About Express Scripts
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Express Scripts is refusing to fill two prescriptions for narcolepsy, even though they are both critical, after three appeals. There is no human to call for help, I've been trying for three months. Each time you call you are passed somewhere else, from the Philippines, to who knows where, no one cares at all, and I feel completely demoralized. They require prior authorizations for EVERY prescription, which is taking months to get. Why do they need the doctor to authorize the prescription, if that same doctor wrote the prescription? It's all to see if you'll give up, and not use your insurance. They refused to fill an ASTHMA inhaler, even though that is also life threatening. I wish to God I never chose this job, because this horrible, humiliating company is my only choice for Rx.
I tried to get reimbursed for COVID tests that I bought online, but they denied the claim, stating that I didn't provide the NDC (National Drug Code, although this was clearly included in my claim. I will follow up further, but I highly doubt they'll reimburse me, even though it's the law.
My son is T1D and we have to go through this company for some of his medications. We were charged for some of his prescriptions but never received them. The medication was sent back to them and they acknowledged that they had received them. They still will not take the charge off of our account. In their words “It is our policy to not reimburse for prescriptions.” They refuse to send his medications now until we pay the bill for something we never received. I’ve spoken with Tricare and Express Scripts Supervision. Still nothing. I’m active duty military and have no other healthcare options for my son. It’s a crying shame that companies like this exist.
They were supposed to make a decision on my case appealing their decision of not reimbursing me since I used an "out-of-network" pharmacy which happens to be the only pharmacy making the specific suppositories my specialist had prescribed me. After receiving my application, a lady called me and said that since she "was on a long hold with" the other pharmacy to verify the NDC number that she "could not see " in their system, she had to cancel my "internal" appeal. I had to call the other pharmacy and verify the number they were looking for and I obtained that number.
However, when I called Express Scripts pharmacy to give them the number they were looking for. I was told that I need to start the entire appeal application all over again. In other words, their "policy" is OKing to quit trying to reach third-party pharmacies and yet it is not OKing to accept the information they are looking for from patient (which they can attempt to get it anyway if they want to bother to re-attempt). Not to mention that they are recording your voice and there is no need to worry about you lying to them. I would never recommend this pharmacy to anyone unless you are stuck with it through your employer choice of pharmacy.
I received a call from Express Scripts this morning and during that call I was transferred to a pharmacist. The pharmacist told me he entered a note into my record of the reason I needed the brand name and another note that if a provider order the generic form, that the brand name would be substituted to ensure I receive brand name for that medication.
Updated on 07/09/2022: Yesterday I marked my review of Express Scripts as "resolved", based upon direct communication with a pharmacist and two ES system generated webmails thanking me and saying that it as was pleasure to serve me. So to recap, a brand name medication was orded by a doctor in Nov 2021 and shipped. A series of endless loops between May and July 1st led me to post an initial review about the incorrect and misleading communication between express scripts and myself. Basically I was informed at the start of a 3 day holiday weekend that I needed to contact my doctor.
Then after posting my review, I was contacted by an ES rep who supposedly resolved the issue yesterday. So now it's, today, a Friday, after hours when I get another call that the issue is not resolved. And I can do nothing about it until Monday! Another 3 day delay added to the three months this has been going on. Here's is what the ES rep told me tonight: Express Scripts can request a renewal and a reorder from a provider except when it concerns a brand name. Express Scripts can substitute a generic medication at will for a brand name that was ordered.
Although I was told by a pharmacist 2 days ago that a note was entered into the system to supply the brand name and although there is an existing order in the system for a very specific Brand Name, I find out on a Friday night that it still cannot be shipped. The call tonight informed me that ES can only ship a RX for a brand name if the RX contains the words "do not substitute generic".
To complicate matters, the orders go electronically from the doctor's office to ES so I have no first hand knowledge nor the ability to confirm what order was transmitted. I have no ability to know if the transmission included those specific words or even if there is a field on the transmission form to enter those words. Only ES knows how "the rules" and can monitor the compliance. I have dealt with many a pharmacy with a pharmacist who is more than willing to request a specific order of a provider. As a retired provider myself, I have had a pharmacist contact me to write a very specific order that they can then fill in accordance with policies.
I asked the ES representative who called me tonight is she could contact the provider to request the order that needed specific wording and was told no, ES is not permitted to do so. She went on to explain that Tricare changed a requirement back in Jan that prevented them from filling my existing brand name order without those specific words. That may be, however it is now July 8. Seven months have gone by since Jan 1st. Hours of multiple calls and webmails and messages and log ins over days, weeks and months.
There are too many pieces to the Tricare-ES communication system and there seems to be no one who is able to manage, coordinate and communicate the various pieces of this one order. This is the 4th time I have been told that if I did, "XYZ", that they could ship the medication and on 3 past occasions of me doing "XYZ" I was told it was resolved.
This company needs create policy to allow direct ES pharmacist-provider communication. There is absolutely no need for me, an elderly customer who uses a computer speech program, to speak to my provider and request him/his staff to place an order with very specific Tricare-ES criteria. I have no oversight as to the order being correctly transmitted. I have no way of knowing if the transmission was successful or not.
One solution may be to ask for a handwritten RX so that I can see that the words, "do not substitute generic" are written on the script and I can capture an image before taking it to my local pharmacist. After filling, I could then go online and request ES to transfer it. However, since a transfer is basically an request for an order and since I was told they cannot request an order that has the words, "do not substitute generic", this solution is also likely to fail. A second solution would be to ask for 2 handwritten scripts. One for my local pharmacist and one to mail into ES, (taking a photo before mailing). I am terrified of the future. I have lost my ability to swallow and talk. As I age further, I will lose more abilities. I am terrified of not being able to physically or cognitively be able to get the medication I need to breathe.
Original Review: Despite a call by me to Express Scripts on June 17 and reassurances by the ES representative that my non generic medication was corrected in the system and would be shipped automatically as ordered, that did not happen. Instead the generic was processed and ordered. It arrived on July 1, just prior to the start of a 3 day holiday weekend. I then used the ES site to compose a message in order to establish documentation. The ES message reply to me contains information directly in conflict with the phone call information I was given 3 weeks earlier. This is not the first time I have had to spend significant time resolving my prescription issues. ES has been placing access to mediation barriers more frequently as the years go by. I am elderly and it is no longer easy for me to deal with message documentation.
I need a company who will not only accept phone communication but will document those phone conversations and act upon the information they provided to me in the phone conversations promptly. I need a company whose system is able to accept and retain resolutions reached during phone conversations. The other issue is the Express Scripts screen display of my medications. After the doctors enter in a medication, I can see the name and confirm it is correct. However, at some point, the ES screen display at a future log while change and show a different medication. In the past, I have added the specific brand name to my cart, checked out and received an email of ES processing my order. Instead of receiving that I will receive a generic.
Last month, I saw a new generic medication has been received and was being processed for delivery. Six days later I received an email to log in. I did. The medication reverted from "being processed for delivery" to "we are contacting your doctor". Another week went by and I received an email to log in. This time the medication was removed altogether and I was advised to contact my doctor for a lower tier medication. Despite the fact that I had already tried lower tier medications and could not tolerate them.
I need a company that displays on the history of ordered medications on the screen. It is confusing to see a medication displayed one time and then disappear another time. It is confusing to see a medication being processed for delivery when in fact it cannot be because the system stumbles along for weeks until it can inform me that it is a higher tier medication. Finally, I need a company who will provide me promptly (3-5 business days) with the criteria they use in regards to approving a medication. Express Scripts will not do that. I am instead directed to write a letter to them to request their criteria. It has been 5 weeks since I requested their criteria over their messaging system and 3 weeks since I mailed the letter to them asking what criteria they use to approve a higher tiered medication. They I have received their reply.
I do not understand why approving criteria cannot be displayed on the screen when I am logged in. What is the purpose of having to request approving criteria in a letter? What is gained by me suffering for months with symptoms that cannot be controlled using lower tiered medications? Ironically, I log into the Express System before my doctor appointment, am satisfied by the screen display, keep my Appointment and inform my doctor what I saw in the system only to discover that a week or more after my appt when I again log in to check a status or respond to an email from ES to log in, that the screen is displaying something different and that I need to again contact my doctor!!
I need a company that offers prescription filling within 2-3 business days not weeks of delays. If such a company does exist, I would be most grateful to learn of their program costs. I am retired military and for the past 18 years have been forced to use Express Scripts due to congressional policy and military directives that prevent my promised lifetime access to free prescriptions being filled at the base medical facility. I am reaching my limits with Express Scripts and I cannot find a way to disengage from their services because it is linked in a unique way with Tricare For Life.
I have been trying to get a prescription to fight covid-19 symptoms transferred to my local CVS, and they cannot get it transferred unless the CVS pharmacist calls them directly. Also, they will not be able to deliver my med until 1-2 weeks; by that time, I'll be at a hospital or not have Covid-19 symptoms. I have been on the phone with their customer service and the CVS pharmacist with no resolution to my problem.
They don't accept prescription discount programs because they want people to go to generic instead of name brand. My drug doesn't have a generic. I'm just going to change pharmacies. Instead of them getting some money filling the script, they'll get no money. Also, they're part of the giant American scam of a medical system. Death panels already exist. They're just in private board rooms instead of public political debates.
I was a customer with Express Scripts within the last 5 years. I tried to log into my old account recently and was unable to get through. I clicked the help - and I ultimately ended up at a phone number. I tried to just register as a new member and ended up at a web page again directing me to the same customer help phone number. I called over a weekend and was told that #1 their web service was out for at least 24 hrs and #2 in order to get my insurance into the account that my benefits person at my job would have to call them! There are thousands of workers at my job. I can't believe a benefits person has to call for each worker.
I called again on a weekday and then I was left on hold for more than 30 min with horrible music playing. There simply is no customer service. I am requesting that my physician switch the prescription somewhere else. I am not going to use a service where there is no way to actually get in touch with a person and get issues resolved. It should be ZERO stars. Don't use Express Scripts - time for them to go out of business.
This company CANNOT get you your medications. I MUST have my medications or I will end up in the hospital/Die and they consistently FAIL to get me my meds on time. Their reps are nice, but the bottom line is these people will kill you.
I had a recent incident where the mailman put the drugs on my front porch and walked away without ringing the bell. I heard somebody on the porch but was in a meeting with my boss and a client. After approximately ten minutes, I opened the door and they were gone. I called Express Scripts about the issue and the agent that I spoke with was not helpful and did not offer any solutions to my issue. Since it was a 90 supply, they will not fill my prescription until after the 90 day window. I saw my doctor, who wrote a new prescription, but when I try to fill it, it is blocked until the 90 day window has passed. I have already gone through withdrawal from my medication and still cannot get relief that the prescription offers because Express Scripts blocks the prescription from being filled. Not sure why I continue to pay for their insurance since they seem to always have a way to not fulfill their obligations. HORRIBLE COMPANY!!!!
I was diagnosed with chronic hives and my doctor submitted authorization to Cigna for approval. I was approved for a year to receive the only medication that works for this condition which is Xolair. I was lucky that my dr had a sample for me to begin the treatment but because Express Scripts / Accredo Pharmacy could not figure out how to get this done, it was a nightmare for over a month. I spoke to them daily and was told not once but multiple times that my medication would be shipped within days only to receive a call, text or letter telling me that my claim had been declined.
Out of ultimate frustration (not the best for a person with chronic hives) I finally asked for a manager. It turned out that the company was applying the claim against my pharmacy benefits and not my medical. Mind you they received the same information that I did and not only that, they had set up 2 separate accounts for me as well which made the situation even worse. Because of their delay, the hives came back with a vengeance and I had to suffer horribly until the injection took effect. I have to use them for this purpose but the manner in which this company is run is shameful to their customers. I would not use them otherwise.
We’re sorry to see this and thank you for bringing this to our attention. Could you please email us at ExpressRxHelp@express-scripts.com with a good phone number to reach you and member ID? We’d like to reach out to discuss this further.
In fairness, I talked to a helpful gentleman named Adam at Express Scripts. If one is using Express Scripts, it is helpful to know that an email address, email@example.com, is available for customers who have trouble with their prescriptions. The failures in the past with Express Scripts mean I will always cautiously follow the renewals and mailing dates for my husband's medications. My loved one's life is precious. Having meds on hand to take daily is a matter of life and death. I think companies need to remember that there are actual people counting on accuracy and timeliness.
My husband takes many vital medications. Express Scripts frequently drops his automatic refills or the medication from his list. That results in my husband running out of medicines and us having to purchase meds on our own to fill the gap until Express Scripts starts the prescription again. Running out of medication can be life-threatening. As soon as I can choose another Medicare-approved pharmacy, I will.
I get a shot for Psoriasis and that shot cost several thousand per month. I have a assistance pay program that covers most of the cost, not sure how that works, anyhow I tell Express scripts/Accredo DO NOT SHIP THE SHOT if it is going to cost me several hundred dollars. Well in this case they shipped the shot and afterward they billed me $1961 for the shot. Had I known the shot was going to cost this much I would have NEVER had it shipped out. After shipping the shot they said my assistance program was maxed out. THIS IS THE WORST COMPANY EVER!!!
Express-scripts has got to be the worse pharmacy company ever.... I pay damn good money monthly and they will not pay for **.... This company should be banned or put out of business!!!! I pay in good faith each month damn good money but they never want t0 pay for any prescriptions and then wants pre-authorization for meds that I need and have taken for a while. Now all the sudden I keep getting denied.... Although when I talk t0 them on phone they tell me I'm approved.... I will not back down with my appeals and no one else should either!!!!
I would have given them 0 stars if it were an option. I have been trying to get my prescription filled for over 18 days. Every time I call Express Scripts I am given a different story. They have charged me( at one point 2x) but I still am without my medication!!! I spoke to a Supervisor named Claire who put the burden on me to resolve the issue and clearly was totally not helpful and very unsympathetic. The latest I was told… to wait until it is 30 days and then try again. If I had a choice I would NEVER EVER choose Express Scripts!!! They have given me such a runaround the details are too long to go into here but the bottomline is I am without my medication through no fault on my part and Express Scripts had done NOTHING to help.
If I could give zero stars I would. I placed an order last week and every day receive a call that my order did not go through. I call back and have been passed around to representative to representative and placed on hold totaling more than 4 hours in one week. They ask for name, address, DOB over and over then place you on hold. Not confident my order is coming. Horrible experience.
Express Scripts is by a longshot the worst pharmacy in the entire world. They do not fill prescriptions, but rather figure out excuses for not filling prescriptions. If you are enrolled in a Part D Medicare Plan with them, you will need to file multiple complaints with Medicare before they start doing anything. Even then you will continue to have problems with them. Their web-site is almost impossible to understand, and the physicians do not understand their formulary.
We understand you are frustrated & want to help. Please email ExpressRxHelp@express-scripts.com your member id, phone number, handle name, date of birth and how we can better assist. Thank you. ^SJ
I had bought medicines through Express Scripts (Accredo Pharmacy) and they are charging me without charging the Medicare coverage I have even after multiple follow up. They will force me to pay and said will not ship my anti-rejection medication without payment. Customer support is horrible and hung the phone when I asked about why Medicare coverage.
I have a bad experience with this company. The medications they send me have short expiration date, so it is not as effective as the one I used to get from a physical pharmacy. Now I have to trash my medication before the expiration date on it because it is not as effective. For my last order with them, they sent me a large ointment tube with short expiration date. I communicated the company twice explaining that I use this ointment as needed and I need a medication with later expiration date in order not to waste my money trashing the tube while it's hardly used. I received weird replies not related to my inquiry.
I called customer service, had to speak with 3 persons for a long period of time, explaining the issue to each one of them without any progress. Finally, I spoke to a manager/supervisor, who spoke with arrogance and did not care when I mentioned that I am not satisfied and will share my experience with other customers. Conclusion, no more Express Scripts. Will switch to another physical pharmacy to save my money and get better customer service.
Charged my credit card $3k+ without my consent. I reported it as a fraudulent charge. I received no bill from them and they did that. Extremely unwarranted and inappropriate. They have never ever charged me this much before In all the years I have been with them so I don’t know what motivated them to act out like this. My meds haven’t changed at all. This happened as soon as my husband got a new employer and we changed insurance companies. I didn’t request any refills, nor did I receive any, so I still don’t know why they slapped that charge on my credit card.
They had my card number on file because the previous month I paid for a balance of $120. Just because of that, they thought they could just go on a spree and charge me $3k+. I’ve reported the charge as fraudulent and it’s in the process of being removed by my bank. This should teach express scripts a lesson that you don’t charge people's card without their consent and you for sure don’t charge them without sending an invoice. I’m not paying $3k.
Possibly the worst company I've ever had to deal with. I should have known when they asked me how to spell Pfizer that I wasn't dealing with the brightest crayon in the box. They can't manage to do simple tasks in anything under an hour, and even then they usually get it wrong which requires another hour+ call. The last straw was when they took over $1500 out of my bank account for absolutely no reason. I'm not even being charged a dime for this medicine and the card I had to give them has a stated max charge of $500 on their own system. Now I have to wait 3-5 days to get that money back. Most people would be sent to prison for stealing that much money but I guess this is their business model.
I lost my insurance. So, they terminated my account. I attempted to get my prescriptions transferred. I was transferred to 4 people, all of whom said they were transferring me to MY representative. I was NEVER able to speak to MY representative. Each new person collected my information. None were able to resolve the transfer. When I get new insurance, I will NEVER send any prescriptions to be filled by them. The convenience of mail order is not worth the hassle of dealing with them for issues.
I have had to use Express Scripts for certain medications through Tricare and they are the worst pharmacy! I ordered my medications on April 16th and asked that they be sent on time and today is May 3rd and they have not been sent and won't be sent out until May 8th, which at that time I will be out of medications again. This is an ongoing problem with Express Scripts and so again, I cancelled my order and got a new prescription to Walgreens, which will cost me a considerable amount more, but I don't care.
Another problem with Express Scripts is that the generic medications they send out are the cheapest of the cheap! A certain medication did not work for me at all so again, I am now ordering that medication through a local pharmacy. I cringe every time I have to call them. There's always the same excuse "We only received a prescription for these 2 medications not the 3rd one." That's funny, the doctor's office said that all 3 were sent at the same time. If I didn't have to use Express Scripts (per Tricare) for this 1 medication then I wouldn't!
Express Scripts (ESI) has a terrible practice of contacting a physician to circumvent the "automatic refill" process. When a refill count is low, they will contact the physician's office to obtain a new order. Upon receiving this order, they automatically process and ship as quickly as possible. In this way, I've accumulated hundreds of unneeded pills, despite having automatic refill turned "off." There is no way to return the pills, no way to dispute. There is one department -- A customer service person who has no authority but to tell you the policy and that they have no authority. This company is scamming the insurance industry, in my opinion, and over-filling prescriptions. If this can happen to me, it can happen to others. And that's millions of dollars wasted on unused prescriptions.
After 6 calls to Express Scripts about a a medical renewal, they still have not provided the medication. They have provided all the usual excuses (we need to speak to you doctor, your doctor hasn't called, you need to provide additional information.) I have literally spent hours on the phone with them with no results. At one point, they even made a mistake, thought I was the doctor, and had me call in with information regarding another patient. What confidentiality? Ready to find another provider.
Employers do not use this company for your benefits. They will present a contract that looks good on paper for your employees and they do not disclose the ways they will deny claims, refuse medications and exhaust your employees trying to fight them. One employee has been fighting them for almost 9 months to be reimbursed for medication that is covered. The forms say to fax in the claim. We faxed in the claim. Express Scripts denied the claim because it was not mailed. We mailed the forms Certified Mail, Return Receipt - they claimed they never got them. They literally signed for them.
We mailed them again, they refused to reimburse because we didn't send the original receipts. The original receipts were sent in the first time. We tried uploading on the portal. Again denied. We tried to call and were placed on hold for hours - not once, not twice, but every time we called. We had since discovered other employees going through similar problems. Read their BBB reviews. Every office has a D rating. Read their online reviews. Don't take what they tell as truth. Run as fast as you can away from this company. Thankful that we are no longer doing business with them.
After four weeks of toil and work I was able to get someone to actually speak with me about the issue and once they reviewed the situation on the phone they called the provider to work through the denied benefit and get it processed again as accepted.
It was a lot of work that on the best note shows a breakdown or lack of investment in high velocity IT practices or process issues. A gap if you will. At worst it shows the possibility of budgeting getting in the way of a medically certified doctor assisting their patient. I doubt every ending is satisfactory in nature.
After years of trying every other medication possible, my Dr's (plural) recommended a medication that had no generic. So we tried it out of pocket prior to this and knew it worked. The other products have caused lots of discomfort, personal damage and inconvenience all the while not actually helping with the condition. I spent two and a half weeks getting bounced around pharmacies, running around to get forms filled out only to have CVS "lose" the paperwork. They seem to be partnered.
I transferred to another covered pharmacy network and they made sure the forms got filled out and sent in over the course an entire day. Finally I thought, results for what we pay them for. No. No, results. They auto denied the claim and explained alternatives do exist and that this medication was too expensive for them. Well, why am I forced to pay you then? What good are you. I spent years trying the alternatives all the while getting my quality of life kicked. Thank you for nothing.
I received a TEXT message from the collection agency stating I was sent to collections for a past due balance. I did not receive 1 phone call, or invoice from express scripts. AND I have ALWAYS HAD A CARD ON FILE! So their incompetent morons in customer service chose to not charge my card, yet sent me to collections. STAY AWAY FROM THIS COMPANY!
If you are considering this company as a healthcare benefit for your employees or have the option run fast. Even atheist will be screaming for GOD when dealing with this poorly run, bureaucratic nightmare of a prescription plan. In my 50 years I’ve not seen anything so bad. They accept no responsibility and would rather the customer stop dead than admit and fix their mistake. It worked until it didn’t. Short story version they mailed refill (supposedly) that never arrives and Uses 1 of my 3 refills to replace it instead of simply replacing the missing medication. Now I’m out of refills and have spent 3 days jumping thru hoops. Just Disgusting!!
I was prescribed a prior authorization medication by my dr over two weeks ago. Today was the first time a representative told me it couldn't be authorized. I've spoken to them many times over the last few weeks. So the pharmaceutical rep (today) suggested a few meds I should take... then the other med could be authorized. YOU COULD'VE TOLD ME THIS THREE WEEKS AGO. Two thumbs down. One star rating.
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