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.
Keep an eye on your inbox, the lastest consumer news is on it's way!
A link has directed you to this review. Its location on this page may change next time you visit.
Updated on 04/15/2019: My review of a few days ago mentioned that Optum owed me $64 for nearly three weeks. They refunded to my card four days ago, but since then my account is frozen for owing $64. They assured me four days ago that the issue would be remedied in 24 hours. It just keeps getting better with this company.
Original review: I have way too many complaints from the past to detail here. However, there are currently two major issues.
1. Recently this organization decided that all new prescriptions for controlled substances would be limited to 30 days instead of 90. However, their insurance plan (UHC Medicare Part D premium plan) only covers 90-day prescriptions. Therefore you have to pay full price for controlled substances.
2. A recent prescription from my doctor failed to denote tabs or capsules. Optum wrote back for clarification, and he replied, "capsules if covered by insurance." They sent me capsules, which were *not* covered by insurance, and in fact, cost $65, unlike the tabs which were free. I intercepted this shipment in transit via the carrier's website, and it was returned to the sender. Meanwhile, the "professionals" at Optum showed on their website a package with the tabs being sent out, complete with a tracking number. I knew this was bogus, as it did not include a claim, and the package was never picked up. Yet I had to wait over two weeks to get my critical meds, most of the time without any left at home.
Finally, after maybe six calls, they generously sent me the tabs. However 17 days after they received the refused capsules, after only four calls from me, they still have not initiated a refund. Representatives assure me the issue contains a directive from a supervisor to refund my money, but no action has been taken.
Like others, I'd give zero stars if I could. United Health Care makes me use their in-house mail order medication service called OptumRX, or I can pay retail prices at a pharmacy, if I want. My choice, right? They constantly screw up my orders, are glacially slow with shipping, and always play dumb with me when I call them. They are currently refusing to fill my blood pressure medication because they figure I can finish my last prescription, that was different, before they'll send the new medication that my doctor prescribed a month ago.
Their web site never works and it is obtusely difficult to use. I believe this is intentional. I can't track orders, can't price check meds, nothing. Every month I have to call them for one screw up or other. I call them and get some drug-addled dunce on the phone whose job it is to say, "I dunno. I can't check that. My computer is down again." My current beef is that they raised the price of one medication from $3.16 per month to $10 per month with nobody able to explain why. "I dunno." I know it's not a huge amount of money, but if it was another, more expensive medication, that kind of unexplained price increase could hit a person hard. That's more than triple. All I got from them after the "I dunno" phone call was a form letter saying I should use their mail order service because it's cheaper. That's where this is all coming from!!
I'm so sick of them. I now have gotten to the point where I query them, and then the next day I can figure on complaining to the state insurance commissioner. It doesn't fix the problem, but at least I get my issues on record with the state and maybe, just maybe, someday the state will take some action against this shady company.
I would give them a zero if I could. They changed the address to send meds to, unknown to me, so I was billed for meds that I never received. Cannot get anyone on the phone. Cannot correct the address on the website even though it is my 'profile'. Avoid these people.
Once my employer was merged and I had to go on COBRA OptumRx has denied my coverage. I have formal evidence of paid coverage from the COBRA assist, Discovery Benefits. Last month after Optum said I had no coverage, I called Discovery Benefits and they had proof that they provided Optum with my coverage information. Discovery sent a second notification file to Optum the next day. This month, Optum again says I have no coverage and they never received Discovery's notice. Discovery just told me they sent notification to Optum twice. Now I am in urgent need because I only have 3 pills left. Discovery is sending ANOTHER notification, but tells me that Optum is known for not even looking at these notices for at least 2 days, then processing. But obviously they haven't processed ANY of my coverage notices. I don't know what I'm going to do.
Coverage is horrible. It says it's covered, then it's not. Optum Rx sucks. I feel stuck. I can't afford anything else, but coverage is bad. It's as if you are dealing with a used car salesman. Can't believe them, can't trust them.
- 1,769,683 reviews on ConsumerAffairs are verified.
- We require contact information to ensure our reviewers are real.
- We use intelligent software that helps us maintain the integrity of reviews.
- Our moderators read all reviews to verify quality and helpfulness.
For more information about reviews on ConsumerAffairs.com please visit our FAQ.
OptumRx is horrible. I've been trying to get a prescription filled for over a week. I'll do anything to stop using this company. They run you around in circles, say the doctor "denied" prescription refill (totally false); then they say the prescription is in the mail; 4 hrs. later, they send an email saying the doctor the refill is denied, over and over and over again. I go to my account on the website to see the status, and it is totally different than what they told me on the phone. Even the rep on the phone said she does not have accurate information. My issue is STILL not resolved, because nobody at this company has a clue.
I have no words how bad this insurance is. Any time I order medication there is a problem! Not competent customer service. It is terrible! Too bad I have it through my employer, otherwise I would NEVER renew it.
I was taken medication for years prior to my work prescription plan changing to OptumRx, now this medication is no longer covered. They sent me medication made in China that has been recalled. I was told I would receive a refund (90+ days of medication) and did not. I sent a prescription via mail and a month later I received an email from OptumRx that the doctor has approved it and it would be sent. Five days later, I receive another email. There is a delay in the processing. Now I am out of the medication. I called and was told the delay was that my doctor did not sign the prescription and the pharmacist was waiting on the doctor.
After finding a photocopy of the signed prescription I mailed, I called again. This time I was told the pharmacist could read the prescription due to the way it was sent. I told her I physically mailed the prescription and the medication name was legible. Her response was tomorrow have a local pharmacy call their pharmacy to have the refill available transferred to be partially filled. Oh and today, the first lady asked me if I wanted to refill my prescription that is not covered by OptumRx.
I have called these people 12 times and successfully gotten 2 prescriptions from them. They lie to you and are poorly trained. I never had to sign for prescriptions. They sent one this time by USPS. Signature required. They do nothing consistently at this place.
Worst customer service, ever. I have had many of the same problems as the other reviewers: orders mysteriously vanish, orders delayed, literally hours on the phone, being told outright lies by reps and managers. 30 minutes today to simply update a credit card number, (they called me, at work - else I would have updated online). The root of my issue is that my company's United Healthcare Plan mandates that I use Optum, I can not use any other pharmacy or they will not provide any benefit. With no possibility of competition, they need not provide ANY level of customer service. They are responsible only to United Healthcare and their shareholders, and therefore it is in their financial interest to substitute, delay, loose orders, and generally find excuses not to fill orders. Profit before patients. This industry needs to be regulated.
I feel like I am working with a state owned and run agency. They have canceled my subscriptions. Said they haven’t been sent prescriptions by doctors, delayed refills, refilled items I didn't approve or ask for. Tried to force me into accepting generic for an on label product only. Transferred me to hell and back. Half of the people on the phone will tell you if you ask, they are not in America, can’t give any information other than what is on their screen, extremely difficult to understand their accents. They are rude, cut me off, make decisions that they then don’t inform you of and don’t get meds to you sometimes in a timely manner.
Nothing is their fault and you as the “unskilled health worker” don’t know what you are talking about. They are dangerous and this business needs to be shut down completely. This is increasingly worsening as consumers and persons who need our prescription needs taken care of have no say so other than paying, full price and out of pocket. This is not freedom. This is a form of slavery. You pay for the coverage without any of the real benefits. Wish I could have given negative stars.
Optum refused to cover my brand name medications that I’ve been stable on for 10+ years. Despite providing medical justification to verify reasons why I can’t take generic versions of the medications and my MD writing DAW-1 Rxs, they claim I’m ‘choosing’ the brand and thus am being charged the brand penalty of... the entire price of the medications which is over 2K per month. They’ve been a nightmare. Honestly if I could take generic I would but can’t. How dare you Optum!
Each 90 days I request my sleep medication and I am placed in the queue. In a few days I get a notice the order is being processed. Then it suddenly disappears. I call and endure the hour long wait and runaround. Then I am called and told to call OptumRX. Then they tell me there is a shortage. Then the process begins again with me being at the back of the line. This seems to happen every 90 days. I called my small local pharmacy and they said they had a plentiful supply.
I am done with OptumRx.
First time using United Healthcare and Optum RX. The experience has been horrible. I had to do two overrides just to get one prescription, paying out of pocket for it. This effort took at least 11 hours of my time. Now I need to fill another Rx for my Dad. It is already in their system. Optum has already mailed it in the past. Optum refused to re-fill, saying that the med is not due for refill until 3/25/2019. Well, Dad's will have consumed the last of the script by then! The service rep said there was nothing they could do; I would have to do an override to get an 'emergency' supply. Like I want to spend 11 more hours going through that horrid process again. Gee, is this how United Healthcare manages to keep people from getting their drugs covered? UHC and Optum are shameful operations. Write your state and national representatives to let them know how horrid they are.
I need a special eye drop. My previous mail order company always delivered with no problems. Then my company switched to OptumRx. EVERY time I need to order this I end up spending anywhere from 30-90 minutes on the phone at least 6 times over the course of 4-6 weeks in order to get it. I get every excuse there is and they always try to get me to get it at the local pharmacy (who never has problems with it being in stock) where it costs $40 opposed to mail order which is $5 or switch to a different drop (higher profit for them) which I can not use.
It's out of stock, it's in stock, they're so sorry, they'll ship it overnight (doesn't happen), send shipping info but it never actually ships, etc. etc. etc. They charge my credit card, return the charge, then charge the card again. Over and over and over it's the same thing every 3 months! I think I have talked to everyone that works for this company from the lowest to the highest. I eventually get it but I must go through this nightmare to do so! If I could change companies, I would in a second. If I could give negative stars for the review I would.
I have been on the phone for two hours switched from person, to pharmacy, to care representative back to pharmacy and the process for pre-authorization for necessary medications for immunosuppression following a ten year old organ transplant is ridiculous. Each year, I (or my doctor) must spend time getting pre-authorization for a drug or drugs I have taken each year since 2009. Each year we "do the dance" of pre-authorization. We are first rejected, spend hours on the phone, explain why the drugs are Medicare Part D and not Part B, ultimately get approved and proceed through the year.
Then in January we start the process all over again, even though nothing has changed since it was approved the last time! This year it is something new. They tell me the medicine I need has a grandfathered approval, but the system keeps rejecting it. They don't know why. I have tried calling the Patient Care Advocate three times. She does not call me back. I just finished with a patient care rep. She is trying to get it approved. I am now waiting for her to call me back. Seriously?
Every single time I have ordered from them and I was basically forced to order from them thru their letters stating there would be penalties. Every order has been wrong, when I call, they state the Dr's office didn't send the script... B.S. When I call the Dr office they can tell me exactly when the scripts were sent. Now my Dr has transmittal receipts. They screw every single order up then lie to you. I hate them. Wish they had to deal with their own dummies like we do. I was happier getting med scripts from Walmart who by the way was cheaper.
After a nightmarish experience with Express Scripts, I refused to provide any credit card info to OptumRx when my new plan required we use them. My prescriptions have a $0 copay, so they don't need it, right? So when I recently logged on to renew a prescription, why did I find they have my cc#... and their system won't let me remove the information. Beyond pissed here.
This company has been a problem since they started with me in Nov. 2017. I am a retired NJ State employee who retired with Express Scripts and had no problems. Then NJ State decided to go with OptumRx and it has been nothing but a nightmare. First, OptumRx would not allow me to stay on a non-generic drug which I was on for years with Express Scripts. They would only pay for generic even after the doctor calling them and complaining that the generic did not work as well for me as the non-generic. Then, I got a prescription from my doctor on another occasion for allergy. OptumRx website (when you log in) stated that the cost would be 5.00 but when I took the script to the local pharmacy, they said that OptumRx does not cover that drug. I called OptumRx and they said their website was a mistake and they never offered to make any concessions.
Another problem is if you use their website to price out a medicine before you take the prescription to the pharmacy, I have noticed that the actual price you pay at the pharmacy very rarely comes out to the price indicated on their website. So it becomes difficult to make the best choice on whether to mail in the script or go to the pharmacy for the better price. I never had any of these problems with Express Scripts and hope the NJ State would get rid of OptumRX.
When I left my employer I paid ahead of time for Cobra, Aetna and VSP medical/vision activated my continued insurance with immediately however OptumRx are continuing to say they have not received notification from Cobra - which is a lie, and says it will take 15 days to process... Meanwhile I can't pick a prescription without paying the full amount. Their staff are useless and just read from a script - not solutions focused. This company does everything it can not to pay for your prescriptions - AVOID THEM PLEASE!
My doctor sent a prescription to OptumRx on 2/25/19. They did not receive it till the following day. Order # **. As of 3/2/19, my order had still not yet shipped & they promised it would ship 3/4. As of 3/5, it has still not yet shipped, but I'm now informed it will ship tonight, & it will take 4 more days to deliver. Pony express could deliver it faster. Unacceptable!!!
OptumRX has been allowed to control what my doctors can prescribe by denying specific medications and arguing that the medication doesn't treat my condition. Keep in mind my medication was prescribed by a Specialist who treats this specific disorder. When you are sick it is rather impossible to go thru the many, many levels of dispute that OptumRx requires. Often the information is first responded to by a Pharmacist. How would a Pharmacist know how to RX and treat a rare disorder? Next a nurse practitioner responds...then a MD who is not a specialist with the specific disorder that the medication was recommended to treat. Keep in mind all this is going on...patient is sick and, there is a TIMELINE to respond.
OptumRX is discriminatory towards elderly who need a specific medication that at one time they even reimbursed. To now...trying many new arguments as to reasons NOT to provide medication. They actually control what the doctor is allowed to give and will argue the diagnosis. My quality of life was getting better until OptumRX was hired by Michigan Public Employees (Teacher's Retirement) Plan. The amount of medication had decreased and I was able to become more independent. Now that my medication are controlled and doctor's ability to prescribe the medication they know will work for me I am progressively slipping. Everyone has a unique body chemistry. However OptumRX tells doctors and patients what type of medicine they HAVE to take In order to be covered...even if it has been proven that that specific medication doesn't work or work as well as another.
Under the OptumRx regime we have become 'Stepford patients." This is becoming a form of socialized medicine in which doctors will be keep in line and told what medications and even diagnosis are permitted and if the patient and/or doctors wants to deviate from OptumRx's required drug and brand they are refused reimbursement. The patient may not respond to the required drug or it is not the drug of choice that would improve the quality of a patient's life.
OptumRX needs a Class Action Lawsuit to stop this machine from ruining patients' quality of life as well as keeping doctors from doing what they know is best for a specific patient. Soon doctors will be punished for thinking outside the box and understanding how to use medication to treat unusual disorders or diseases. What happened to democracy in medicine?
I would like to be a part of a Class Action Suit against OptumRx for denial of medication and creating a process of appeal that no person who is sick can possibly fill out requirements... Contact doctors to repeated write and/or make phone calls on my behalf as well as all the other patients that are having trouble getting the medicine they need from OptumRx. No sick person can keep up with rigid timelines that have to be adhered to. No sick person can continually argue with a pharmacist, Nurse, and or doctor as to their diagnosis and need for specific medication that they had paid for for the last 8 years.
Now...I get a letter saying I have to live within a certain area or I will be disenrolled from the OptumRX Medicare Prescription Drug Plan. OptumRX just keeps getting worse. Now they can control where I live in order to fill my prescriptions. What is odd...I have only gone to Florida for the winter months. I return home to get my medications. I have had my medications send to me from my home based pharmacy on 4 occasions. Now OptumRx says they 'received information that my address has changed' and I am going to be disenrolled by a specified date if I don't report my new address. Is this 'big brother'?
This is the first time I have been away from home for winter months. I do NOT get my medications from the state where I am vacationing...and, I still get a letter from OptumRx threatening to disenroll me from the drug plan. Go figure... It is time to end this company's ability to control where I get my medication and where I live and what type, kind of medication my doctor can prescribe in order for me to receive my reimbursement. It is almost not worth having a drug plan that only allows drugs that they deem as appropriate for my diagnosis and treatment plan.
I'm forced to use this company, and they are the pits. Absolutely horrible. It's supposed to SAVE me money and in some cases, I have to pay MORE for maintenance prescriptions. Although the people you deal with are very pleasant, the overall service is just terrible. The website is difficult to navigate, it never remembers default payment, so you have to call - and even though the people are pleasant - you won't get away with anything less than a 30 minute call. If you have other options, I suggest you explore those first.
My mother needed a prescription for ** - which was sent to OptumRx, we were told the doctor did not get a release to fill the prescription, OK - the doctor's office calls and takes care of it. A couple of days later I call (2/28/19) to find out when we can expect the medication - a week! Well my poor mother needed it before that, OK - they will overnight it for delivery today (3/1/19). Nothing delivered. I called back - no record of my calls. They cannot reach the doctor - last call to them was at noon. The doctor's office phone message specifically states that they are at lunch from noon until 2:00 pm. When I stated this to the person at the other end of the line, she accused me a yelling. I said I was yelling but my mother is in excruciating pain!!
To make a long story short - she was going to transfer me to the pharmacy (?) - after 2 and a half minutes - the call disconnects. I tried calling two more times to complain, with the same results - the call gets transferred and disconnected. I feel bad for my mother, I'm glad she didn't have to deal with this incompetence! The doctor called in the prescription to a local pharmacy and is cancelling whatever is happening with this one at OptumRx. Good thing I didn't get charged for customer service - because I didn't get any!!
I am allegedly enrolled in their "hassle-free" program but my medications never get shipped out automatically. I've called them twice today. I am actually on the phone with them now, I called back to make sure my medication was being expediated. Good thing I called, because my order had not been. My insurance wants new "preauthorizations" for a medication but OptumRx did not notify me until I called today. Not sure what the point of their online portal is - why can't they send a message or an email to notify you of changes? Super frustrating. Has anyone been able to make a formal complaint anywhere that got results?
I logged into my OptumRx account to search for a medication my Urologist had prescribed. It clearly states $31.92 for 90 day supply, under my account. My doctor logged in the prescription and I received the delivery with a charge of $356 for the 90 supply. They had charged my credit card which they apparently have kept on file without my specific approval for this transaction. I have spent probably 3 hours on the phone being passed from one person to another. Their first point customer service is clearly not US based. They won't honor their stated online price. (Yes! I still have a print out of this price!) They say they will refund the price if I take the meds to an approved disposal site with instructions they will send to me. We'll see! What a rip off!
We have been trying to get our son's insulin, **, approved for approximately 2 months. They informed us that ** would no longer be covered and ** would be covered. Our son tried ** approximately two years ago and his blood sugars were OUT of control. At that time, we returned to **. Our doctor has been trying to get a preauthorization for ** for two months! We received an emergency supply of ** after I cried on the phone with a nurse advocate. They said we could pay $3800 and receive a 90 day supply of ** insulin. I received a letter in the mail dated January 24, 2019 that stated we already had a preauthorization from July of this past year. So, I thought they would be sending the medicine. Then I received an email to call them.
After an HOUR on the phone, the preauthorizations department told me that the policy changed. I asked the person when the change took place and he stated January 1. I shared with him that I received the letter dated January 24 that stated the preauthorization had already been approved. All he could do was apologize. I really think this is a money making venture and they have NO understanding (or do not care) that this is a life and death situation for our son. I have been a Republican most of my life, but I think I might become a Bernie Sanders healthcare for all fan. This SHOULD not be that difficult. EVERY time I call them, I spend an enormous amount of time on the phone and get so upset!... and we PAY BIG bucks to have United Healthcare insurance!!!!
I receive emails from OptumRx that say my prescription is on its way. It never comes. I have to call them to find out why. They tell me that it was not ordered on the day it was supposed to be. I have hassle free refills. When I ask for people's names they tell me that their name is Dandelion, Lavender and what I think are fake names. I am told I have to go to the doctor's office and get a new prescription. I am not allowed to drive at this time since my surgery. I am currently cutting my pills into pieces to try to get my dose...FOR PILLS I HAVE BEEN TAKING SINCE I WAS 42 YEARS OLD. I AM NOW 64.
I have never had a problem with any of my other past mail order companies. The pharmacists say they can't help me. They tell me that they have called my doctor...I grew up with my doctor and his family and he would not lie. Neither would the staff that I've known forever. They are stressing me to the limit. I had a stroke at age 42 and now am in complete Heart Block. Are they trying to get rid of me? I am a Registered Nurse and my husband is a Pharmacist. We realize how things work. OPTUMRX company is the worst and something needs to be done.
I phoned last week to order blood pressure meds as required by my plan. I was told I had an outstanding balance but I don't believe that was true and could not prove it. So I had to pay the balance before making the new order. The CS was rude and tried to say her tone of voice was just how she speaks. Anyway, she charged my card and said she placed the order. Today I get a letter in the mail which wasn't very clear but made me think perhaps I did not have a current order. So I called the call center and found out that I did not have an order that it had been cancelled because it was too soon to place the order according to them but that doesn't make sense when my 30 day supply I received at the local pharmacy is almost gone. I have 5 days left. The rep I spoke with today place to order and swears I will get it in three to 5 business days. Somehow I don't believe her.
I think my plan will be to contact my doctor and have him send a new prescription to the local pharmacy and then I will just use one of the discount cards that are available I either locally or in the app store for instance. I might just use the GoodRx app. The cost is a little more but it would be worth it to be able to get my medications on time and so I can consistently get the same brand medications. This is my second-year dealing with the service. It was fine until my third month are refills and then that's when all the issues started. I have had mail order service from other insurance companies without this much trouble for simple prescriptions. I have three prescriptions from one doctor. How hard could it be.
This service has been the worst aspect of my family's medical care since the day we were told we had to enroll. We have had the wrong medicines sent, we have had no medicines sent, we have been told we have to switch medicines etc. If you can think of a way for a pharmacy to be incompetent, we have seen it with OptumRx. Luckily we have been able to move most of our medications back to Walgreens, where the pharmacists actually listen to our doctors and care how we are doing.
Optum only cares about their bottom line. BEWARE for long term prescriptions that you can count on your refills being various generic brands EACH TIME you refill. If you are sensitive this can really wreak havoc on your system. Each generic producer of a medication only has to be within 15% accuracy of the name brand composition. That means that each generic product is different. 15% is huge when you are talking about somebody sensitive or a child and you could be changing that every single month. Optum DOES NOT TELL you which generic you will get and the people that answer the phones ARE NOT PHARMACISTS and do not know anything more than how to type in your address and run your credit card. Yes, Optum is often cheaper than going to a local pharmacy but the saying holds true here - you get what you pay for (or less).
OptumRx (formerly Prescription Solutions) Company Information
- Company Name: