Caremark PHC, LLC

CVS caremark is the insurance carrier my company has for prescription medication For years I have been taking [redacted] 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, [redacted] 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 [redacted] I was to have refills

December 28, Revdex.com Donald Lynch Boulevard, Suite Marlborough, MA 01752- Complaint ID: [redacted] / [redacted] To whom it may concern: CVS/caremark administers the prescription benefits portion of the health plan for Teacher’s Retirement System of Texas, of which Mr [redacted] is a member This letter is in response to the correspondence we received from your office on December 18, 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 found that the plan requires prior authorization for the medication in question The prior authorization was initiated on December 16, The completed criteria form was received on December 23, Prior Authorization was approved for months from December 23, thru December 23, We sincerely apologize for any frustration or inconvenience that Mr [redacted] experienced We value Mr [redacted] as a member and we remain fully committed 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 to contact me at [redacted] Respectfully, [redacted] - [redacted] Member Advocate

May 3, 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 memberThank you for the opportunity to address Mr [redacted] 's concerns as expressed in Complaint ID [redacted] Upon review of Mr [redacted] 's concern, we confirmed [redacted] requires all high dollar cold packaged medication orders to be placed on a hold and a phone call placed to the recipientThese calls are made to both gain approval to release the order as well as to make the recipient aware of the shipping of the orderFurthermore, a signature is required for deliveryThis process is part of the plan benefit and went into effect January 1, To assist with resolving Mr [redacted] ’s concern, as of April 1, 2016, comments have been added to Mr [redacted] ’s account pertaining to the medication in questionThe comments state that the medication can be shipped without a phone call and no signature will be requiredFurthermore, Mr [redacted] will be responsible for these orders Lastly, upon review of Mr [redacted] 's interaction with the customer care team, we recognize that there were several opportunities for additional training and coaching for our staff Where necessary, feedback has been provided to each member of the customer care team Mr [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 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] my business hours are from 9:a.mto 5:p.mCentral Time, Monday thru Friday 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. This company has all pertinent information regarding personable identifiable identifyers regarding [redacted] on the complaint form itself (order # [redacted] ). Any additional information forwarded may place my privacy and security at risk by the unknown individual conducting the investigation and leave me with no recourse in legal action. [redacted] initiated this complaint due to company's failure to maintain proper record keeping and documentation in their database. Voice recording is available for [redacted] egards, [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. The response did address the fact that that cvs sent a fax to my doctor asking why I not filled my prescription in a timely manor. which in non of there business. My doctor misinterpreted the fax as a request from cvs to have the order refilled. I had nothing to do with it. Also they did address the request to not fill any other orders not requested by me. regards, [redacted]

My company changed providers at the 1st of the year to CVS so I attempted to create an account on the websiteI was able to create the account, but no information was transferredWhen I went to log back in later to check the data transfer I was unable toI changed my password and connected, but when logging out and back in it fails again, so I called to talk to someone and was hung up on when I told her to stop interrupting me and actually answer my question about my accessI called back and spoke to another equally helpful individual, and when I told her I needed to file a complaint about the first person she hung up on meI called a 3rd time and asked for a supervisor and told the girl about my previous callsI told her I would be filling this complaint, and she told me to go ahead and do so

I am employed through *** *** and they began using CVS Caremark as their prescription drug company this year In the last month, I received a notice that they would no longer be covering a prescription that myself and my husband have been taking since (*** **) until we obtain additional testing to confirm that the prescription is necessaryWe are in process of getting the additional testing but the issue is that the first available testing date isn't until October My complaint is that CVS Caremark gave us less than days notice that they would not be covering the prescriptionWe filed an emergency appeal stating that we did not have an issue with additional testing but going four months without taking a prescription that we have been taking for years is not logical We requested that they continue to cover the prescription that was ordered by our regular primary car physician until we were able to take the testing they require for continued coverage Less th

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,

Received RX insurance coverage for CVS Caremark a few weeks prior Filled my prescription on August 30th and was told to pay the full $deductible on this purchase, only to find out a later date that the 30th was the final day of coverage for the year and that the deductible had reset when going to fill prescription once again in early October Any reasonable prudent person who knew the deductible would be reset the day after would have waited hours to fill that prescription unless it was life or death
Have contacted customer service and they have refused to work with me to refund this

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 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

The company has refused to cover an infant formula for my daughterIn the state of NJ insurance companies are required to cover infant formulas are prescribed by a physician for for infants under that have been diagnosed with a milk protein allergyOur physician has sent an appeal which contains documentation of the perscription and diagnosis of the milk protein allergy

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

My husband has liver damage and takes a medication called lactulose*** has issues covering this so we need to open a TAR to get it approvedEvery month there is a delay between the pharmacy, *** and the Dr office so we end up having to pay out of pocket for a portion of the prescription and we are promised that we will get reimbursed once the prescription gets approvedThe prescription always goes through but we never have gotten a refund because every time I go in and ask (with my receipt) they say that they cannot do itSo not only do I pay a portion out of pocket but then CVS bills *** for the full amount so essentially they get paid twice for a portion of the prescription

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*** 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 went to see my DR for my asthmaThe DR renewed my prescriptions electronically with CaremarkI advised the DR that I didn't need any prescriptions at this time, as I still have inhalersHe advised that "he is just renewing them and they shouldn’t be sent in theory." A week later I receive a box that is NOT marked "Caremark"I think it is something we ordered from ***I open it up and I see inhalers that I DID NOT order and a bill for stating that my credit card declined the purchase, so here is the billI called Caremark and they said sorry, that is our policy and you have to pay for the medication that you did not orderI even asked to speak to a manager and who said more of the sameI think this practice of Caremark is criminal and needs to be investigated

I was ordered on a specialty medication to start immediately for a health condition that I haveAfter waiting several weeks, I still do not have my medication, am being put off continuously and had to reschedule surgery that is reliant on being on this medication.Caremark specialty pharmacy keeps saying they don't have the correct script, my insurance and meds need to be verified and will not ship my medicationAll this even after my physician has sent the script several times and spoke to them personally several timesIt has been weeks and due to my health insurance plan, I am obliged to use caremark specialty pharmacyMy health is beginning to suffer and I don't know what else to do as no one at caremark will get me my medication

CVS Caremark ships me automatic refills for prescriptions that I do not have enrolled in automatic refills I turned off auto-refill for prescriptions on 11/6/ I received an email on 11/22/telling me that these prescriptions, including that my doctor took me off because it was affecting my potassium levels, were being shipped and charged to my credit card I immediately called CVS Caremark upon receipt of the email to cancel the shipment The representative said it was too late to cancel the shipment She said that auto-refills are started days prior to shipping, so I told her I cancelled my auto-refills days ago She then changed her story, saying that I had cancelled my auto-refills three hours after the refills had been started I asked for a refund for the prescriptions, and she said I would have to ship them back I spent half an hour speaking to this representative, and now I'm expected to go to the post office to return items I never ordered Th

MY DOCTOR RECENTLY SUBMITTED A PRESCRIPTION THAT WAS FOR A DAY SUPPLY OF ***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

March 3,
Revdex.com
*** *** *** *** *** ***
*** ** ***
Complaint ID: ***/ *** ***
To whom it may concern:
CVS/caremark administers the prescription benefits portion of the health plan for *** *** ***, of which *** ***
is a memberThis letter is in response to the correspondence we received from your office on February 19, Thank you for the opportunity to address Mr***’s concerns as expressed in Complaint ID: ***
Upon review of this concern, we confirmed that Mr*** contacted our customer service team for assistance and was given misinformationThe turnaround time for new prescriptions is within 4-calendar days after the order has been placed/receivedMr***’s prescription was received as a verbal transfer from his local pharmacy on December 31, at 3:43pmThe prescription was processed, filled and ready to ship on January 4, 2016, which is within mail order fill guidelinesThe order was cancelled by Mr*** due to the cost of the medication
Mr*** should have been informed by the customer service team to have his local prescription transferred from his *** Pharmacy to a local CVS Pharmacy to have his prescription filled for a day supply through his Maintenance Choice benefitMr***’s plan has the Maintenance Choice option which allows him to fill a day prescription at a participating local CVS Pharmacy at the same mail order copaymentAll representatives involved with Mr***’s concerns have been provided feedback on correct procedures and turnaround times.
Mr***’s request to have his prescription reprocessed under his benefit copayment structure was denied by the plan benefitAdditionally, the prescription was originally received from the *** Pharmacy as a verbal transferThe prescription may be transferred back to any participating CVS Pharmacy to be filled for a day supply
We sincerely apologize for any frustration or inconvenience that Mr*** experiencedWe value Mr*** as a member and we remain fully committed 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

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