OptumRx
Reviews and Complaints

Optumrx charged me 417.03 for three 15g tubes of generic hydrocortisone valerate . Without insurance, I could have bought this same item and quantity for $50 at any one of four local drugstores. Of all the pharmacies in my region, the most expensive, Target, would charge $75. You charged me 8 times what I should have paid. I deserve a refund of the overcharge.

Details
Invoice of 10/23/19, account [protected], William S Thornhill Jr.

Whom do I complain to about the BAD customer service at OPTUMRx? I have been trying since January 3, 2020 to get my Rx moved from CVS to OPTUMRx. I have talked to Michelle, Stephanie, several others. Here I am leaving for Wave 1 and I still don't have my medication and I am out. OPTUMRx does not have:
Decent voice recognition system on automated system…..keep having to repeat information
Information given in automated system does not transfer over to customer service representative. I have to tell them all information again, this make 3-5 time of repeating myself.
Mail order is a mess, I can only get 30 day supply and not 90.
Can we switch to CVS again?

I am a type 1 person with diabetes. I have been I ducking dependent for 44 years. OptumRx wants to charge me $885.93 for a 30:day supply. You're in bed with big pharma and should be ashamed. It's not a narcotic I need it to live. I'm on my 4 th appeal by Monday I will have no insulin which will mean I'll be in DKA and ina few more days comatose. You want me to use humalog which is over 20 years old and quite a few folks are insulin resistant to it because it's so old. Upon my deathbed
Regretfully hating Optum Rx

After 2hrs and 45 min on the phone today with countless amounts of people. I am no closer to a resolution than I was before.
I recieved notification a week before 1/1/20 that 2 of my rx's will no longer be covered. I have severe contraindications and side effects from medications and it has taken me years to find ones that agree with my body. These people do not care about any of that. After 2 phone calls with my dr's offices, they till denied me. They don't care if I end up in the hospital or suffering from not taking my madication which I am now 2 days late on. I am missing a major medication for 2 days unless I want to pay $161.00.
I have never dealt with the run-a-round with any company the way I did today and the people there should be ashamed of themselves for even working there. This company's last concern is for the well-being of it's members. It's disgraceful. And the fact that the state of nj switched it's workers to this is an embarassment! What a bunch of crap. I won't stop here, I will continue to make complaints about this 1 out of 5 star company that the state has saddled its wokers with. We don't receive great salaries so the health insurance and rx plan was our only incentive to even work here. Bang up job union reps!

What a nightmare this place is. You are on hold forever, no one speaks clear English and it seems no one has a clue what is going on. If I could give it a "0" I would. They charge wrong prices, they give you wrong prices. They told my medicine is $45.00 but my copay is $150.00 so I should pay the $150.00 "NOT" I have now been on hold for the 4th time, it has been 45 minutes. I told them the computer gave me a price they told me the price was wrong and gave me a different one. Unbelievable. It is a circus act there. I just started this plan in January 2020, I don't recommend anyone to take this plan. I am changing my plan today, there is no way anyone should deal with this horrible customer service. Plus their system has been up and down all day.

1. OPtum rx sent notice in December re: my mother's RX for Ranitidine = can cause cancer. Stop taking. I called OPtum & they refuse to provide coverage for the replacement drug Famotidine. I called our MD who states they called in a replacement. Optum states they never recived the request for a new Rx and still refuses to cover the Famoditinde.
2. Optum Rx sent me an email stating they could not complete order for another rx - her Pravastatin & to call them immediately. When I called after speaking to a customer service rep who was not helpfuyl - I was told that they had already mailed the Pravastatin. Could not give me an explanation as to why I was sent the email at 8:22 this morning.
I have no idea what to expect at this point.

On Oct 29 I ordered a home prescription delivery. I called the same day and cancelled it because I didn't realize the cost. I was assured it was cancelled but they could not give me a conf # only that I would see it online cancelled. They still sent me the medication. I called to return and get a refund. It has been going on since Nov. They received the prescription back. I was told a refund would be issued. I called a couple weeks later. Was told it was issued to wait. Called again was told they needed my debit card info to issue the refund. I just called today and was told a check was issued on 12/13 because I paid using my checking account. They said it would take 7-10 biz days. that I should get it on the 24th or the 30th?!? What? I have never done business with such an incompetent facility. They owe me a total of $150 and if I don't receive that by the 20th which is 7 days I will be filing a civil lawsuit. All the operators are outsourced and every single time I call it takes them 10-15 to pull up account and read notes and talk to a lead here a lead there to figure it out.

I AM FRUSTRATED!

Hello,

I am an employee (professor) at the University of Virginia and have had Thyroid Cancer. Because of the metastatic disease, I have to have a test to determine the potential spread of the cancer for 5 years (I am in year 3). The test requires injections of Thyrogen (no longer supported by OptumRx), or a withdrawal of my synthetic thyroid medication - that will make me seriously hypothydroid (anxiety, weight gain, insulin resistance & diabetes, heart rate and blood pressure changes, alterations in calcium and sodium metabolism, increased risk of infection). The total time of illness associated is estimated to be 2 months. I assume my insurance company will pay for treatment of these avoidable factors and cover the cost of a temporary replacement at work.
I have been trying to find out why Optum nor Aetna support Thyrogen as a test for metastatic cancer. The Thyroid Cancer Association and every PubMed indexed journal article support Thyrogen since 2007 as a much safer method of testing. Can you tell me what evidence was used for Optum to make this decision, and why an insurance company would place its constituents under so much physical harm? I just want to know before I go through the next 2 months of hell un-necessarily because my insurance company's investigators have not done due-diligence nor used evidence based decision making.
Sincerely,
Susan Saliba

WORST WORST WORST COMPANY I HAVE HAD TO DEAL WITH!
Where do I start, here are some thought that come to my mind, incompetence, slow, horrible customer service. I had my doctor prescribe me some medication on the 26th of Nov. I go to the pharmacy later that day only to have them tell me that a PA (prior auth) is required. So I call OptumRx to find out more, they stated that they sent my Dr's office a form that needs to be returned. I call my doctors office and they tell me that it was sent to OptumRx. A week goes my, I hear nothing. I call back OptumRx only to find out they was no record of any pre auth or nothing has been received. They told me to have my Dr's office send the faxed requested info and mark it urgent since it can normally take 14 days to process. "14 days to process"! Seriously!? So a few more calls back and forth to my doctor's and OptumRx gets nowhere and another week goes by, all the while the innocent patient is waiting for the meds and having to be the middle man between the 2 entities because there is apparently a disconnect. Fast forward to today Dec 13th, still no word nor meds. My doctor's office called earlier this week and confirmed with my that they received and submitted the requested info, via fax. I called OptumRx today only to find out that the there are denials on the PA. Who are you to deny, not let anyone (my Dr's office) know and move on. The 1st 2 attempts were denied, these are before the fax that was resubmitted from my Doctor's office this week. I finally get someone one the phone at OptumRX and again a clueless agent gives me the generic response and run around. I ask them the reason for why I don't have my meds, after looking into it further they state that they have to contact PA dept. I wait on hold for 5 minutes then get dropped to some automated response menu, as is when I 1st dialed in. I hit the option to get to an operator and have had it at this point. After giving my story again, I here the denials of the PA. I ask for a supervisor and in which I am placed on hold once again only to come back with the same operator stating that she is going to take ownership and walk this one through till the end by contacting the Dr's office and getting what is needed. Now I commend her on that however its the end of the day and my Dr's office is closed so guess what I have to wait till Monday which is going on week 3 of no meds. This operator exemplified proper customer service, however ever one else I spoke in the handful of times calling were just waste of my time and someone should have done what this operator is willing to do in the beginning. Mind you I never got a supervisor on the phone. I will be filing a formal complaint with this company an its work ethics. I wish to never have to deal with this company again nor do I wish it upon anyone.

If I didn't have to deal with these idiots, I certainly would NOT! For over 2 years I had spent hours on the phone, speaking with supervisors who said they put a note in my file to not auto-ship meds without my consent, yet they kept shipping them. Finally had to cancel my credit card I used for them. It seems that no transaction with them can go smoothly - now I find that they are out of my blood-pressure medicine, so it's MY responsibility to go back to my doctor to have a new prescription sent to my local CVS store, and now I have to go pick it up. Saying you're sorry just doesn't cut it when you're dealing with people's health and lives. If you want to treat this as a hobby rather than a serious business, you should not be in it!

Telling me I had not met my deductible, when it clearly shows on their app and website I did.
Type 1 diabetic - need insulin TO LIVE.
$450+ ($350 is the deductible).
Deductible shown as met on their website and app ($402.98). Clearly shows we are in the initial phase.
Called many times. Special Prior authorization made by endo time after time. Approved, then overturned. Rejected. Approved, but still the same price.
What a scam. Not sure how they state licensed in the State of New York.
Would not recommend anyone to use this service.

OptumRx Mail Order part of United Health Group. UHG is my prescription insurer, they set our policy to favor OptumRx mail-order for 90-day supply vs the retail pharmacy (like Walgreens). OptumRx does NOT accept manufacturer coupons. For Tier 1 and Tier 2 drugs, Optum charges hundreds of dollars. While when I go to Walgreens with the manufacturer coupon, I pay $0 at Walgreens vs $222 at Optum! Another drug, I pay at Walgreens a 1/3rd of what Optum charges for the same drug! In other instances, I have found that I over-pay at Optum when I order 90-days by mail vs when I can find pen needles at online stores (with the same prescription) at a fraction of the price. We have other drugs where Optum and UHG pay $0 towards the drug and charge us the co-payment which is the actual cost of the drug. I see alot of price-fixing taking place at Optum. And don't try calling their customer care, they don't care.

i went to see my primary dr today and he wrote me a prescription for a cough medicine that my pharmacist told me they would only pay half the amount of the medicine because they need a prior authorization from the dr...so im trying to explain i just left the drs office and i had the paper hand written prescription with me...hes a doctor...what more proof do they need?...im the patient...stuck in the middle...and im sick...with a bad lung infection and cough and these jerks are telling me they wont pay for all my medicine...i understand i have a co pay but to say u wont fill it to what the dr ordered is absurd...when a medical doctor writes a prescription...fill it...period...as a pharmacy company ur job is to follow what the doctor says...its a disgrace...u want a prior authorization?...what the hell do you call the prescription?...hes an m.d...he knows what hes doing...dont deny me my medicine again...please...im not there for kicks on a friday night...im sick for a week already

My husband is a type 1 diabetic and he requires to take an insulin. He uses penn needles in order to do that. I placed the order on September 20 th to charge the specific card with expedited shipping. However when I checked my account on 24 optumrx charged wrong debit card and they dropped a ball on expedited shipping. I talked 5 times to different people and they all assured me that they will reverse the incorrectly billed deceit card and will submit it to Hsa card I had originally put the charge through.as of today September 25th I can not access my money on my debit card, because still has not reversed the charge. And lady on the said or just pick it up at you local pharmacy for $120 30 days supply. Are you kidding me, why should I pay 120 for 30 day supply, when I placed the order of 90 day supply for the same amount! It is just ridiculous. My husband insular dependent and he can not leave without taking insulin, those needles play a big role as well as the insulin. And for optumrx to treat a customer like that is very unprofessional. This is the worst mail order pharmacy. We used many of them, this is truly the worst. Optumrx customer service is the worst, not only they charged to wrong debit card and dropped a ball on the expedited shipping, they also put s charge for extra $17.30 to my other debit card.

These people are going to kill some one, if they haven't already.

They do not have a clue what they are doing, they order the wrong meds, won't send the right ones, screw up every order, the website doesn't work and every single person you talk with is utterly clueless. They constantly charge your credit card for orders you don't make, won't send you ones you did make, call the real pharmacies and randomly cancel orders, lie to the insurance companies about how much you have paid.

But I am forced to work with them to try to get my son medicine he needs to live. But every day is fight and a full time job unscrewing up what they keep doing.

On 9/4/19 I had the worst interaction with the team members of Optum RX.
Card Id Due to my current health plan, I am required to use Optum RX for home delivery. The hormonal medication that I take is of extreme importance. My script for this medication was sent to CVS pharmacy. I was able to fill the medication once or twice before having to call Optum RX for an override to fill the medication at co-pay cost.
I certainly appreciated the override and the ability to pick up my medication in a timely fashion.
Please be aware my doctor has been contacted by CVS pharmacy and my self on multiple occasions to have the script sent directly to Optum with out any cooperation from the physician. My next appointment would be Oct 3, 2019 and at that time I would be able to force her to do her job.
Well its September and I need a refill on my medication. I spoke to a woman from the call center who simply denied my request to grant an override to fill my script.
I asked to speak to the supervisor. When she answered my call and I gave her the entire story and hardship that I had been having with my physician to order my medication in the correct manor, she laughed and stated that she will not authorize an override. Laughed. She thought that my situation was funny.
I asked to speak to someone above her, she stated her name was Becky from Minnesota. Becky also found my situation humorous. When I called her "Lady", she reminded me that her name was Becky.
Becky proceeded to tell me that she would not authorized for me to pick my medication up at CVS pharmacy. I was given the option of paying out of pocket if I needed it right away and filling out some form for reimbursement. Option 2 she could pull the script from CVS and attempt to fill it but I would not receive my medication for 7 day. Becky also stated that CVS pharmacy may not allow the transfer of the script because they would be losing business. Option 3 I reach out to the doctor and have the script sent directly to them. Either way, I will not receive my medication for 7 days.
Every month that I was given the authorization to pick my medication up at CVS pharmacy, not ONE person ever gave me these options/information.
NOT ONE representative from your corporation went the extra mile to assist me with the process of reaching out to the physician, obtaining the RX to prevent future override request. NOT ONE person from this company stated "let me attempt to transfer the RX from CVS so that you can begin receiving your medication at home during one of the months that I called for an override.
Due to the inadequacy of your team, a couple months of authorized overrides, and my discussion with laughing Becky, I have things in place but I am without medication for 7 days. Sadly, I had to ask Becky if she could expedite the medication to my home, it was not offered.
Another annoyance is that the co-pay for my medication is $8 more than what I pay at CVS pharmacy. This is a disgrace.
Overall, I am simply unhappy and beyond disappointed with your service and your teams attitude. Your customers should have the ability to receive their medication in a timely fashion especially those medications that are taken on a daily basis. It is extremely unacceptable to have to wait 7 days for a medication that I need to take daily.
It is unacceptable to have your team laugh and find humor in a very frustrating situation. I wonder how they would feel if the shoe was on their foot?
I am forced to use your services due to my health plan. I will be re-evaluating that health plan just to get rid of your services. I should not have to beg and plead to have a medication filled in a timely fashion. Absolute disgrace!

My husbands doctor ordered prescriptions from Optum Rx, he did not need these meds, sent them back and cancelled the credit card that Optum Rx had charged the 618. Dollars for the meds he did not want or need. Optum Rx will not talk to synchrony bank to get this charge straightened out and synchrony bank will not talk to Optum Rx! So my husband is caught in the middle of these two rip off companies! Now Optum Rx says he cannot order any drugs until this is straightened out, but neither of the companies will help us! He did send the drugs back and Optum Rx is accusing us of having the 618. Dollars! What a mess!

My specialist submitted the necessary prescription for an Albuterol HFA (PROAIR) Inhaler. It was denied because they required a preauthorization and all medical records before it could be approved. My doctor stated she has never in her career had an inhaler denied. I really feel frightened that if I need any medicine it may be denied regardless. The company is sugguesting I try other medications instead of giving me what my doctor prescribed. Seems to be a money grab!

This company has got to be the worse I have ever dealt with. I've had to submit preauthorization 4 da in 3 weeks on med I desperately need. They force prescriptions thru mail even though cvs is cheaper. This company is not consumer friendly only corporate friendly. Costing me more for prescriptions that are "supposed" to be cheaper. Something needs done.

OptumRx did not fill a prescription for me that was faxed to them on July 6, 2019. They also did not contact me about why they didn't fill it. On July 28th, I was completely out of this daily medication. I called OptumRx, and supplied them with all the information they said they needed. During that phone call, I was told that I would receive the medication by August 5, 2019. I also had to go through the hassle of getting an interim prescription filled -- and that OptumRx would not pay for.
August 5th came and the prescription did not. However, a letter came from OptumRx. The letter instructed me to order medication online. This was the first information I have received about going online to order. I went online immediately and ordered it. I was given a delivery date a couple weeks out. However, I again was out of medication. I called OptumRx. The staff had no idea why I was told that everything was done on July 28th; that the order that I had just placed minutes before I called was the first time they knew that they needed to fill a 90-day prescription. However, they did not ask for credit card information. I had given that to them on July 28th...Now I have to drive in for another emergency prescription. Who knows if the medication will really arrive by the expedited date the staff woman promised -- which is August 13, 2019? So far, OptumRx has been 100% unreliable and incompetent.
My member ID is [protected]. The minimum OptumRx should do is reimburse me for my out-of-pocket expenses.