Caremark PHC, LLC

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] ***

June 11, [redacted] Complaint ID: [redacted] To whom it may concern: CVS /caremark administers the prescription benefits portion of many health plans as well as offers services through our Specialty Pharmacies This letter is in response to the correspondence we received from your office on May 20, Thank you for the opportunity to address Mr [redacted] ’s concerns as expressed in Complaint ID [redacted] Upon review of Mr [redacted] ’s concern, it was confirmed our specialty pharmacy received a request on April 24, from Mr [redacted] requesting we transfer six of his medications from his local pharmacy to our specialty pharmacy and fill upon receipt During this process there were delays experienced since not all of the prescriptions were available to be transferred due to there were no refills available and renewals were needing to be obtainedOn May 18, 2015, our specialty pharmacy contacted Mr [redacted] informing him of the status of his prescription order; it was at this time which he expressed dissatisfaction regarding our pharmacy being unable to fill all of his prescriptions at the same time Mr [redacted] was informed he was out of refills and several attempts to contact his physician for renewals went unanswered On May 21, we received new prescriptions for all of Mr [redacted] medications via electronic prescription from his physician Mr [redacted] was contacted by our specialty pharmacy and arrangements were made to have all of his medications delivered on May 23, to his local CVS 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 ###-###-#### 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] Regards, [redacted]

On behalf of CVS/pharmacy, I would like to apologize to [redacted] for the problem she encountered with CVS mail order pharmacy At CVS, our goal is to be a trusted partner in our customers' health care When we find that we have disappointed a customer, we believe that it is important to understand what happened and to take the appropriate action It is our understanding that your orders were delayed from shipping due to policies and procedures that our pharmacy must abide by If we can be of further assistance we invite [redacted] to contact Customer Relations at 800-SHOP-CVS (800-746-7287)

I am enrolled in my employee prescription health plan through my employer [redacted] since 2014 . I pay foy this service directly from my paycheck. I am forced by my insurance to use CVS caremark for long term medicine through CVS Caremark Pharmacy in order to get a 90 day supply. However, every time my doctor calls in a prescription the order is put on hold for billing issues. This happened at least 3 times. It goes to billing and put on hold and then I am told I am in "collections". When I attempt to call CVS caremark I am put on hold a minimum of 30-50 minutes to be transferred to a billing specialist. Depending on whom I speak to I get a different answer and am told we have no record of your insurance and I have balance. I give them my account info and then they tell me it will take at least 2 weeks to process before they update their billing records. My medicine is critical to maintain my health. I cannot miss a single dose. I order through this pharmacy t

August 19, 2015 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 Ms. [redacted] ... [redacted] is a member. This letter is in response to the correspondence we received from your office on August 6, 2015. Thank you for the opportunity to address Ms. ***’s concerns as expressed in Complaint ID [redacted] .Upon review of this concern, we confirmed that Ms. [redacted] was sent two orders of [redacted] ® for her son. One order was sent on June 24, 2015 and the second order was sent on July 15, 2015. This was due to CVS/caremark receiving a duplicate order which was placed on a future fill. A return mailer was requested on August 4, 2015 for the July order and issued to her on August 7, 2015 to allow her to return the medication for credit. Her file will be given a credit of $150.00 credit when the medication is received back in our filling facility. Additionally, upon review of Ms. ***’s interactions 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 our customer care team with whom Ms. [redacted] interacted. We sincerely apologize for any frustration or inconvenience that Ms. [redacted] experienced. We value Ms. [redacted] as a member and we remain fully committed 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 866- [redacted] . Sincerely, [redacted] Member Advocate

July 21, Revdex.com Donald Lynch Boulevard, Suite Marlborough, MA 01752- Complaint Id: [redacted] / Complainant: [redacted] To whom it may concern, CVS/caremark administers the prescription benefit portion of MsAloha ***'s health plan with State of Florida This letter is in response to the correspondence we received from your office on July 12, Thank you for the opportunity to address Ms***'s concerns as expressed in complaint ID [redacted] Upon review of the concern, our specialty pharmacy has confirmed that Ms [redacted] contacted our pharmacy on June 20, to order her prescription for Copaxone®At this time she was informed that the prescription was expired and we would contact her physician to obtain a new oneOur dispensing pharmacy sent request to the prescribing physician’s office on June 20, and June 22, however; our attempts to obtain the medication were unsuccessfulOur records reflect that the physician office did not contact our pharmacy to provide the new prescription until July 6, Ms [redacted] was contacted this same day and delivery was scheduledWe have confirmed that Ms [redacted] was able to pick up the medication at the retail CVS pharmacy on July 11, Furthermore, we have verified that Ms***'s plan requires members to utilize CVS/Specialty pharmacy for specialty medication If the medication is obtained outside of the plan parameters, the plan member will be responsible for the full cost Please keep in mind that CVS/caremark only administers the prescription benefits for State of Florida and must adhere to the provisions set forth by the plan sponsor Lastly, upon review of Ms***'s interaction with the customer care team, we recognize that there were opportunities for additional training and coaching for our staff Where necessary, feedback has been provided to each member of the customer care team Ms [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 Ms [redacted] experiencedWe value Ms [redacted] as a member and we remain fully committed 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 ###-###-#### my business hours are from 9:a.mto 5:p.mCentral Time, Monday thru Friday Sincerely, [redacted] Member Advocate

I was billed $for medication that I did not receive, nor did I request to have that medication mail orderedI contacted CVS Caremark [redacted] at the time I got notice on I explained to the representative that I had not ordered or requested to have an [redacted] inhaler mailed to me, not did I approve of the billThe representative gave an explanation that I was responsible for the cost of that medication when it was sent because the doctor placed the order and "it's cvs' policy" to mail the first refill without needing permission I don't mind paying for items I received, but I, in fact, did not receive the medication they claim to have sent

I m not able to utilize my CVS Caremark insurance for my secondary insurance for my dependentMy dependent has primary insurance through [redacted] and secondary insurance through [redacted] which both use CVS CaremarkI called CVS Caremark advise several times in the month of January that the [redacted] is my secondary insurance which [redacted] 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 [redacted] 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 am looking at different insurance companies with our benefit choice enrollment approaching, Caremark is the approved pharmacy manager for the plan I am looking at. I spoke with the insurance company and was able to get all my questions answered. I then called Caremark and hit nothing but brick walls. I called to ask about medications for my wife (transplant patient) and myself (diabetic type 2 insulin dependent). I was told that there was no way to know what co-pays would be. I find this to be unacceptable. You don't just jump into something without first researching. We are told by the State to call these companies for information, then its not provided.

RevDex.com 290 Donald Lynch Boulevard, Suite 102Marlborough, MA 01752-4705Complainant ID: [redacted] / [redacted] ***To whom it may concern:This letter is in response to the correspondence we received from your office on September 25, 2015. Thank you for the opportunity to address [redacted] ***... [redacted] concerns regarding a past due balance. We verified that on February 14, 2014 [redacted] contacted our specialty pharmacy costumer care to verify and update her insurance information for her order of [redacted] During this conversation, [redacted] and our specialty customer service representative verified her current [redacted] insurance. Additionally, [redacted] was only using our specialty pharmacy to fill her medication this one time. [redacted] went on to explain that she had a new insurance carrier as of February 1, 2014. At this time it would have been appropriate for our service representative to obtain the new insurance information to process the order for [redacted] ***. On February 17, 2014 [redacted] called to make arrangements to ship her order and at this time there was no discussion of insurance information. On April 25, 2014 [redacted] was contacted due to her insurance being rejected and she provided specialty costumer care with her new insurance information. On May 7, 2014 [redacted] ***’s new insurance information was verified by our benefit investigation team to reprocess her order. [redacted] was contacted and given her amount due for the medication on June 10, 2014. Due to our delay in obtaining and updating [redacted] new insurance information a courtesy adjustment was made to clear her entire of balance $772.65. We sincerely apologize for any frustration or inconvenience that [redacted] experienced. We 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 [redacted] have any additional questions or concerns, please do not hesitate to contact me at [redacted] . My office hours are Monday thru Friday from 9:00 a.m. until 5:30 p.m. Central Standard Time.Sincerely, [redacted] Member Advocate

I filed to have a Rx filled at my local pharmacy and CVS had this RX cancelled and did not contact me to state they were not allowing my pharmacy to fill it and that CVS had to do it My Pharmacy advised me of the situation and advised me that I had to contact CVS directlyI called the [redacted] number and spoke with [redacted] She told me that I had to have my pharmacy transfer the Rx over and that as long as it was done today (31Dec2015), it would be processed today and billed for before the 1st of the year [redacted] was contacted and I advised them of what I was told and they advised me that was NOT common practice and that CVS had to contact them to get the RxI called CVS back and spoke with a lady name [redacted] ( not sure how it was spelled, sounds like [redacted] )This woman had attitude with me f

Dear Sir or Madam: Today I asked the plan for a day supply of medication ETECAVIR due to having to leave the country for days due to family issuesI was told that I can only get my regular day supplyWhat is for other prescription plans is abfor Silver ScriptThey DO NOT GIVE A VACATION OVERRIDEThis is illegal but they are getting away with itWithout a medication my illness will certainly turn into cancerI ask that your office intervene and makes it clear that they are not allowed to treat the patient in this manner Thank you, best regards

I have my health insurance thru [redacted] (member ID= [redacted] ), which requires me to get my prescription medication thru CVS/Caremark CVS/Caremark allows for mail order service where they are supposed to provide me with a day supply of a medication I received a script dated February from my Dr [redacted] for a day supply of [redacted] ( [redacted] (base), which I was told by CVS to be canisters I mailed it in to their Pittsburgh PA address, and only got canisters back (Rx # [redacted] ), and they charged me $ I called to complain, and they told me that they instituted a new rule on January 7, reducing the amount they ship for this medication I was never aware of and I was not notified of such a policy change, my policy being a month policy which began on July 1,

July 5, Revdex.com serving Eastern Massachusetts, Maine, Rhode Island and Vermont [redacted] Complaint # [redacted] / [redacted] To whom it may concern: CVS / caremark administers the prescription benefits portion of the [redacted] plan, of which Mr [redacted] - [redacted] is a memberThis letter is in response to the correspondence we received from your office on June 20, Thank you for the opportunity to address Mr [redacted] - [redacted] concerns regarding his issue Upon review of this concern, Mr [redacted] - [redacted] has been prescribed [redacted] **, at this time the prescribed medication is not covered under Mr [redacted] - [redacted] prescription benefitIn order to gain approval, this medication needs to go through CVS/caremarks appeals processAt this time, Mr [redacted] - [redacted] has exhausted all levels of appeals administered through CVS/caremarkThe only available option is to move forward with an External Review, which was initiated on June 25, This process can take up to days to reach a decisionAs a courtesy, we were able to approve an override for the [redacted] to be filled under Mr [redacted] - [redacted] prescription benefitThe override is approved until September 1, while the External Review process is complete We sincerely apologize for any frustration or inconvenience that Mr [redacted] - [redacted] experiencedWe value Mr [redacted] - [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] - [redacted] have any additional questions or concerns, please do not hesitate in contacting me at [redacted] Sincerely, [redacted] Member Advocate

I get a drug from this companyMy copay is $30, but I have a copay assistance program where my copay is paid by the drug company ( [redacted] ) in fullOn 08-18-2015I was charged $for the drug, [redacted] paid my full copay to CVS alsoI have been trying since 08-to get refunded the $that CVS charged meI have called them times nowtimes I was told that I would get a credit back to my credit card, times I was told I would get a refund check, and time I was told that [redacted] was responsible for the refund (that is totally false- [redacted] never charged me- CVS did)CVS charged me improperly and has been withholding the refund for monthsI want the refund and an apology ASAPThank you

CVS/caremark administers the proscription benefits portion of the [redacted] ***, of which Ms [redacted] is a memberThis letter is in response to the correspondence we received from your office February 29, Thank you for the opportunity to address Ms [redacted] 's concerns as expressed in Complaint ID [redacted] Upon review of this concern we confirmed there was a systematic issue that created the erroneous chargeAs the order was being processed processed, [redacted] ( the assistance program), was only being of the bill which triggered the remaining balance to be charged to Ms [redacted] Once the matter was corrected, the charges were reversed which gave a credit balance to Ms [redacted] and remained on file with specialtyA refund check for has been requested and will take a approx to business days to generate and mail to Ms [redacted] Internally, calls will be reviewed and feed back and coaching will be provided to each member of the customer care team with whom Ms [redacted] interactedWe 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]

July 28, 2015 Complaint ID: [redacted] To whom it may concern: CVS/ [redacted] administers the prescription benefits portion of the health plan for the [redacted] of which Mr. [redacted] is a member. This letter is in response to the... correspondence we received from your office on July 21, 2015. Thank you for the opportunity to address Mr. [redacted] ’s concerns as expressed in Complaint ID [redacted] . We verified that there were instructions in a previous account requesting that the mail order benefit not be utilized if any prescriptions requests were received for Mr. and Mrs. [redacted] . When the order in question was received for processing there were no instructions which would have stopped the order. We have confirmed that when the plan was renewed, the previous notated request did not transfer to the new file. For this reason, the order was shipped. We have contacted Mr. [redacted] and confirmed that there are now instructions on the mail order account to prevent future orders from processing via the mail order benefit. Additionally, a credit of $13.87 has been issued to the account as of July 22, 2015. We sincerely apologize for any frustration or inconvenience that Mr. and Mrs. [redacted] experienced. We value Mr. and Mrs. [redacted] as a member and we remain fully committed to our purpose of “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 ###-###-####. Sincerely, [redacted]

A few weeks ago I sent a paper check, check no***, not an electronic check by mail to CVS Caremark Mail Order Pharmacy for $ for a year's supply of medicineOrdinarily, if a check takes two weeks or more to clear my bank the reason would be that the check was slow in reaching the merchantEither the postal service was late in delivering my check or the companies mail room was backloggedWhen the check finally reached the merchant, the merchant would cash the check that very day and the check would clear my bank the day after In the case of CVS Caremark, according to their own customer service, the check reached the company on February 24, CVS Caremark DID receive the funds and applied them to the year's supply of medicine The only problem was, the check never cleared my bankI contacted [redacted] ***, my bank, to conduct a search to see if the check ever entered their bank After a thorough search, [redacted] stated they had no evidence that

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] . Again, CVS has not stated specifically as to why the medication was rejected. As I stated in the original complaint, when I spoke with a CVS/Caremark representative, she stated that the contested medication, in the CVS/Caremark guidelines was not an appropriate medication for a yeast infection, which is contrary to both the National Institute of Health and Mayo Clinic findings. As well, no alternative medication was proposed (as far as I know, there are none). As a result, the CVS/Caremark policy appears to be that I should suffer with my condition, untreated, until a time that I would not be able to function, as both the medication was denied, and no alternative was proposed. In essence, a flat denial of any medical treatment. I have yet to receive a specific reason as to why the medication was denied, and/or an alternative that would treat my condition with reason(s) why an alternative would be suitable. Again, no alternative was ever proposed. In regards to the statement above in regards to contact. I did receive two phone messages from " [redacted] " from CVS who never identified what his position was (clerk at the store, President of the company?) with CVS/Caremark. He simply stated that the case was being appealed (again, no specific reason as to why it was denied initially, or an alternative) and that I could contact him via phone, if I wished, but it was not necessary as it was going through appeal. I am not a physician, and I have already stated what I found via research, the relevant support in the NIH and Mayo Clinic, so I find that further discussion would be fruitless as it is in appeal. In addition, I would appreciate contact via email at [redacted] versus phone conversations while I am at work. This way I could have a more precise record as to what is going on. Again, I would like to know the precise reason why the medication was declined, and why CVS/Caremark thinks it is wise that my infection continue without providing an alternative as per its apparent standing policies. "Attempts to contact Mr. [redacted] directly and provide updates on his request for coverage have been unsuccessful. To date, Mr. [redacted] has not returned our calls." This is from CVS/Caremark, and no requests were made to return calls. " [redacted] " simply stated that it was being appealed, and I could call if I wished to in order to add something, which I did not. Again, this was made during work hours where I cannot pick up the phone, and I wish for further contact to be made via email, and a phone number provided should I have questions. Attempts to contact Mr. [redacted] directly and provide updates on his request for coverage have been unsuccessful. To date, Mr. [redacted] has not returned our calls. Regards, [redacted] ***