OptumRx
Reviews and Complaints

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.

I am a transplant recipient, so I am eligible for my transplant prescriptions to be covered under Medicare Part B. I have spent two months trying to get OptumRx to process my prescriptions properly. They continue processing through Part D ($125 copay), and I have repeatedly told them these need to be processed through Part B, so that my copay is 20% of the standard Medicare amount.

After 2 weeks of frequent phone calls and no progress, even though my doctor returned their requested information, my transplant team sent them confirmation and I was calling them every other day for status updates, I had to get a fresh prescription from my doctor and pay cash for my medication. This happened again the following month because they continued having challenges processing the prescriptions properly. At one point, I was told it was ILLEGAL for them to process the prescriptions under Medicare Part B, after I sent them a screenshot from the Medicare.gov website.

So, I have submitted requests for reimbursement, which they are "processing" for zero dollars.

I'm not their only transplant patient with Medicare Part B coverage, so either they're ripping off everyone eligible for better coverage, or I have fallen into the black hole of customer service. Reading the other complaints, I don't think I'm alone, they are cheating other transplant recipients who are on disability and covered by Medicare.

I have been trying to get a prescription for my arthritis and every time I go look to see if it is being delivered it says it is canceled. My doctor sent a refill last month for it, but it has not changed.

I moved and let them know my new address they just cannot get it right and I have told them over a month to change it. They try to tell me that there is no such address.

I am now going to go to Walgreens instead.

There have also been other issues on about other prescriptions of mine.

My doctor phoned in my prescription and the next day I noticed a charge on my debit card for 121.50. I had switched health insurance to another carrier that paid for my scripts.In speaking with optum the order had not been shipped so they told me it would take five-ten days to show back up on my account and that script would be canceled. Spoke with someone else on either wed. Or thurs and they said my funds wouldn't be put back on account, since they supposedly sent the script out anyway. My back is charging overdraft fees. You had no business going into my account without my permission. What you did was wrong. I will be officially filing a complaint against you. I have never been victimized like this. Who is going to pay my overdraft fees. Bills I had paid thru my account got overdraft fees because of your selfish act to go into my account without permission.

I have been trying to reorder. a prescription for more than 3 weeks. My doctor and I have called OptumRx many times. At first OptumRx we're trying to contact a doctor I have never heard of. I contacted them and gave them the correct info. I also asked my doctor to contact them. From there my doctors called them several times over the last 2 weeks. Optum continues to send me emails that they have canceled my order. I called them today and they disconnected my call. They have yet to fill my prescription for a common medication

It's crazy that medications that I was on prior to being put with Optumrx was approved for me and now they are denying it. I have been on latuda, had to go off while I was between insurance. Now they deny it because they need more info. so doctor sends the needed info and now they are asking for yet more info. Then my biologics that my rheumatologist is trying to get approved for me they deny saying I have to try others first. My doctor picked this one because she felt it was the best option for me. Apparently what the doctor thinks and what I think and feel doesn't matter to them. I feel like my life is in limbo and is held in your hands. So if I die I will make sure that everyone knows it could have been prevented but the insurance denied me the medications I needed. It's like they enjoy telling people no and then listening to why they need it and still saying no. So you guys continue to dig my grave and people will have the evidence to go after you, since my doctor gave you the info you needed and you still denied it.

I recently started on AARP's UHC Medicare health plan and there website lists OptumRx as their mail order Pharmacy. for almost one month I have been trying to get 2 prescriptions filled through OptumRx and have been unable to - numerous calls to my doctor's offices and OptumRx reps. OptumRx service is unacceptable!

I eventually had my doctors send the prescriptions a local pharmacy and used GoodRx to make the purchases.

I spoke with UHC Benefits and they said that I do not have to use OptumRx for mail order, and I can use CVS Caremark where I previously have had good experiences.

Their drug pricing is always significantly off from what they charge. For the medication in reference today their drug price says $33.09 for a 90 day supply but they charged me $495. They said because I haven't met my out-of-pocket deductible I had to pay full price for my medication but almost all other prescriptions I've gotten, every month this year, the majority of the cost has been covered. They had me paying full price for another medication the first four months of this year then changed their mind and started covering it. I have another medication that has been different price each order which makes absolutely no sense. For a 90 day supply I got in August, I was charged $100 but this month I'm being charged $150. Trying to get answers from the customer service representatives is pointless as they're all very rude and completely unhelpful. It seems this company is a complete scam so I will not use them ever again.

My doctor called order in not once, but twice. No one bothered to tell my ordering prescriber that medication is on back order for unknown length of time. This is a time sensitive medication that I cannot go without. I've called pharmacy 6 times and never once said anything about back order. Today is my day to fill and now tell me that can't fill.

I have been having issues with my insulin pump infusion, not the pump, so I do not need a new pump. I am trying to get the vial of insulin that I've had to use because of the catheter the is not allowing the insulin to go in. They asked me to send a new prescription so my insurance can then process it. I do not need a new prescription, I just need that vial that vial replaced. I don't need the whole prescription of my 90-day supply refilled or replaced, just one vial. Needing a new prescription is just ridiculous! I've been diabetic for close to 30 years, and have never had to deal with a pharmacy like this. All I'm asking for is one vial that was wasted, didn't get to be used because of it just being spread out. Not going into the body through the catheter, just wasted.

Best Regards,
Amanda Law
[protected]
[protected]@gmail.com

OptumRX mail order is an incredible rip-off. For MONTHS I received requests from Optum/UHC to "save money" by switching home delivery for a 90-day supply. When I finally went online to do it I learned that the cost would actually INCREASE from $9 to $25 every 90 days. They wanted to get me to pay almost 3X more! When I spoke to an account rep he just said that is the pricing "for this particular drug." He tried to avoid admitting that Optum and UHC are part of the same company. Truly a misleading rip-off attempt.

I called 10/16/21 around 6:15pm EST because when I log into my account not all of my medications are listed and I need to order 3 medications that I couldn't see. The VERY RUDE guy that I spoke to picked up the line saying, "Can you hear me clearly?" I said yes and waited. Then he repeated, "Can you hear me clearly?" I said yes, can you hear me clearly?" He said yes, I asked if he could help now. He ask with what. I told him that my medications were incorrectly listed on my account. So he told me to go to OPTUMRX.com and go to forgot username/password because he did not listen to what I was saying. So when I told him again what my real issue was he VERY RUDLY TOLD ME THAT IF I WAS LOGGED I TO THE CORRECT ACCOUNT I WOULD SEE THE CORRECT MEDICATIONS! So I asked him just to confirm if he was going to help me at all with this problem and he hung up on me.

After quoting my insurance agent one price for a particular medication, once ordered, the price doubled and upon renewal would have put me into the Donut Hole! They are charging twice what CVS is charging and THREE TIMES what Rite Aid is charging. Attempts to get this issue addressed through the filing of "Escalation" letters led to weeks of no response despite multiple calls by myself and my agent who then found out they closed the case without ever speaking to either of us. This is going to cost me hundreds of dollars for no other reason but OptumRx misrepresented the price of one of my key medications. They are a disgraceful and shameless company who do not deserve anyone's business. BTW, AARP constantly pushes advertising for UCH and, therefore OptumRx, but attempts to get them to advocate for a 19 year AARP Member were completely ignored.

When you file an Prior Authorization with Optum for relugolix (Orgovyx) there is a question asking if if the days supply is "less than or equal to 1.0700" or "greater than or equal to 1.0700". The directions for relugolix for the first fill make it 30 tablets for a 28-day supply (1.07 tablets per day). Adding the additional zeros is very misleading and causes a "quantity reject error" that requires a rework of EVERY SINGLE PRIOR AUTHORIZATION for this drug. This delays patient care which is unacceptable.

When rounding numbers, you cannot just put in trailing zeros. That is against the rules of math and the safety rules for healthcare (JCAHO).

I think that particular Prior Authorization form needs to be re-worded to "less than or equal to 1 TABLET per day" or "greater than 1 TABLET per day". That way the question can be answered correctly and stop all the delays from having to rework Prior Authorizations that delay patient care.

I have sent several emails and made several phone calls to OptumRx.
I am a new customer. My doctor sent 2 prescriptions to Optum. The prescription info was incorrectly loaded onto Optum's website, and now I am unable to order my meds.
Every time I contact customer service has been a nightmare.
None of the customer service reps understand English. They speak English, but they don't understand it.
After hours of explaining my problem, I am instructed to have my doctor send in the prescriptions.
My doctor will not send the scripts again.
Optum's representatives cannot comprehend that.
Such incompetence is unacceptable when it involves medicine.
Borderline criminal.
Borderline warrants removal of pharmacy license.

Stupid thing is not accurate. App says testosterone rx is in process. Pharmacist says it was denied aweek ago.
Also no call, notification etc ever.
I cannot remember a time when Optum rx prescription service worked correctly.

Ok, additional info. The phone app is showing my testosterone rx in progress. So I have been waiting for an update. Got tired of waiting and called in. Turns out that the RX was denied. The phone app is therefore incorrect or the pharmacist is.

Resolution would be to get my prescriptions right without my intervention every time.
Also fix the phone app so it displays the correct status and supporting info like why denial or why it is in process like doctor call needed etc...

Called on Thursday, 9/9, said when they ship my meds on 9/12 (Ativan) please ship overnight because I am going on a trip at the end of the week. They said call back 9/12 to make the request. I did. They promised to ship overnight. I called 9/13 to check. They assured me it was shipping overnight. I called 9/14 (today) to check because it did not arrive. The advocate said it shipped regular ground and will not arrive until Friday. She claimed I was told this (I absolutely was not!). I asked to speak to a supervisor. I sat on hold for 45 minutes, no one picked up. I hung up.

There was a great deal more confusion than I am describing here, because there is not enough room, but the incompetence and misunderstandings, causing them to contact my doctor repeatedly while he never once received their messages, is staggering. They told me to all USPS and see if they can deliver it before 6 am Friday, the day I am leaving, which is of course impossible. I have no idea what I am going to do.

You guys are refusing to reimburse us for medications you were supposed to cover that we had to pay for out of pocket

I received my mail order medications automatically and sometimes I get stuff I don't need right now. I have some really big bottles I received some time ago and I keep them because when I receive 3 small bottles I just fill up my big bottle and toss the little bottles. On Saturday, I attempted to empty out the 3 bottles of Gabapentin in the big bottle but notice one bottle had no seal. I decided not to use and called Optumrx on Monday 8/23, only to be told that I am trying to pull one over on them. I was looking for some credit or something as I mentioned this is the first time this ever happened in the years I have been using this company. I am a very honest person who hates when people question my sincerity. I am not looking for anything because I have enough gabapentin to last till the next delivery. The guy actually told me to go ahead and use it because it's safe, my response, anything I buy to put inside me that is not sealed I will not use.

This company will do anything It can to not pay or provide the services you need. They constantly stop services saying they need prior authorization for any little thing you need to stay healthy and alive, even if you've had no trouble getting it beforehand.