Caremark PHC, LLC

This is in response to your inquiry dated August 8, regarding a mail order prescription We attempted to contact the member; however, we were unsuccessfulWe are unable to research the request as we do not have a drug nameThe member must provide the drug name in order for us to research further

March 29, Revdex.com [redacted] Complaint ID: [redacted] / [redacted] To whom it may concern: CVS Caremark administers the prescription benefits portion of the health plan for [redacted] , of which Mr [redacted] is a memberThis letter is in response to the correspondence we received from your office on March 16, Thank you for the opportunity to address Mr [redacted] 's concerns as expressed in Complaint ID [redacted] Upon review of Mr [redacted] ’s concern, we have confirmed that effective January 1, The [redacted] prescription drug plan would no longer cover any brand or generic proton pump inhibitor medicationWe verified that letters were mailed to members prior to this change taking effect allowing them time to discuss alternative options with their physician If members of the plan are unable to take the alternative medications due to a diagnosis of Barrett’s esophagus or Zollinger-Ellison syndrome an exception request can be submitted by contacting CVS/caremark at [redacted] At this time we have not received the necessary information needed from Mr [redacted] ’s physician to complete the exceptions process We sincerely apologize for any frustration or inconvenience that Mr [redacted] experiencedWe value Mr [redacted] as a member and we remain fully committed to our purpose of "helping people on their path to better health"Should you or Mr [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted] Sincerely, [redacted] Member Advocate

July 12, Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont [redacted] Complaint # [redacted] / Mrs [redacted] To whom it may concern: CVS/caremark administers the prescription benefits portion of the [redacted] health plan, of which Mrs [redacted] is a memberThis letter is in response to the correspondence we received from your office on July 5, Thank you for the opportunity to address Mrs***'s concerns regarding her issue Upon review of this concern we verified via tracking information, the order in question was deliveredto Mrs***’s home address on May 26, Due to Mrs [redacted] stating she had not received said order, a courtesy reshipment of the order was mailed out on June 16, with a confirmed delivery date of June 18, Voicemails were left at the phone number on file for Mrs***; we did not receive any return calls from Mrs [redacted] to confirm delivery of this reshipmentOn July 12, 2016, due to no confirmation from Mrs [redacted] that she had received the reshipment, we mailed out a second reshipment as a courtesy via overnight delivery waiving the copayment of $This is the third order that was sent to Mrs***, any additional reshipments or orders will be at Mrs***’s expense We value Mrs [redacted] 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 [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted] Sincerely, [redacted] Member Advocate

I place an order in May for my prescription and paid for my orderI called in June to order the medication refill and customer service said I got an order in MayI told the lady I did not receive an order in May and that was why I am ordering it nowShe said the insurance want let them do an over ride and I need to check with the Post Office, I told them the Post Office take people packages, so she said it was tracked to my door and I told her I didn't get itWhwn I called the Post Office the manger said it was tracked to my doorI told her than scan it at my address but, they didn't leave itShe said she can't say the carrier stole it, I she to her I can [redacted] said I could get a day supply and she would talk to her boss about a creditShe said she would follow back up on the credit along with getting my refillWhen I called to place an order for another medication they tacked on the amount for the lost orderI told them I not paying twice for something I didn't getI s

I called in a refill for the first time with this prescription plan for my month old daughter on 4/25/ I was told that the insurance company would not cover the medicine I then contacted them to advise that she needed the prevacid as it is a solutab and she cannot swallow a pill They had wanted her to take a generic that only comes in a pill form I was given the appeal number and fax number for her Dr to contact Since the 25th I have been told they are waiting on my Dr or haven't received the information needed I've been told by multiple associates different stories, as one will say they have everything the other will say they have only received partial and then I will be told they have received nothing When I contact my Dr they have proof of the phone calls as well as the letter of medical necessity that was faxed I contacted this business on 5/5/and escalated to a supervisor She asked that my Dr's office call one more time and she would track the follow and

In order to properly investigate your concerns, we are in need of additional information Please provide us with the following information: Member ID number, Date of Birth, and the name of the medication in question

February 5, Revdex.com of Eastern MA, ME, RI, & VT Donald Lynch Boulevard, Suite Marlborough, MA 01752-Complaint ID: [redacted] / [redacted] M [redacted] To whom it may concern: CVS Caremark® administers the prescription benefits portion of the [redacted] health plan, of which Ms [redacted] is a memberThis letter is in response to the correspondence we received from your office on January 20, Thank you for the opportunity to address Ms [redacted] ’s concern as expressed in Complaint ID: [redacted] Upon review of this inquiry and concern, we verified that Ms [redacted] ’s accumulations were satisfied in October We re-verified and confirmed that Ms [redacted] ’s deductible was completely satisfied on April 2017; then in October Ms [redacted] satisfied her Maximum out of Pocket expenseMs [redacted] ’s accumulations were checked multiple time to verify they were correctWe could not find any evidence of Ms [redacted] being overchargedAt this time we conclude Ms [redacted] is not owed any reimbursement for copayments assessed for her medicationsIf Ms [redacted] can provide any documentation which reflects where she was overcharged we would be glad to further review this situation We value our members and we are confident that future service will better reflect our commitment to our purpose of, “helping people on their path to better health.” Should you or Ms [redacted] have any additional questions or concerns, please do not hesitate in contacting me at 1- [redacted] Sincerely, [redacted] Member Advocate

September 29, Revdex.com Donald Lynch Boulevard, Suite Marlborough, MA 01752- Complainant ID: [redacted] / [redacted] To Whom It May Concern: This letter is in response to the correspondence we received from your office on September 19, Thank you for the opportunity to address Ms [redacted] ’s concerns regarding the payment of $that was processed on September 18, On September 18, 2016, Ms [redacted] ’s most recent order of medication was shipped; the total cost for this order was $Prior to this order, Ms [redacted] had a balance on her account of $The $balance was from orders placed on March 28, 2016, June 17, 2016, and August 26, As part of Ms [redacted] ’s plan design she is allowed to have orders of medication dispensed without a method of payment on file if the balance on her account is less than$ This would explain why Ms [redacted] was able to have her three previous orders dispensed without payment On September 18, Ms [redacted] added a method of payment on file and the whole balance due of $was applied Ms [redacted] has been advised that we will use the method of payment on file to pay for all future orders We value Ms [redacted] 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 Ms [redacted] have any additional questions or concerns, please do not hesitate to contact me at [redacted] My office hours are Monday thru Friday from 9:a.mto 5:p.mCentral Time Sincerely, [redacted] Member Advocate

June 29, [redacted] Complaint ID: [redacted] To whom it may concern: CVS/Caremark administers the prescription benefits portion of the health plan for ***, of which Ms [redacted] is a memberThis letter is in response to the correspondence we received from your office on June 17, Thank you for the opportunity to address Ms [redacted] ***’s concerns as expressed in Complaint ID [redacted] Upon review of this concern, it was determined that due to Ms [redacted] ***’s location, her refills need to be placed and shipped in advance to prevent any delay in therapyWe have confirmed that once her order is shipped, it takes days for deliveryCaremark Specialty Pharmacy has made the necessary adjustments and accommodations to ensure that all future orders will be placed and shipped days in advance to ensure they are delivered on time We sincerely apologize for any frustration or inconvenience that Ms [redacted] experiencedWe value Ms [redacted] 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 Ms [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted] Sincerely, [redacted] Member Advocate

May 16, 2017 BBB of Eastern MA, ME, RI, & VT290 Donald Lynch Boulevard, Suite 102Marlborough, MA 01752-4705 Complaint ID: [redacted] / [redacted] ***... To whom it may concern: CVS Caremark administers the prescription benefits portion of the health plan for [redacted] Idaho, of which Mr. [redacted] is a member. This letter is in response to the correspondence we received from your office on May 5, 2017. Thank you for the opportunity to address Mr. [redacted] concern as expressed in Complaint ID: [redacted] . We have reviewed Mr. [redacted] concerns regarding the amount that he was being charged for his order. We verified that Mr. [redacted] order was submitted on April 28, 2017 via Caremark.com website. Mr. [redacted] order was held due to a payment issue which caused delays and prevented the order from shipping. Mr. [redacted] was only charged a $50.00 copayment and was not charged a shipping fee for the order. Mr. [redacted] was refunded his $50.00 copayment for the order. Additionally, expedited shipping is $23.00 for overnight delivery and $17.00 for 2-day delivery for a complete order and not per item. Mr. [redacted] order was mailed on May 5, 2017 via [redacted] Overnight delivery. Per the [redacted] tracking # [redacted] the order was delivered on May 6, 2017 at 10:28 am. Furthermore, we have reviewed Mr. [redacted] telephone interactions with our customer care team and it was verified that our customer care team followed the correct process. We value our members and we are confident that future service will better reflect our commitment to our purpose of, “helping people on their path to better health.” Should you or Mr. [redacted] have any additional questions or concerns, please do not hesitate in contacting me at 1 [redacted] . Sincerely, [redacted] Member Advocate

CVS/Caremark administers the prescription benefits portion of the health plan for [redacted] & Company, of which Ms [redacted] ’s son 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 Ms [redacted] ’s concerns as expressed in complaint ID [redacted] Upon review of Ms [redacted] ’s concern, we have confirmed there have been no privacy or HIPAA violations committed Our records reflect the phone number being used is a shared number between Ms [redacted] and her son; therefore, she may receive phone calls or messages regarding her son’s prescriptions Representatives who make contact with our members are trained to obtain a combination of three to four primary and secondary authentication elements in order to ensure that CVS/caremark is in adherence with the Health Insurance Portability and Accountability Act (HIPAA) Additionally CVS/caremark will not release any protected health information regarding Ms [redacted] ’s or her son’s account unless we have documentation providing authorization release information to a specified named individualShould Ms [redacted] ’s son choose to no longer receive phone calls or messages on the shared phone number, he may contact our customer care team at ###-###-#### to make the appropriate changes to his account CVS/caremark is committed to protecting the PHI of individuals in compliance with the Health Insurance Portability and Accountability ActWe sincerely apologize for any frustration or inconvenience that Ms [redacted] experiencedShould you or Ms [redacted] have any additional questions or concerns, please do not hesitate in contacting me at ###-###-#### Sincerely, [redacted] ***Member Advocate

Complaint ID: [redacted] To whom it may concern: CVS/caremark administers the prescription benefits portion of the health plan for the PBA of The City of [redacted] ***, of which Mr [redacted] is a memberThis letter is in response to the correspondence we received from your office on June 24, Thank you for the opportunity to address Mr***’s concerns as expressed in Complaint ID [redacted] Upon review of this concern, it was determined that Mr [redacted] utilized the caremark.com website to obtain copayment information for his medicationWe have confirmed that the copayments provided to Mr [redacted] via caremark.com with the option to obtain his prescription from either CVS/caremark mail order or his retail CVS Pharmacy for the same co-payment was not accurateMr [redacted] is able to utilize either pharmacy; however, there is a difference in cost between a day fill through mail order compared to utilizing a retail pharmacy including a CVS PharmacyAn update to the website is currently in process which will be more specific to estimates provided for or day fillsThis change will take effect in August As a courtesy, we are providing a courtesy credit to Mr [redacted] in the amount of $for the difference in the estimate provided; a check has been issued as of July 2, We sincerely apologize for any frustration or inconvenience that Mr [redacted] experiencedWe value Mr [redacted] 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 [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted] Sincerely, [redacted] Member Advocate

CVS/Caremark administers the prescription benefits portion of the [redacted] ***, of which Mr [redacted] is a memberThis letter is in response to the correspondence we received from your office on January 27, Thank you for the opportunity to address Mr [redacted] 's concerns as expressed in Complaint [redacted] Mr [redacted] had three fills of [redacted] between the months of June and August of at [redacted] Pharmacy on [redacted] ***The price of each fill matched the [redacted] plan design, showing a co paymentAccording to the plan design Mr [redacted] would be responsible for 20% coinsurance with a maximum of at a retail pharmacy for an approved brand medication [redacted] was contacted and confirmed a discount coupon was used to reduce the rate to Once Mr [redacted] switched to mail order, he was assessed the proper co payment of which also matches his plan designMail order charges for a formulary brand medication would be 20% coinsurance with a maximum charge of which also matches his plan designMail order charges for a formulary brand medication would be 20% coinsurance with a maximum charge of Due to the member not being informed of the estimated cost when calling customer care to inquire about mail order, the return was allowed and credit was given on January 27, Mr [redacted] will be receiving the credit balance in the form of a paper check because the credit card used for this order had been removed from the accountWe sincerely apologize for any frustration or inconvenience that Mr [redacted] experiencedWe value Mr [redacted] 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 [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted]

Revdex.com: I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint # [redacted] I want to add that over the phone they also promised to send me a check for all my out of pocket from the 8/date until the date of resolution I understand that by choosing to accept the business response that my complaint will be closed as resolved Regards, [redacted] ***

I got a prescription,my doctor wrote it wrong, and wrote it for 1-pill a day which I'm getting charged for $20.00's for that prescription, when it was suppose to be 2-a day. I've called and asked them to charge me $8.00's a month. Which is what I pay locally. I called today. I said all new prescriptions should get a phone call to confirm they are correct. Employee [redacted] said we have 10 of thousand people to deal with and we don't have time for that. Which cvs pharmacy is referring me to only a number. Second I tried to explain the overcharge to Employee [redacted] who talked over me and as she brought a pharmacist on the line. When talking back to Pharmist the employee [redacted] talked over me so I couldn't speak to the pharmacist. This would of been resolved if you were to call customers before sending out first prescriptions. I already paid $12.00's on this prescription I would get locally for cheaper! YOU REFUSE ME THE RIGHT TO GET MY PRESCRIPTION LOCALLY IN MY TOWN! I've contacted cvs ph

This is the second time this company, has given me the run around about a prescriptionFirst of all, they sent my eye doctor an authorization form in which my eye doctor faxed to them times, and they keep complaining they haven’t gotten the formThen without any reason, they have denied me by [redacted] eye drops that I need, because I have been diagnosed with severe eye drynessI have been using [redacted] for over years, and CVS Health who have never met me or anything is denying me of a prescription I seriously needThis is the worst company I have ever had the misfortune of using, I would not recommend this company to my worst enemyThis company is horribleI need my [redacted] and they have no legitimate reason denying me this prescription

I would give them a Unfortunately, It is not an optionRecently there was a drug recall for [redacted] I was on the medication that was recalledI made several calls to CVS regarding the recalled medicationI asked them why didn't they message everyone via email and let them know about the recallIn my case, I missed the news that week because I had personal problemsCVS Caremark said they don't reach out to their customers that way regarding recalled drugsThey wait for their customers to reach out to them I was shocked because I was on this drug from one of the pharmacies & I was taking a recalled medication every day They went on to say they could not help me with a substitute that was not recalled They asked me to reach out to my local drugstoreMy local pharmacy tried to help me and they did not have a substitute medication for meI called CVS back a couple times and I felt like I was talking to high school kids that had no idea what was going on with this recallIt was very confusing and many holds and answers that kept changingI finally got a new medication from my doctor nd was able to refill it at CVS at a [redacted] nearbyI must say [redacted] pharmacy was 100% better than the CVS Caremark mail order service I was supposed to get a mailer to send back the recalled medicationThat also never happenedMy local pharmacy Is [redacted] Drug [redacted] Drug is actually the one that notified me about the recall They called me because I was previously their customer until BLUE CROSS forced me to use CVS CaremarkSo another pharmacy actually contacted me via phone call and asked me if I was still on that medicationThey took the time to advise me to call my doctor and find another medicationI can not say enough good things about [redacted] DrugI was forced by [redacted] to get my medications from CVS Caremark earlier this yearCVS Caremark is a nightmareI will actually find another health insurance so I don't have to deal with month supplies of drugs I may never use & Customer Service that doesn't existThis is my life and my health I don't trust CVS Caremark with this responsibility We need choices and CVS Caremark should not be the only choiceIts unfair and they are not doing a good job

December 14, 2015Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont [redacted] Complaint ID: [redacted] / [redacted] ***To whom it may concern: CVS/caremark administers the prescription benefits portion of the [redacted] ***, of which Mr [redacted] is a memberThis letter is in response to the correspondence we received from your office on November 30, Thank you for the opportunity to address Mr***’ concerns as expressed in Complaint ID [redacted] .Upon review of the concern, we found that Mr***’ request for reimbursement was denied in error by our claims departmentOur claims department has been made aware of this and is working to reprocess the reimbursement requestIn accordance with Mr [redacted] plan guidelines he will be reimbursed based on the contracted rate and not the cash price he paid at the retail pharmacy Mr [redacted] can expect to receive a reimbursement check within 30-days.We sincerely apologize for any frustration or inconvenience that Mr [redacted] experiencedWe value Mr [redacted] 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 [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted] .Sincerely, [redacted] ***Member Advocate

I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint # [redacted] I understand that by choosing to accept the business response that my complaint will be closed as resolved Regards, [redacted] ***

Revdex.com:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # [redacted] Please add your rejection comments below When a quote is made, it should be honored Also, if a charge is made that is more than the quote, the client should be notified Any increase beyond what was quoted should be considered credit card fraud Regards, [redacted] %