Caremark PHC, LLC

December 20, 2017 Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont Donald Lynch Boulevard, Suite Marlborough, MA 01752-4705 Complaint # ***/ *** *** Dear Sir/Madam, CVS Caremark administers the prescription benefits for the ***
health plan, of which Mrs*** *** is a memberThis letter is in response to the correspondence we received from your office on December 12, Thank you for the opportunity to address Mrs***’ concerns. Upon review of this concern, we verified the *** benefit implements a retail fill limitation for medications at local retail pharmacyMrs*** is required to use mail order or her local CVS Pharmacy and *** Pharmacy to fill maintenance medication once a retail fill limitation has been metCurrently, the plan does not have the option to opt out or override this benefit plan restriction Once a plan member reaches their plan benefit retail fill limitation for medications at a local retail pharmacy, their options are to use either the CVS Caremark mail order service or the Maintenance Choice program. The Maintenance Choice program provides participating plan members with the choice of receiving up to a day supply of medication through a CVS or *** pharmacy for the same co-pay as mail orderAny medications that are filled outside of this plan benefit fill limitation will result in plan members being responsible for 100% of the cost of the dispensed supply. Should you or Mr*** have any additional questions or concerns, please do not hesitate in contacting me at 1-***. Sincerely, *** ***Member Advocate

On March 25, called CVS Caremark regarding a refillTold I did not put in for automatic refill when submitting Rx, however, my primary physician submitted the script The medication is one that can not be started or stopped abruptly as to the horrible side effectsMissing a day or would not have led to the side effects of withdrawal I had to go through had my medication arrived in a timely manner On 3/30, (days later) I received a call from physicians office informing me they (CVS Caremark) was out of the pills and needed to substitute capsules, they gave the okI had expected to receive the meds, instead, they were just being shippedOn 4/1/medications arrived and I have now endured days of withdrawalPrior to that I spoke with "***" a female rep from CVS, (3/31) told I can no longer stop delivery or payment (autopay) but will credit my next delivery of the same medication I no longer want to resume this medication as I have experienced the withdrawal and would

CVS/caremark administers the prescription benefits portions of the *** *** ***insurance plan, of which Mr*** *** is a memberThis letter is in correspondence we received from your office on February 9, Thank you for the opportunity to address Mr***’s concerns
as expressed in Complaint ID: ***.Upon review on Mr***’s concerns regarding the delay in his medication, it was determined there were multiple missed opportunities to register and complete his orderDue to this oversight, the order was not placed until February 9, 2016, approximately one month after the initial request was received.Once processing began, the order shipped the same day with overnight delivery scheduled for February 10, CVS/caremark was able to obtain confirmation the medication was delivered as scheduled.We sincerely apologize for any frustration or inconvenience that Mr*** experiencedWe value Mr*** as a member and we are confident that future service will consistently reflect our commitment to our purpose, “helping people on their path to better health”Should you or Mr*** have any additional questions or concerns, please do not hesitate in contacting me at ***.Sincerely,*** ***Member Associate

August 26,
Revdex.com
*** *** *** *** *** ***
*** ** ***
Complainant ID: *** / *** ***
To Whom It May Concern:
This letter is in response to the correspondence we received from your office on August 18,
Thank you for the opportunity to address Mr***’s concerns regarding receiving an unauthorized order of medication
Upon review of this concern, CVS Caremark mail order received a prescription from Dr***’s office for processingThe prescription was received electronically and was filled automatically per our processThe prescription request was not initiated by CVS Caremark and there were no instructions dictating to hold the prescription on fileMr***’s order was processed and shipped on June 28, and he was charged $At the time this order was shipped, Mr*** was unaware that the medication in question was being filled via mail orderDue to the inconvenience, a one-time courtesy adjustment of $was givenMr***’s account now reflects a zero
We value Mr*** as a member and we are confident that future service will consistently reflect our commitment to our purpose, “helping people on their path to better health.” Should you or Mr*** have any additional questions or concerns, please do not hesitate to contact me at *** My office hours are Monday thru Friday from 9:a.mto 5:p.mCentral Time
Sincerely,
*** ***
Member Advocate

December 31,
Revdex.com
*** *** *** *** *** ***
*** ** ***
Complainant ID: *** / *** ***
To Whom It May Concern:
This letter is in response to the correspondence we received from your office on December 17, Thank you for the opportunity to address Mr*** ***’s concerns regarding receiving an unauthorized order of medication.
Upon review of Mr***’s concerns we were able to confirm that the prescription received was not filled in errorOn March 10, CVS/caremark sent out a Medication Non Adherence Therapy Advisory letter to Mr***’s prescriber’s officeCVS/caremark monitors adherence of medication to insure safety and proper usageOur records show the medication was filled once between September and March The letter was not an attempt to request a new prescription but only to notify the doctor of prescription adherenceOn October 2, we received a prescription from the doctor which processed and shipped as of October 5, Once a prescription is received by our mail order pharmacy, if there are no errors with the way the prescription is written or questions regarding the prescription, it will be filled as normalFor this particular situation, CVS/caremark’s return policy does not allow for the return of medication for credit
We sincerely apologize for any frustration or inconvenience that Mr*** experiencedWe value Mr*** as a member and we are confident that future service will consistently reflect our commitment to our purpose, “helping people on their path to better health.” Should you or Mr*** have any additional questions or concerns, please do not hesitate to contact me at ***. My office hours are Monday thru Friday from 9:a.muntil 5:p.mCentral Standard Time
Sincerely,
*** ***
Member Advocate

January 26,
*** *** ***
*** *** *** *** *** ***
*** ** ***
Complainant ID: *** / *** ***
To Whom It May Concern:
This letter is in response to the correspondence we received from your office on January 18, Thank you for
the opportunity to address Mrs*** ***’s concerns regarding her fertility Maximum Allowable Benefit (MAB) limitations
Currently under Mrs***’s plan benefit the Maximum Allowable Benefit for fertility medication is $10,000. Once this limit is met it does not reset due to being a lifetime MABMrs*** has recently changed her carrier from *** to *** in an effort to have her Maximum Allowable Benefit resetRegardless of having a new carrier the limit will not be resetMrs*** has been advised to contact her benefits office to gain a better understanding of her plan structure, and coverage limitations
We value Mrs*** as a member and we are confident that future service will consistently reflect our commitment to our purpose, “helping people on their path to better health.” Should you or Mrs***have any additional questions or concerns, please do not hesitate to contact me at ***. My office hours are Monday thru Friday from 9:a.mto 5:p.mCentral Standard Time
Sincerely,
*** ***
Member Advocate

April 19,
Revdex.com
*** *** *** *** *** ***
*** ** ***
Complaint ID: *** / *** ***
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the health plan for *** ***, of which Mr
*** *** is a memberThis letter is in response to the correspondence we received from your office on April 8, Thank you for the opportunity to address Mr***’s concerns as expressed in Complaint ID ***
Upon review of Mr***s’ concern, we have confirmed that the balance in question was from an order which CVS/caremark shipped December 29, In accordance with applicable law, CVS/caremark is prohibited from applying charges to FSA cards for orders that shipped beyond days agoOur pharmacy confirmed that Mr***’s balance was paid April 8, and a new prescription order was processed and shipped via *** on April 12, Per *** tracking information the order was delivered on April 14,
Additionally, a review of Mr***’s interaction with the customer care team, we recognize that there were several opportunities for additional training and coaching for our staff. Feedback has been provided to each member of the customer care team with whom Mr*** interacted. Please note that our goal is to ensure that our valued customers receive only the highest level of customer care
We sincerely apologize for any frustration or inconvenience that Mr***’s experiencedWe value Mr*** as a member and we remain fully committed to our purpose of "helping people on their path to better health"Should you or Mr*** have any additional questions or concerns, please do not hesitate in contacting me at ***
Sincerely,
*** ***
Member Advocate

Member called in response to a letter sent to advise an order was being held due to payment issuesCCR advised one order had shipped and two other prescriptions were in a future fill until April. CCR said the member was called multiple times about the order cost, which was $208.41, but member
said she hadn’t received any medications and had remitted a $check to ExactusCCR explained Caremark was now the PBM for the planShe advised for orders costing $or more, Caremark would contact her to get a confirmed payment method before shippingMember questioned co-pays and was transferred to Wellcare for that information.We have issued a mail tag for the member to send the order back for a refund

I would like to start off saying I have MSI have been getting *** for the last yearsI started working for the State of Florida and the *** *** *** used accredo pharmacyIt was changed to CVS\caremark 1/6/I received my day refill from December untill March 2015, The next refill was to be due in June When I did not receive a call for refill from CVS I called them June 20,around 12:00pm, on 6/21/around 6:35pm, at this time I spoke with different CSR who was not sure why the medication was not in their system to be deliveredand they were working on it On 6/28/around 12:03pm I called to inquiry about the medication and was tol I had to call my neurologist to get a new prescription which I did around 12:13pmI spoke with *** my doctor nurseBy this time I was out of medication because the last days ran out in June*** let me know she sent a new prescription electronic to CVSOn 6/29/I spoke with the Droffic

I have contacted the CVS/caremark specialty pharmacy an unknown amount of times at this point to get my prescriptions filledI set up delivery after of hours of run around, transfers, and so on then never get my RX which is required (by them) to be sent via mail orderI have gone through this for the past year with this company and for the last 2-months it has become impossible to get my prescriptionWhich mind you is for HIVI have been without my meds now for about a month, maybe more and really have no idea what I can do furtherI can not get them filled with a local company due to policy

Synopsis of Problem August 2016:
We were informed by CVS/Caremark that they had decided to look at a prior authorization with an expiration of 2018, and they had to deny it and informed us that my wife was no longer allowed to have the doctor prescribed *** mland that CVS/Caremark had decided to switch her to the more cost effective generic drugBeside the fact that we wanted to stay with our doctor’s advised medicine I pointed out numerous articles revealing that the FDA had approval strong reservations about the drug’s reliabilityCase in point *** online article “pharma & healthcare dated 7/07/@ 7:am”We were still told we had no choiceAfter several phone calls and much frustration they granted us an appealThe next week we were informed that the appeal had been denied and CVS/Caremark would be deciding my wife’s treatment for usAt this point I requested corporate headquarter names of people I could state our case toAccording to *** *** the

Caremark is a horrible company that is dealing with medical, similar to doctors in that they are to ensure that patients get their proper medications prescribed by their doctors Unfortunately Caremark thinks they are better than your personal doctor and get to tell your doctor how to practice even though they are NOT DOCTORS and the doctors they have working for them have never met the patient They will deny medications playing games with your healthThey are indirectly in the medical field and causing harm to people

Placed refill order for RXs on 3/22/ Was contacted on 3/23/to confirm delivery of these RXs after having requested to not be contacted for this issue Contacted customer service times and the first two times were put through to an a voicemail box for the same number where I had to call and confirm my delivery address On the third attempt I requested to speak with a supervisor, found her response to be unsatisfactory so I requested to speak with her supervisor After waiting on hold for 10+ minutes I was informed that her supervisor was not answering and I would have to be called back When I asked the time frame for this call I was told that it would be within hours So at this point I arranged to take the day off of work on 3/24/so that I could be at home to sign for my RXs (first time I have ever had to sign for these RXs in the years that I have been taking them) RXs never arrived on 3/24/after caremark had me make arrangements to have someone at

On 11/1/I called in response to a letter I rec’d from CVS/Caremark telling me I HAD to order my prescription for *** once a month pill directly through CVS or mail order Service person *** took my info and told me we could do ALL of my prescriptions that way, that I could just go on-line and re-order them as needed He told me he’d contact my doctors and previous pharmacy and get all the info, took my credit card and we were done
A week later I began receiving packages, bottles of a nasal spray supplement and a package of *** I NEVER REQUESTED THESEWhen I called spoke to “***” who tried to tell me that my doctor requested these First of all, Drs*** and *** would have NO KNOWLEDGE of CVS/Caremark unless CVS CALLED THEM, which they didThe doctors ordered nothingI asked for a supervisor as *** was no help (kept telling me to call my doctors!) *** was somewhat helpful but told me “we need to listen to the original phone call to proces

CVS took an unauthorized $off my debit cardI did not authorize or approve that paymentI had just returned to work on Sept 6th, I had been on LOA since April 5th They shorted my check some hours and I'm currently in the process of getting another check cut to for the hours I was shortedI went to make my power payment this morning, it's due to be disconnected/interrupted on TuesdayBut I couldn't make that payment, they sucked all but $off my cardAnd for another thing, I don't owe them $I filed a complaint with Consumer Financial Protection BureauThis is exactly why people don't want to do business like thisAnd for another reason, they're telling me I can't get one of my prescriptions refilled until Sept 29th, when the local CVS Pharmacy has the same prescription filled but wants to charge me times the price of the mail order

I have a health insurance that uses CVS/ caremark a prescription site for the employees employed by *** *** **I have purchased an antibiotic medication in January 2016, and I have paid full price $because my CVS discount card has not arrived yetI have contacted CVS Claim department in January r/t the claim, have received a claim form, submitted on Jan.7th, and received a response from CVS on Feb.11, that all my documents were submitted correctly, and I should receive a reimbursement of $in 30-daysI have called CVS in the end of March and again on April 5, questioning about reimbursement checkI have been told that I should have received it and customer service were not sure what happenThey promised me to refile the claim again, and to speed out the process since I have been waiting for long timeToday is May 27, and I have not heard from CVS, nor I have received a check for $CVS ***

CVS caremark is the insurance carrier my company has for prescription medication For years I have been taking *** for extreme acid reflux Starting about years ago CVS started questioning my Dr.s prescription and wanted a "prior authorization"This practice is ridiculous because my authorization is my prescription my doctor wrote So we would have to go through about a week's red tape before CVS would honor the scriptThe process included numerous calls and visits to my doctor that ballooned my medical bills far beyond what they were when my doctor wrote the original prescription Fast forward to 2015, *** came out with a 'genertic' drug, which CVS Caremark immediately switched me toI did not mind, the generic worked fine In January my doctor wrote a script for day supply with refills to send to CVS caremark to cover me the entire period The script was mailed and CVS sent me the 1st script of day supply of generic ***I was to have refills

I am just trying to refill a prescription The prescription is from June And good for refills Second refill was October Tried to submit 3rd refill, January 26th
One of the medicines showed "on hold" with request in to doctor I've called times about it this week, Jan 30th, Feb and twice today, asking about the issue Every time I get a different answer I point out that the prescription hasn't changed, they first insisted they needed more information I asked what was different than in October? They told me later I could put a patient override for the medicine and it would go out on *** immediately I checked back later that day, it showed back "on hold" so I called the 4th time I am not getting any resolution and talk to someone different each time
Again - prescription is JUST a "refill", 3rd of refills called in back in June Nothing has changed from doctor since originally received Whatever has changed is from Caremark's end and they

CVS knowingly and willingly shared my personal and private information with a '*** Systems, Inc' who then proceeded to harass me about a bill I was unaware I owedRather than use the conventional billing system they chose to use this '***' companyI do NOT work with collection agencies because I am never in default or miss payments everIf this was missed I was not appropriately billedI did not give CVS permission to share my personal information to another companyI already filed a complaint with *** and they then proceeded in trying to contact me additional times after being told not toThis causes stressI got another threatening letter in the mail today

Yesterday I was at the doctor's office and was prescribed a medication that I normally get locally By mistake they set the prescription electronically to CVS Caremark They immediately sent CVS Caremark a cancelation and then transmitted the to the local pharmacy I picked up that prescription and paid $ Six hours later I received an email stating that CVS Caremark was processing the prescription and the cost was going to be $ I called CVS Caremark and told them that they were not supposed to process that prescription because it was cancelled by the doctor I stated that I had already gotten my prescription locally They stated that they didn't see the cancelation and now there is no way to stop the processingI am surprised they were able to process a duplicate prescription on the same day but they can clearly see that I had gotten it in my prescription history They are sticking it to me and I clearly have a problem every time I have to get a prescription from th