OptumRx (formerly Prescription Solutions)ConsumerAffairs Unaccredited Brand
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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I'm leaving a 1 star because I can't leave a negative star review. Everything from the website to the paperwork is designed to stop members from collecting on the benefits they paid for. Website currently will not correctly display last 9 months of claims for medications. Fails to display correctly for last years claims. Only displayed correctly upon custom year tab. Doesn't display any actual prescription information. Claims prescriptions that have full year of refills are expired after 5-7 months. No way to pull up images of actual prescriptions even though MD's office says RX is for 12 months.
Prior Authorization for ADHD, (Attention-deficit/hyperactivity disorder), made difficult for adults diagnosed, due to ridiculous question about being diagnosed earlier than 12yrs of age. Since I'm nearly 50 there was no ADHD diagnosis when I was 12. There has been nothing but difficulty and problems dealing with this company. No wonder our hospital system dropped them for Caremark. But OptumRX couldn't even handle the transfer of user prescription history correctly. They failed at that basic database transfer task. I'd love to be part of a class action suit against this company. They are worse than useless, they are actively working to defraud their customers.
They don't care about their customers. Found out wife is taking a generic med that has been recalled. Called Optum and confirmed they had sent her tainted meds. Asked why they did not reach out to the people they knew they had sent bad meds to, no answer. Asked if they were going to replace the tainted meds. Was told had 3 options, 1 destroy them, 2 continue taking them, 3 return them. Chose to return. Asked if they were going to send replacements or at least a small amount to tide until the return was processed. Was told they had a limited supply and could send me a small amount to tide over till I could get the full script amount, but could not overnight any nor could they say when they would ship.
Was told to go to Dr and get a new script for name brand and go to a local pharmacy. Did so, the name brand is out of stock in Little Rock, AR and the Dallas Fort Worth area. Called Optum back to see about getting a few days worth until could try and locate somewhere else. Now they say they can do nothing. Their suggestion is to continue taking tainted meds, unacceptable. I have contacted attorney to investigate both the mngr and Optum's total lack of professional ethics and actions. Won't use again as prefer my wife NOT take their tainted meds.
Don't use this company if you want to live! Issues I've had: 1. Lost prescriptions (six times -- different prescriptions -- various family members). 2. Lies about them sending out medications. 3. Sent wrong prescriptions -- three times! 4. Extremely defensive instead of solving problems. 5. Refused to dispense heart medication -- required getting a lawyer. 6. Every single month a different problem. That company needs a management audit. Their practices are one of the worst I have ever encountered. Ever.
We have had nothing but issues with this company. From unauthorized refills, to overcharges to not refilling Rx's as stated. Most recently we had to call 7 times to get our Rx refilled. The Dr's office sent the Rx 3 times. They claimed they didn't receive it. Each time my husband called he got a different story. Today he spoke with a supervisor. She stated, "Oh yes your Rx is here. We received it some time ago." At one point they sent a triple order totaling over $500. Do not give them auto Rx refills as they overcharged our account. Also, every time I get my Rx the pills are different shape, never really know if they are what was prescribed. Do not trust them. This is a horrible company, but had no choice d/t insurance. Wanted to give them a zero but couldn't. DO NOT USE OPTUMRX.
I switched my prescriptions (supposedly) about two weeks before I was going to need my order, having been told by the customer service rep. that it usually takes four days. When I had not received my prescription after seven business days I called to find out what was going on. It took the rep. some time to find me and when he did he said nothing was scheduled for delivery. I told him I was due to run out in a few days on one of the prescriptions and he said no problem, he would overnight them. After waiting another three days I called back... I was told by "Shelly" that they had not heard back from the Dr. having sent a request on the 11th. So what I should do is go ahead and order these meds from my previous provider. At this point she disconnected me so I could not take the survey. I'm just very disappointed.
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AVOID THIS COMPANY IF YOU WANT TO LIVE! They lied about a prior authorization for my transplanted kidney medication and REFUSED my medication because they said it was too expensive. One of their reps. asked me if I could take a vitamin instead! What nerve! I was forced to use this ** show of a company by the State of NJ and will probably die because of their cheap and reckless decision. Screw NJ and screw OPTUMRX!
This has got to be the worst plan I've ever chosen. It's confusing: the worst part of the confusion comes with how to find a prescription. The plan uses two names: Walgreens and Optum Rx. Nowhere on the insurance card does it mention that the longer-term, mail in prescriptions have to be filed through Optum Rx. It took me a long time to find this out. Optum's website is almost completely unusable, when it's even working. My wife was just diagnosed with asthma, and come to find out that NONE of the medications that she could be prescribed are covered by Optum/Walgreens.
What kind of insurance company is that? Charges for medications are somewhat arbitrary. Phone "help" is really useless, in some cases, possibly harmful. Example: when I was researching asthma inhalers, the person I was talking with told me that one inhaler was covered, she thought. I looked it up, and it turns out that the medication she mentioned was specifically for Chron's Disease. AARGH!!!! Another time, my doctor wanted me to take a certain medication with a 150mg dose twice a day. They denied that prescription, but did allow me a 300mg tablet with the instructions of taking it once a day. (I simply cut that one in half). The website is terrible, when it works. I can't wait to drop this plan.
I have been using OptumRx since 2013. I live in MI. I don't know if problems are regional or not. I have had very positive experiences with them, be it by phone, text or computer! They have called me if a fax for prescription refills sent to my dr office had not been responded to, and asked for my help. I have not been advised by the drs office that they had responded, just saying that they would put the prescription through. I have not had problems with orders being messed up in any way! In fact, I had to leave home for personal reasons several times. Each time when I asked for refills, using my tablet or laptop, I put a new address into the mailing address. I did receive my medications without problems at my temporary address. OptumRx has called me to see how things were going, and inform me of other benefits on their site that I might be interested in! I am really shocked all the complaints, I really don't understand it!
Most recent- I ordered a prescription refill online at OptumRx, they contacted my doctor for renewal, consent received 6/26/18, was billed and told order would arrive by 7/6. Contacted OptumRx by phone 7/6 when order did not arrive. Told order was never filled, they were sorry, they would expedite the medication to be delivered by 7/9. On 7/8 received e-mail order would arrive 7/12. Due to OptumRx incompetence, I am left without my medication for over a week. 3/12/18- I placed a prescription order with OptumRx, my copay was $40. My credit card was double billed $40 on 3/12. It took 6 weeks, more than 5 phone calls to OptumRx and United Healthcare, then letters to OptumRx, United, and Medicare Fraud Hotline to finally get the $40 charge off my OptumRx account. During this time, OptumRx placed a "restriction" on my account and would not fill ANY of my prescriptions until they figured out their error.
OPTUMRX rejects numerous prescriptions as well as the appeals based on technicalities that every doctor finds unreasonable. The doctors complete the appeals processes and OptumRx denies it again. I have taken to getting the prescriptions and filling them at our own expense as the only means of obtaining the needed medications. The drugs which have been rejected are not terribly expensive, thankfully, but the medical conditions are severe which require them. My husband is a 60 year type 1 diabetic amputee with numerous serious complications and OptumRx has made his treatment so much more difficult. If that is how they are saving money, by denying benefits never denied by prior drug plans, then someone should know it amounts to a scam.
My doctor sent prescriptions for both my husband and myself via fax to Optum RX. Of the four medications, only one was filled. When I spoke with a customer service representative about the situation, she informed me that the other medication for me would not be available until the end of August, if at all. I received no notice of that; I only learned it because I contacted them. (When were they going to tell me?) My husband's prescriptions were "not received." My doctor faxed them again and has a confirmation.
Now, the representative just told my doctor that they have no profile and/or information about my husband so they can't fill the scripts. Mind you, they have previously filled those same meds twice. If there is no such person in my account, how am I able to read all of his information when I log onto the account? The people on the phone are useless. The service they provide is useless. I, along with every retired NJ teacher, am subjected to this inefficient company. I am totally disgusted!
We had Express Scripts for years, until we were forced to OptumRx in Jan 2018, due to the State of NJ switching prescription companies (husband) a public worker, just as my prescription was up for renewal it was we were switched. I just assumed it would be as easy as Express Scripts. Well it wasn't!! They refused to give me my Brand medication ** that I have been taking for 17 years, for my epilepsy. So now I have a company telling me I have to go to generic or I pay $3,000 for 3 month supply (mail-order price). I have denied me 3x (even with my neurologist) filling out everything, they're telling my dr and myself that my dr should try me on generic, since I have never been on generic, basically they want me to be a guinea pig and "see" if it works? I get... "Oh it's FDA approved... Blah, blah..."
Trust me I begged, explained everything about why? Like if you have a seizure in the state of NJ could face possible 6 month suspension of license, etc. But you just get the clueless customer service reps that have no idea. Even my husband work it trying to step in and help, his work gave us "special rep" to deal with instead of me calling and getting someone each time. The lady has gotten me "2 emergency " 30 day refills because this has been going on since March and it's now July!! Yes!! That long!! I only have another week left!
But now!! The lady rep is telling me she can't do any more for me (get my more Meds) so waiting for my dr to fill out appeal, but then find out that there is a total of 3 appeals, how can this company play with people health. I have been a nervous wreck. Because they want to give up fighting and take the generic. I guess having breakthrough seizure is no big deal if I had a bad reaction to the generic. See photos posted. Not sure if everyone knows about the situation that is going on!! This isn't helping any of us now. But maybe Express Scripts will be back!!
This is the worst company that the State Michigan has every contacted with. Can't my medication that I have been on and need for the last 10 years and have refill left. Now all out the blue they need more information from my doctor like the doesn't have other things to do. WHAT A BIG JOKE THIS COMPANY IS? PLEASE STATE MICHIGAN GO BACK TO EXPRESS SCRIPTS OUT OF MICHIGAN!
For months now the OptumRx website does not work. This has been brought to the attention of OptumRx, but no ones does anything to fix the problem. Calling on the phone is just about useless. These people are idiots and could care less if you get your prescription medications. If it were not for my AARP United Health Care Plan I would switch to another mail order pharmacy.
Your OptumRx website log-in has been broken for months. You cannot complete an online log in. You have to make a phone call and talk to an operator. I am an retired computer professional. This is totally unacceptable from both an customer ratification standpoint (Very Poor). But also, it costs the co. a lot of money. Mr. CEO, You need to take charge of the Web Master and his manager and demand rapid changes and verification of the web site. Messages like "Oops, something went wrong, please try again later" are not acceptable. This is not a new problem, It has been going on for a long time. You need to address this NOW.
I was switched to this co. after an ins. change at work. Every time I receive my meds the same one is missing. Have called 3 times trying to fix this issue. They said it's fixed, the last batch came. In my stupidity I didn't check. So I finally open them before leaving on vacation. Guess what. They failed again. Monday 6/11/18 I call. They say no worries they will overnight them. I leave on the 20th no pills so I go without for 6days. I return on the 20th. Guess what no pills. I call again pissed off speak with customer lack of service rep and a manager. I am told they will phone in script to my pharmacy and call back to confirm ask for my phone number.
Guess what? No call. Waited 18 hours. Called back same steps 2 people assured that the pharmacy has filled script, I comment is the major requirement to work at OptumRx incompetency as that is all I have experienced. I own my own biz and if I ran it this way with no regard to service or customer service I would be out of business. I will be calling my insurance provider to ask for options on other providers. If the answer is no I will go to HR and mention that one of the next requirements for ins. providers be that this is not their mailorder Rx company. I am 57 yrs old and this is the worst customer service including DirecTV and cell companies I have ever experienced but judging by the other reviews I read nothing will change unless I change Rx company or ins. company. Sad state of affairs should be reported to AGs office and local BBB.
I would give 0 stars if at all possible. First, a few months ago I was told I could no longer use CVS that I had to go thru Walgreens or mail order. This was ok (although I prefer CVS). Last week I tried to get my prescription refilled and it was denied because my doctor wanted to have me make an appointment before he refilled the medication. This is fine and I called yesterday and set an appointment for 7/3 (my first availability) and my doctor called in a 60 day supply of my medication to Walgreens. Walgreens then tells me the insurance claim got denied because OptumRx wants me to order the pills via mail order, this happened this morning 6/20. I took my last pill today.
I call OptumRx and they say if Walgreens puts an order for a 30 day supply they will honor the claim. I call Walgreens back and they put the 30 day order in and OptumRx denies it. Walgreens then calls OptumRx and OptumRx tells Walgreens that I either need to place a mail order for the meds and request it get filled in store or opt out of the mail order service, mind you I never opted in to mail order service. They give me the number to call OptumRx. I call OptumRx again and they now have no record of me as a member. Eventually I get on the line with a supervisor who literally asked me if I could ask the pharmacist to “just give me a couple of pills to get me thru to my appointment?” This is exceptionally unprofessional in my opinion.
She then tells me they will not fill a prescription at Walgreens for less than a 90 day supply. They say my only option is to call the doctor back and ask him to give me more pills (which the doctor doesn’t want to do because I haven’t seen him in about a year, again this is understandable.) This is also a complete contradiction to my first conversation with OptumRx. I have now called my Doctor and spoke with his assistant and explained my situation. She is going to see if my Doctor will authorize the 90 day supply. This has taken up basically my entire morning and still isn’t resolved and if my Doctor won’t issue the 90 day supply I’m out of options and can’t get my medication because according to OptumRx “that’s not how our plan is written.”
Meanwhile, it’s my health that is in question. Also, there is zero chance I’m willing to do any mail order with OptumRx given that they have shown complete incompetence in resolving a simple prescription fill for me. This company doesn't care about patients' health or well being AT ALL! They are trying to push everyone to their mail order service. I would not use them at all but unfortunately they are the only people on my company's prescription drug plan. A terrible organization and I have already notified the benefits VP at my company (a fortune 200 organization) of my experience and have been told it's not uncommon. SHAME ON YOU OPTUMRX!
On May 1, 2018 my Doctor's office called in a new prescription. Five weeks later I called to find out when the medication would ship. The first customer service rep said it would ship today. Then I was transferred to their supervisor who said that it would take another 8 days to fulfill. Sarcastically I asked if they were shipping via Pony Express. The idiot said no they don't use Pony Express they use FedEx. Why 8 days - no response. Moving up the chain I spoke with the supervisor who contradicted their two subordinates and said the order was cancelled and would ship without going back to the doctor. Asked why the order was cancelled there was no explanation. Asked if I wanted to prepay for the order that was cancelled I replied that I had no intention of using this company ever again.
I would NEVER use them except they are the provider under our insurance. They constantly get the billing wrong and all you get is "I'm sorry, we will correct it". They take entirely too long to get you your medications. I had 2 refills remaining on one item and they cancelled the order because they said "prior authorization" was needed. They said they sent the info to the doctor but he didn't completely fill it out so they cancelled the script. They didn't get me involved before they cancelled the order. Why? I am the one who needed the medication. They send you emails saying your order of ** is being sent. I have asked them repeatedly to spell out the full name as I have medications with the same first 3 letters. How do I know which one is being sent? Do I spin a wheel, flip a coin or what? DO NOT USE THEM.
Over 6 months I have been trying to get my information set up. They are no better than United Health Care who they partner with in regards to getting payments set up and paid timely. They won't accept my bank statement because it comes from a Local Credit Union and their confirmation letters are not satisfactory to their guidelines. What else can I do, I have done everything as well as my credit union to conform to their unreasonable guidelines. This company is awful!
If I could give 0 stars I would. I am the caregiver for my Mother. You can look on our accounts on their website and see I have permission to have anything concerning her discussed with me. I get emails saying they need further information to fill prescriptions but when I call they can’t discuss it with me because I don’t have permission. It’s on the accounts plain as day. Has to be the dumbest bunch of people to ever hold a job. This place is horrible. Go somewhere else even if it costs a little more. This place isn’t worth all the time it takes to get something done.
Terrible customer service beginning with the robotic call-in line. The non-robots were equally poor, some of whom I could barely understand due to language dialects. Wading through the drugs prescriptions and who was responsible for contacting the physicians is a nightmare. It shouldn't be this difficult and isn't with other pharmacies. The prices are competitive and the only reason for one positive star, not sure it's worth it.
First off, my wife and I switched health insurers to UHC due to her employer. They recommended OptumRx as a way to save money and have 90 days worth of meds. First refill on our meds, the shlubs at Optum tried to "early order" the scripts with my doctor's office and were denied. After a reorder at the appropriate time, our meds arrived as expected. But this week some telemarketer type guy from Optum calls and wastes 15 minutes of my morning going over personal info, my medication dosages, and says he can save me money by looking at alternative drug companies. I told him that I didn't really see the point of the phone conversation, as all the info he needed verified was right in front of him on his screen.
He continues with his BS and I'm becoming more irate with him. He then tells me that I can go on the Optum website and opt out of these courtesy phone calls that they are required to make every 90 days. There is no such thing on their site. At the end of the call, he's going on about current prices and credit card info and never once said anything about looking up different prices. Bunch of idiots employed over there with no oversight or direction. Never once had this kind of deal with any other pharmacy companies.
My prescriptions were about to run out and I had not received them in the mail yet, so I called OptumRx to see what the deal was. The first conclusion that the customer service rep came to after looking at my file was that they were still waiting on an authorization, but when I asked a follow up question the rep. went back to check and noticed that they were actually NOT waiting on an authorization but that they were OUT OF STOCK for one of my prescriptions!! How does this happen? Thankfully my meds don't keep my heart going or promote any function of that nature. But, I hope to God that people who would die without their medications never experience this level of incompetence.
Without going into great detail I have had an issue filling my Rx every month for the past 6 months and it all comes back to "needing prior authorization" from my doctor. Last month I got prior authorization (which took 2 days and a 4 hour phone call each day) and was told that I was all set for 12 months. Okay, fair enough. This month I go to the pharmacy to fill my Rx and what do you know I'm told I need prior authorization. I cannot believe how a company like this could still be in business. As of today I have been hung up on, out on hold for hours and spoken down to by "customer service advocates" and I still cannot get my prescription. I feel like I'm in the twilight zone. Some government agency needs to step in.
Twice they have tried to ship scripts when I didn't need them and deducted the cost of $251.72 from our checking account. Since it took 4 phone calls and 10 days to get a refund the first time, I cancelled the contract with them entirely on April 13, 2018. To date they again deducted the $251.72 again and sent me an email that they were shipping the same medication to me, however the medication hasn't even been shipped yet. After another phone conversation today with them, I was told the agent I spoke with to cancel the account didn't process it correctly and that they would not refund my money until they received the script back. To my knowledge, it hasn't been shipped yet!!! PS: Because they have blocked my entry to my account, I can't even go in and cancel the banking information. My alternative... close our bank account and reopen with another number!!!
I have never been so upset with a company ever before! If I could give a -20 star review, I would. They don't even deserve 0 stars. I am required to use OptumRx through my work's insurance and I have never had any good experiences with OptumRx. When I have used Express Scripts in the past, they were awesome and I never had any bad experiences with them. The first time I tried to get asthma prescriptions through OptumRx, I received an automatic e-mail that my prescription was on the way and then 2 weeks later when I haven't received it I called them, so that I wouldn't run out of life-saving medications that allow me to be able to breathe. The automated phone system took hours, they didn't understand any words I said, and eventually I got to a live person who said that there was a hold on my account because their records state that I have other insurance (which I don't).
When I asked why they didn't tell me about this sooner, so that I wouldn't run out of my asthma medicine, they didn't know anything (which seems to be a recurring theme with Optum Rx, no one knows anything). I didn't get any notification that I wouldn't be receiving my medication or that there was a problem, in fact, I received a couple of e-mails saying that my medication was on its way. Their records stated that I was covered by Medicare, and I am not because I'm only 48, and when I told them that, they said they couldn't take my word for it and I had to call Medicare to verify that I didn't qualify for Medicare. So eventually I was able to convince them that I didn't have other coverage.
Then they sent me the wrong inhalers, while the automated e-mail said that my prescription was on their way. When I called to find out, they said they are required to have me try ** instead of **. I tried it, and it made my asthma worse instead of better. I had my asthma doctor call OptumRx to explain that we had to get the ** instead and after several more delays I eventually received the medication I need to be able to breathe. Then they wouldn't send me the ** inhaler, and even after the doctor called them to explain that I needed to get the **. They said they are required to send me ** first, even though I had received e-mail notifications that I was being sent **.
The ** ended up working well, so I've been on it for a few months and now when I tried to get a refill, they sent me a different inhaler without telling me. When I called them they said the ** was discontinued. ** is still on Teva's website, it seems that they changed the inhaler format. I was able to get a 1 month prescription filled directly through Walgreens, so I am OK for a month, but I don't know how long it will take to get OptumRx to get me something that will work. My doctor told Optum Rx that I needed **, and I received an automatic e-mail that it was getting refilled, even though when we spoke to Optum they said I was required to try either ** (which I have tried before and doesn't work for me) or ** and fail with those medicines before they can give me **. Every time we called OptumRx, we got a different answer.
The last time I called they said they were sending me **. Then I got a letter today saying that I am required to try either ** or **. Unfortunately, I don't have any records of trying and failing with ** because it was with a previous asthma doctor, who moved away. This whole process has taken so many hours and I still don't have a solution, and I am frustrated beyond words, that we keep getting different answers every time we call, and that they won't let me have the ** inhaler which is what they had required me to switch to in the first place.
Why in the world does OptumRx get to decide instead of medical doctors what prescriptions patients should be on? It must be whichever pharmaceutical wins the contract, but it's absolutely ridiculous to have a mail-order company have so much control over whether or not patients, who have gone through the painful trial and error process to determine which life-saving medication works best for them, actually get to use the medication their doctors and specialists prescribe for them. It's amazing that all of the reviews I've seen for them are completely negative. Is there a way to have OptumRx go out of business, so that millions of patients can actually receive the life-saving medication that their doctors prescribe for them?
Where to begin?! Mama bear came out roaring mad a bit ago. My husband is on heart meds. OptumRx has messed up major league twice now. They first almost let him run out of one med by keeping the med unavailable for refill over a week past the date on the label and he would run out well before an order would process and be sent.
I had them transfer meds back to local pharmacy, or so I thought. The past couple days, I’ve gotten a text from CVS that a med was ready for pickup. I go by there yesterday and they cannot find it. No record of it. I check with the doctor office. They’d called it to mail order but said they’d fix it. Get a text today from CVS. Called again. They found the script that had been transferred by Optum this time-in Bristol, RHODE ISLAND, which is nearly 800 miles from us in Bristol, TENNESSEE. Optum can’t even get the right state??!! Wow! This is absolute idiotic incompetence. I so wish I could give less than one star. They’ll never get our business again.
CHECK YOUR PRESCRIPTIONS! They filled a prescription with the wrong pill and I didn't notice for three months. I just assumed they had changed manufactures AGAIN! I take two maintenance prescriptions and I had just finished taking the last pill in the bottle for my blood pressure and when I opened the bottle I noticed it was different. So I opened the second prescription thinking that I had just grabbed the wrong bottle and it matched the pill that I had been taking for blood pressure.
I called the company and the pharmacist said they take pictures of every prescription... pills with bottle that goes out of the pharmacy. My blood pressure pill was suppose to be green, but I had been taking a blue and pink pill for 90 days. (FYI, the label on the side tells you what color and the markings that should be on the pill.) Funny thing... after researching it, they didn't have a picture of my prescriptions. Then they tried to accuse me of mixing my prescriptions and telling me I didn't know what color pill I had been taking. They tried to convince me that it was really a green pill I had been taking and not a blue... or light purple. I even had one pharmacist tell me that both of those pills were in the same vicinity not that he was admitting to the mistake but it could have happened.
Our insurance was due to expire at the end of April, so I sent a request to contact the doctor for a refill in order to have enough supply until the new insurance kicked in. Their website had some issues (every time) and I was unable to cancel the old doctors name, so I just added the new doctor. I thought they would be smart enough to realize they would need to contact the new doctor. They didn't and then they found an old number from when we had to use them in Texas and called that phone number (we have been living in Florida for over 2 1/2 yrs.) They shouldn't have even had that number. Needless to say after speaking to many people at OptumRX. They will not fill the prescription. Although I had submitted this request April 16th. That is not Customer Service only customer Disservice.
OptumRx (formerly Prescription Solutions) Company Information
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