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Caremark RX Inc

Caremark Rx • Changing Prescriptions • Delivery Problems • Refusing to Fill Prescriptions • Shorting Prescriptions --- News • Caremark Settles Drug-Switching Charges • CVS, Caremark Rx Agree to Merge • CVS In Merger Talks With Caremark • Feds Side With Whistleblower In Caremark Case • Pharmacy Benefit Managers Scrutinized • Class Action Filed

Caremark Rx is one of the big three pharmacy benefit managers, companies that supposedly save consumers and, not least of all, their insurers big bucks on prescriptions. But these savings, if indeed they exist, all too often come out of the consumer's hide, as the complaints in this section demonstrate.

Renee of Denton, TX November 1, 2009

Since my employer switched to Caremark, the price of my medications has gone up while my freedom to choose who fills my prescriptions has decreased. They price me with inconsistent information over the phone so that I am unable to make a sound, affordable health plan.

During the transition, Caremark mischarged me for a prescription. When I called to report the problem, they admitted that they had made a mistake. An employee named Carl told me that Caremark would refund me the difference. They also told me not to return to my preferred pharmacy at Target, even though Target had gladly offered to resolve the matter for me. I had always had a good experience with Target's pharmacy (and terrible experiences at CVS, with whom Caremark is affiliated), but followed Caremark's advice in good faith because it appeared that they were going to correct the problem.

Nearly one month later, Caremark decided not only to deny the refund but to change my medication to the highest priced tier so that I will always pay the greatest possible price. No-one from Caremark notified me about the decision or change; I found out because I called to request a status report. When I asked them why they hadn't notified me, they told me it was my employer's responsibility and that I should call ERS or Healthselect (note: those institutions told me to contact Caremark). Caremark insulates themselves from responsibility by deflecting blame and making it inconvenient for customers to get information from them.

When I asked Caremark how a person could make an affordable health plan, they told me that I can call them during my Doctor's appointment to inquire how much each one of my prescriptions will cost. But I am regularly on hold for 10-15 minutes each time I call Caremark, and even longer for them to bumble their way through their database. In more than one instance, I had to prompt Caremark employees to give me accurate information because what they were telling me contradicted information I had received previously from them. I doubt that my Doctor is going to put up with that! Besides, I believe my Doctor should give me recommendations based on their knowledge and experience. Caremark employees like Brandi freely acknowledge that they know nothing about drugs or health, so why should they get to make decisions that impact my health directly? Why are the non-experts at Caremark making health care decisions? I pay them a huge portion of my paycheck and I am but one employee in a large institution, so why can't they afford to hire medical experts or let the real medical doctors make the decisions?

Caremark tells me that they do not have to publish how much each drug will cost, so they don't. It's up to the customer to call and inquire, and it's still subject to change at any time without notice. So one month I will be charged 35 for a drug; the next, 75. Because Caremark won't put their prices in writing, the price can change from one moment to the next (as it did for me). How can this be legal?

Challi of San Antonio, TX October 14, 2009

I recently went for a follow up with my doctor after having surgery on my hand. He asked me some off-the-wall questions concerning medications I have taken for pain and present medications for my Anklylosing Spondolitis. I thought it was an odd question, so while I waited to have my cast removed, I looked at my chart. There was a letter from Caremark/CVS stating that they are concerned because I had refilled numerous prescriptions for pain medications. In the last year I have had three surgeries on my hands, so of course I needed to take the pain medication prescribed to me after my surgeries. I also take one Ultram on a daily basis as a maintenance for my back pain. They have record of all my surgeries. Why was there a need to embarrass and humiliate me by insinuating that I may have, as they stated it, a possiblity of drug abuse.

Wesley of Old Town, FL October 7, 2009

Below are some of the scenarios we continue to encounter in our quest to get the medicines our Dr. prescribes us. We are repeatedly in a situation where we cannot wait or are forced to wait on Caremark's mail order service. Ultimately, we are left days without the medicine, some of which are life threatening or with withdraw symptoms if abruptly stopped. Caremark has a simple solution, just pay full price out of pocket at the local pharmacy. Which incidentally does not get applied toward your annual deductible. These are just a few of the scenarios. There are many others , but the end result is the same.

Scenario 1: Your Dr. prescribes you medicine that is considered a "Maintenance" medicine. Your prescription is for three months of medicine. 1) You drop off your prescription at the local pharmacy. And get your first fill. 2) Second month you get your second fill. 3) Third month is denied by insurance (Caremark)because it is "Maintenance". ) Day one without your medicine. 4) Caremark refuses to transfer from CVS pharmacy because it is controlled substance. Day one without your medicine 5) Forced to contact Dr. requesting new prescription , Dr. still sees you have one fill remaining. Day one without your medicine. 6) Dr. contacts CVS to determine final fill was not done. Day two without your medicine 7) Dr. calls prescription into Caremark -- Day three without your medicine. 8) Caremark processes your order -- Day 4 to day 7 without your medicine 9. Caremark ships your order 7 to 10 days -- Day 10 without your medicine.

Scenario 2: Your Dr. prescribes you medicine that is considered a "Maintenance" medicine. Your prescription is for three months of medicine. 1) You mail your prescription and form into Caremark. Day one without your medicine. 2) Caremark processes your order -- Day 2 to day 7 without your medicine. 3) Caremark ships your order 7 to 10 days -- Ten days without your medicine.

Scenario 3: Your Dr. prescribes you medicine that is considered a "Maintenance" medicine. Your prescription is for three months of medicine at specific initial dosage. Fourth month dosage will be increased by Dr. 1) You drop off your prescription at the local pharmacy. And get your first fill. 2) Second month you get your second fill. 3) Third month is denied by insurance (Caremark)because it is "Maintenance". ) Day one without your medicine. 4) Caremark refuses to transfer from CVS pharmacy because it is controlled substance. Day one without your medicine 5) Forced to contact Dr. requesting new prescription , Dr. still sees you have one fill remaining. Day one without your medicine. 6) Dr. contacts CVS to determine final fill was not done. Day two without your medicine 7) Dr. calls prescription into Caremark -- Day three without your medicine. 8) Caremark processes your order -- Day 4 to day 7 without your medicine 9) Caremark ships your order 7 to 10 days -- Day 10 without your medicine. 10) Fourth Month new prescription increase in dosage. 11) Caremark refuses to fill at local pharmacy ( maximum fill on medicine (previous dosage) has been reached. Day one without your medicine. 12) CVS refuses to give new prescription back to you to mail to Caremark 13) Forced to contact Dr. requesting new prescription -- Day two without your medicine. 14) Dr. contacts CVS to determine why fill was not done. Day two without your medicine 15) Dr. calls prescription into Caremark -- Day three without your medicine. 16) Caremark processes your order -- Day 4 to day 7 without your medicine 17) Caremark ships your order 7 to 10 days -- Day 10 without your medicine.

Debra of York, PA September 3, 2009

I was beginning to think that my years of constant problems with Caremark was unique. This company has about made me crazy. They've lost prescriptions in the mail...then delayed replacement. Then, charged my CC TWICE for the prescriptions. They charge my CC with no authorization; They've lost checks I've sent, because I do not want them to have my CC anymore. They've changed prescription dosages, and number. They lie constantly; one person tells you something, then another person tells you something completely different. We've had to run to local pharmacy to get needed asthma medication refills, and pay out the nose, due to the incompetancy of this company. They send me letters saying they've tried to contact us by phone, and could not get in touch with us, so they cancel prescriptions, which is so untrue. They sure contact, me with no problem, when they want money. They claim they tried contacting my dr's office, which again, is an outright lie, as my dr's office informs me they never heard from Caremark. I'm so disgusted and sick and tired of dealing with them. Someone needs to sue the pants off of them, with this many complaints out there. As long as noone does anything, they will continue their totally unacceptable practices. I cannot wait to find another job, just to get rid of this place.

Richard of Sarasota, FL June 20, 2009

I just moved to Sarasota, Fl from Ft Lauderdale, Fl. I was in the process of Changing Psyciatrists, before I could se my new Psyciatrist for my medications management I ran out of "Provigil" and "Vyvance". I called the Psyciatrists office to see what to do, they said I should go to my Primary Care Physicion to have enough medication prescribed until I could see the new Psyciatrist. I went to my PCP at Manatee County Rural Health Services, Inc. Southeast and received the prescriptions from Dr., went to the pharmacy to have them filled, Caremark Approved the Vyvance and denied the claim on Provigil. Please note I have been taking both medications for over 2 years. Caremark has never denied a claim on this medication. Once a year they do ask for a pre-approval from the Dr which I forgot about. I got the telephone number for the emergency appeal line, the Dr's office was obtaining the approval from Wachovia Bank since Caremark was administering the prescription plan for them. On the appeal letter I received from Caremark the appeal would take 72 hours. It has well over 72 hours and no response from Wachovia/Caremark.

I suffer with Narcolepsy, without this medication I am lucky to stay awake 6 hours a day, and without it I certainly can't work. It is also making it very hard on my relationship with my Fiancee to deal with. Because of this I am being kept from having any quality of life. I am on a limited income, this prescription costs well over 650/month in the drug store. I need help! Thanks You

Angela of Chubbuck, ID June 16, 2009

To start Cvs caremark is the prescription insurance provided by my husbands work. I had gone to the Dr. in February to get my presciption refills which are Lexapro for depression and Levothyroxine for my bad thyroid. The Dr. filled my prescription and I went to Walmart to have the first one filled cause that is what Caremark will allow, after that you have to use the mailorder for maintenence meds. So the last week of March I called Caremark and my dr. and thought everything was fine until I logged into my account on Caremarks website and my prescription was cancelled the first week of April 2009.

We called caremark to find out what was wrong and they told us that the doctor did not write the prescription dispensing information the right way. So we called the dr. and they resent the information to Caremark, this was now the first week of May 2009. My husbands debit card was charge for the prescriptions which is for 3 months worth of both Lexapro and synthroid(caremark did not have levothyroxine). I watched the website everyday and finally on May 14,2009 my meds were shipped and they had put a tracking number to track it. I put the tracking number into the USPS website and it showed that I could not track from their website, so I looked everywhere to find where I could track this number to no avail.

I waited for 2 weeks and tried the number everyday with the same results. We then called Caremark to find out where it was and they told us they did not know and pretty much told us we are not telling the truth. We waited another week and no meds, and the tracking number still did not work. So we called Caremark again and they said they would send out a new prescription asap and if the other one arrived to send them a blue card so that we would not be charged again. Now we have already paid them almost 58.00 for meds we have not ever recieved!

On June 3, 2009 I recieved an email saying that they would not fill the prescription cause they needed the dr. to send them a new prescription, they said they had talked to the doctor and she would not refill the prescription cause I needed blood work, but I have not been able to take my meds consistently because of this HUGE mistake by Caremark. We found out they did not ever talk to the dr. because she only works 1 day a week at the local office. We have repeatedly called Caremark and the drs. office to get this taken care of but no one wants to help us. I refuse to pay Caremark another 58.00 for medications that are nowhere to be found. And since I have not been able to take my medications regularly I will not go to the doctor for an appointment just so she can ask why I have not been taking my meds. I am so tired of the run around with Caremark on this matter, and my drs. office too. But my main concern is Caremark. I dont think it is fair to deny someone their medications that they need, just because someone made a mistake.

Barbara of Dania Beach, FL June 15, 2009

I am a retired administrative secretary from the Trenton Board of education and am under the NJ State Health Benefits Program. Our union fought long and hard to get the best benefits we could, and at times, went without raises to get them. This includes our prescription benefit which is now under CVS Caremark. I am presently having an ongoing problem with the specialty pharmacy of Caremark in getting the medication Humira. Caremark insists on getting preauthorization forms every 6 months so that I can take this drug. I've been told that my insurance only allows me to take the drug every other week for 75 days, unless my doctor says it is necessary that I take it every week. My doctor writes the prescriptions and tells them that I need this drug every week, but Caremark has decided that I only need it every other week. They also make me get this drug by mail order and not from my local pharmacy. I take this drug for rheumatoid arthritis that I have had since 1971. This crippling and deadly disease is not going to go away. The drug Humira is a miracle drug that keeps me from being in a wheelchair or bedridden. I don't believe Caremark has the right to decide how much of a drug I need to have a decent quality oflife. I have been put through all the stress and bureaucracy I can handle. If I don't receive this medication, my R/a will go out of remission. I have spoken with Caremark representatives, supervisors, care coordinators, my doctor's office and so far everyone says they don't know why I'm not getting my medication. I'm out of humira at the present time. If I don't receive this soon, my R/A will come out of remission and I will start suffering severe, crippling pain. Before Caremark and now CVS Caremark took over our benefits program, I had no problem getting my medication from the local pharmacy. I know that Caremark is a large corporation and has a lot of shareholders, but I feel they should not be paid with the monies they save on me. Thank you for any help you can suggest. I don’t know where else to go.

manuela of Cranston, RI May 6, 2009

The Pulmicort that was sent to me in March was not requested by me nor my physician. I had been taken off Pulmicort in January and placed on other medications. However, have charged me a 40 co-pay for a medication that I do not even take. Representatives (Ashley, Rosey, and Janice) claim they received a fax from Dr. Sherman's office. I contacted Judy who handles the prescription refills for Dr. Sherman's office, and she has no record of sending any such fax. There is no record of having any contact with company since January 2009. CVS Caremark refuses to credit my account. I do not want my credit ruined for their mistake.

Tom of Jenkintown, PA April 29, 2009

On April 9, 2008, my daughter had broken out into a very bad rash, and the doctor has prescribed the medicine that was purchased under this claim. When I went to the pharmacy, they said that Allison was not on my policy. I corrected them, but they told me to contact Caremark. I called Caremark that night and spoke with a representative who said that there was an error on your end and that Allison was covered. She told me to buy the medicine and submit the receipt for reimbursement (less my standard co-pay of course). So this medicine was purchased with authorization from the representative at Caremark. Please do not deny this claim again. I need that money refunded. The current economy has left me in a personal financial mess. I cannot have this claim denied again. Please check your records to see that I did call on the night in question, and your representative said I should buy the drug (as my daughter was in a lot of pain) and that Caremark would correct the problem and reimburse the difference. This has been going on for a little over a year. I want it resolved. This error on their part has cost me 187 less my co-pay (30), so I'm out 157.

Dina of Hamden, CT April 14, 2009

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