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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They have some of the lowest prices and offer quick delivery of prescriptions. Their app is very easy to navigate and they have excellent customer service to assure that you get your prescriptions on time.
This is a mail-order pharmacy associated with United Healthcare and it works quite well and in most cases my copay is zero dollars which is very nice. They even ship my product that needs to be kept cold in a chilled box.
Have used OptumRx for years for med. prescriptions. A little rough in past but much better now. They are helpful, pleasant to work with, and caring. An occasional bump in the road, but rectified quickly. When receiving a prescription I receive numerous paper instructions. Ok, I get it but you should use both sides of paper. I don't read most of it. It's become redundant. I'm aware I can get that info online but frankly I don't want all that stuff sitting in my PC.
Cannot get ID cards for my children away at college. We have 4 people on our policy and they send us 2 cards. I call the number that came with the cards that it said to call for cards and was told this was not the correct number. When I asked for the correct number she said I do not know and put me on hold. After 5 minutes I hung up. After 3 requests over a 3 week period still no cards and no confirmation they have been sent out. I cannot view another family members prescription online. I have tried the instruction and no luck. It keeps saying not registered, but that is not true. Have an account number to prove it. I have sent 2 emails and both times their response took 2 days and they did not answer my questions. Just gave me standard pre-written answers instead of actually looking into my needs. This is just a sample of my poor experiences. I could go on and on. Simply put nothing is working.
I work with OptumRX daily for prior authorizations and this company is terrible. They don't even give you enough time to obtain the medication the PA is for before the PA expires. So you have to get a second one and hope they give it to you or the patient will never get the medication. Most of the staff is NOT helpful at all and are mostly argumentative. If I could chose to never work with them again, I would. Unfortunately, I do not have a say in this.
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Three months ago, OptumRX pharmacy indicated that my prescription for ** 40 mg was out of stock and wouldn't be available until the end of 2019. We requested the once daily 80 mg capsule as a replacement. They told me United Healthcare didn't cover the 80 mg once daily extended release medication, only the 2x day 40 mg. After forcing my doctor's office and myself to spend 2 hours calling back and forth, we finally got the 80 mg authorized and paid for since it was their fault it wasn't in stock - not mine.
Pharmacies have this medication, but I was advised I would have to pay a copay. Three months ago, after authorization to fill the 80 mg, when I called to get the 80 mg filled, they said oh guess what, the 40 mg is available. They are totally unconcerned with taking up anyone else's time. Fast forward three months, they are telling me again that the 40 mg. tablet is not available and that I am not covered for the 80 mg tablet. Same garbage. I told them that they needed to figure out how they got the 90 day supply time. They are totally unconcerned with anyone else's time. Not a nice group to deal with. Time consuming. Totally incompetent group of people. Again, we are forced to jump through more hoops.
Have been trying to get medication my Dr ordered for a month now, with no results. Says they have to have a prior authorization form for FISH OIL TABLETS!!!! Can you believe that... Fish Oil. I could perfectly understand if it were some type of controlled medication, or something top that effect, but Fish Oil, c'mon man, really. So I call them out on it, and they blamed my doctor didn't put a diagnosis on the "prior authorization form", that's why it was denied. Asked to speak to a supervisor, and he told me the above was the reason, and until my doctor completed the form it was denied.
So, I asked them to send me an "appeal" document and he told me that he could not send this to me, but he could send it to my doctor. We PAY THEM, not the other way around. They should do as they are paid to do. The bottom line I found out is that the medication the doctor prescribed is pricey, that's the whole reason they are denying it.... But it's all about the price. It's really sad that the insurance companies control what the patients consume. "They know better that the doctor you are seeing." :( Really sad the health care has gotten to this point.... SMH
I was a years long customer at Wal-Mart pharmacy until I became a UHC member 2 yrs. ago. I was given the options of using CVS Pharmacy or OptumRx. Things started out well enough. Prices are great.The last 6-8 weeks have been a nightmare. I recently transitioned to a new insulin pump system. One day I got an email informing me that a prescription had been received & was in transit. I had no idea what was going on. The rx was for test strips that were for a glucose meter included in the starter kit. I use a different meter that is more affordable so I didn't need this prescription nor did I request that it be filled especially not for $135. I called to cancel the order but as the email read it had already shipped. Against my wishes, OptumRx took the funds from my account in the blink of an eye.
I'm paid on a biweekly schedule. I cannot stress how important it is to plan out my expenses. It was still a week 'til payday & I had 2 Dr. appts that I had to reschedule. Even though OptumRx was so speedy in withdrawing the funds. It took a month to refund them. Now no more than a couple weeks later they've done it again. I asked OptumRx who placed the order & I was told my doctor did & could do so & OptumRx could process filling, shipping & billing without consulting me. I have multiple medical conditions. Payroll will be deposited tomorrow & there are already charges pending against money I haven't even received yet. But here's the shady part. I was seeing a provider at my endocrinologist's practice. She is the one who sees to any refills or new meds needed.
By the way this practice utilizes a completely electronic system which means requests for refills are sent to the pharmacy at the speed of light. My last appt. was Apr. 30th. Today is June 26th. And may I point out that the last few prescriptions I tried to refill by phone were never shipped due to alleged failure to reach my provider for authorization which has never been a problem. So I was told to contact my provider myself.
In addition my last appt. with my provider was just that. Ms. ** submitted her resignation prior to Apr. 30th & her last day of work was May 3rd. I am being assigned to a new provider whom I will meet August 6th. The prescription is for a 90 day supply of insulin, 11 vials. I filled this same rx so recently ago that I still currently have 8 vials in my fridge. My plan this payday was to fill my other maintenance meds. 6 in all. I guess my plans have now changed. Thanks a lot OptumRx. I've decided to opt out of OptumRx. Maybe CVS will be the better choice.
I feel I deserve an explanation. How is it that a pharmacy or Dr. has the authorization to withdraw funds from an account not owned by them? And wouldn't the professional & ethical way to conduct business be contacting the patient to confirm 1. The patient is aware a prescription was received. 2. Confirm the prescription is correct & needed. 3. Confirm the funds are available or confirm when the funds will be available. In other words do your due diligence.
I have diabetes and my medication at 750mg was pretty cheap to refill a 3 month supply, something on the order of less than $20. My doctor increased my dose to 1000mg, a 33% increase in my dose. At first they refused to fill the prescription saying that it was not covered. My doctor had to fill out a request for pre-approval. I got the medication so I figured I am approved. It is now time for my refill and and they are now charging me $100 for the medication even though I paid less than 20% of that at 750mg! I would freaking drop these guys in a heartbeat but this the is the only insurance carrier that I am sure will let me keep my current medical group.
Denied medication I've been on for 13 years. Just awful. My Dr. called in expedited pre-authorization. Apparently, the pharmacist tried calling her 1 time. Since she did not answer the call that 1 time, she wasn't even given a chance to call back, they made a medical decision to deny my coverage.
I gave up using this mail order pharmacy. Your prescriptions disappear down a rabbit hole never to be found again. When I call, I either get disconnected or laughed at. I called three times in a row. The agents are rude and not helpful at all. I am going to request my dr use a local pharmacy, it’s not a brain when you can not get your medications.
I was on a medication for a long standing medical condition. I have been on this medication for over 5 years. Optum refused to renew my primary care physician's order and instructed us that I was to be off my medication until I became sub-therapeutic to show need. While I feel that force anyone on a non-narcotic medication to withhold their medication intentionally to make them sub-therapeutic against what that person's PCP has ordered borders on either medical malpractice or practicing medicine without a license if these decisions are being made without a medical provider. I did comply and became extremely sub-therapeutic with the expected physical issues of being so. When my PCP requested again to restart my medication it was denied and a 2nd, later sub-therapeutic level should be drawn. Why is my pharmacy dictating my medical care?
In March my obgyn prescribed ** cream for atrophy. The price for the medication was over $100/mth so I asked for a generic version called ** which was $25/mth. OptumRx would not accept the doctor's prescription without her filing a "step therapy" request. That request was granted but I was billed $101.00; not $25. I called OptumRx and they said my doctor needed to file a "tier cost exception" form because for some reason this generic medication is considered third tier and is almost the same price as the brand medication. (Why didn't OptumRx mention this the first time round?) I called my doctor and the nurse spent time filling out the "tier cost exception" and then faxed it back to OptumRx. Fax is the only option and that means OptumRx can say they never received the fax. I did dispute the charge on my credit card but had a family emergency and could not follow up so I ended up eating the $101 charge.
I refilled the prescription again in June and was again charged $101. I called OptumRx and was told that they had accidentally charged me for the brand name and would send a note to research and would hear back in three days. I called on the fourth day and they said research hadn't responded so they were sending a second note to research and to accounting and that I'd hear back in three days. Nothing happened so I called four days later. This time I spoke to a woman who explained in great detail without letting me speak how their system worked and that my doctor had never sent in a "tier cost exception." She also said the people I'd spoken with earlier had misquoted me. The cost was $75; not $25. $25 was for pills. (I don't take the pill form because the doctor is concerned about intake of hormones vs using a topical treatment.)
She insists several times that my doctor failed to send in the fax and had failed to write "tier cost exception" on the fax, may have taken too long to send the fax back as there was a time limit and that they have no records of ever receiving the fax. I finally asked her to stop saying my doctor "failed to send in the fax." She did send in the fax and your office failed to receive it. The woman remained rude and really seemed to make an effort to put all the blame on the doctor. She said she would send a fax to the doctor and carefully explained all the details I'd heard 20 times again. I called my doctor and the nurse said she'd kept records, written "tier cost exception" on the fax and had proof. She also said she sent the fax again and had then called OptumRX to confirm they received the fax. She said the person she spoke to said they tried to enter the form in the system but instead of saying "processing" it said accepted.
I called OptumRX to find out. This time the customer care person was even more rude.. He used the same strategy as the woman the night before; lots of detail about what I had to do, accused the nurse of not sending the form in, didn't let me speak etc. It was as though the staff have been trained to turn on the customer and doctor/nurse so we give up and don't ever get our discount. He told me there was no way he could see if the fax came in; that they receive thousands of faxes a day and it takes time to process the faxes. I tried over and over to ask questions and for phone numbers of departments I could speak with. I did receive one phone number but with great reluctance. Finally he told me "ma'am you are not understanding what I have been saying.." I thought well and you have not listened to anything I've said..but at that point I'd had it.
I told him I was sick and tired of being forced to jump through hoop after hoop and spend hours and hours of my and my doctors time trying to get something done. As I talked he talked over me and continued to say "ma'am, ma'am." I mean maybe I was rude because I did curse and hang up but what kind of service is this? Let's top this whole thing off with the fact that you are trapped into your health care provider's rules or I'd be paying $450 for this medication. One more thing. I went to Mexico to visit a relative, got off the plane, went to the pharmacy and purchased ** (same brand; same name but in Spanish) for $10. I'm sure this is illegal which makes this all worse. This is a negative rating.
Disappointing and frustrating (1.0). I am caretaker of my husband who has several medical issues and takes a lot of medications. I also take many. The hassle of going to different local pharmacies one day and another on another day was wearing me out. Solution? OptumRx - NO. As hard as I tried to set up accounts for my husband and myself, could not. Signed up as caregiver but it didn't allow me to see my husband's account. So now I am caregiver to myself. Maybe it's an online issue but that's what I wanted, to manage online!
I registered for myself but then couldn't get his. I registered for him but then couldn't see mine. I called several people, several times and couldn't get them to understand the problem. Each kept telling me to change passwords then receive a text with a code. Did this several times! I have been dealing with this all day. I do not want to change anything again! Set up for caregiver isn't working. VERY frustrated. Don't I have enough to deal with?!
I am now a week past when I was supposed to have my medicine. I have been waiting on a PA, which has so far taken longer than their maximum estimate. No news. First call I made, go through the automated system, get the status, wait for a real person, finally get one. She calls me ma'am the whole time.. Not that I really care, but firstly; I have a deep voice, second; this is a health company isn't it?? Seems to me they should be able to double check their guess quite easily. Whatever though, not a big deal, just a red flag as to competence. She also didn't know what medication I was calling about, but there's only ONE. You looked up my account, twice. umm.. Literally the only thing she could do was repeat exactly what I can see online. 'Pending'. Could not tell me anything else. Told me I had zero course of action. I'd just have to go without meds that are time sensitive and scheduled. Cool. You do realize you're supposed to be a 'health' company, right?
Second call, same thing but at the end she said there was a different number to the PA department. Later when I called it was the same person. Couldn't tell me anything. She did say my doctor's office could waste some more of their time filing out an 'expedite' request (why didn't anyone say this before now?). Even though the time period they already quoted had lapsed. For some reason, the PA department couldn't just do that, and neither could I. My doctor and MA have to spend more of their very valuable time doing your job for you instead of helping people. What's messed up is that this company seems to be making people less healthy, which I guarantee eats into your profitability. Unless the only point is to do the minimum necessary to keep up the sham of a service, and screw the rest out of benefits. My employer just switched plans, I would never recommend.
Really bad customer service. Got the runaround when I needed a prior authorization for a medication my doctor prescribed. Medication was prescribed on May 31. Received notification that a prior authorization was required. Dr. sent required paperwork. Prior authorization was denied the same day, May 31. Dr. sent in more information on June 5. OptumRX appeals department says they didn't get the information until June 7, 2 days later. I called on June 10 and was told that it takes 48 hrs for appeals. Called back on June 12 and was told by John that there was nothing in my file for the medication. Called the appeals department and was told it takes up to 15 business days for the appeals review. What the heck is going on with this company? I can see information on the portal that your employees say they can't see. You need to properly train your employees. You are messing with someone's health and well being.
WORST mail-order pharmacy EVER! I had a three week supply of insulin when I placed order. I have NONE and not expecting to get the order for at least 2 days. They can't manage anything in a reasonable manner. Order was on hold but I was not notified it was on hold! How am I supposed to resolve a hold if I do not know there is one!
The customer service person did everything she could to keep me from getting my prescription from CVS. I insisted that I would pay the additional cost to use CVS several times. She finally said she would set it up so I could use CVS get my prescriptions but she was put off by having to do it and rude for the rest of the call. By the end of the day I was no closer to get my prescription. Being with CalPERS we have no choice but using OPTUMRX. They know that and so why should have put themselves out.
Saying they are inept, incompetent idiots does not adequately describe OptumRx. Most recently, I entered a refill order a month ago. When it didn't arrive, I went online and saw all five prescriptions were available for refill, so I assumed I had only imagined ordering. I placed the entire order again and saw the confirmation. After a week, checked and guess what. Yes, nothing had changed. All still available for reorder. The billing department is no better. A year ago they billed me nearly $600 twice. Called and got them and they agreed to refund the charge. The refund, for some reason, was $7.94 less than the charge. Called them three times and sent them copies of the credit card statement. Still no luck so I've given up.
Three months ago I got a letter stating there was a problem processing my order and I should call them. Called to find out there was no problem, the representative thanked me for being a customer for the last six months. I've been a customer for over three years. Then it dawned on me, my account was out of balance by $7.94 so they cancelled that account and started a new one. This place needs to be audited and investigated. Avoid them at all costs.
My company switched us to OptumRx in January 2019, and dealing with them has been a nightmare since day 1. The customer service reps are friendly, but they're clearly not trained in anything medical---they spell drug names to me because they can't pronounce them. Don't bother using their online form for someone to contact you---they don't bother to call you.
In addition to using OptumRx for mail order scripts, they have a contract with a large drug store chain so you can get 90 days meds at your local pharmacy, but they aren't allowed to dispense 90 days of meds. I use an eye drop for glaucoma and have always gotten 3 bottles each time I get a refill. OptumRx has counted the drops in each bottle and won't let the local drug store dispense 3 bottles because the amount of drops comes out to more than 90 days. But OptumRx is allowed to dispense the 3 bottles. I had to switch a maintenance drug because OptumRx does not cover my dose, but the replacement drug isn't on their maintenance list, so I can only get 30 days supply at my local drug store. But once again, OptumRx is allowed to dispense 90 days of this medication.
OptumRx FORCES you to use their mail order service but makes you fight for everything you need. This company is shady for forcing you to use their mail order service, and they really need to train their customer service reps---they should be able to pronounce the medications we call them about. OptumRx needs an overhaul, and maybe the Insurance Commission should pay them a visit.
I have gone around and around with this company that it has been the standing joke with friends. Every time you call you get a different answer, it’s a complete circus act at this company. I spend so much time on the phone with this company and get nowhere. My doctor wrote a script for a 90 day supply, they won’t send it. They will send me a 30 day supply but a 90 day. They have given me an excuse that my plan doesn’t cover it. The latest drama. I took a medication 6 months ago, it was an extended release, I’m on the medication with the same strength but on a sustained release. The pharmacist won’t fill it because she wants “clarification” from the doctor. I have never heard a pharmacist feel she needs to intervene on a valid script. I am filing a complaint with my company. This company is absolutely horrible.
In the last 2 weeks I have spent no less than 6 hours on the phone trying to find out why we were not getting a medication refill that is supposed to have a valid script good through 12/31/2019. Each and every time the person I talk to tells me something different from the last person I spoke to. Yesterday evening when the call center rep (notice I didn't say customer service) came back to the line after putting me on hold for 54 minutes that I was done. She would come back on the line at least every minute to say 'I'm still working on this, thank you for your patience'. At the 54 minute mark I said NO MORE. This call put me over 3 hours with this company yesterday alone! And, as of today, still no resolution.
My employer uses OptumRx as a pharmacy benefits manager. I use one specialty medication, ** eye drops for a chronic dry eye condition. ** is supplied in two formats, a multi-dose bottle which has a month's supply and individual dropperlets which are one or two day's supply of medication. My eye doctor prescribed the multi-dose medication in February and I received a 3 month supply from OptumRx. Now that it is time to refill the prescription, the manufacturer is not able to supply ** in the multi-dose format. OptumRx instructed me my doctor would have to write a new prescription for the dropperlets method of delivery. My doctor's office sent the prescription to OptumRx electronically 6 days ago and OptumRx has no record of receiving it.
Today they sent a fax to my doctor's office requesting a prescription. I will have to call back into OptumRx to find out whether they've received the prescription, and then there's another step where I have to order it! It is annoying and embarrassing to have to keep calling my doctor's office to compensate for the broken processes on OptumRx's side. My doctor's office is a small business that is bearing the burden of a lot of work for a company whose parent is a multi-billion dollar health care company. I feel sorry for all the customer service reps I speak to on the phone who have to bear the brunt of all the frustrated customers. My next step is to complain to my company's benefits department about the poor service and bad experiences I've had with OptumRx. Oh, and worst of all they have chatbots to deal with questions! Automation is no substitute for broken processes.
A mail order company that is not saving me any money and requires me to buy three months of a prescription that I have problems paying for one month. Forced to go off my medication. Absolutely ridiculous. And one star is too much.
I am forced use OptumRx via contract through my retiree benefits. Every time my insulin order is suppose to ship it does not. I have to call every time and argue with someone. It states clear on packaging when the next can ship. When I call they always give some arbitrary date down the road 5-10 days later. I realize that insulin is expensive but to try and shave days every due date is just plain wrong. They save all those days over the course of a year it saves them thousands regardless of what risk it causes to already debilitating disease. They should be investigated.
Every time I need a prescription there is a delay and problem. My doctor authorized a new medication for me that required pre-authorization before it was covered. This went through 4 days ago and I ordered the medication. They have been "reaching out" to my doctor for approval for the last 4 days. My doctor's office contacted them again yesterday and were told all is complete, still no updates, no reply to messages. Wasting 20 mins on the phone to be told the same thing. It is now a holiday weekend and I am without medication. This was a process that began over a week ago. I cannot wait until my company changes back to another script service. OptumRx is frustrating and doesn't care about the patient.
My 82-year old mother is being forced to use OptumRX for one particular subscription -- it is a brand name sleeping pill. Every three months it is the same old song and dance... "We need a new script from your doctor," or "His signature looks wrong so we are calling to confirm (and of course, that takes days)," or "It is being sent out and you should receive it on XX day" and then XX day comes and you hear it has been cancelled. My mom has a heart condition and is an insomniac -- with this pill she gets 4 hours of sleep a night which helps to lower the strain on her heart. OptumRX does nothing but stress her out on a regular basis. This to save a few bucks?! Ridiculous. Their customer service absolutely sucks. If you have a choice to work with another pharmacy, ANY OTHER PHARMACY, take it -- nothing is worse than this company.
One window in my OptumRX account says that I have no email address on file. So I click on the add an email address and it goes to the window that shows my email address. It is very confusing. I am trying to go paperless but can't enter an email address. They say I don't have when it clearly shows it in the system, This company's website sucks.
I called at 12:45PM EST for help. I had ran out of ** insulin. My mistake, I thought I had a box left but it was **. After a couple transfers, I was assured that the 90 day supply was on its way and that an exemption for an emergency 30 day was on its way to CVS in my area. A full 6 hours later I went to CVS in my area and they had no idea what I was talking about. I called UHG back and they recognized that I had called earlier and asked if it was about the same thing. I said yes and was put on hold for 30 minutes (thanks for asking). Someone finally answered and he had no idea what I was talking about either (clearly I was transferred to the right place, and thanks again for asking). He transferred me to another guy who said CVS has to provide me with a prescription for a 30 day supply before OptumRx can cover it.
If I had not not been LIED TO earlier in the afternoon, I would have had time to request a prescription from MY DOCTOR! I mean I know that doctors have less and less authority these days but I think they still need to issue prescriptions (you know the paperwork). I pressed the OptumRx guy further and he insisted, "Yes, the Pharmacy must issue you a prescription". When I told him what he was saying he corrected himself and said, "Oh yeah, a doctor has to prescribe a 30 day supply." A lot of good that does me now, 6 hours later when all doctors have already gone home. I asked again, 'Is there nothing you can do'? He said 'No not without a 30 day prescription'. Why did I bother calling, I'd get better service in a morgue.
OptumRx is owned by United Health Care. I recently cancelled United Insurance and moved to BC/BS. I had couple of Rx refill with Optum. I called Optum to see how much they would charge without insurance as I could buy those medications from Costco or Walmart for 5 dollars or less. Publix provides them for free. Optum quoted me 145 dollars and I said no thank you. I told the operator not to send any Rx and I will be transferring them to Walmart. They also have my credit number but they are not Allowed to charge without my permission.
Three days later I get an email that they shipped my order. I called right back and explained that I neither ordered the Rx nor did I authorized to charge my credit card. I spoke with the supervisor who assured me that the order wasn’t shipped and my credit card will be promptly credited. I asked her to send me a confirmation email that she said will go out but later. The email never came at the end of the day so I called back. This time A gentleman answered my call and could find any record of the content of my earlier conversation. I told him I am not accepting the shipment. He told to accept the shipment and return them. They are going to send a return package to send it in. I never got the return envelope. They also never reversed the charges. I finally filed a dispute with the credit card. NEVER trust Optum with your credit card, debit card or bank account.
OptumRx (formerly Prescription Solutions) Company Information
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