OptumRx (formerly Prescription Solutions)

OptumRx specializes in the delivery, clinical management and affordability of prescription medications and consumer health products. Our high-quality, integrated services deliver optimal member outcomes, superior savings and outstanding customer service. We are an Optum company - the world's largest provider of integrated health services.

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Consumer Complaints and Reviews

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Tried about a week ago to set things up on their website to start using this mail order pharmacy. Click on what I thought was just going to get my information in the system, not actually order meds at that point. I was wrong. I called and explained to the person I was talking to that I must have misunderstood and need to cancel the order because I didn't need those refills at the moment and didn't want to be charged for them. I stayed on the phone with him until he confirmed they were canceled. Next day I saw the charge for the meds to my checking account. I called OptumRX and the person said they have no record of me calling and policy is... Blah, blah, blah. I accepted that I would get the meds and have to pay for them but that I wanted to make sure this didn't happen again and that they would not send meds without my requesting them.

SUNDAY I logged in to check the status of the meds because I hadn't received them yet. Upon logging in I see an order for $1553.15 worth of **. YES!! $1553.15!! What the crap?!?! I called immediately and asked how in the world this order could have gotten in the system. I got a lot of incomplete sentences, "ahhh's, I don't see... looks like some kind of automatic order or maybe the doctor ordered it. The order was placed today" (SUNDAY). I did not get an answer for how this order was placed or who placed it. Of course I instructed the person to cancel the order, take my credit card off file, and opt me out of this service so that I can just use my local pharmacy. I stayed on the phone with them until they confirmed that was done.

The very next day I got a call from OptumRX. They put the pharmacist on the phone who proceeded to ask me if I needed the ** in vials or pins. I explained the whole situation to him. He apologized and said he would cancel the order. I was put back on the phone with the original person I was talking to during this phone call. I asked her to verify my credit card was taken out of the system and that I had been opted out. My card was out of the system but I had not been opted out. I asked her to opt me out, take me completely out of the system, and forget that I ever existed. I will never try to use them again. It's supposed to save money but trying to charge me $1553.15 for a bunch of ** definitely isn't saving anyone anything. WHAT A JOKE OF A COMPANY.

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In getting authorization, I spent 2.5 hours on the phone with this company, was given incorrect information, transferred multiple times, dropped from hold, and put back in the phone tree to start all over again 3 times. Finally insisted on speaking with a manager who was able to get me to the correct person. Next time, I am calling the insurance company of the patient and having a representative go through the process with or for me. Ridiculous, terrible customer service, poorly trained employees, horrible company. I would pressure your insurance companies not to use them.

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Two times I ordered my medicine and waited till they said it would be delivered. When I called the order was never placed so I fired them. It doesn't matter how good their prices are if they can't get your medicines to you. Now I am out of medicine and I have to find some other answer. DO NOT USE THIS COMPANY IF YOU NEED YOUR MEDICINES.

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I saw my doctor 2/28/17. Rxs faxed in. I was out of some of my meds. I called OptumRx today (3/15/17) as of today my Rxs had not been sent. This should be against the law. I suppose when someone lose their life something will be done about this. I'm on 12 med's, if I didn't need them I would not be taking them. I am very upset about this.

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Called doctor to send refill request to this company. The dr did submit prescription. After one week I did not receive any info on my request. I called this company and they said the dr would need to fill out pre-approval request. They never asked the dr for more info and they never contacted me. This med is for high blood pressure. So now I will be without my meds until this mess is corrected. The person at OptumRx said they could send me another med that was "like" the one I was prescribed. They are not doctors. They were very rude and not at all helpful.

I worked 30 years for the SOM. Never had a problem with MedImpact. This company does not care and does not acknowledge dr prescriptions without going through a lot of red tape that takes time. In the meantime my high blood pressure will soar due to their incompetence. How do we get rid of this company??? Before someone dies or has serious health complications because they don't want to issue dr prescribed medicine.

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Firstly, just try getting a price for your drug at their Web site. Good luck. You end up having to call them. The people answering are very nice, but you get a different answer with each person. They apparently love to force you to get prior authorization even if you've used the drug before. And their prior auth process takes a long time. And it's just stupid. I finally got prior auth for ** (conjugated estrogens plus progesterone), but they want $100 for 3 months.

At my previous mail-order pharmacy it was $40/3 mo, which was outrageous enough. (I'm required by my retirement plan to use a certain mail-order and local pharmacy; they changed it at the first of the year). So I asked my doc to Rx two generic pills (together, $20 for 3 months) that do the same thing, and according to research, the form of estrogen in the generic is not as risky as the form in **. So he sends in the Rx. THEY WANT ANOTHER PRIOR AUTHORIZATION!! It's the same stuff, folks, only safer! Pay attention! WTF??? Could it be that they just want me to pay them $100 instead of $20 (for the generic) so they can make more money? You think?

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My employer switched from an rx provider that provided me & my family with excellent service for the past five years, with zero problems, to Optum, with whom myself & my pharmacy have had two problems with during the first three months. The worst was that I apparently was informed there was a mandatory mail order service in which I needed to enroll, for my maintenance prescription to be covered. Evidently there's no option to continue actually visiting the local pharmacy with whom I have an excellent relationship. My pharmacist is one of my trusted healthcare providers & has always been able to answer any questions.

Also, I looked back through all the information (mostly Optum marketing materials) I received from my employer & Optum when I enrolled in the new program. Among the info on telephonic wellness coaching, info on Optum's "fun, interactive website that helps you focus on your health", & other ephemera I discovered no notification of Optum's mandatory mail order service. Since then, I've been trying to enroll and figure out exactly how this service works, & even that is hard, with myself & my pharmacist receiving conflicting information.

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United HealthSelect of Texas just moved to OptumRx. Apparently prior authorizations didn't get moved over. Medicine I've been taking for 5 or 6 years just got denied, creating a medical emergency. They claim I need to prove I need the medicine first. That's like asking a diabetic to stop taking insulin so they can get test results saying you need insulin. How dumb and how dangerous. This is a horrible group to work with. I've called several times.

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This is such a JOKE! I pay UnitedHealthcare a TON of money each month for benefits and then when I need medication they have some deal worked out that I am FORCED to go through this piece of crap pharmacy that can not even make phone calls out. SO, not only do I have to go through all this, and pay them out the bucket but I have to make all their calls for them because the UnitedHealthcare pharmacy program is a joke for specialized medications. Whoever the millionaire is that is lining their pockets with my money SHOULD GET ON THE DAMN PHONE AND MAKE THE CALLS THEMSELVES TO GET MY PRESCRIPTIONS. Unreal joke of a company.

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I recently was advised to get my diabetic testing supplies from these clowns. After my dr sent in the scripts 3 different times, I have the confirmations from my dr, they told me, after promising my order would be in by Feb. 20, 1017. Received my order on Feb. 27. My insulin was almost out, so I tried these guys again because my dr is a stickler on sending scripts (will not send to 2 different pharmacies for same meds, no matter). Placed order on 3-3-17 and needed it by Monday, 3-6-17, was assure it would be there. On 3-6-17, went online to check status. Processing and had wrong delivery address. Called and had it changed and stressed the importance of Tuesday delivery. Check status again, processing, called back and Chacobi said it would be there by Friday. Asked for supervisor, gone for the day. Most inept group ever.

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As with many others, I was forced to accept OptumRx for medications by my employer United Health Group. I have lost track of how many hours I have had to spend trying to get my medications as ordered by MY physician. Keep in mind, none of which are narcotic medications. For every single prescription and refill I have tried to order from Optum, I have had to make multiple phone calls to customer service, and have had to ask for a supervisor each and every time!!! As a Registered Nurse, I wonder what happens to elderly patients that are forced to depend on Optum for their life sustaining medications. I can just imagine some poor 85 year old patient passing out and dying at home while waiting for the cardiac or respiratory medications!!! This is one of the absolute worse companies that I HAVE EVER HAD THE MISFORTUNE TO DEAL WITH!!!

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OptumRx prior Authorization is way over the top, needs to be doctor orient. 15 year on the same drug can't seem to get OptumRX to approve in three months yet. It seem I am not the only state of Michigan retiree to have this new problem with this new provider. Based on what I have seen if we all come together we could file a class action lawsuit. This would be the best way to bring them under normal control for a pharmacy as they are not trying to provide medication but to prescribe not caring what the circumstances are or even seeing the patient. Most importantly they are not listening to the treating physician.

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These people will let you run out of meds, asking for pre-authorization, then they deny the preauthorization Like they're the Dr and delay it even longer, by asking the Dr why you aren't on the meds they think you should be on instead of what you were prescribed. Worst company I ever had the displeasure to associate with.

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February 27 & 28. Spoke to: Marjory, Tameka, Deja, Carmen and Carry. The 1st 3 useless kept insisting I signed for 2 packages call USPS. That's true that I signed. HOWEVER! Never got particular med I've been w/o for countless weeks. Heart med no less. Carmen made like she was trying to help talking the entire time to me and herself, couldn't get word in, then hung up when it came to register complaint because I said bad word. Spoke to Carry - wonderful. Took cursing words with humor, had me talk to pharmacist and put complaint in for me. The others would do well as garbage collectors. Poor disabled people get the worse "help" available. 3 months worth of meds for cost of 1 is great, but who needs the aggravation!!! Hope this helps others.

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I have experienced a lot of the same issues as the others here. 99.9% horrible experience. Website is horrible, app is horrible, communication is horrible, customer service is horrible. I have no other choice through my provider. Once I got someone on the phone who was knowledgeable and could help get the job done. Once. Plan to be on the phone for at least an hour each time you call, and good luck if they have to transfer you. The one good review I saw here was either an alignment of the stars (a dead clock is even right twice a day) or a fake review by an employee of OptumRX. If you have a choice, choose anything else.

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I was on 3 ** medications that I had no trouble filling last year. Starting 1/1/17 OptumRx stopped reimbursement on my prescriptions as I was told I was over the MME. OptumRx offered me a lower number of one of my prescriptions to meet the new MME threshold. I agreed to it and picked up the lower amount of pills. I thought problem solved - then the nightmare began. OptumRx continued to deny the other 2 **. OptumRx would tell me and the pharmacy that they needed a prior authorization even though my doctor had already submitted this. My doctor then said they were rejected and she had to file an Emergency Appeal as I am now forced to stop my ** medications cold turkey.

I called 4 days ago and filed my own grievance and was told by OptumRx that someone would get back to me in 72 hours. Well that time ran out last night and no call or text or email from OptumRx. OptumRx are liars and the people they have answering the phones are a bunch of ignorant parrots reading from the same script that OptumRx gives them without any ability to properly respond to patients. How many 1 star horror stories does OptumRx before something is done about them! Outrageous!

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I am a State of Michigan retiree who as well as many other of us, on January 1st, 2017, we were forced to switch to OptumRx prescription coverage. Today I went to refill my ** script and was told I couldn't get it because Optumrx was requiring a pre-authorization. I have had this script filled twice in 2017 with no problems, now all of a sudden I can't get. I went into the formulary and it does not state that this medication requires pre-authorization. I sent a complaint this evening to the company along with talking to two different reps (the last one was to transfer me to her supervisor and I was transferred to Charter Cable Company instead). I was ticked and I still am.

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My company switched to OptumRx this year, as a mandatory provider for prescriptions. The first order went relatively smooth, except that I had to contact my physician a number of times. After that, getting new orders has been a nightmare, and the website functionality is useless. I spent two hours on the phone trying to get it resolved. I am still waiting for my order, and because I'm diabetic, this will be a medical emergency soon. I don't know what to say to other users who might be having problems, except to keep trying and keep calling until they are forced to improve their product and service.

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OptumRx has lost my orders, blatantly lied to me about the status of orders, shipped orders of medicine I did not ask for and left me without my medications I have taken for a decade. I'm having withdrawal symptoms and horrible pain. They can't tell me where my order I need actually is and I've called no less than 15 times for pre-authorization for my pharmacy and my pharmacy and doctor's office still can't fill my 'emergency' prescription because of OptumRx giving us a run around. The random medication order I did not ask for was of a controlled substance which was inexplicably sent USPS and left in my mailbox without a signature or any notice of delivery... which seems irresponsible. This company is ruining my life... I am mortified that I'm now forced to deal with them through United Healthcare.

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I am a knowledgeable medical health professional. I have a terrible time dealing with this company. At no time have they given me correct information, filled prescriptions correctly, or answered questions correctly. However they do seem to be able to send out their invoices correctly. I have interacted with many mail order pharmacies and this is by far the worst.

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I had to make over 20 phone calls regarding my medications last year. Each phone call takes more than one hour. I now have over a year's supply of one medication and cannot get another due to the incompetence of this pharmacy. At one point, they completely stopped all automatic refills. Another time, they inadvertently changed my birth date which ended all medication shipments. The employees do not care if you get your medications and seem to have a goal of obstruction. If given a choice, I would never use this pharmacy.

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I am a new patient of Blue Cross with a medicine considered a specialty medicine. I was told I have to go through Briova. I have been trying to get medicine for six weeks. Absolutely nothing has been done and they continually blame my doctor for not sending in the prior authorization, which my doctor has done several times, including the last, in which a representative called for it while I was on the phone! No one in the company seems to know who to call to resolve the issue; no department seems to communicate with each other. I am now told I need to call Optum, which is connected, but no one at Optum has any answers as well. I suppose they know the patient can do nothing, there is no one to complain to so incompetence is irrelevant!

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Upon calling to refill my regular prescription for ** Capsules, 1 gram, I was informed that my out of pocket prescription cost would be $100 per the contract with MPSERS, Office of Retirement Services from MI. After a lengthy call with MPSERS, I discovered that my benefit plan did not change from 2016 to 2017! BUT, I did find the manufacturer "Par Pharmaceutical" has raised the price 400% and thus my co-pay would be over $112.00 for a 3 month refill, but since my MPSERS plan has a $100 maximum co-pay, I would only have to pay $100.00. Whereas when I last refilled in October, as with all previous quarters, I only paid $25.00. Thus the manufacturer is price gouging senior citizens.

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Do you like long waits on the phone? Do you like making several phone calls to resolve an issue? Do you truly enjoy POOR customer service? Then OptumRx is the company you are longing to do business with. If at all possible, (unlike my situation) and you are able to place your medication needs with Express Scripts, run, don't walk, and move your business. Due to a prescription my dermatologist wrote I have now made five phone calls into OptumRx trying to resolve the issue. On the second last phone call I thought the issue had been resolved. Then a few moments ago an email appeared stating the same concerns that the original email had expressed. I called Optum and a nice Customer Advocate answered the phone, listened to my concerns, and then told me her computer was updating and she could not help me. She suggested I call back and receive assistance from another Customer Advocate.

While speaking with the next Customer Advocate whose computer was working I finally asked for a supervisor. Big mistake on my part for a great many more minutes were used up on my cell phone. Once this nice young woman came on the line I was able to receive some helpful information but did not resolve the issue that had started five calls earlier. To cut to the chase, the services provided by Optum and not as good as the services I received from Express Scripts. When I called my insurance carrier I was informed I was not able to pull out of Optum and move back to Express Scripts because Optum is owned by my health insurance company. i.e. it is a monopoly!!! In conclusion I would just like to suggest again, if you have an option, you will love the service I once enjoyed if you send your business to Express Scripts!

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This morning at 9am I have an appointment with my neurologist who also is also my pain management specialist. I will mail out 3 prescriptions from him to OptumRx. All three are controlled substances. 2- c2's and the third is a c4. OptumRx is medicare part d's (Rx) mail in pharmacy. My neurologist also electronically sends my non controlled script during my appointment with him. The 1st time I contacted OptumRx to inquire about mailing my scripts in, they told me that my physician has to send in my scripts, initially, before I can mail any future scripts on my own. My physician told me: "they always tell new patients that, however, it's not true. Just mail your scripts to them and I assure you they'll dispense and mail them to you."

I mailed my scripts along with a brief letter in the envelope containing my contact, address, and UnitedHealthcare Rx & group # even though it's already in their system and typed on my scripts. The co-pays were $3.30 per script totaling $9.90 and free shipping from Irvine, CA to my home in Southwest FL. I received all three scripts including the non controlled meds that my neurologist sent via his computer within 5-7 days from the day I mailed the envelope from Southwest FL. 3 days after mailing out the envelope, I signed into the convenient OptumRx app on my android smartphone and saw that my order was in process.

The following day, OptumRx emailed me with a tracking # informing me that my order had already been shipped with an expected delivery date on the 5th of January. I actually received them a day earlier on the 4th. The following order, same 3 c2 scripts I mailed to OptumRx on the 19th of January. They were dispensed for $9.90 again and I received them all via USPS signature required on the 28th of January. OptumRx is a 1st class act with outstanding customer service and convenience far beyond any pharmacy I've previously used. I assume that those of you have encountered outrageous prices for your meds are likely not medicare part d beneficiaries. If you're a Blue Cross Blue Shield member, ask your physician to refer you to their mail in pharmacy instead of medicare's and that will likely resolve your problems with OptumRx. Hope this information has been helpful and goodluck in the future.

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OptumRx is terrible. Keep getting the runaround in getting a medication that the doctor has written. Never had this problem before. It's as if they are doubting the doctor. The medication is covered but it's as if they don't want to cover it. Horrible horrible company.

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My experience with this reprehensible company started a month ago. My husband has had a debilitating autoimmune disease for 15 years and has been on the same medication for that time. The prices for these meds has risen exponentially in the last couple of years so I called optimize to see if I could get a better price. I was told several times that it would be 8.00 instead of the hundreds we had been paying. I've been lied to every single time I've called these people. They've told me it was in the mail, had been expedited, that it hadn't been filled, that it was denied, that it was on its way, that I would receive it in two days. I don't know how they stay in business - they should be shut down. It's now been a month since my husband has had his meds. It's unconscionable, unethical, and disgusting that he has to suffer so much. I wish I knew a way to have them investigated. DON'T do business with this company!

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Because of my wife's employer we have had to endure this horrible company for the last three years. The vast majority of the time they are very slow in shipping coming up with a myriad of excuses why. At other times you will get a year's worth of 90 day refills in a matter of six weeks. This allows them to get a new prescription order from your physician and refill all of those as quickly as possible.

At the present time I am having a big problem with them changing my formulary on a weekly basis. After contacting me with yet another cryptic email I spent an hour and a half last week with a representative going over my meds as Optum won't allow you to see your formulary online even though the link for formulary is there. I get another email this morning saying I needed to call them. This time it was for another one of my respiratory meds even though I was told last week it was on the formulary. You will find out that with these people they will lie to you in a heartbeat to get you off the phone. They tell me that there is a appeals process but that it take several weeks to complete. Am I suppose to stop breathing for several weeks?

And then there's the shipping. They will send a notice that they have shipped your meds, but they haven't ACTUALLY shipped them. It can take more than a week before the carrier gets the package if they get it at all. I have had times when I get a tracking number but two weeks later the carrier says that THEY never got the actual package. Of course Optum says they shipped it! I can tell you from my own personal experience that OptumRX could care less whether you actually get your meds as long as they can collect from the insurance company. As far as they are concerned you are just a nuisance.

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My better half is in the process of changing getting her medication from this poor excuse for a caring pharmacy. She has been out of one of her medications for 2 weeks now. There have been numerous phone calls made to both the pharmacy and her MD trying to get this prescription released for shipment. First, the representative indicated that the prescription was received, but there was no response from the MD for additional information. After contacting the MD and verification that the info was sent, the pharmacy was contacted again. (The next day). The pharmacy again indicated that the information received was not what was needed. The pharmacy was asked exactly what was needed, along with how to expedite transfer of the information the best way. A FAX number for the physician review was obtained, but we were told the pharmacy could not tell us what information was needed.

We asked to speak to the pharmacist, and after about a 20 minute conversation, we were given the information of what was needed, along with another number for the physician review. The pharmacist stated that that was all the information that was needed, and the medication would be shipped "priority" so it would be received more quickly. Checking with the MD's office, we were assured that the information was sent. Not having received the prescription in this morning, OptumRx was called again.

After checking their records, we were given a tracking number. We kept the pharmacy on the phone while checking the tracking number. That number was for a completely different prescription. When pressured to check the status of the prescription in question, we were advised that the prescription was no longer valid for the medication ordered. The receipt of the additional information was acknowledged, but we were told they got it too late. However, the confirmation of the fax showed it went out the day we talked to the pharmacist. So how does all of this happen?

Experience with this pharmacy shows that new, or changed prescriptions require all new documentation. That is understandable in some cases, and would not have been an issue, if the pharmacy had taken care of what they needed to in a timely manner. However, their insistence that everyone else wasn't following through, as well as their reluctance to tell the patient what was needed to provide the medication speaks volumes. Just a side note, we specified which medication we were inquiring about at the beginning of each conversation, but each time, the OptumRx employee had to be corrected as they kept referencing the wrong medication. As I am writing this, my better half is making calls to other pharmacies to facilitate changing pharmacies. Two weeks without medication, with no effort to resolve the issue, is poor customer service, as well as neglect. This is not the first issue with this pharmacy, but will be the last.

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I thought Caremark was bad, but CALPERS switched us to OptumRx on 1/1/17. My wife is a diabetic and was prescribed ** insulin by her doctor. OptumRx has refused to allow that medication, even though it took her numbers down and she'd already been taking the medication with prior approval. What's sad is that they'll approve the medication for me under Medicare, but my co-pay goes from $20.00 to $50.00 for a 30-day supply. It took five days of telephone calls to OptumRx and the doctor to be told no twice by Optum.

When I asked them what they'd do if my wife ended up in a diabetic coma for lack of the proper medication, they wouldn't answer, but did say I could pay full price for the insulin. The cost, through Walgreen's is $641.00 a month and, as a retiree, I don't have that kind of money. OptumRx is the worst prescription plan I've ever had, including the military, Kaiser and Caremark and CalPERS doesn't seem to care if their members and retirees get proper medication. Hopefully, when my wife's Medicare becomes active in July and we enroll in TriCare, all of her medications will be covered.

Expert Review

ConsumerAffairs Research Team

The ConsumerAffairs Research Team believes everyone deserves to make smart decisions. We aim to provide readers with the most up-to-date information available about today's consumer products and services.

OptumRx is a healthcare management company that offers pharmacy benefit management solutions to organizations across the healthcare industry. Their pharmacy solutions include home delivery services, member engagement, pharmacy management and specialty pharmacy management.

  • Member engagement: OptumRx focuses on educating its members through personalized tools and 24/7 support. Their mobile application lets members refill or renew home delivery prescriptions, locate a pharmacy and find generic drug prices and discounted prices. OptumRx also gives its members the option to receive text messages to remind them when to take their medications.
  • OptumRx home delivery: The OptumRx home delivery service includes free standard delivery to United States addresses and territories. New prescriptions will arrive within 10 business days, while refills will arrive within seven business days. Members can create accounts with OptumRx, select their medications and place orders. OptumRx will contact primary care doctors and licensed medical professionals for approval as needed.
  • Pharmacy benefit management: OptumRx pharmacy benefit management solutions focus on optimizing its members’ health through monitoring and engagement. It teaches members about safe medication use and cost-effective treatment options.
  • Specialty pharmacy management: OptumRx helps specialty pharmacies by identifying trends in specialty care and creating clinical programs to help alleviate costs. Their website includes resources on specialty conditions, one-on-one video consultations with pharmacists and information on how to increase adherence to specialty drugs.
  • Accreditation: OptumRx holds multiple accreditations with URAC, including one for specialty pharmacy services, pharmacy benefit management and drug therapy management. They are also accredited by VIPPS and the NABP.
  • Best for organizations needing pharmacy benefit management solutions.

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OptumRx (formerly Prescription Solutions) Company Profile

Company Name:
OptumRx
Website:
https://www.optumrx.com/RxSolWeb/mvc/home.do