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BJC HealthCare - Shiloh/O'Fallon IL Office

Cross Street, O'Fallon, IL, United States

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BJC HealthCare - Shiloh/O'Fallon IL Office Reviews (%countItem)

• May 05, 2025

Care Complaint
I work for a large company in STL. CVS/Caremark, who manages our prescriptions, started a new obesity management program on 4/1/25 in which they will now cover GLP-1 medications. They did not previously cover them. My doctor, Jennifer Neville, had prescribed Zepbound for me back in March 2025, which was denied at the time, not covered. However, now it is. I joined the obesity management program and had my first call with my care coordinator on 4/30/2025. I was told prior to that call, that I would need a prior authorization form from my doctor's office. One was sent to the doctor's office on 4/28. I am told by CVS/Caremark that it was denied because the doctor's office did not include my BMI information. A second prior authorization was sent to the doctor's office by CVS on 4/30. It was again denied by CVS on May 1. I am told by CVS that they did not receive the 2nd PA form from the doctor's office and that the second denial was because they never received the required information from the office, BMI and reason medication is needed. I received two responses in MyChart from the NP I have seen and one of the nurses pretty much telling me "to bad so sad". We won't resend the form and you'll just have to pay for it out of pocket. Sure, $1250 a month as opposed to $30 a month. Told me I could appeal decision with CVS, which I don't know how as CVS tells me it's the doctor's office's fault. They are now ghosting me. Pretty much "screw you". I really need some additional help with my weight that I was hoping the medication would give me. I pleaded with them to please try one more time, and if it was again denied, I would let it go and go back to CVS about the issue. I really feel like I've been kicked to the curb by two skinny gals who can't possibly understand what it is to be morbidly obese all of your life. I really liked my doctor, great doctor. No choice now but to find a new one. Not that they care, but I won't go back to that office.

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Address: Cross Street, O'Fallon, IL, United States


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