OptumRx review: Worst pharmacy company in the world

Optum RX is the worst pharmacy company I have ever had the unfortunate experience of dealing with in my life. If I could leave a negative star rating I would. I have had so many bad experiences in the short 7 week period that my insurance changed and I had to switch all my 90 day prescriptions to them from Walgreens as required by my Blue Cross Insurance. I recently changed from Blue cross of Illinois to blue Cross of Kansas City. I went from being able to get all my 90 day prescriptions filled at Walgreens to only being able to get them filled at Optum RX mail order. My life hasn’t been the same since. In the past 7 weeks I have logged somewhere around 20-30 hours on the phone with them Struggling to get prescriptions filled.

I have a single prescription that I have been on the phone with them for about 10 hours over 8 different phone calls and never have been able to get it filled. It all boils down to a Copay card that they cannot figure out how to process in their system. After repeated calls and countless hours on the phone they finally were able to determine they do not have ability to process the Copay card and that I would not be able to use it with them. We only figured this out after I called the manufacturer while I had the customer service person on the phone at the same time trying to figure out what Optum RX was doing wrong. This means I cannot get my 90 day prescription from my Dr filled without paying a large amount that exceeds my budget to get the medication.

There are a number of issues with this company that just cant be avoided.

1. Every time you call in, you get a different customer service person and you have to re-explain your problem and give them the same information over and over and over again. There is no type of ticketing system where they can keep track of repeat or follow up calls for the same issue to check on status or updates.

2. The customer service representatives have very little to no ability to resolve problems directly themselves. They have to take notes or send messages to other departments or people for them to follow up on. I never once received any calls or follow up from anyone on issues that I had called in about once I hung up the phone. Horrible service. No resolutions to problems.

3. The representatives cannot make outbound calls. So if your call gets dropped, they cant call you back and you have start all over again from the beginning with a new call.

4. They lack the ability to allow me to talk directly to the person that I need to talk to for resolving my problem. For example, I cannot talk directly to a pharmacist. I cannot talk directly to the person that knows why my copay card is not being accepted. Getting real answers from the right person is non-existent.

5. This is a big one. Optum RX DOES NOT handle preauthorization requests with your doctor. I was told repeatedly that I would have to fill out a form and send it to my doctor to have them fill out and send to the insurance company. This is crazy. I have never had to manage my own preauthorization on prescriptions. This is what my insurance premiums are supposed to be paying for.

6. Their web site IS NOT real time up to date. So status of fills and prices and shipping is not accurate. Sometimes you don’t get prices until its shipped and by that time its too late to cancel the order if you cant afford it.

7. I had issues with prescriptions that were automatically filled and shipped even though they were not setup for autofill and auto ship. I had several prescriptions that I canceled the same day they started filling these prescriptions. Four days later they shipped them to me anyway without notifying me and without even knowing what the cost was going to be for the prescriptions. Once they are shipped, you own them and cannot return them. Every time I was on the phone with them I told them do not ship me any meds without me knowing what the cost is. I’ve had problems with mail order in the past not applying my insurance and discounts properly and I don’t want them shipped unless I know they are processed correctly.

8. Managing your prescriptions with Optum takes a huge amount of time and resources compared to other pharmacies. I constantly had to follow up with them on why my meds were not shipping or not ready or what they were waiting on. They would remain in various statuses for days like they were waiting for someone to look at it. It was taking days and even weeks to get issues resolved since I had to manage things manually on my own with doctors. I have several that I have never been able to get resolved in the 7 weeks I’ve been trying to use them.

9. Their Voice automation system does not work reliably. It does not recognize basic phrases like my birthday. I would have to repeat it 2 or 3 times before it would give up and move on. Then I would have to give it again to the customer service rep.

10. Optum uses offshore customer service from India. India accent and dialect is very difficult to understand and communicate with. 3 out of 5 times I got the offshore support and went through my lengthy process of explain my problem, they would tell me they don’t have access to that information and I would have to be transferred to the Onshore team. Then I would have to start all over again explaining my problem.

11. Because they cannot make outbound calls, they do not have ability to call your doctors or copay card companies to get proper details for processing your prescriptions. This is a big problem. I was always the one playing the middle man having to make calls to get answers then call them back.

12. They cancel prescription refills with no explanation on the web site and no phone call or contact to explain why. This means another 1 hour phone call to customer service to find out why.

13. I had one prescription they wanted to charge me $225 for. Previously I was paying $30 for this filled at walgreens for 90 day supply with my Copay card. Since they could not figure out how to process my copay card, I could only get 30 day supply at Walgreens which was $10. Their pricing just doesn’t seem right and since you cant talk to the pharmacy directly, you cant get answers on why.

14. Its not uncommon to spend an hour or longer on the phone every time you call in. Probably 70% of my calls I was on the phone more than an hour, and 5 or 6 times a week. Who has that kind of time to spend managing their prescriptions every week?

15. There is no compassion or sense of urgency for getting your medications filled when they have let the refills lapse or taken weeks to get them shipped. Constant unexplained delays.

16. Not customer oriented at all.

Bottom line is, AVOID using Optum RX at all costs. You are gambling with your health if you do. Its not worth the time, aggravation, and stress in dealing with this company. Everything is bad. Very inefficient, poor communication, poor follow up, poor problem solving and resolution, over priced, poor service, poor everything. I cant find anything good to say about them after using them for only 7 weeks. I cant believe a company like this is even allowed to stay in business or why insurance providers would even use a company like this to provide for their patients.