Caremark PHC, LLC

I have received my money from CVS Caremark. Thank you!

I was given a prescription from my doctor for a drug that needed to be compounded because I take it at a very low dose Since CVS is my designated pharmacy through my insurance plan, I called their specialty pharmacy on 3/24/to find out if they could compound my particular drugThe representative said they could I asked her to make sure because it wasn't a common drug or dose, she put me on hold to find out She then assured me they could I checked with her one more time and she said yes, they could do it, I only needed to fax my prescription to them, and she gave me the fax number I asked if it could be emailed, she said no, it must be faxed So I faxed it to them the following day On April 3rd I received a phone call from CVS and was told they could not fill the prescription but they could send it to a compounding pharmacy for me, and I gave them the fax number of The Medicine Shoppe, a compounding pharmacy that assured me that they compound my drug within hours B

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 The order was for packets and Caremark only provided packets so Caremark's statement that they filled the order correctly is very clearly to any reasonable observer Simply stating that Caremark may not provide a partial box is meaningless If this is due to statutory or regulatory restrictions, then Caremark needs to demonstrate this Caremark is simply declining to fulfill their obligations to provide the full ordered quantity, while at the same time charging me for the full order.Regardless of whether federal statutory or regulatory restrictions govern their decision to under-fill my order, it is illegal for Caremark to charge me for a product which they are not supplying Based on my consultations legal with a legal expert, at a minimum, Caremark must provide a pro rata refund In the absence of this refund, I will pursue this matter via litigation, as, over time, Caremark's intent to persistently under-fill my prescriptions will become very costly, and will amount to stealing hundreds and even thousands of dollars from me Regards, [redacted]

In order to properly investigate your concerns, we are in need of additional information Please provide us with the following information: Member ID number and your date of birth

Dear sir or madam, Thank you for giving us the opportunity to address your concerns regarding the member’s mail order prescriptions handled by the CVS Caremark Mail Service PharmacyThis is in response to your correspondence dated March 30, The drug [redacted] 20mg tablets is listed on the Formulary (list of covered drugs); however, the drug has a Step Therapy restrictionA utilization tool that requires the beneficiary to first try another drug to treat his medical condition before we will cover the requested drugThe beneficiary was required to first try atorvastatin, before we could cover [redacted] On 03/03/2016, we received an order via phone for [redacted] 20mg tabletsThe prescription was prescribed as pills for a 90-day supplyIn terms of the copay, [redacted] has a $copay at mail order because it is a Tier drug Additionally, the beneficiary has a $deductible that applies to Tier 3, and drugsOn the call, the beneficiary was advised that the cost of the order was an estimated $The member agreed to the cost and the Customer Service Representative completed the order The order was processed as pills for a 30-day supply as the [redacted] 20mg has a coverage restrictionA letter dated 03/03/2016, was sent to the beneficiary advising that we had filled a 30-day supply of this drug in order to avoid interruption of therapy; however, the beneficiary would need to request an exception to the coverage of the drugThe order shipped on 03/04/and was delivered to the beneficiary’s residence on 03/08/ The Plan has authorized an exception to allow the coverage of [redacted] An override was placed on the account to allow the beneficiary to receive the remaining pills without an additional chargeThe order was shipped on 04/13/2016, and is currently in transit for delivery To find out which medicines are covered, the beneficiary can refer to his Formulary booklet or call CVS Caremark Customer Care Please feel free to contact me with additional questions regarding this response Sincerely, [redacted] Medicare Part D Regulatory Grievances Phone [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 belowRegards, [redacted]

Complaint: [redacted] To whom it may concern: CVS/caremark administers the prescription benefits portion of the health plan for [redacted] & Co., Inc., of which Mr [redacted] is a memberThis letter is in response to the correspondence we received from your office on February 16, Thank you for the opportunity to address Mr [redacted] concern as expressed in Complaint ID: [redacted] Upon review of Mr [redacted] concerns regarding his deductible for his benefits we verified that the correct plan information was not attached to his accountMr [redacted] benefits office is responsible for submitting plan details to his Medical and Prescription providersMr [redacted] has been updated in CVS/caremark’s System to reflect the appropriate plan information In researching Mr [redacted] accumulation, all claims were reviewed and accounted forMr [redacted] was provided incorrect information when we was advised that he would be receiving reimbursed for an over paymentThe retail transaction in question went toward Mr [redacted] deductible for the benefit year which has been met We 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

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 I am rejecting this response because it does state correct informationThey did not mention that they illegally charged my credit card without authorization, no apologies for the hardship they caused me with my bank, and there was no remedies to satisfy my outstanding balance since they messed up Regards, [redacted]

I was notified that one of my prescriptions ( [redacted] ) 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

In two sentences, for over weeks CVS/Caremark refuses to mail my prescriptionsAfter speaking with almost different persons they still refuse when they acknowledge that it was an IT problem in their ranks CVS/Caremark (CVSC) received my and my wife’s order on July 24, I set up another profile on their website for my wife and myself since we were under another insurance planThis process required two profiles for myself and my wifeWe waited a period of days before reaching out to them to find out why the orders were delayedStarting on August 2, I found out that the problem was the same for the both of us The doctor’s office stated that they resolved the problem and that I should callCVSC then advised that the problem was with my insurance, no coverageI called my insurance and they confirmed coverage for both the doctor and the prescription programAfter calling again, the case was escalated to [redacted] [redacted] was unsure of our information an

Tell us why here June 3, Revdex.com [redacted] Complainant ID: [redacted] / [redacted] To Whom It May Concern: This letter is in response to the correspondence we received from your office on May16, Thank you for the opportunity to address Ms [redacted] concerns regarding receiving and unauthorized order of medication On May 10, Ms [redacted] doctor’s office faxed in two new prescriptions to be filled via mail orderMs [redacted] ’ order was later processed and shipped on May 11, As a new prescription is received, it will automatically go into processingIf there aren’t any rejections or concerns with the medication the order will ship shortly after completing processingMs [redacted] was provided this information on May 16, and was also told she would be responsible for the order balance of $Due to the frustration and inconvenience this issue has caused, a mail tag was mailed on May, 17, for Ms [redacted] to return the order When speaking with Ms [redacted] to inform her that the mail tag was on its way, she then informed me that she had already threw away the medicationsMs [redacted] was previously told that no credit would be given and chose to discard the medications sent in the orderSince the medications were no longer in Ms [redacted] ’ possession, the mail tag process was unable to be completedIn an effort to rectify this issue, a courtesy credit of $was givenMs [redacted] ’ mail order account now reflects a zero balance as the credit has been applied 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 Standard Time Sincerely, [redacted] Member Advocate

MY DOCTOR RECENTLY SUBMITTED A PRESCRIPTION THAT WAS FOR A DAY SUPPLY OF [redacted] I WAS TOLD THAT THIS WAS A TIER DRUG AND THAT I WOULD BE SUBJECT TO A DEDUCTIBLE OF $PLUS $FOR A DAY SUPPLYI TOLD THE OPERATOR THAT I COULD DO THATWHEN I RECEIVED THE PRESCRIPTION IT WAS ONLY TABLETS FOR DAYS.(WHICH I PAID A TOTAL OF $215) I CALLED AND SAID THERE MUST BE AN ERRORAFTER WEEKS OF DISCUSSING THIS WITH THEM THEY SAID THERE WAS NOTHING THEY COULD DO THAT THE ASSOCIATE THAT TOLD ME I WOULD BE GETTING DAYS FOR $WOULD BE RETRAINED AND DISCIPLINEDI OFFERED TO RETURN THE PRESCRIPTION AND FOR THEM TO REFUND THE $THAT I HAD PAID FOR THE PRESCRIPTION,THEY SAID OH WE CAN'T DO THATI SAID WELL THEN SEND ME THE OTHER DAY SUPPLY THAT YOU OWE MEOH WE CAN'T DO THATSO I AM OUT PILLS THAT I PAID FORI AM ON A FIXED INCOME AND NEVER WOULD HAVE AGREED TO $PER PILL FOR A MAINTENANCE DRUG PLUS A DEDUCTIBLE OF $BEING ON MEDICARE/HEATH NET I NO CHOICE

December 7, Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont Donald Lynch Boulevard, Suite Marlborough, MA 01752- Complaint # [redacted] / [redacted] To Whom It May Concern, CVS Caremark administers the prescription benefits portion of the Comcast health plan, of which Mrs [redacted] is a memberThis letter is in response to the correspondence we received from your office on November 24, Thank you for the opportunity to address Mrs [redacted] ’s concerns regarding an order she received which she did not need Upon review of this concern, we verified Mrs [redacted] attempted to remove medications from the Auto Refill programThe Auto Refill and Renewal program allows members to receive prescription refills and renewals of maintenance drugs automaticallyMrs [redacted] was sent an email advising her order # [redacted] was processingFurthermore, the email advised if she needed to cancel or change the date of the order she would need to contact customer care or go on Caremark.com before November 20, Mrs [redacted] contacted our customer care on November 22, when the order was in the process of being shippedCustomer care could not cancel the order at this time As a courtesy and in an effort to accommodate this situation, packaging has been sent to Mrs [redacted] to return order # [redacted] for a full creditIf Mrs [redacted] needs to remove any medications from the auto refill program she can call CVS Caremark customer care or go on Caremark.com to do so 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 1- [redacted] Sincerely, [redacted] Member Advocate

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 [redacted] (ID: ***), who basically told me that I had no choice but to pay for the Rx I didn't receive,

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 understand that by choosing to accept the business response that my complaint will be closed as resolved Regards, [redacted]

January 4, Revdex.com [redacted] Complaint ID: [redacted] / [redacted] To whom it may concern, CVS/caremark administers the prescription benefit portion of the health plan for [redacted] , of which Mr [redacted] is a memberThank you for the opportunity to address Mr [redacted] ’s concerns as expressed in Complaint ID [redacted] Upon review of the concern, it was confirmed that the [redacted] prescription drug plan does requires prior authorization in order for the medication in question to be coveredOur records reflect that Mr [redacted] 's prescribing physician’s office contacted our authorization department on December 22, and the authorization request was submitted and approved the same dayOur pharmacy was able to process and ship the medication in question and we confirmed it was delivered to Mr [redacted] We sincerely apologize for any frustration or inconvenience that Mr [redacted] experiencedWe value him as a customer and 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 additional questions or concerns, I may be reached at [redacted] Sincerely, [redacted] Member Advocate

I was charged for prescriptions total $after my out of pocket maximum was met I have been trying to get a refund since October 17, I have called repeatedly and I am always told someone will call me back but they never do I have confirmation from my medical insurance company that the out of pocket max was met in July but Caremark continued to charge for scripts through October I have had my medical company [redacted] contact caremark directly but Caremark still refuses to resolve the issue

Dear Sir or Madam, Please review the attached responseSincerely, SilverScript Insurance Company

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] Dear Mr [redacted] Thank you for your continued efforts in assisting a member.According to the plan benefits – day supply would be billed at $25, and day supply be billed at $for the medication in interest This is clearly stated at the CVS Caremark website for my particular plan, [redacted] I am attaching the benefits and copayment information that were downloaded from the CVS Caremark website for your reference.If [redacted] cannot assist me, the member, to retrieve and to help refund the overcharged copayment, in this case $25, I would then request [redacted] to provide me further appealing channels / contact information so that I can discuss this case further with other appropriate personnel regarding the overcharged copayment.Thank you for your assistance.Regards, [redacted] **

June 12, Revdex.comDonald Lynch Boulevard, Suite 102Marlborough, MA 01752-4705Complaint ID: [redacted] To whom it may concern: CVS/ caremark administers the prescription benefits portion of the health plan for [redacted] of which [redacted] is a memberThis letter is in response to the correspondence we received from your office on June 2, Thank you for the opportunity to address [redacted] concerns as expressed in Complaint ID [redacted] Upon review of this concern, we confirmed that our mail order pharmacy did receive a day prescription from [redacted] physician and the prescription was filled in accordance with his plan guidelines and the appropriate mail order copayment was appliedAs a onetime courtesy, [redacted] was issued the $refund that he requested [redacted] credit card was refunded on June 3, This day prescription has been discontinued to prevent it from being refilled through the mail order pharmacyAdditionally, upon review of [redacted] interaction with our 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 [redacted] interacted with 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 [redacted] experiencedWe value [redacted] as a member and we remain fully committed to our purpose of “helping people on their path to better health”Should you or [redacted] have any additional questions or concerns, please do not hesitate in contacting me at ###-###-####Sincerely, [redacted] Member Advocate