Prime Therapeutics
Reviews and Complaints

By mistake my health plan was changed to a Blue Plus plan which took me away from my normal health providers. I was able to get changed back but not until the next month. I went to pick up my auto refill insulin and was told denied need a prior Auth done. Which would take time insulin is something I need to live and not something that can wait until I go back to prior good plan. spent time with many calls saying what was I do what insulin could I take they would not answer me. The other plan was great if a person was new to plan and needed a prior auth you were given 2 months and the needed med was covered. The people that speak with you have no medical training no understanding that INSULIN is a life saving drug. had to research on my own write down what was covered and go to urgent care where the doctor was willing to write a script to keep out of danger for a few weeks until I am back to my old plan. Their website lies says that cost is not a factor in what drugs are covered. This leaves a bitter taste in my mouth.

My story is the same as most that I have read read. BCBS requires I use Prime Therapeutics for my specialty medication. Each month it is a new but similar nightmare trying to order my refill. I have had same prescription and same insurance for years but each month there is a new issue/delay and each time I call I feel like it is the employees first day. They seriously act as though they are incentivized to NOT fill my prescription. It is so terrible that I am seeking other treatments just to keep from having to deal with this company each month (physician administered medications). And agree with others below that pre-Walgreens, I had zero issues each month when BCBS used CVS Caremark. #terrible #worstever #byefelicia

I'm incredibly disappointed by the recent situation I experienced with Prime Therapeutics. I have never been treated so unprofessionally or rudely by a company that my health depends on. I spoke with a representative the other week before sending in my prescription and was told there wouldn't be any issues with it getting filled. My doctor wrote out three 30 day prescriptions vs. one 90 day but was told it was OK to send in and get filled because that was essentially a 90 day prescription. I spoke with another representative today who told me that:
1. My prescription wouldn't have been filled anyway because they did not have the generic version available - they ran out of it and wouldn't dispense the name brand because my doctor didn't authorize that.
2. The 30 day prescriptions wouldn't be filled because they weren't technically written out as one prescription. She said I would have to fill it at a local pharmacy... which leads to
3. Since the medication is a schedule 2 - my doctor had to actually write out the prescription form. The prescriptions are now getting mailed back to me. Therefore, I have to wait to even fill it at a local pharmacy until it gets back to me which can potentially take up to 10 days.
I was told something completely inaccurate by one representative. If I had known the way I was sending it in would prevent my medicine from being dispensed - I would have gone to my doctor the same day to get it corrected. The representative I spoke with today was incredibly rude and I asked to speak with a supervisor who was even more unprofessional - raising her voice, telling me to stop talking and demeaning me by stating I had no idea about medication dispensation laws. I've been taking this specific medicine for 15 years and am knowledgeable regarding the regulations. Essentially this entire situation was degrading, disappointing and disrespectful. Unfortunately I have no choice but to use this company for my prescriptions because it's what my insurance covers. Hopefully this experience can serve as an example on how clients should not be treated.

Prime Therapeutics recently sent out a letter on 8/25/16 saying that coverage for several mental health prescription medications would be limited to a certain number of pills per month, regardless of patient history. The motives for this limitation are unknown, but it looks a lot like bias against those with mental health disorders.

The letter says that patients can ask their doctor to fill out a "quantity limits exception form", but when I called the number that the letter provided to ask for this form, the customer service person didn't know what I was talking about. She said that the form probably wouldn't be available until the limit takes effect. So I need to figure out how to coordinate my once-a-month prescription refills so that I can have my doctor send in the form and get it approved by Prime Therapeutics. Since Prime Therapeutics seems to take about 3 months to approve anything, this will likely be impossible. Therefore, I will have to pay for my own prescription for a few months despite having healthcare coverage. It is unclear whether Prime will cover part of my prescription or just reject the whole thing since it's above their arbitrary limit.

I would like the company to recind this ridiculous request, but at the moment I would be happy if they just told me how I'm supposed to get they quantity limit exception form.

Prime Therapeutics refills and charges for prescriptions without patient knowledge and consent. They kept my credit card information on file without my knowledge. They filled prescriptions and charged my card without my knowledge or consent and continued to do so even after I called and emailed them and ordered them to stop filling and charging me for prescriptions. They have refused to contact me regarding this issue. I filed a complaint with the Board of Pharmacy, but they continue to refuse to discuss this issue. I am aware of other consumers who have had the same issues with Prime Therapeutics. Their practices and policies are bad for consumers.

I suffer from Parkinson's Disease and my Doctor prescribes a certain medication every month, at an amount that is a little above what my insurance normally allows. So, my Doctors has submitted a request for an exception, every 6 months, for the past several years. It was time for a new request, so, I had my Doctor submit a new request. Later, I went to fill my prescription and was advise by the Pharmicist that the request had not been reviewed for approval. I called Prime Pharmaceuticals and asked why the request had not been approved. I ended up calling back a few times over the next few days, until I learn that they had disapproved the request. I inquired as to why it was denied. They would not tell me; however, it was obvious that they retaliated against me for questioning why it was taking so long with the review.