently by independent pharmacies, either regulatory over site or increased financial penalty through fines and class action suits seems necessary to correct bad actors and illegal policy and procedures at OptumRx.

After overnighting a prescription that was needed for pain they were unable to locate the envelope for two days. After that I still had to keep calling them so they would do what needed to be done because I tried once before to have a prescription filled and it never was. Something that should have taken maybe a week at best is taking almost two weeks because it takes them several days to get from A to Z. It makes me wonder if the pharmacist does some of this purposely because it’s a narcotic. This is happening all over the country now where chronic pain patients are judged very harshly and seem to enjoy claiming they don’t stock the needed medication. Because of that we should at least be able to depend upon our insurance co online pharmacy but they’re worse.

I returned two prescriptions on March 21,2022 via first class mail. I took pictures of both prescriptions and the sealed package to avoid a problem. I have called nine times from March 24, 2022-june 8 2022 to make sure the package was received and my reimbursement was credited. I get a run around every time I call and a confused representative each time I call. I just received a letter I owe Optum RX money now as of June 8 2022. I after spending 45 minutes on the phone was told Optum never received one of my returned prescriptions? Therefore I have called nine times since March 24 and now am told on June 8 2022 they didn't receive my mail? This is more than sad it's ridiculous. I will take this issue Forward tomorrow and make a formal complaint. I spent two and a half months trying to straighten any issues out and get a run around each time and no one knows what is going on.

End of statement

The pharmacy has put my order of insulin on hold. I use the insulin in a pump and the basal setting is 86 units a day. The pharmacist will not fill the order without the doctor giving the maximum insulin used a day. This is difficult to set a number because the amount of the bolus used depends on the amount of carbs I eat and the readings of my glucose level. I had Caremark as my online pharmacy prior to Optumrx. I was never asked to provide any of the pump set basal or bolus amounts. My doctor has send the precription order a number of times. Apparently your pharmacists are not knowledgeable about insulin pumps.

I now have two vials of insulin left. I have already contacted my attorney to start a lawsuit. I am also contacting Medicare to file a grievance.

THIS IS A MATTER OR LIFE OR DEATH.

Judy Brewer

I am a new customer of Optum Rx since 2022. All of my Rxs are on auto refill with available refills.

One medication I was due to receive before 5/14/22 or at the end of 90 days was not filled. The medication could be filled on 4/18/22.

I have been expecting to receive notice from Optum Rx by text or email that my medication had been shipped. No such correspondence received.

I am not a patient that stockpiles medications. Medications are filled for 90 days; taken as prescribed; and at the end of 90 days I need a new refill.

On 5/20/22 I phoned Optum Rx customer service which was a joke.

I asked the individual to check my file for the needed Rx.

Could she see any attempted refills for the medication?

The answer was "No".

I wanted to know where the medication was.

I was told to go to a local pharmacy for an emergency refill.

Pharmacies do not stock the medication on their shelves. It is a medication that requires a special order.

Again, in questioning the individual I received no answer as to what occurred.

If this was a medication that was optional to take daily I would not be as furious as I am.

The medication is taken 3 times daily on schedule or I will suffer serious life-threatening problems.

I told the representative that I expected the medication to be filled that afternoon and Fed Exed to me for delivery on 5/21/22.

Optum Rx in their sales pitch when you phone in to set up service with them states they will use any means to insure medications are received on time.

The representative still would not guarantee this would occur.

It is now 5/21/22 in the evening and of course no Fed Ex delivery occurred.

My phone call to the company only served as a reminder to fill this prescription.

It did not matter that I am totally out of the medication and now have been for 7 days.

Now I will be forced to find another pharmacy that delivers to handle my prescription needs.

If I suffer any physical problems from not having my medication daily I am left to suffer. No hospital even carries the medication in their pharmacy.

I do not have medications filled at various pharmacies as many people do.

I use one pharmacy only.

I was forced to leave CVS Pharmacy only because they stopped delivery service at the beginning of the year.

I was a CVS customer for more then 30 years minus any errors.

Optum Rx seriously needs to revise their business practices. Individuals lives are at stake.

Yesterday (5/17) I called OptumRX because I received a flier from United Healthcare that I could save money by subscribing to prescription delivery. I went through the sign up process with the person on the phone, and when I asked about the pricing, it was higher than what I pay at the pharmacy, so I asked them to cancel the order. Until I asked, they never mentioned the pricing. Today (5/18) I received text messages that my order was being shipped. I called to cancel my order, and the representative put in the order to cancel, but it needs to be approved by someone. I have no idea when this will actually be cancelled, and it may affect my ability to fill my prescription at my pharmacy The rep I spoke to today said she had no idea when the cancellation would be approved. This person also could not connect me with a real person to talk to about this error on their part which is impacting me negatively. I am so frustrated with this company.

May 5th, 2022.

My daughter and her boyfriend just called me. They cannot administer the covid test as it does not have the liquid needed in it. Since the kits cannot be opened prior to administering, they now have to figure things out in Pisa, Italy. Great way to finish their trip!

I purchased the kits (2 pack) on April 11th and received it on the 12th.

This situation is adding a huge amount of stress on my daughter and her boyfriend. We count on quality product to make travel possible and easier. It is critical that your QA be top notch.

I had an order on file for 5.5 my Ambien which was to be processed on 5/3/22. They cancelled the order and did not notify me. They saw the order exceeded their guidelines. They had the order for over a month and cancel without a ppep

Worst mail pharmany ever. They we ok last year but once Jan 2022 they hored many new employees and changed their website too. Sent script that I did not order then charged my cc without my authorization. Told me they couldn't refund my cc until they got the return back WTH.

Also tried to double charge me for a blood glucose meter. I sent them the cancelled check and was told the accounting department would investigate and get back to me, never got back to me.

Needed sensors for the meter , they couldn't get them in stock for 4 weeks, really?

Made phone calls during Feb/Mar truing to get things straighten out. WILL NEVER USE THEM AGAIN

They sent the wrong script, then sent a script that was not even ready to be refilled. Then it took 9 days to receive a bag and a return label to send back wrong med. Was told the bag and return label was sent [protected]. This original error happened on [protected], now I am waiting for a refund, and they are taking their sweet time to process the credit. They had "NO" problem charging my cc before the meds were even refilled. PEOPLE! DO NOT DO BUSINESS WITH THIS COMPANY! Go to the drawing board and find another Pharmacy!

April 5,2022

received 4 medications in the mail from Optum rx which were not authorized by my cardiologist doctor nor authorized by me.Optum rx debited my bank account for $487.75. I asked about a refund but I was told it would be 3-5 days. Called again and was told to put them in the mailbox. I did not think that was too safe. No one ever picked the drugs up and I called again April 14 and now I need a label from Optum rx to take to UPS to send back to them. Another 3-5 days for my refund. I would appreciate your help.

I have been taking this medication for 10 years and all of a sudden optum rx wants to deny my pa and there is nothing i can do about it.

My doctor has sent in sleep study and blood test results showing i have narcelepsy but still denied. My doctor knows how bad it is and they have no clue.

I need my medication in order to keep me awake to drive to work and back home which is an hour and 1/2 round trip. I take my medication at 5 am, 10 am and at 2 pm. My doctor and my family knows how bad my condition is and until i retire ; i have no choice but to work to support my family.

I have had it with this company. I will be contacting my employer and the appeals department to have an outside source look at my medical file. If i have an accident because i don't have my medication- i sure hope optumRX is prepared to suffer the consequences.