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 Reviews and Complaints

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The absolute worst experience in medical ever. Been without needed meds for a month. Talked with at least 6 different reps. No internal coordination. One person promises delivery day and time frame then it doesn't come and the next call is "oh no that order or prescription is not approved." Colossal and total incompetence.

If this was life threatening I'd be dead. As it is my quality of life has declined as the fiddler's fiddle. Only the last person I talked to seemed to be able to put two and two together. It remains to be seen if they follow through on Monday. This online prescription concept is 100% fail.

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I have been receiving ** patches for several years now. In order to have Actavis brand, I have them filled at a local drug store. Last week I attempted to have them refilled, the prescription is not expired. However, OptumRX would not approve for them to be filled. All this week I have called the drug store, OptumRX and my doctor in order to have a prior authorization done. It was denied. I cannot take narcotics such as ** or anything of that nature. That is why I am prescribed the patches. I have had four back surgeries, after the third I caught MRSA and was in ICU at MUSC. It appears that if I do not get some relief from the pain, I will be going for a fifth surgery. The pain at times is unbearable and the patches do help.

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I ordered ** 300mg for heartburn, and they wanted to charge me $251 for a 90 day supply (60 tabs). I went to GoodRX.com, and found that I could get the same 90 tablets for $10. And I have been paying them for my Medicare Part D, which costs me $69 per month. What a rip-off! I will be changing my Medicare Part D next year, I now use United Healthcare, but I will definitely find another insurer in December!

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My group was changed over to this RX without our knowledge and we have had nothing but problems trying to get our RX filled. "This RX is NON FORMULARY and we are refusing to fill" is the usual reply that I get from the pharmacy for my own personal scripts. I have called them on multiple occasions and even had a verbal fight with one of their pharmacists. WTF?

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The level of frustration is beyond words. Unfortunately, my company switched from Cigna to United Health Care which uses OPTUMRX for the mail service. The amount of time and energy I have spent trying to fill prescriptions is astronomical. Never in my life have I had such incredibly incompetent people “try” to assist me with the most BASIC requests for filling an Rx. There is nothing special about ME or MY Rx’s that would require the level of effort I have gone through. I have been struggling with OPTUMRX for over 2 years now on a monthly basis, I thought CIGNA was bad… They were a dream compared to OPTUMRX.

Making an average of 5-6 calls PER RX is unacceptable. These are calls that I had to make TO OPTUMRX, this does not include the numerous emails, calls and voicemails I have left for my poor doctor’s office and staff. I read reviews a few years ago when my company switched over… And they scared me a bit but I really just thought, “It can’t be that bad”… Well, I’m here to tell you TWO YEARS later… They are THAT bad!

I am willing to pay more money for any of my Rx’s and I’m perfectly fine with the inconvenience of having to get an RX fill every 30 days… Over “saving money” and having my Rx mailed to me by this company who will randomly send me an RX in the mail that I have not ordered, or the wrong milligrams etc. Unbelievable that a company can survived TODAY in the United States of America with the kind of chaos they create.

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OptumRx was hired by the University of California for 2017. They systematically deny approval for medications that are expensive. This has affected both myself and my spouse, who is diabetic, who was denied medication prescribed by his doctor and taken by him in 2016 and which OptumRx then rejected. They insisted on an alternative that doctor did not prefer, and I suspect that they are getting a cut from drug companies. I, who has not had medical problems or any expensive medications, suddenly developed an eye problem in August. They rejected my doctor's medication as a non medical necessity because the drug was expensive, in my view. I won't go into the details, but after enlisting the support of our medical facilitator, who is wonderful, the medication was finally approved. These people are very unprofessional and their ethics are questionable. They should be put out of business.

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My insurance company wants me to use OptumRx or I wouldn't. They seem to make it as hard as possible to fill a prescription. Just when you think someone is really going to help, it is just to get you off the phone. I take over 10 prescriptions, so lots of headaches.

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I have never had so much difficulty getting prescriptions filled in my life!!! If you are one of the unfortunate souls being forced to deal with this company god help you!! Spent hours on the phone dealing with a screw up on their end!!! They filled 1 daughter’s script and made the insurance claim on my other daughter. This resulted in the other daughter not getting her medication because "it's already been filled". Was told after multiple calls ok we've got it taken care of only to get a letter saying it's NOT coming.

Have had trouble with scripts not being covered "Well have they tried this?" because of course our doctor doesn't know what's best. He's left prescribing whatever crap they tell him they'll cover. Make no mistake this company is run by a bunch of ** clowns who don't care if you die in the streets. Please if there is a god release me from dealing with this horrendous company. They should NOT be allowed to sell used cars let alone a lifesaving medication. I miss CVS.

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I am sick and tired of dealing with the incompetence of the customer service individuals at OptumRx. I have had to make 5 calls within the last 3 weeks for my mother, some lasting more than an hour after I escalated the calls to supervisors. Each and every time I have been assured the situation has been corrected, yet here I am 3 weeks and 5 calls later and my mother still does not have her prescriptions. OptumRx puts the blame on the doctor's offices "not responding to their request", however each of my mother 5 doctors have nothing civil to say about the service. In addition, since I was having such a problem I actually went to two of the doctor's offices and watched while they sent the scripts electronically to OptumRx. Still they state they have received nothing.

It is a shame that United Healthcare who provides supplemental insurance to retirees, insist on using a company with so little concern for the elderly. They did not even have the courtesy to send an email explaining why no prescriptions were sent. Due to their complete negligence my mother has had to have these prescription sent to the local CVS which results in larger co-payments for 30 days supplies. I have had enough - I am in the process of taking all the information I have gathered, including names, dates and even screen copies of the optumrx.com sites and filing a formal complaint with both the National Association of Boards of Pharmacy and the NYS Board of Pharmacy. If more people filed formal complaints maybe our elderly would have better opinions for their prescriptions.

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After calling a number of times after Hurricane Harvey, I was always on lengthy hold while each representative I spoke to said that there was no way to get me a prescription. I asked what their disaster recovery procedures were and received no response or no assistance. Eventually they informed me that they were shipping my order but then did not send it as UPS was on a shipping delay still for the area. Never informed. Their email says that they have disaster assistance where patients can go to a pharmacy but none of their customer service representatives knew or presented this as an alternative.

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I have had OptumRx since 2014. I got this insulin pump in 2015. On January 1, 2017, OptumRx stopped covering the test strips that go with my meter. My meter communicates through Bluetooth to my pump, so it calculates the dosage and tells my pump to deliver insulin. Thanks to UHC, I can't get another pump until next year. I am very close to running out of test strips (because OptumRx used to send ridiculous amounts of them and I stocked up), and my only choice is to go to a pharmacy and buy 100 of them for somewhere around $180, which I can ill afford, even with flexible spending (because I use that to pay for the infusion sets and insulin cartridges, which ARE covered!). I was told that I needed to have my doctor send a prior authorization form the first time I called. Doctor does that. Denied because they don't cover it.

Second time I called, I was told that I needed to file an appeal, which I haven't done, because stuff came up. Third time I called, I was told that I could file an appeal, but because it isn't a covered med it "probably won't go through". I don't think customer service knows a damn thing. And while they pretend they're looking up stuff or trying to find me an answer, I think what they're really doing is twiddling their thumbs. Patient care, ha.

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On advice from United Health Care we switched to this mail order pharmacy. After 10 days, we still had not received the prescriptions, one was a stroke preventing medicine that my Mom had been out of for 3 days and needed every day. I spent almost 2 hours trying to get an answer about this. I was transferred, talked down to, and hung up on. They finally told me to go back to our previous pharmacy to get the medicine. I repeatedly asked to speak to a manager, but was hung up on. Someone is going to die due to their incompetence. Do not use them!

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I am required to use this company with my health care - for my prescriptions. I thought I would try out the mail order, for convenience and because I would be leaving out of town for a couple of months. It's been the worst experience! I tried re-ordering my birth control pills (easy right). I click order, receive the order confirmation, and confirmation email. After 3 days I check the status - no order. I wait a couple of days, receive an email that my order can't be processed - I have to call customer service. I call customer service and the girl (after 30 minutes on the phone with me) couldn't figure out why the order couldn't be processed. She passed it to the pharmacy and told me to call the next day.

I call the next day and the guy tells me that this particular prescription is no longer carried, so I have to have my doctor call in for a covered drug. I have my doctor call in. I check the website and there is a new drug listed in my refill section - great I say - so I click the refill button. Order confirmed - confirmation email received. It was a few days, and check the website - no order found for the past 3 weeks. I click the order button - order confirmed - confirmation email received. Wait 3 days - check the website - no orders found. So I call customer service to see what is going on. I explain the story and the girls says my order is on the way - great! I should have it in 7 days.

7 days go by - no pills but I do get a notice in the mail that my order could not be processed! I call the company again - the girl looks at the order, says everything looks good - she puts the order thru (supposedly) says yup - you should have the order in 7 days - WE ARE NOW IN THE 6 WEEKS since we started this process. Well needless to say - 7 days has passed and no order.

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Three weeks now trying to get my prescription filled. My doctor prescribed a brand name medication. They won't fill. My doctor then prescribed generic. Message left of another denial. Reason stated this time is I need a prior authorization. My doctor is the prior authorization. Doctor emailed seven times. Still no approval. Three weeks now of being jerked around with excuse after excuse and lame reasons not to fill the prescription. I received constant telephone messages stating prescription was denied but couldn't give me a logical explanation. No reason except prior authorization needed. OptumRx is trying to frustrate the customer to the point of giving up. How unethical is that??? Withholding necessary medication authorized and prescribed to a patient by their doctor is illegal.

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I have a past due balance. However I need my day to day medication. I was going to pay for my current medication. They don't care about your health. I spoke with a manager and he no compassion or worry about my health.

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Optum claimed my doctor failed to respond to them, yet, my doctor has the proof on their computer of their responses. Becky, from doctor's office, called Optum and was given another address to send prescriptions, (not given on their RX card!) and the scripts were re-sent (for the second time). I received 2 letters saying Optum received the prescriptions and confirmed that my meds were on 'my plans list of covered drugs'. My member I.D. was listed on these letters. Received no meds. Called and was told 'due to my doctor's failure to respond, Optum cancelled my account'. Doctor has responded multiple times but Optum will not send my meds.

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My employer (State of Michigan) changed from Norvixus to OptumRx 1/1/17. I previously paid $60.00 for A ** supply with Norvixus. I was quoted a price of $180.00 for the same package at OptumRx. I was unable to fill the prescription.

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The worst company! I wasted hours of my life trying to get one of my husband's prescriptions refilled. I talked to numerous people and no one could give us an answer on why I couldn't get a refill and was very close to calling me a liar. This RX was a blood thinner that my husband has been in for years! I finally told them to forget it and went to Sams and it only cost $6.00. Well worth it!!!

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Awful, terrible, time-consuming, inept customer service. Tanesha blew me off and transferred me to "the pharmacy." However, there is no pharmacy to connect to. It was just another customer support rep. His name was Jerry ** and he was very helpful. He got my issue straightened out. Thanks Jerry **. The other two reps I spoke with were ignorant of procedures and unable to help. They were also curt and rude. United Health Care should dump OptumRX.

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I recently signed up with them and had my Doc put in 2 scripts for me, one for generic. Checking their website for drug pricing it wasn't bad for my meds. But when I got the bill I called them and ask why the generic is so high at $80.00 for 90 days. They stated it depends on the mfg. of that drug, blah, blah. While I'm talking to them I have their website up and I'm looking at this med and it's for $62.66. They don't see what I'm seeing. You got to be kidding me, it's your website and you don't see it, they blah, blah. Hung up!! So on an errand I stop at COSTCO pharmacy to check their prices. They don't give insurance prices but cash price. My generic price, CASH ONLY for 90 days would be $36.46, I repeat $36.46. Boy was I taken!! Anybody knows where to go to the top of UHC to complain??

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They keep sending me refills of prescriptions I don't want or need. I tried to cancel the auto refill and it worked for a bit, but yesterday they sent the medicine I asked to be halted because I already have 540 pills! They auto charge my HSA account. Site sucks, it took 10 minutes to get a live person on the phone and she had no clue how to deal with me. Waited 5 minutes on hold for a "manager" before handing up. Now off to dispute it with my HSA or request and new HSA card because as far as I am concerned they are one step removed from fraud.

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I have fought against genetically-based, severe mixed hyperlipidemia since I was diagnosed in my mid-twenties. I have submitted to so many tests and trials of medications that I have literally lost track of them. None of the medications, including several variations of the Statin family, have worked to get my LDL into a non-life-threatening range. All the diets and exercise programs got me muscularly fit, but did very little to address the lipid imbalance in my body. I have had two myocardial infarctions, one open heart surgery that resulted in four arterial bypasses, and three stent implantations. Yet, all of that appears to mean nothing to OptumRx. They have refused to cover the use of either of the two medications that were specifically developed to combat my exact situation.

I find it tragically ironic that I have watched and waited for decades for a medication that would help me fight my condition, only to discover that my insurance would not provide it. There is literally no justifiable explanation or excuse for the actions taken by OptumRx. The only reason must be that they are in the business of saving corporations money by denying employees their rightful benefits. I guess they see it as more cost effective to refuse the insured their rightful benefits and thereby reduce the surplus population.

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Incredibly dishonest company. They refused to fill my prescriptions correctly, sending a much smaller quantity than ordered. They double billed me for co-pays. I called many times. Every time they somehow had lost the approvals for my prescriptions. They never seemed to be able to reach my Doctor, although I have been in my Doctor's office when the Doctor's office contacted OptumRX and verified approval of the prescriptions. They say that they cannot approve this quantity per United Healthcare, however, United Healthcare says this is untrue. I have worked on getting refills for over six weeks, then last week being told they had all my information and would send out my prescriptions immediately, only to receive an email today saying that they need to fax my Doctor's office for more information. Don't do business with this company if you can avoid it.

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I am medically retired from a state job. My Rx insurance was changed to OptumRx as of Jan 2017. I have had nothing but problems with them since day one!! The first thing they did was tell me they won't cover ** twice a day, only once. They said I needed a "prior auth" from my doctor, which I did have the Dr send, but OptumRx denied it! I have severe GI issues and I need ** twice a day! Now I have to pay for one dose over the counter!

Here's my current issue: Once I meet my out of pocket medical expenses, I'm not supposed to have any co-pays on my Rx's!! I met this back in mid-June (it's now 8/2) and I am STILL trying to get it through their heads that I have met my out of pocket! Blue Cross has even verified it with them! I've been on the phone with them, Blue Cross has been on the phone with them, yet it is STILL not fixed! I keep getting told it's all set. Yesterday Blue Cross and OptumRx both told me I should be all set and to give it a few hours for OptumRx's computer to receive the info. That was YESTERDAY at 10:00 a.m.! STILL not fixed!!! I guess I'm going to have to call a lawyer, coz I'm at my wit's end!!

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CalPERS switched to OptumRx this January and I have had trouble every single time I try to refill my prescription. Not only is my co-pay 4 times as much as with CVS, but the customer service is horrible. They sent me generic when it is very important for me to have name brand. They refused to send me a new prescription because they had already sent generic (this is even after talking to my doctor). I had to call at least 3 times and have the same conversation 3 times and talk to 2 different pharmacists before anyone would do anything. My doctor is the one who had to send them 2 new prescriptions before they finally accepted it. Meanwhile, I had run out of brand name and had to be on generic (not the best for my condition) until it was sorted out.

Another time I called for a refill and paid to have it delivered in 2 days or I would run out. They said it was guaranteed but it did not arrive for 7 days. I had to get an override 5-day supply from Walgreens because of their error. Then I called today to set my refill in motion and they said they no longer have a prescription for me and I will have to get a new one from my doctor. My bottle says I have 3 refills left. They said that because I got the 5-day supply from Walgreens (3 months ago) that the whole prescription transferred over there and is no longer theirs (even though I received my late 90 day mail-order and have been using it for 3 months).

This company is utterly frustrating and I really dislike interacting with them. I definitely do not feel taken care of. Please CalPERS, they need to go!

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I have had multiple contacts with OptumRX for a wide variety of problems, with only ONE experience resolved satisfactorily. Even that customer service person admitted that she didn't have a written list of maintenance meds that could only be filled through mail order (and not at my Walgreens pharmacy). So patients are left to take her at her word.

Also, never once did OptumRX notify me that I would no longer be able to fill my 90 day maintenance medication at my Walgreens pharmacy, with six of my other maintenance meds that ARE filled there! I was on the phone almost two hours, with four different reps trying to escalate my issue before resolution. I have found that the majority of customer service reps are incompetent on a wide range of issues. They give multiple excuses in response to the problem/issue, without resolving it. They are by far the worst mail order pharmacy I have ever dealt with! I hope CalPERS does NOT renew OptumRX's contract for 2018!!

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The OptumRx website changed so that in order to refill your prescriptions, you must click the box for automatic refills. I believe this is in order to increase their profits by refilling prescriptions as quickly and often as possible. I used the option on their site to have them call you. The first call I received, I was hung up on while I was in the middle of explaining my issue. I tried again and this time I somehow ended up in their Medicare department. The rep said she would connect me to the correct department and then I heard an automated message saying I had reached Gateway Vacations. Press 1 if you have already scheduled your vacation...

I called the number on the back of my card and spoke to yet another person who apologized for what I explained happened. She said she would disenroll my prescriptions from the auto refill. I expressed my concerns about this being an issue the next time I tried to refill online. She asked if I would like to talk to the website tech department. I said yes, I would like to talk to someone. 30 seconds later I was hung up on. This shouldn't be this difficult.

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OptumRx had the wrong phone number for my doctor, therefore OptumRx initially denied my prescription. I gave the Appeals customer service person the correct phone number and also gave her my doctor's fax number. After 6 tries and speaking to 6 different people, over the course of nearly 2 hours, it worked. Subsequently, my request for a Tier change from a Tier 3 cost of $100 to a Tier 2 cost of $40 was denied because OptumRx still had the wrong phone number for my doctor so when they phoned no one took the call. In fact, when I tried the "wrong" phone number I got a loud buzz on the line. Again, I tried to correct the wrong number, but this time I was told they couldn't correct it. And that because my doctor's office did not take the call. My case was closed and I would have to pay the more expensive amount. Outrageous!

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My employer decided to switch to OptumRx 6 months ago. During that time, every single prescription has had an issue. Every. Single. One. They choose to fill the highest priced generic medication regardless of cheaper options. When the script is specific, like the actual Brand name is listed and it states DAW (dispense as written), then they decide to fill generic. If you need to move your prescription from a pharmacy to mail order, they don't transfer it, they fax the doctor for a new one and don't tell the doctor the script you need refilled, so he may write it a little different and they fill it... however they want to instead of how it's been filled before. Then when you call customer service, they argue with you and say it's your fault... If that happens, ask to speak to a pharmacist and they can help more than the phone rep.

They send vague emails saying "call us", then the rep has to fiddle with the system to find any info and they say "you didn't pay when you placed your order".

When you complete an online order, you can confirm the price visually, confirm you chose the 0$ shipping option. And yet they decide you needed it now, and charge for the expedited 1 day shipping. Without consent, without confirmation. The email you get will have 0 details of the order so there is no record for you to use to say you didn't want 1 day shipping. Make sure you screen print your order in case they try to charge 40$ for shipping you didn't want.

Also, the reps don't seem to speak English well, so that's super fun too. They will tell you that you'll get a survey on the phone after the call if you hold on the line, I never have gotten one. This company is awful and I hope my employer switches back to Express Scripts in 2018. They were slightly annoying but they didn't fill the medications wrong and they didn't charge for things you didn't order. Do yourself a favor and skip the mail order, only fill at a local pharmacy if you can. It's worth the extra few bucks for peace of mind.

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I receive paperwork in the mail informing me that my health insurance (employer insurance NOT Medicare) included the option of enrolling in OptumRx and the letter instructed me to call to notify them of whether or not I want to enroll. I called the number provided and the lady I spoke with explained how the program worked and what my prescription cost would be. I decided to take advantage of it. We went through the enrollment process. I only have one prescription and I told her I just got a 90 day refill on June 30. I did not need a refill at this time. She proceeded to set it up to be refilled now. I told her again that I did NOT need a refill yet. She informed me that I was enrolled and to call a few weeks before I needed my refill, provide my CC info and my prescription will be filled.

A few days later I received an email from Optumrx instructing me to call or go online and provide my CC information so they can complete my order and ship my prescription. I called Optumrx, spoke with a lady, and explained everything again. She apologized and informed me it was taken care of and my prescription would not be filled right now. Today I received yet ANOTHER email from Optumrx instructing me to call or go online and provide my CC information so they can complete my order and ship my prescription. I called Optumrx ONCE AGAIN, spoke to ANOTHER lady and explained that I did NOT need a refill right now. I told her when I enrolled I told that lady twice that I did NOT need a refill right now. I told her about already receiving an email about needing my CC information to process my order and that I already called to tell them again that I do NOT need a refill right now.

This lady explained to me that my order was never pulled. She apologized and said that the previous person lady I spoke with did not take care of it properly. She assured me my order had been pulled and was now on hold. She assured me that I would not be contacted about it anymore. Although all three ladies I spoke with were professional and pleasant in their tone, it was VERY aggravating that I had to tell them a total of 4 TIMES that I did NOT need a refill before they took care of it properly. This is my first experience using a prescription delivery service and my first impression of it is negative. Even though things have started off negatively, I believe in giving a company the chance to redeem themselves. If they are unable/unwilling to that I will cancel my enrollment and never recommend it to anyone.

Expert Review

Jonathan TroutConsumerAffairs Research Team

As a member of the ConsumerAffairs Research Team, Jonathan Trout believes having access to free, comprehensive information on products and businesses is vital to making smart purchasing decisions. He focuses his efforts on researching and reviewing multiple brands across a variety of industries, with the goal of writing unbiased buyers guides to help inform consumers on impending purchases.    More about Jonathan→

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