this is just one of so many bad reviews of optumRx

this is just one of so many bad reviews of optum.

Original review: Jan. 22, 2018
I have been taking ** for chronic pain for 10 years plus. In 2017 we were covered with OptumRx and Blue Cross thru my wife’s employment at Walgreens. I am totally disabled and also on Medicare. For the year 2017 never had a problem getting my prescription filled. It’s now January 2018 and the trouble begins! My Doctor sent my prescription for ** to the pharmacy to be filled on January 17th within 2 hours of my requesting it. I am required to request refills 3 days before my medication is gone. Within an hour my pharmacy called to say they couldn’t fill the prescription because OptumRx needed a Prior Authorization. My pharmacy also sent a request to my Doctor’s office on my behalf. The pharmacy also recommended I call my Doctor as well just to expedite the Prior Authorization. On Tuesday I had enough medication to last until Friday morning the 20th.

On Wednesday morning the 18th I stopped by the pharmacy to get my prescription because the pharmacy said they should have approval by then. Well, no approval from Optum. I called the pharmacy again that afternoon and still no approval. I then called Optum to ask why my meds hadn’t been approved. I was told that they could take up to 7 days to approve the Prior Authorization. I told the rude customer service rep that the medication was an ** and I couldn’t wait 7 days for it or I would end up in the Hospital Emergency Room with severe withdrawals. I was then told that if it was an ** I would have to contact my Doctor and have another P.A. sent marked urgent and could then get my meds within 72 hours instead of 7 days and if that wasn’t soon enough I could pay for it out of pocket and would be reimbursed within 30 days.

I told her the cash price for a month’s supply of my medication is 900.00 dollars and I don’t have that kind of money available to me. Why is Optum doing this since it has never happened before. I then told her again without my meds I would be in withdrawals on Friday. I was told that this was the new policy due to the ** Crisis. First I asked her what has that got to do with me? This is a legal prescription written by my Doctor and I’m not an ** Crisis’ but I’m going to be if I don’t get my medication in time. I explained that I’m not allowed to get my prescription far enough ahead to cover the number of days Optum is requiring. No Doctor is going to do that nor would insurance pay for a next month’s refill that many days ahead. By this time I’m dumbfounded, angry and about to have a stroke. The Rep tells me that if I get that new P.A marked urgent it would more than likely be done by Saturday the 21st.

So by this time on Wednesday my Doctors office is closed. I was at my Doctors at 8am on Thursday to get the new Urgent P.A. sent. The new P.A. was sent within the hour. I waited all day Friday to hear from the pharmacy that I could come get my Prescription. Finally my Pharmacist called to say they still did not have approval. I call Optum again and was told that the approval Dept would be open Saturday and it should be done by then. I waited till 3pm Saturday and still no approval. Called Optum and told that they closed at 3pm and I was lucky that the Rep had even answered the phone but there was nothing they could do!

It is now 2:30 am on Monday and I’m in extreme pain and having horrible withdrawal symptoms. Fever, vomiting, diarrhea and just waiting for my Doctor’s office to open. Can’t go to the Emergency Room because Blue Cross won’t authorize the visit because I could have paid for the Medication but choose not to. I am so angry and hurting and just plain disappointed that OptumRx thinks what they’re doing is OK. If at all possible I will beg and borrow enough money to hire a Lawyer to stop OptumRx from continuing their horrible and damaging behavior! Please, Please don’t ever sign-up for coverage by these Monsters!

OptiumRX is part of UNITED HEALTH… and UNITED HEALTH is ENDORSED BY AARP..  I wonder how many millions of dollars that AARP gets from United Health for that endorsement.

Here is AARP’S MISSION STATEMENT FROM THEIR WEBSITE https://www.aarp.org/about-aarp/

Our Mission

AARP is a nonprofit, nonpartisan, social welfare organization with a membership of nearly 38 million that helps people turn their goals and dreams into real possibilities, strengthens communities and fights for the issues that matter most to families — such as health care, employment and income security, and protection from financial abuse.

13 Responses

  1. Boy, do I empathize with you. I’ve been trying for a month now to get approval for Repatha through OptumRX. My company’s insurance was switching to Optum in January so I made contact with them in mid-December and they told me I was already in their system so they could start the process now and I should be approved by Jan. 1 Awesome!….or so I thought. They sent my doctor the pre-authorization paperwork on Dec. 20, right before the holidays…and a weekend. When he didn’t get it completed in two days, they rejected it. So we tried it a second time…they sent it to the doctor on a Friday afternoon, then rejected it Monday morning. When I called them to check on why, they said he did not respond in the two-day time frame. It was a Friday afternoon!! What doctor keeps office hours on a weekend? We are now in the process of trying a third time. I have no idea where it stands at this time, but it is so frustrating. My drug can make a longterm difference in my chances of having a third heart attack, but at least its not an issue and pain and withdrawal as you are experiencing. I wish you much luck! And, yes, if you have a choice, stay away from OptumRX. Unfortunately, we usually don’t get that choice.

  2. I have found other insurance company and so far, I am happy with them.

  3. I would give them 50 negative stars, but I had to pick one in order to be able to put in a comment.

    I tried to find out how much a prescription would cost. After being transferred to 5 different “customer service” people (one who I was transferred to was humming songs to himself instead of talking to me and then he said he only handled government people so he had to transfer me again) who each told me how much I would have to pay but continually changed what I would need to pay and other information (at one time telling me the brand name was less expensive than the generic – a person later said the brand name was not covered), I was given to Estella Green. Estella Green assured me I would be able to get 12 injections (4 injections per month for 3 months) for $268.17. I asked her to process the prescription. She said she couldn’t because my prescription was expired and I would need to get a new prescription from my doctor. I asked if the price would be what she said, and she said, “yes”. She even conferenced me in with a pharmacist to verify that I could get the 12 injections (due to plan limitations).

    My doctor quickly approved the prescription. So, last night I went on the website to verify the cost and the cost was $5,797.17. I did not want my charge card charged this amount and the medication sent to me and not be able to send it back, so I called and immediately removed my credit card number from their web site.

    I spoke to a person named Jerome who once again told me a bunch of different answers (first was that it would cost me $10, then it would cost over $2,000, that I needed a prior authorization, etc.). I asked to be transferred to a supervisor.

    After being on the phone for over an hour I was given to “John” Junrell. His story changed constantly. First he told me that he would send me the additional kits and credit back my account so I would only be charged $268.17. I told him that nothing had been sent yet. Then, he said that my prescription was written wrong and I need to get a new prescription. I asked him to conference in the pharmacist. The pharmacist explained that the prescription was not written incorrectly. Junrell said there was an issue with the “day charge”. But after discussing the “day charge” issue, it turns out that the amount was the same without having to have my prescription re-written. I asked what happened to the ability to adjustment my account and he said he never said that, to which I said, “now you are lying to me?” He kept telling me that I needed a new prescription. I kept telling him that the pharmacist we spoke to together said I didn’t need a new prescription. I asked him to look back at what Estella Green wrote in her notes. He said she quoted me the price for only 4 injections. I said, “no I specifically asked if it was for 12 injections and she said ‘yes'”. He said I needed a prior authorization. I asked why I needed a prior authorization if the pharmacist said my prescription can be filled. I asked to be transferred to his supervisor. He said I was already in the escalation line and I could not be transferred to anyone else. I asked who I could talk to to get this resolved and he said he could give me the address to the CEO. During this time, I was also sending messages through their internet site (under Contact Us). I called back again and this time I spoke to Sierra (and she didn’t sound foreign). I think their telephone system knows if you just called and if you did, they don’t send your call overseas. Instead, they give you to someone who knows what is going on. She claimed that the notes that Estella Green wrote said the $268.17 was for 4 injections. I explained to her that was not what she told me.

    When I called each time, I was told that I had been chosen to take a survey at the end of my call. I always said “yes”. Yet, when the call did not go well, I never was given the survey. So, I asked Sierra if the customer service reps get something positive if they get a good score on the survey. She said “yes, that along with other things.” I said, so, Estella Green told me the low price so that I would rate her high on the survey and she would get perks!

    So, the company can say they get great customer service reviews because the bad calls never get the survey!

    I asked Sierra to cancel my order. She said, “it was cancelled yesterday”! My doctor had not even written/approved the prescription “yesterday”!!!!!

    I looked on their site today and it looks like it has stopped being processed.

    This past December, I needed the medication. When I went to Walgreens, they said the cost for 2 injections was $364. I cancelled the prescription. I went home and I found an insurance card on the internet (one where I don’t pay any money), took that to Walgreens and was able to get the medication for $244! The only bad thing is it does not go towards my deductible. Yesterday I received a Summary of Benefits from United Healthcare. It was for the prescription that I did not pick up at Walgreens with the United Healthcare insurance for $364! Their records state that I picked it up!

    Stay away from this company!

  4. DO NOT ever use Optum RX through AARP to do a mail order prescription. I have been trying to get my dads prescriptions filled for the last 3 weeks and due to multiple errors that they have made. We are still without it. They are the most incompetent people to deal with. Nobody knows their head from their ass. Spoke to a supervisor to make a complaint and she hung up on me.

    • There were too many things went wrong with them. I don’t have energy to describe about the incidents. I was using OptumRx for decades never had such horrible problems before. Do they changed the ownership without change the name? The latest problem I have is when I ordered my refiles, they sent me a note saying that I owed them $6.70 So I wrote them with my VISA # told them to charge it, as I always had before and they even had on them on file. They always automatically charge whatever there is the cost involved. When I changed the Visa/MC number, I always notify them.. On August 8, I mailed them with number to charge. Well when I ordered the refills, the man answered for the mail order department said, you owe $6.70 Until you paid we will not refill your order. Do you want to pay now? Too much to explain to him so I said yes. That was December 13, 2018. When I got my refills ($0 copay) again the payment slip says I owed them. I called again on 17th, to talk with a young woman who answered. I explained the woman all over again. Told her I will give you the number again so please put that amount in my card. Then she asked me if my doctor called for refill, can we charged to you account. It has been the agreement for decade. Why now!!!. I told her that I am disenrolling with AARP United Healthcare so that will not happen. She said “yes or no.” I felt my blood pressure was rising! I have never have experienced such incompetent people. By the way, the men who I spoke with were American men, no accent what’s so ever. I will be so happy I will not dealing with them…or do they still continue to hassle me about the $6.70 !!!

  5. This is a disgrace. What a sad world we live in.

  6. I get Social Security disability therefore I’m insured by Medicaid. It happened to me with this bullshit pre-auth with NO warning this month. No problems in getting refills in 2017. This is getting BAD! One med didnt get approved for 3 days.

  7. Anybody know if UHC is doing this to all their insureds? Never dreamed this part would happen and worse yet it’s “acceptable practice”. I think it won’t end with these meds, soon it will be insulin, heart meds, etc. How did torture become okay? People can die from withdrawal although I’ve heard the powers that be are saying that doesn’t happen – yes it does. So, isn’t withholding meds attempted murder at least? What a set up! First make it so no one can fill a day early and then this. And they’re getting away with it.

    • If they are not now.. .they will be soon… it is a cost control/increase profit driven. SS is in financial trouble, Medicare/Medicaid are in financial trouble.. Pain is subjective and they can’t feel the intensive of your pain. There is no test to demonstrate the intensity of your pain. IMO… it is a covert genocide – thinning of the herd. Cities, counties, states are trying to get their money back over the opiate crisis by SUING.. but there is no concern about cost of addiction to alcohol and Nicotine … IMO… the chronic pain community needs to come together… and sue for pt abuse, discrimination under Americans with Disability Act, medical battery… and those who feel that they have no other choice but suicide… make videos or detailed suicide notes… that accuses those people and entities that have driven them until that point and make sure they get into the hands of friends/relatives that will use them to have charges filed or lawsuits filled for assisted suicide and other appropriate laws that they caused to be broken

      • Good luck finding an attorney to take that lawsuit!

      • Yep, people should be responsible for taking their medication correctly. They ruin it for chronic pain sufferers, so they cannot get any medication that actually works in a severe pain attack.

  8. I decided to drop AARP after the article they published in their magazine trying to “scare” older adults about using opioids. I wrote them about it and got a form letter back.

    • They got so big they don’t care. When I called to cancel my membership, the woman telling me so many strange question which had nothing to do with my disenrolling, She talk so fast I could not understand the words what she was saying. Finally, I asked her to send print out these questions via regular mails. When I received it was nothing but “how they care about their patients and their health.” Nothing more than PR. BS. The questions they asking were so elementary that I had to laugh. They wanted me to take the form to my doctor so he will be aware of it! I happened to have an excellent PCP over 18 years.

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