Caremark PHC, LLC

Back in June 2016, I decided to use CVS/Caremark to get my prescriptions through mail order since it was cheaper than the local pharmacyMy health insurance is through *** *** *** *** *** Federal governmentMy first bad experience with CVS/Caremark is when I called in June to check to see if they had my prescriptions from the doctor to fill, I was told yes and I said hold off because I just filled one at the local pharmacy because I needed it right away, they said they wouldAfter that when I did call back, I was told I needed a prior approval because my previous one expired in May (note I called in June and no said anything)After that it was downhill, every time I spoke to someone I got a different answer but one agent I talked to filled of my three prescriptions and asked how I wanted to be billed, I said invoice which he did; however when I called about the third medicine because I had received an email that it was cancelled, I was told that they could only invoice for

I don't know when it changed but Caremark has managed to have removed the "Care" from CaremarkThey should change their name to “DontCaremark”Automation is supposed to enhance customer service, not replace it I was having my meds filled at my local CVS but for some unexplained reason they would only give me a 30-day supply instead of 90-day supply even though my prescriptions were for a 90-day supplyNo one at CVS could explain why so I decided to try Caremark mail order another try and hoped they had fixed the glitchBoy was I wrongIt’s worse I used to be able to request when and where I wanted my medicationsNow they just automatically send them even after I call to specifically ask for them not to do soI have never signed up for auto refills yet they still continue to automatically mail refills on their schedule without me requesting themI was planning a move to another state and wanted to make sure that no meds would be automatically mailed to my old address so I ca

The bank sent a check for $for a bill for medicine, (mail order) in Jan, I kept getting calls about the bill not being paid and I told them that is was paidI looked at my bank account, found the cancelled check that they cashed, sent it to where the girl told me to, that had to be about a month agoNow my husband got a letter from a collection agency about the check, that they cashed in JanThis really makes me so angy

CVS is demanding that I pay for a prescription that I never received Several months ago, I called because I never received my first round of prescription They said that the postal service had confirmed delivery, but I explained that I did not receive it
They said that was not a problem, asked if I wanted it reshipped, and I said "no." Just call it into my local pharmacy, which the company did I went to my local pharmacy, paid for it CVS systems shows that I made this purchase on or about the time I told them I did not want to reshipment
I also filled out a form, at CVS's request, asking if I had received the initial shipment, and I marked the box that I had not I believed that was the end of it Then, months later, I receive an invoice stating that I owe money for the shipment I never received I spent over an hour on the phone, eventually ending up speaking to *** (ID: ***), who basically told me that I had no choice but to pay for the Rx I didn't receive,

CVS Caremark sent me a three month supply of a medication that I do not need, and already have It is listed on my medications my CVS Caremark personal webpage, and I have it stopped I did not know, but my GI doctor wrote another script that I had no idea about CVS claims that this is a 'new' prescription, and did not contact me, or give me notice, and sent me a three month supply and charged me dollars I called and emailed them, however, a 'Team of Pharmacists' reviewed my order and denied any refund I will to get a refund for something that I was NOT informed about, and don't need

March 11,
Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont
*** *** *** *** *** ***
*** ** ***
Complaint #*** / *** ***
To whom it may concern:
CVS Caremark administers the prescription benefits portion of the *** ***
health plan, of which Mr*** *** is a memberThis letter is in response to the correspondence we received from your office on February 26, Thank you for the opportunity to address Mr***'s concerns as expressed in Complaint #***
Upon review of Mr***'s concern, our filling pharmacy was able to confirm that CVS/caremark reduced the quantity of Mr***’s prescription to a day supply in errorMr***'s plan allows him to obtain up to a day supply through the mail order program. In an effort to maximize his benefits, an order was submitted for the remaining day quantity at no charge to Mr***The new order was shipped to Mr*** on February 27, and delivered via UPS on March 3,
We sincerely apologize for any frustration or inconvenience that Mr*** experiencedWe value our members 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 Advocate

I m not able to utilize my CVS Caremark insurance for my secondary insurance for my dependentMy dependent has primary insurance through *** and secondary insurance through *** which both use CVS CaremarkI called CVS Caremark advise several times in the month of January that the *** is my secondary insurance which *** has listed as secondary and asked for them to update the second plan as secondary and they advise they cannot helpI am not able to utilize my secondary CVS Caremark insurance at the pharmacy due to both CVS Caremark plans showing as primary insurance*** has also contacted CVS Caremark 01/13/and they were unable to get assistance as well I am having to pay for prescriptions and force to pay for mailing postage for prescriptions to CVS Caremark for reimbursement

I was notified that one of my prescriptions (***) would no longer be covered beginning UNLESS the patient had one of underlying conditions (which I have)If that was the case, the doctor could request an exception for medical necessityMy doctor did that and I received a letter stating the exception was granted and to go ahead and fill the prescriptionI tried doing that multiple times but each time was deniedAfter numerous lengthy phone calls and promises to look into the matter, CVS finally said the exception was granted in error, even though I met the conditionsI have had to spend far more to maintain my prescription over the nearly two months this has been going onCVS has given me the run around asking my doctor to resubmit prescription requests and authorization requests, without any results to showIf I had the option of using a different provider, I would never use CVS again

I contacted Caremark at the recommendation of Dilley Allergy, San Antonio TX to set up medical treatment for allergies CAremark (CVS) clearly stated they required me to make the appointment in advance with my doctor for these allergy shotsThey needed proof of the appointment to ship the medicineHowever, my doctor's office said they could not make the appointment until they had the allergy shots This was contradictoryI was not sure what to do, and told CVS and my doctor I was not able to solve this as their requirements conflictedI became very busy at work and was not able to pursue the matter any further
I did not authorize CVS to ship the medicationI did not make an appointmentI did not apply for the *** insurance or fill out any paperwork that would imply I was moving forward with this treatmentA month or two later, CVS left a message that they had cancelled my request due to lack of responseThat was fineI thought it was done
A few months later I

I recived a prescription from cvs/Caremark that I did not order I spoke with a representative from them and they stated that they would not refund the medication I only set up two medications to get from them on auto refill This medication is not one of them The automatically charged my credit card $ The price of the medication at my local pharmacy is with a card from the prescription I just paid for months worth of medication

September 17, Revdex.com *** *** *** *** *** *** ** *** Complainant ID: ***/ Mr*** *** Dear to Whom It may concern This letter is in response to the correspondence we received from your office September 11, 2015. CVS/\caremark administers the prescription drug benefit for the *** *** Company health plan, of which Mr*** *** Jris a member. Thank you for the opportunity to address Mr***’s concerns regarding his plan design. This letter is in response to Mr***’s questions regarding his refill limitations as set by his plan benefitThe *** *** company prescription drug plan has had incentivized maintenance choice program in place since 2012. Once Mr*** has reached the plan benefit retail fill limitation for maintenance medications at his local retail pharmacy, his options are to use either the CVS/caremark mail order service or the Maintenance Choice program at a CVS/pharmacy retail location. The Maintenance Choice program provides participating plan members with the choice of receiving up to a day supply of maintenance medication through a CVS/pharmacy for the same co-pay as mail orderMaintenance medications that are filled outside of this plan benefit fill limitation may result in a higher member cost share CVS/Caremark is unable to reimburse Mr*** for any out of network transactions due to the plan limitation of one initial fill and one refill If Mr*** would like to further press this issue regarding his refill limitations, Mr*** can speak with his benefits office to verify what other options may be available to him. Should you or Mr*** have any additional questions or concerns, please do not hesitate to contact me at 1-***. My office hours are Monday thru Friday from 9:a.muntil 5:p.mCentral Standard time. Sincerely, *** *** Member Advocate

August 28, 2015 Revdex.com2** *** *** *** *** *** ** *** Complaint ID: ***/ *** *** To whom it may concern: CVS/caremark administered the prescription benefits portion of the health plan for Assurant Health, of which Ms
*** *** was a memberThis letter is in response to the correspondence we received from your office on August 13, Thank you for the opportunity to address Ms***s concerns as expressed in Complaint ID ***.Upon review of this concern, we confirmed that Ms*** placed her order for the medication in question with our specialty pharmacy customer care team. The prescription request would have been processed through Ms***s medical coverageMs*** called to schedule her order on December 15, to be delivered December 18, The medication shipped December 17, via overnight deliveryMs***'s plan coverage ended on December 15, 2014, and Ms*** was unaware that the billing date would be the fill date, not the date the order was placedHer coverage was verified as active at the time of her call on December 15, 2014. Ms*** did not communicate that her coverage would be ending on midnight of December 15, When Ms*** was asked if there were any changes to her insurance, she stated “No.” The medication was filled and processed after coverage had endedA request to write off the balance as a courtesy has been deniedIt has been confirmed that all procedures were followed correctly, and no error occurred with filling and processing this order request. We sincerely apologize for any frustration or inconvenience that Ms*** experiencedWe value Ms*** as a member and we remain fully committed to our purpose, “helping people on their path to better health”Should you or Ms*** have any additional questions or concerns, please do not hesitate in contacting me at ***. Sincerely, *** ***Member Advocate

February 8,
Revdex.com of Eastern MA, ME, RI, & VT *** *** *** *** *** *** *** ** ***
Complaint: ***/*** ***
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the *** *** health plan, of which Mrs
*** *** is a memberThis letter is in response to the correspondence we received from your office on January 25, Thank you for the opportunity to address Mrs***'s concern as expressed in Complaint ID: ***
Upon review of Mrs***’s concern we confirmed the medication in question was enrolled in the ReadyFill at Mail program on April 14, The ReadyFill at Mail program allows members to receive prescription refills and renewals of maintenance drugs automaticallyThe process of requesting Mrs***’s medication via the program started on December 20, On December 22, the request was canceled due to no response from the prescriber’s office
The prescriber’s office is able to authorize a new prescription by responding to the form that is initiated via the ReadyFill at Mail programFurthermore, the prescriber’s office can request a prescription via fax, phone call and/or electronicallyOn December 22, the prescriber’s office made contact with our pharmacy and provided a verbal prescription for a day supply. Mrs***’s order processed correctly at a $copaymentAs a courtesy, a $credit has been adjusted to Mrs***’s mail order account
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 in contacting me at ***
Sincerely,
*** ***
Member Advocate

My account has been under review by Caremark due to a third party pharmacy reimbursement, which is understandable I was told the account review would be complete on 9/14/ On 8/31/17, I received a call stating the review was complete, no further reviews would be done; my deductible and out-of-pocket had been met On 9/8/17, I was advised by this same representative that the review was NOT complete On 9/14/17, I was advised via email that as I was told on 8/31/17, my review was complete and all further co-pays would be $ Later on 9/14/17, I received a phone call from the same prior representative apologizing for the conversation on 9/8/17, and that the review was, in fact, complete No further reviews would be done Everything was met and my copays would be $ Everything remained fine until 9/20/when I logged into my account to discover that my deductible and out-of-pocket max were not met When I called to find out why, I was told my account had been "adjusted"
D

This is in response to your inquiry dated September 16, regarding the member’s mail order prescription
I verified the member ordered the medication on August 23, and it was processed with the correct address on file; however, there were comments on file stating to ship it to a different addressThe address was changed in the pharmacy and the medication was shipped to that address. I reviewed the phone call taken by a Customer Care Representative on August 23, and the comments were not reviewedThe Customer Care Representative provided incorrect information as the address on file was verified not the address in the comments. The comments have since been removed and all future prescriptions will go to the address on file unless the member provides a different address
In addition, I reviewed the phone calls where the member states she was advised she would receive UPS next day shipping on all future orders at no charge to her. I verified the member was not advised of thisThe member sent an email to us on September 1, confirming all her orders would be sent via UPS next day shipping with signature requiredAt the time of this email, notes were placed on file to ship future prescriptions with signature required and UPS next day shipping at her expenseAn email was sent to the member advising of this; however, the member has not yet read the email
I spoke with the member and advised of this informationThe member did not want to be responsible for the UPS next day shippingPer her request, I removed the comments on fileThe prescriptions will be sent signature required going forwardIn addition, I mailed an apology letter to the member due to the Customer Care Representative not reviewing the comments on her fileThe Customer Care Representative has also received the necessary coachingThe member was not satisfied at this time

My annual deductible on my health insurance and prescriptions through my health insurance is $1,I was in the hospital in the beginning of January of and met my health deductible by January 4, My understanding is that it can take a week or so for the hospital to get that information over to *** *** so when I went to pick up prescriptions I had to pay full price as if I had not met my deductible for the yearLast week when I went to *** I had to pay about $for my medicine and I knew that there had to be a problemSo I called Caremark customer service, they advised they showed I was on a family plan with my health insurance which meant I had a $2,deductible that had not been met yetI explained they had incorrect information as I was on an individual plan which meant my deductible should be $1,Long story made short, *** *** the company who offered me the health insurance called CVS/Caremark to advise they had the wrong info, and

February 24,
Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont
Donald Lynch Boulevard, Suite
Marlborough, MA 01752-
Complaint # *** * *** *** ***
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the health plan for the *** *** ** ***, of which *** *** *** is a memberThank you for the opportunity to address *** ***'s concerns as expressed in Complaint # ***
As a onetime courtesy we have credited *** ***’s account $25. We would like to reiterate that the order and prescription in question processed and billed correctly through the plan benefit.
CVS/caremark administers the prescription drug benefits for the *** *** ** *** health planAs the administrator of the *** *** ** *** health plan, we are required to administer the prescription portion of the benefit plan in accordance with the benefit features adopted by *** *** ** ***.
We value *** *** 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 *** *** have any additional questions or concerns, please do not hesitate in contacting me at 1-***
Sincerely, *** * ***
Member Advocate

Trying to perform a prior authorization for a medication for a patientI have called several phone numbers, spoken with several people and no one can get this prior authorization completedI asked for a supervisor and they declined

On 02/06/2018, Caremark sent me the wrong medications from their #* *** *** *** ***, PA location
On 02/09/2018, I spoke to *** at Caremark customer service (***) to notify Caremark of the error, I asked where to take the medications to return them, and to notify Caremark that I will not be paying for the medications sent in error*** said, I will receive a call or email or I will receive a snail mail document to get the issue resolved
I waited until April 2018, to give the company enough time to respond to my complaintI did not hear back from anyone at Caremark except they sent me another bill for the medications that I cannot use
On 4/3/2018, I called and spoke to *** at Caremark customer service*** connected me to *** Nin Caremark in San Antonio, TX*** said she wrote a priority note on my account stating Caremark is to never fill prescriptions for me without calling me firstShe said she called Clinical to ge

CVS Caremark forced me to change my daily Asthma medication from picking it up in the stores, to ordering it through the mail, which I have done That was a week ago I am currently out of my Asthma medication, and they can't tell me when I will get it!!!!!!!! They are putting my health at risk and they aren't doing anything about it!!!!!!