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Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
07/17/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
My employer switched to caremark on jan 1- they said nothing would ***** and then proceeded to request and not ***** new PAs on meds i have been taking. In particular they denied Virbezi which has kept my chronic diahhrea from making my life the h*** im in now. I have lost 40 lbs since then to diahhrea and nausea and stomach pain. Its the only med that has worked for me. It also caused me to fall several times getting to the bathroom which necessitated xr and mri of my back and now i have gallstones from the rapid wt loss and had to purchase clothes shoes and dentures because what i had were fAlling off and out by that point. They have also denied my spevigo that is the only med to treat pustular psoriasis. When you call to talk to somebody you get the run around and nobody admits anything. My doctors dont want to try anymore because they waste hours on hold only to be told they need to talk to somebody else. Caremark has ruined my life! I am now so deep in debt from the medical exams imaging and purchases for dentures and clothes and now have to wear diapers its humiliating. You should be ashamed of yourselves and rectify this!
Business response
07/26/2024
July 26, 2024
BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on July 17, 2024. Thank you for the opportunity to address the members concern.
The members plan requires an approved prior authorization for coverage of the requested medication. The member has an approved prior authorization on file for the requested medication until December 31, 2024. Prior authorization requests are reviewed and determined by the plan sponsor, not CVS Caremark. The members prescriber may initiate a prior authorization request by calling the plan sponsor or by visiting the plan sponsors website.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
*********************************
AdvocateCustomer response
07/27/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
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 #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*********************************Initial Complaint
07/13/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
Dr prescribed this medication. We were NOT contacted by caremark to even let us know it was being shipped or that the cost would be $112.39! We recieved a package unattended and unsigned for containg this medication that we didn't know was even comming with a bill in the bottom for $112.39. I called caremark as I signed u up for the copay assist through the manufacturer and was informed that " it didn't work for mail order and to avoid paying the $112.39 next time instead of the $15 copay to fill it in the store! We were not even aware that was an option as nobody in their right mind would spend almost $100 extra to avoid a 3 minute drive!Business response
07/17/2024
July 17, 2024
BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on July 14, 2024. Thank you for the opportunity to address the members concern.
The members plan has approved a balance adjustment of $62.39 bringing the members remaining balance to $50.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
*********************************
AdvocateCustomer response
07/17/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
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 #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*************************Initial Complaint
07/05/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
On 6/27 I contacted CVS Caremark by phone and informed the person I had lost my prescription blood pressure medication, I explained that I live in a remote ***************** where the prescribed drug is not available at any pharmacy (there is only one pharmacy in town), and that I needed a refill sent **** Express mail to my PO Box. The person I spoke with said they can do that. I agreed to pay the $130 required for express shipment and authorized them to bill it to my credit card. I hoped to receive the medication during the coming weekend. It never came.Five days later, On 7/2, I received a call from CVS Caremark (the call was recorded) during which I learned that the order hadn't shipped yet. I explained my situation again. I requested shipment by Express Mail. I was hoping to receive it today (July 5th). This AM I logged in to CVS Caremark and discovered an order for my medication, was entered into the system on 7/2/24 with a tracking number **********************. I checkd the tracking number on the **** website and found the medication had shipped "parcel select," and that the delivery date was "unknown." In other words, they shipped my blood pressure medication by ground, when I had clearly requested express mail delivery and agreed to pay for it twice. I have high blood pressure. I need my medication. I do not understand why they shipped it "parcel select." These mistakes put my health in jeopardy.Business response
07/15/2024
July 15, 2024
BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on July 5, 2024. Thank you for the opportunity to address the members concern.
Upon review, the member was refunded the $23 shipping charge and their mail order was delivered to their P.O. Box on July 8, 2024.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
*********************************Initial Complaint
07/04/2024
- Complaint Type:
- Product Issues
- Status:
- Resolved
I **ntacted CVS Specialty via chat in February to **nfirm my **payment showed as $5 before I requested shipment of prescription because I cannot afford full price, and this was the arrangement approved. I was told yes, ** pay is $5. Then, I received a bill on 4/13 for $2921.44! I called and spoke to ***************************** on 3/27/2024. She put me on hold for like ***** minutes to research. She said she **uld see I did a chat and was told **pay was $5. She said she **uld see exactly what happened, that my February shipment was cancelled, not sure why, and then it shipped on 3/7. She said I should have been billed $5 because I was **vered for that order under the $5 **pay arrangement. She advised she would send over to post ship escalation and to allow 4-6 weeks for a **rrection to be made. Also, I told my Rheumatologist what happened, and CVS Specialty was saying her office not responding. My Rheumatologist said they had sent prescriptions over 6 times to CVS Specialty for Humira, she finally just changed by prescription because of this issue. Since 3/27 I have talked to the following: *********** on 4/29, he said wait 2 more ******************************** told me to call back on 7/5. In the meantime, I am getting **llection calls for $2921.24. I would suggest go back and listen to the call with rep *************************** to hear her explanation of issue and the proof I was told the last shipment of ****** should have been $5.Business response
07/10/2024
July 10, 2024
BBB serving *********************,*****, ************, and *******
5 Mt. *********. ************************* **********
Phone: ************
Complaint #: 21942246
To Whom it May ************************ letter is in response to the correspondence we received from your office on July 4, 2024. Thank you for the opportunity to address the member's concerns.
On July 9, 2024, a request was submitted to have the balance removed from the members account and it was approved by the Supervisor. The member should allow 2-3 days for completion.Additionally, our records show the members copay assistance program was updated.
.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Respectfully,
*********************
AdvocateCustomer response
07/10/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
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 #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*********************Initial Complaint
07/03/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
*** made clear statements that are false. I would like information on the reason why my insurance company is involved when the patient care program is the one chosen. There is no law that "loops around" the constitution(as sometimes those exsist, and those are american civilian duties to fix) that state CVS can cafeteria pick and choose the paymemt method for the medication I have. Someone made an error or needed a clarification, made up a reason, and sent me a fake reality, to why my $36,0000 medication is not being sent. No medication needs approval from a insurance company, ever. Thats practicing without a license. Surely we can assume a doctor will deny(?) My valid prescription in the face of corruptive practices if my illness was a questionable one, but it isn't and very well known. In the event the medication is already paid for, as is such, thid message is impossible. Now, the issue is still that CVS Caremark/Silver ran my prescription over to my insurance as "it claims" but when calling the rep said the Pharmacist needs to do some stuff'. Now I know thay they failed to articulate that the injection is awaiting CVS profits. Shots fired CVS Caremark!Business response
07/11/2024
July 11, 2024
BBB serving *********************,*****, ************, and *******
5 Mt. *********. Suite 100
***********, ** 01752-1927
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on July 3, 2024. Thank you for the opportunity to address the beneficiarys concerns.
Our Specialty team spoke with the prescribers office and the member on July 9, 2024. Both are aware of the authorizations required for the medication in question. Once the coverage request is approved, the prescription will be processed.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
*************************
Member AdvocateInitial Complaint
06/26/2024
- Complaint Type:
- Delivery Issues
- Status:
- Resolved
Date of transaction: 6/3/24 Amount billed on 6/3/24: $90 copay In April 2024, I filled a prescription at a CVS Pharmacy which accepted a manufacturer's patient savings program through Bausch and Lomb for a $0 copay when filling the prescription. On May 17, 2024 a prescription for the same medication was submitted to CVS Caremark. When CVS Caremark filled the prescription, they charged $90 to my account. When I contacted CVS Caremark on June 5, 2024, within 3 days of processing the order to ask if they would reprocess this order with the patient savings program information, they refused to do this. I spent more than 2 hours on the phone with CVS Caremark representatives, including a conference call with a representative from the Bausch and Lomb patient savings program to ask for a direct reimbursement from the manufacturer's program to CVS Caremark, this was refused. I asked if I could return the medication for a refund/bill adjustment, and this was denied. I reported this situation to ****************** Blue ************************* which is my health insurance carrier, and they referred me to file an appeal with the Director of ****************** ****************** Blue Shield, which I intend to do if the order is not reprocessed with the manufacturer's patient savings program, and the copay amount of $90 is not removed from my account.Business response
06/28/2024
On April 18, 2024, a local CVS Pharmacy processed a claim for 120 quantity 60 day supply; the claim processed correctly according to your retail pharmacy benefits. We are unable to verify if a manufacturers saving program was applied to this claim.
Caremark mail order received a prescription from your provider on May 17, 2024. On May 17, 2024, a notice was sent advising the medication was too early to refill. On May 26, 2024, a notice was sent advising the order has a new processing date to begin on June 2, 2024. On June 3, 2024, a notice was sent advising the order had shipped and a tracking number was provided; the package was delivered on June 5, 2024 according to the tracking information. Caremark mail order did not receive a request to cancel the order prior to the order being shipped. Caremark also did not receive a request to place patient savings program information on file before the order processed.
Existing claims cannot be reversed and reprocessed in order to apply a Manufacturer Copay Card. The Manufacturer Copay Assistance Card program may also not approve use at Mail Order. You should contact the Manufacturer Copay Card Assistance Program directly for more information regarding the rules for their specific card and verify if manual rebate options are allowed if the card is not applied to a claim.
We are unable to allow you to return the medication for a credit to your account as there was no Caremark error. Your current outstanding balance of $90 remains due and payable.
Thank you.
*****Customer response
06/28/2024
Better Business Bureau: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 # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
The response received from CVS Caremark is not satisfactory, and I am rejecting the conclusions reached by the CVS Caremark Representative since they were aware of the April 18, 2024 order for the same medication that was processed by a local *** Pharmacy which had the information about the manufacturer's savings program that was approved and used for this order. This April 18th claim was processed, and included the manufacturers patient savings program information that was in the patient's record to qualify the order to be covered under this savings program with a $0 copay. In addition CVS Caremark mail order was again made aware of the previous order information when they received a prescription from on May 17, 2024, and when the patient notified CVS Caremark on June 5th, 2024. Since the medication order was too early to refill, based on the information made available, the order processed on June 2, 2024 should have been processed with the same information about the manufacturer's savings program that had already been submitted by the patient to *** Pharmacy. The patient spent more than 2 hours speaking with CVS Caremark and ****************** Blue ************************ representatives between June 5h and June 17th, including a conference call with a representative on the line from the manufacturer's patient savings program in order to provide the information needed for the manufacturer's savings program, and CVS Caremark denied having the information from the *** Pharmacy which had been given to them for the patient in order to waive the $90 copay. The patient is still asking CVS Caremark to correctly process the June 2nd order with the patient savings program, and credit the patient account for the $90 copay as requested.
Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
FAQ
Regards,*********
Business response
07/08/2024
The claim dated April 18, 2024 that was processed by the local retail CVS Pharmacy only shows what the copay would be as per your retail benefits. CVS Caremark mail order would not know if a coupon or Manufacturer Copay Assistance Cards were used to fill that medication at retail. CVS Caremark mail order would have to obtain that information from the member for Manufacturer Copay Assistance Cards.
Manufacturer Copay Assistance Cards are to be added before the order is processed but there is no guarantee. It is suggested that member continue to use retail pharmacy to fill prescription as there is no guarantee at mail order the Manufacturer Copay Assistance Card will reduce the members' copay.
A onetime exception has been approved to credit members' account for the $90.Initial Complaint
06/25/2024
- Complaint Type:
- Delivery Issues
- Status:
- Answered
march 1st 2024 rinvoq 15 mg tablets. never ordered and never received yet i am being charged for them. *** been calling cvs speciality for months and telling them this but they are still trying to charge me for this. i keep telling them to review all the calls i made since march where i tell them i did not receive this bottle. they keep telling me that the issue has been escalated but it is not being resolve and i continue to get a bill for $6568.54Business response
07/03/2024
July 3, 2024
BBB serving *********************, *****, ************, and *******
5 Mt. Royal Ave.Suite 100
*************** 01752-1927
Complaint #********
To whom it may concern:
CVS Caremark administers the prescription benefits portion of the UNIFORMED FIREFIGHTERS ASSOCIA health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on June 25, 2024.Thank you for the opportunity to address the beneficiarys concerns.
Upon review,the member has a $6,521.25 balance for the April 9, 2024 order, not their March 1, 2024 order.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
*******************
Member AdvocateCustomer response
07/03/2024
Better Business Bureau: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 # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
FAQ
Regards,Ivanka
if this bill is really for the ***** prescription then they have to provide transcripts of my telephone calls to the agent at Cvs specialty . I did a three way call and included a representative from ***************** assist. I did the three way call because I received a bill for over 6k BEFORE I ordered my ***** prescription and I was trying to have them figure out what happened (explained to them that there was a mystery bottle of 15mg that I didnt order in March and never received yet it was on my records and billed for it) I specifically told the agent I do not want ***** order to be sent out if i was going to get a 6k bill she told me that will absolutely not happen. I did not approve this ! The proof is in the phone records that I know they record.
Business response
07/10/2024
July 10, 2024
BBB serving *********************, *****, ************, and *******
5 Mt. Royal Ave.Suite 100
*************** 01752-1927
Complaint #********
To whom it may concern:
CVS Caremarkadministers the prescription benefits portion of the UNIFORMED FIREFIGHTERS ASSOCIA health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on July 3, 2024.Thank you for the opportunity to address the beneficiarys concerns.
On July 8,2024, the plan approved reversing and rebilling the March 1, 2024, claim to apply those copay assistance funds to the members April 9, 2024, claim. The members balance was moved to pending copay assistance and the member will not receive statements while this process is taking place. The member can contact their single point of contact, ***** with Specialty at ************************* for updates.
We have asked management to review this matter for coaching, training, and process improvement opportunities.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
*******************
Member AdvocateInitial Complaint
06/21/2024
- Complaint Type:
- Product Issues
- Status:
- Resolved
I submitted a prescription reimbursement request. It was denied, saying that the ***** and NPI numbers were not valid. I reviewed my submission. The numbers are 100% accurate and valid.Last time this happened, I made approximately 20 phone conversations and written submissions over the course of 15 months to try to resolve it, only to be led in circles. I made a complaint to the BBB and it was resolved within a week. The reference number on the denial letter I received is **************.Business response
06/26/2024
June 26, 2024
BBB serving *********************,*****, ************, and *******
5 Mt. *********. ************************* **********
Phone: ************
Complaint #: 21882626
To Whom it May ******************** letter is in response to the correspondence we received from your office on June 20, 2024. Thank you for the opportunity to address the member's concerns.
The necessary information was gathered,and the claims were processed. Please allow 7-10 business days for the member to receive reimbursement.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health.Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Respectfully,
*********************
AdvocateCustomer response
07/05/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
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 #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*******************Initial Complaint
06/20/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
CVS Caremark mail order pharmacy has failed to deliver me one of my medications resulting in me being without my medication for weeks and I am still seeking resolution for this issue. During my many phone calls to CVS Caremark mail order pharmacy, I made multiple attempts requesting them to not fill any more prescriptions. Despite my many requests, I received an email stating another medication was shipped without my authorization. I have already filled this medication at a local pharmacy and do not need this refill. I am extremely frustrated and am requesting the BBB to officially record my complaint in hopes to urge CVS Caremark mail order pharmacy to take their responsibility of dispensing medications seriously. I have never experienced such high level of incompetency in any medical field. I would also like to request CVS Caremark mail order pharmacy to cancel the second prescription I did not authorize and issue a refund so I can fill it at a local pharmacy. I am also requesting CVS Caremark mail order pharmacy to provide assistance with the first prescription so I can get the next refill for that prescription at the local pharmacy as well.Business response
06/24/2024
The most recent order was originally received on April 17,2024; however, it was too soon to be refilled. Notification was sent on April 17, 2024 advising it was too soon to fill the medication and would begin processing on June 19, 2024. Notification was sent on June 12, 2024 advising the order would begin processing on June 19, 2024. Notification was sent on June 19, 2024 advising the medication shipped. **************** Pharmacy sent an Electronic Mail Tag (E-Tag) on June 21, 2024 allowing you to return the medication for a credit to your account. Upon receipt of your medication, your account will be credited $15. Returns will be reviewed and credits will be posted on the account in up to five ************ days upon receipt at the pharmacy.
A comment was placed on your account on June 20, 2024 advising member has asked to not receive Rx via MO without providing consent.
We also verified an order for another medication was received on April 11, 2024; the order shipped on April 11, 2024. A request was placed on April 23, 2024 to reship the medication as the original package had not been received; the medication was reshipped on April 25, 2024 and delivered on April 26, 2024 according to the tracking information. This medication is eligible to be refilled on June 30, 2024.
We apologize for any inconvenience you experienced.
Thank you.
*****Initial Complaint
06/18/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I gave birth on 3/8/2024, and I had preeclamsia. As I was getting discharged from the *********************, they sent over a prescription to CVS Caremark for post-partum hypertension. CVS Caremark filled a 3 month prescription of Nifedipine, and sent the drug to an address that I haven't lived at for over five years, which was ****************************************. When I called them to report the error, I asked them to resend the medicine to my actual address. They refused. They said they needed the referring doctor to resend the prescription in order for them to resend the meds. I called the hospital a few times and spoke to the referring doctor, who said that she resent the prescription. CVS Caremark never sent the new meds. I was unable to get the prescription filled and covered by insurance because my insurance said that CVS Caremark had already fulfilled a 3 month supply. I then had to pay over $300 of my own money for a three month supply of the prescription outside of insurance. I spent hours on the phone speaking with my insurance and with CVS Caremark and was still unable to get the meds covered by insurance or resent to me. When I why CVS fulfilled the prescription without my authorization or confirmation of address, they said that this was "Just their policy." CVS Caremark is now still sending me a bill for $21.49 to pay for the three months of the medicine that I never received. This should be illegal what they have done. This could be crippling to someone who didn't have the money to pay for these medicines. Without medicine regulating my high blood pressure, I could have a stroke post-partum. Desired solution is that they send me the medicines to the correct address, or they drop the bill for $21.49. And one more thing - they obviously know my correct address because even though they can't send me the medicines to the right location, they have still been able to send me multiple bills to where I live.Customer response
06/30/2024
I have contacted CVS Caremark multiple times, spending hours on the phone to only get transferred from team to team. They told me that the doctor who initially sent my medicine had to approve to resend it. I then spoke with tbt doctor who confirmed that the medicine had been resent and called CVS back multiple times to request the resend of the medicine. CVS consistently said that they hadnt received the doctors confirmation and that there was nothing more they could do. After calling back more than four times without resolution, I decided to file a claim with the BBB.
Business response
07/02/2024
Good Afternoon
Please see our response to Response to Case ******** for ***********************.
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