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.
United Healthcare now switched us to OptumRx. Has covered my ** for nerve damage from diabetes for over 8 years but this year won't approve the prior authorization and because of their nonsense my doctor is scared to write my prescriptions. So now the legitimate pain patients are being kicked to the streets to fend for themselves. Is it any wonder people commit suicide, get arrested for ** or illegal prescription drugs or die from overdose. This is just awful. Sorry I had to get that off my chest.
Oh some other notes on OptumRX. Theft is excused as mistakes so make one time payments only. Don't leave a credit card on file. Told 50 different stories about above incident, so many incompetence. Finally 8 days after I should have gone into withdrawal I just paid cash with no insurance. Good thing I didn't trust them to keep my medicine timely. I ordered another medicine beginning of December when it would have cost me $14 and was told, "Sorry didn't go through." Now it is $800 until I meet my deductible. They are the worst and unlike other reviews I can't say Express Scripts was any better. Just my opinion.
BEWARE - BEWARE - BEWARE. This company is a parent's worst nightmare to deal with. After over 3 years of taking a medicine for my son's ADHD they have now completely refused to cover it and after many calls from both myself and our doctor, an ORTHOPEDIST has decided that my son no longer needs his current medicine and he has to now take a generic substitute of a completely different class (** versus **)...for a child to go through such a thing and have to deal with the horrific side effects and possible suicidal tendencies that could accompany this change, I can only pray that my son does not suffer too long with this forced change. The company was completely unreasonable, could offer no explanation for the decision and the decision was made by a doctor that was neither a psychiatrist or a psychologist, but an ORTHOPEDIST! BEWARE - BEWARE - BEWARE.
Company fails to send out orders when promised and consumer is billed for price changes in interim. In the matter that finally led to me dismissing Optum RX as a supplier, they (deceptively) agreed over the phone to charge me what they should have had they sent the meds on time. They then went ahead and charged me what they wanted anyway. Moral of the story: Don't use this dishonest company.
My husband retired end of December 2017. Got the medicare insurance and supplement. Tried to get his diabetic supplies from OptumRx. It has been an ongoing battle, 1st tried to sign up on website, that didn't work, so called in. That didn't work, so called our Doctor's office and they sent RXs to OptumRx. We got a refusal because the company said he has other insurance. I faxed the proof he does not and it still was not accepted. I called them and they said it would take at least 5 days to process. On all the phone calls, at the end I can give a review of performance from phone help and every time the phone hangs up so can't do it. In meantime--- it's too bad mister, no diabetic meds.
I recently called to get a refill of my medication. After finding out that my medication was going to cost me 4 times the amount I paid last month and the previous 8 months, I had to check and make sure they had the right insurance info. Just asking insurance verification with the customer service rep was such a headache. I talked to 2 different people who seemed so confused! I then decided I had to call my insurance to verify my copay. Prior to hanging up, I told the rep that I was gonna call my insurance and call back.
OptumRx has my credit card on file from previous refills. Before I could call my insurance OptumRx went ahead and charged my card for the meds 4 times the previous charge and shipped the meds!... I called them right away to ask why my card was charged without my authorization? The rep told me to, "Just call and ship back the medication. When I get it the money will be refunded". I told her I wanted to speak with a supervisor and asked if a supervisor would call me. She told me if I need to speak with a supervisor I needed to call back and speak to one for a supervisor could not call me. I am waiting to receive the meds so I can ship it back. How unprofessional and what an inconvenience! I am done getting my prescriptions with them! I will be sure to warn my family and friends about them!
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This place has really messed up my prescriptions. I have 2 that have 1 refill, 1 that has 4 refills and the last one with 0. I now have to go to the doctor to refill the one. Each one started out with 6 months worth. I went to the website which had none of them and can’t find a phone number anywhere. Ridiculous. I’m not going to use them anymore.
OptumRx has become a major problem. They do not recognize my ID or password on their website, thus I can't order my much needed medications. I need the meds. There should be a public notice sent out by someone that alerts people of this. Like airbags and other safety issues, people need to know that when they need their medications, OptumRx is not operating. This is a dangerous situation that needs attention!
New Jersey State employees have had their insurance switched to OptumRx and Briova effective 1/1/18. What an absolute nightmare. When you call you will sit on hold forever. However, if you agree to take their "survey" you will be immediately connected to a customer service rep. The rep will be pleasant and you will think they are helping you. They will convince you they will solve your problem, even call you back with an update, but all they are doing is lying to you so you don't give them a bad survey result.
10 days into this change and still no prescriptions. I have to deal with Briova, Optum's specialty pharmacy for a specific med. They have lied through their teeth and just keep rejecting the prescription and THE AUTHORIZATION! They have given the excuse that it was written incorrectly even though the doctor has sent it properly 3 times. The doctor sent me a picture of all that was submitted to Briova and those pics clearly prove that Briova flat out lied about why the claim is being denied.
I was told my claim would go to the "escalation department". I have the names and even a voicemail from someone claiming to be from that department, but when I called again last evening and spoke with a "manager", she claimed they have no one by those names in that department. More lies. I spent an hour on the phone with the "manager". After I told her I have the pics of the paperwork sent to them and there are NO ERRORS she went on to change the story to, "someone entered it incorrectly". Yeah sure. I also received a letter that was dated prior to this insurance being effective regarding this medicine that said to talk to the doctor about taking an alternative. There IS NO ALTERNATIVE. They would rather you just take an aspirin and go away than have to fill the actual prescription. After 53 minutes and 56 seconds, the "manager" said she finally resolved the "issue" and will give me back to the rep to set up delivery.
The rep set up a delivery for today, 1/10/18 and then went on to tell me that I MUST talk to a pharmacist about this medication in order to keep receiving it. I sat on hold another 10 minutes only to have the rep come back and tell me the pharmacist is too busy to talk to me. She said, "I will have them call you tomorrow morning". Well that time is here and, of course, no call as of 10am. Given their track record of lying and denying, I'm sure I will not get a call nor any medication.
I am about to call Briova now as I never got any email confirmation that the order shipped. Stand by... Well surprise, surprise. It was sent and is out for delivery. It only took 10 days of repeated calls, lies and complaining. I sit now on hold waiting again to speak to the pharmacist so I can continue to receive the medication. Another shocker... I actually spoke to the pharmacist. I will update when I try to get a refill next month. REMEMBER... DON'T SIT ON HOLD, AGREE TO TAKE THE SURVEY AND YOU GET CONNECTED IMMEDIATELY. So sorry they changed my insurance. Never had any problems with the previous company.
I never write these type of reviews. I have not had one single positive experience with this company. They can't find me, tell me my account is inactive, take months to contact my doctor. They are worse than Caremark.
I was on the phone for an hour, spoke with 5 different people, different departments and not one could answer my question. I also needed OptumRx legal dept contact and was told they do not have a legal dept. Really, a Pharmaceutical Co in the USA has no legal dept? Like I said, not one person there knows anything.
Worse ever company to do business with! I have to send prescription refills registered because they "didn't receive it". Then they delay the medication because they "need more information from the doctor", but never contacted the doctor, but send emails stating the medication is "on the way". How convenient that this happens 7 days after the new year starts and the medication is now $761 for 3 months!!
After switched to a different program within the United Health Care, I cannot login to the OptumRX web site. The worst part is: I called them at least 10 times during last 3 months. Every time, every call is a fresh call as if they don't know the issue. Every time, they told me to wait for 7 business day. Week after week, it is still not working. And they don't care, because it's IT department's business!
I use to have Express Scripts and never had a problem with my refills, my insurance got switched to OptumRx and now my prescriptions can't get refilled without prior authorization and I run out of my meds because the insurance company takes days to get authorization. I have been on the meds for over 2 yrs and they are still giving me problems to refill.
Worst customer service I have ever had to deal with. When you have a problem and you call their customer service they yes you to death and do absolutely nothing right. I called a prescription in on December 4th and didn't get a response until January third and then had to pay my deductible because it was the beginning of the year. When I called customer service and explain that to them all they could say was, "Sorry but you still have to pay that deductible even though you called it in on December 4th in 2017."
My daughter has a chronic condition, and United Health Care requires that we get her specialty medication through Briova. When she is late getting this medication, she ends up in the hospital, missing school, family activities and life. Briova has made sure twice in the last year that she's gone to the hospital, rather than take the medication that would 100% keep her out of the hospital. I call what they do intentional incompetence. They feign incompetence to avoid shipping medications.
Every month, we have to order her medication, and every month we spend days and days on the phone arguing about what the copay is on our plan for this medication. They frequently "lose" the prior authorization, or require a new prescription from her doctor. And even after days on the phone, they like to play an end-of-the week game, meaning they say they'll ship on Friday (meaning daughter waits yet another two late days to get her medication), but then when we call at the end of the day on Friday, they tell us we didn't, "Call back to authorize them to ship the medication." It's not just this one medication for this one daughter. They've done the same to my other daughter with a different medication.
This morning, my wife has already made the first three of what will be many calls to Briova (Optum's specialty pharmacy), and has been quoted a different co-pay for the same medication each time. Ultimately, we usually have to get United Health Care on a conference call with them. Even with our insurer on the line, telling them the medication is covered and what copay they should charge, they will inevitably fight and argue with the insurer while we listen in on the line for at least an hour, before they give in. Then, they'll find another way/reason to delay the order.
Their other game is to claim you owe a huge balance, and just simply ask what kind of credit card you'd like to put it on. Last month, they claimed we had a balance of $5000, and they wouldn't ship the medication until we paid it. UnitedHealthcare confirmed that we were well past our maximum out of pocket for the year, and should be charged $0 for the medication. That took 4 days on the phone, at least 8 hours of phone time between my wife and myself. Someone with money might just pay the $5000. I'm sure they are banking on that.
I don't want to completely blame feigned incompetence, though. Let me be clear, many, many of the Briova customer service representatives you will get on the phone really are genuinely incredibly incompetent to answer a phone call, let alone to answer a prescription question. I believe United Health Care/Optum/Briova does that by design. The system is designed to make the patient give up and give in, to go without their medication or healthcare because they simply make getting the care too much of a hassle. My advice to others, use your state insurance commissioner's services to make sure that you get what your plan covers. Don't let UnitedHealthcare use Briova's feigned incompetence to deny you care, or to put your children in the hospital. That's what I intend to do from now on.
WARNING!! This is the worst company of any type I have ever encountered. Managers are complete greedy and biased idiots. Systems are always down. Reps are always new because it is such a terrible place to work so they don't know anything and always make mistakes. OptumRx is so cheap that they don't hire enough people to keep up with the calls. Do not use OptumRx to get your meds under any circumstances or you will be sorry.
I am a patient with a chronic condition and in the 12 years that I have been under treatment I had never experienced such bad customer service. I have to get one of my chemotherapy medications through them. I have found it difficult to get a representative that knows what they're doing. Recently they denied me the medication that I need to take in order to survive because I have a balance of $2800.00. I spoke to one of the reps before who told me that my balance would be $0.00. My infusions representative also spoke to a person and was told the same , that I owed nothing. I am out of medication and they refuse to provide it for me. Just a really bad company who doesn't really care about the wellness of its patients.
I have never experienced a more inept, incompetent, incredibly irritating outfit than OptumRx. There is not ONE thing I can say positive for them. For example, though I am signed up for automatic refills, I ALWAYS must contact the company and jump through 20 hoops before they release the prescription. They also send email alerts that don't say what the alert is about. And their website rarely works. Hence, a phone call is required, which almost never goes through.
Today, for the last 45 minutes, I have been trying to talk to someone at OptumRx. Repeatedly, after very long waits, an assistant picks up the phone only to then disconnect it. At one point while going through Optum's myriad menus, I got a recording saying I had won a cruise to the Bahamas! This is outrageous. This company cannot be taken seriously. I had Prime Therapeutics for over ten years with zero problems. I've had OptumRx for two years now and have had it with their totally unprofessional bush-league operation. They should lose their business license. I am now going to contact my insurance and see if there is ANY alternative. STAY AWAY FROM THIS COMPANY!!!
Add me to the list of people with bad experiences. They think an apology is enough, so they just keep on making United Healthcare's patients (and AARP's members) miserable. If they can't fix their computer problems, please replace them, AARP! Here was my message to them and their response: Me: "Your call back status says "Service is disabled"! Absurd! You screwed up my prescription (doubled the order), said my doctor didn't approve when he did, and now won't let me contact you. I'm all done with OptumRx and will post critical comments."
Them: "Thank you for contacting OptumRx Customer Service. Our apologies for the inconvenience this matter has created for you. Currently, with the new updated website we are attempting to work out the problems and ongoing issues with it as well as some sections becoming temporarily unavailable which included are reply button and call us feature. We are aware of the issues and are in process of addressing them. Your patience on this matter is greatly appreciated. To speak with a Customer Service Advocate, please contact us at 1.877.889.5802. We are available 24 hours a day, 7 days a week. If you have any further questions, please reply to this message by submitting a new feedback form."
I am new to OptumRx and asked my doctor to use them to save me money by doing a 90 day supply of my very expensive medication. I wish I'd never done that. I'm am SO grateful my benefit plan doesn't force me to use mail order. I had the same experience I've read about over and over on this site. Orders will sit forever in processing and OptumRx never reached out to me for more information. I called 3 times total to ensure my order would arrive before I ran out of medications. My most recent call had me talking to an incompetent agent who was also quite rude. She initially said there is no order, then said it's out of refills (it had never been filled at all, so refills don't apply), then she put me on multiple very long holds only to come back and say they needed more information from me so that's why it's been sitting processing so long. I told her I have called in twice in the past 4 days, and why is this only now an issue?
She told me nothing the previous two agents did "saved" in their system and now the process must start over. I told the agent I would be out of meds before the order arrives and she actually just scoffed at me and sighed loudly to indicate she did not care. Stay away from OptumRx. These people will do harm to you by letting you run out of meds and they will not do anything to change. That is evident by the years of reviews with the same complaints over and over. Demand your benefit plan drop them. Make yourselves heard! I did, and found my employer had received hundreds of similar demands, and so they did remove them from our benefit plan for the coming year. That is the only way to get rid of OptumRx, so do it!
I had a prescription that all of a sudden required a prior auth after being on it for 2 years. It took 2 weeks to get this handled. Mostly due to the fact that whenever I called in to speak with someone I would be told they couldn't help me, be given a different number to call or transferred to someone else, who would also tell me they couldn't help me. No one at this company (managers and supervisors included) had any initiative to help with my problem. They only wanted to pass it off to someone else. I had been hung up on by a representative on numerous occasions, as well. This company is unprofessional and unqualified to help with customer's problems.
As I started with United Health Care back in Feb I was told Optum is their mail order pharmacy, ok cool, my deductible for 90 day was 8.25, sweet. Then as of Dec 2nd I placed my order. Charged the 8.25. Done. Then that Monday at 5 pm Pacific time there was a charge of 311.40 on my credit card, I called Optum, spoke to them over an hour, asked them not to proceed because I have to call the insurance co in the morning. Well I started in the am to call insurance co then all of a sudden within mins of each other I had 311.40 debt from my account.
My bank refused the charges. So I contacted my bank letting them know they had no authority to take these kinds of funds from my account, so I went to the bank, had to cancel my debit cards and as I was sitting at the front door of the bank, Optum placed another 311.40 on my account, now this is 5 times in less than 24 hrs they done this. DO NOT STORE YOUR CREDIT CARD INFO with them, because of them I cant buy anything for a 8 year old little girl. TY Optum for not giving a darn and being very rude not only to me but to employees from United Health Care. YES a for complaint has been filed.
3 month subscription service, took 4 months to get my order, they keep blaming the doctor, every time you call, they will tell you what you want to hear, but no one keeps their word. Prescription sent to a wrong address (after getting meds for 2 years). I asked for a refund, 7 weeks ago!!! When I call they say the same thing, "You should get it in several days." Why is behavior allowed???
What a disgrace. Meds that you must have never show up on time and you are at the mercy of them and the mail when we used to be able to pick up our med at a local pharmacy. Absolutely disgraceful. They can delay processing, screw up your order and don't even have the sense to overnight or priority ship. ** this company.
I called to re-order a prescription and, after taking the order, the agent informed me that the cost would be over three times what I had been paying. When I asked why he said that there was gap in my coverage. I then told him to cancel the order, that I couldn't afford it and didn't want it, that it was either cancel or don't eat. He put the order through anyway and charged my bank account. Now I can't pay my rent.
I have called and spoken to a supervisor on three different dates and gotten three different stories about why I can't get my money back right away. The first one said tomorrow, the next 3 to five days and today she claimed I never canceled the order at all and couldn't find any evidence that I had talked to another supervisor and that I couldn't get my money back until they got the prescription back and I had to wait for them to send me something to return it in. This is not the first problem I have had with them either.
I thought Medco Express-Scripts was bad. These folks make them look fantastic. EVERY single representative is a brain dead zombie. Zero common sense. Unable to complete a sentence. Everything they tell you, without exception, is wrong. Transferred from 1 ignoramus to another. 5 days and 8 calls later and they are still unable to process a simple refill.
Worst required website for medication from United Healthcare. They have deleted medications, they have not sent auto-refills, they have the worst customer service in the history of medication management. This is not OK. You don't screw around with people's medication! I'm 59, suffered a stroke, and am now on blood pressure meds - but do I get them from the auto-refill portion of this moronic website? Of course not! I am also on antidepressants. So, if I kill myself or have another stroke who do you think is to blame. These are not doctors running these sites. This is criminal!
I read other complaints posted about this company and see the same issues being echoed over and over. Mine will be no different. I started using OptumRx almost two years ago. I have learned to schedule my doctors appointments early and mail in my prescriptions utilizing overnight delivery to ensure timely processing of my medications. Every month I have to get intimately involved to make sure things go smoothly to no avail. I called last Sunday to ensure the shipping was set for overnight as my prescriptions require a signature. I have to make arrangements for someone to be home. After the first representative made extremely inappropriate comments to me I asked to speak to a supervisor. I was not permitted to speak to a supervisor initially and had to insist upon it. Once I did speak to her she tells me there is no such thing as overnight delivery, only expedited.
I assumed incorrectly this was simply semantics and did not challenge what she was saying to me. She "waived" the shipping fees and set my prescriptions for autodrop. I called back two days later (Tuesday) to get a tracking number and was told that not only did my prescriptions not "autodrop" I also would not receive my medications until the following week. When I asked why, the representative explained that the shipping was set for expedited and not overnight… What?! So I explain my previous conversation and allegedly the problem is resolved. I call on Wednesday to get a tracking number and learn the order was once again expedited and not overnight. That rep cancels the order, tells me to call the next morning (Thursday) to reorder it with the proper shipping elected. She put a detailed note in my file and read it back while assuring me this would correct the problem.
I do as instructed and when I followed up the next morning I was told it was already taken care of and I would receive my medication the next day (Friday). However, this rep could not give me a tracking number as the system hadn't updated and she told me to call back in a couple hours. When I did call back I had the same exact conversation with another rep. I called back a third time (Thursday evening) and when I asked for the tracking number the rep told me there was a hold on my prescriptions because they wanted to know if I was okay with the shipping fee... What?! She then tells me that expedited and overnight are the same and I won't get my medication until Wednesday of the following week. I asked to speak to a supervisor. He gets on the phone and tells me that he has notified the fulfillment center that it is to be shipped overnight with the option of a Saturday delivery. He notated this in my file.
This morning I wait for an email notification and when it never came I called back only to be told that the changes were never made and I won't receive it until next week. So I won't have my medications before I run out. I won't be able to work or care for my family all because this company can't get it together. I go to great lengths every month (some that cost more money) to do all I can do to prevent this from happening and it does no good. The reps don't know what they’re talking about nor do they understand their own services. I called every day for 6 days, some days multiple times and they couldn't get it together. I am seriously considering talking to someone to see what I can do to receive compensation for lost wages as a result of not receiving my medication on time. This company is highly negligent and I have no confidence in them at all. I am forced to use them by my insurance company.
This company just added another level of "security" that required them to send me a verification code. I was on my home computer. The phone number they used was my home phone - no problem. But they did not have my cell or work number. That meant I couldn't log in to my account from work. There was no option to add other phones. That's a failure in web design.
I called a rep, and despite my careful enunciation she could not understand my very ordinary name, so I hung up, tried again. The next rep understood me the first try. Said it was up to ME to update my phone records, not her... BUT she would this one time take my cell # so they could TEXT me the verification code. They didn't; they dialed my cell phone instead. I'm beginning to see why this company has a 1-star average rating - you don't see that very often!
I have been trying for 4 days now to switch my scripts from a retail pharmacy to OptumRx, as UHC is requiring maintenance medication be filled through mail order in 2018. I figured, how hard could it be to switch my prescriptions over? It's been nothing but mistakes, poor customer service, a broken website that doesn't show the correct information about my medication. The OptumRx rep even misspelled one of my medications when requesting a new script from my doctor's office, causing one of my required medications to not be filled on time.
I am STILL in the process of playing middleman between my former retail pharmacy, my doctors, and OptumRx because of their mistakes. Easy, simple... not at all. Nothing but a hassle and I barely even save any money on prescriptions and now I have to worry about them being lost in the mail or stolen off my porch if they're delivered when I'm not home. If OptumRx were a brick and mortar pharmacy, I would have walked out the door, but unfortunately, they are the ONLY pharmacy I am allowed to use with my plan or UHC will make me pay full retail price for my medications.
OptumRx expert review by Jonathan Trout
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.
ConsumerAffairs 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.
OptumRx (formerly Prescription Solutions) Company Information
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