Need to file a complaint?
BBB is here to help. We'll guide you through the process.
Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
09/21/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
Our insurance coverage uses CVS Caremark for its prescription coverage. We dont get to pick. We dont have a CVS within an hour drive of our house. I am on a hormone patch treatment and I get VERY sick if I dont have them. *** has refused to allow me to pick up my medication at my local pharmacy, and I requested them to be mailed to me over a month ago and still havent received them. I did NOT want my medicine mailed to me and begged and begged for them to cover it at my local pharmacy and they declined over and over until I had no choice. Last month I had to pay out of pocket to get my patches and will have to pay again because they never mailed them to me. I should have access to the medication I am prescribed and this company has made it to where I do not. So, we already pay for prescription coverage and now I have to pay for my prescriptions to because they will NOT cover it. I am basically being charged for a service I dont receive.Customer response
10/02/2024
[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
08/29/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
CVS Caremark is not returning my call regarding a tier exception for a hormone medication- Bijuva. Ive spoke with 12 different people and no one seems to know how to help me with a tier exception. I know their calls are prerecorded, so I have proof that *** spoke with this many people. I just need help with this tier exemption. *** contacted my work HR regarding the concern and they are considering not renewing their contact with CVS pharmacy. This pharmacy seems to be incompetent on their customer service. I told them Im filing a claim with BBB. They didnt seem to care. I just need to know what medications I need to try and fail on to get approve for my Bujuva medication. Im having serious health issues without having this medication and CVS Caremark doesnt CARE! I just need the BBB to help me with this pharmacy. PLEASE HELP!!
Business response
08/30/2024
Please go to www.fepblue.org/pharmacy/prescriptions,scroll down to Covered equivalents for drugs not on our formulary and select your formulary drug list to see the formulary exception process and covered alternative drug list. There are several covered options in the same therapeutic class.Customer response
08/30/2024
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 # ********.
I NEED A SUPERVISOR FROM CVS CAREMARK TO CONTACT ME AT THIS NUMBER ************.
THIS EXPLANATION DOES NOT HELP MYSELF NOR MY PHYSICIAN.
I need the exact names of the medications the pharmacy needs me to try???CVS Caremark denied my tier exemption they DID NOT LIST WHAT MEDICATIONS I NEED TO TRY AND FAIL ON.
Im NOT GOING through this list and picking and choosing. YOU ARE DENYING ME, so show me the exact medications. You need to do this for every patient you deny. Then send them a copy of the medications in a letter stating this.I feel this is a serious issue, Ive been without my medications for over a month.
IM ON THE ***** OF SNAPPING!!!
Im contacting an attorney at this point and will be SUEING CVS Caremark for Negligence and Neglect!!
There is serious consequences on letting a patient go off hormone drugs cold turkey!!
I will be waiting for a phone call from a supervisor regarding the above concern.
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
09/03/2024
According to our records, you spoke with a ************* supervisor on August 30, 2024. We also verified your Tier Exception request was re-reviewed by the ****************************** on August 30, 2024. The request has been approved from August 30, 2024 to August 30, 2026. An approval letter was mailed on August 31, 2024 to the address on file. We also verified there is a paid claim at a local retail pharmacy for date of service September 3, 2024.Initial Complaint
08/26/2024
- Complaint Type:
- Delivery Issues
- Status:
- Resolved
I placed an order for a prescription refill. Since I was out of medication, I was given a bridge supply. Then, a few days later I received a text that I...I...made a request to place my prescription on hold. This is not true. I called and the *** did not understand why the system noted "I" place my prescription on hold, when I did not. It has to be illegal for any company to make dishonest decision about customers.Business response
09/04/2024
September 4, 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 CHICAGO TRANSIT AUTHORITY health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on August 26, 2024. Thank you for the opportunity to address the beneficiarys concerns.
A system error occurred while the technician was processing the prescription transfer back to the mail-order pharmacy. To correct the error, the Bridge team requested the order be stopped. The corrected order was processed on August *******, and it shipped next day air. According to *** tracking (1Z74W0A61322103635),order number ********** was delivered on Wednesday, August 28 at 11:15 A.M.
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
09/05/2024
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.
[My concern is not about the bridge order. My concern is that, after receiving a text AND speaking to a ***, CVS system noted I...I...made the request to place my prescription on hold. The system did not indicate a CVS *** put my prescription on hold. The system noted that I put my prescription on hold. There is a difference and it matters.]
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,Ta'fanesamekeya
Business response
09/16/2024
September 16, 2024
BBB serving *********************, *****, ************, and *******
5 Mt. *********. Suite 100
***********, MA 01752-1927
Complaint # ********
To whom it may concern:
CVS Caremark administers the prescription benefits portion of the CHICAGO TRANSIT AUTHORITY health
plan, of which the beneficiary is a member. This letter is in response to the correspondence we received
from your office on August 26, 2024. Thank you for the opportunity to address the beneficiarys
concerns.
We have asked management to review this matter for coaching, training, and process improvement
opportunities. We apologize for any inconvenience the member may have experienced.
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
08/19/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
To whom it may concern,I have an ongoing issue with ********************** and *******. I use **************** copay assistance program to help cover the cost of my ******* prescription, so my payment is only $5 each injection. I have two bills from a year ago, one of which was recently sent to collections because *** claimed the payment was repeatedly denied. I've spent countless hours over the last year attempting to remedy this issue, including three-way phone discussions with both CVS and *******. ******* displays that I have funds loaded on the card, and CVS attempts to charge the card, but there is always a difficulty with payment processing, so the balance continues bouncing back. I do not believe I should be held liable for these expenses, which should be covered by the copay assistance program, as ******* continues to inform me. This is a billing issue between CVS and *******, but it is now impacting my credit. This is really aggravating and unjust to the patients who are experiencing this type of predicament. If I had known the sums would not be paid, I would not have filled the prescription. The balance was covered for multiple previous refills, so it's unclear why the two balances from a year ago aren't processing properly. I've stopped renewing my medicine, which was recommended to aid with my psoriasis. I'm currently coping with my condition without the pharmaceutical my doctor prescribed, and I'm having credit problems that I shouldn't even be experiencing. I would like this matter investigated further. There must be some sort of resolution. I feel backed into a wall and I am left feeling helpless as I continue to be treated unfairly by both CVS and *******. If they are going to provide a service to patients, shouldn't such services be valid? I appreciate your immediate attention regarding this matter.Business response
09/06/2024
September 6, 2024
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on August 21, 2024. Thank you for the opportunity to address the members concern.
As of September 3, 2024, ************* and the members copay assistance were able to rebill the claim dates of 5/1/23 for $460.90 and 7/12/23 for $2,517.72. The member is now no longer in collections.
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,
********* *******
AdvocateInitial Complaint
08/09/2024
- Complaint Type:
- Order Issues
- Status:
- Answered
This is a two part issue which concludes the following - *** specialty overcharged me by $1133 for a specialty prescription (Enbrel) on 5/14/24 and though I have reached out to them multiple times, I have yet to have this resolved. This error was due to a malfunction of their copay assistance program which I believe is called Change Healthcare or connective Rx which occurred in April 2024. This resulted in a overcharge but also in an incorrect ledger on *** Specialty account record. I initially used this assistance program but had exhausted its funds so switched to a copay assistance program called Amgen Support Plus. This is a direct manual reimbursement (DMR) plan which means that I pay the copay out of pocket and then submit that claim to Amgen Support Plus who then sends me a check. After many phone calls and countless hours on the phone with them, it was determined that *** Specialty needs to reimburse Connective Rx in order to correct their ledger so that I can get reimbursed from Amgen Support Plus in the amount of $2001.16 as this is the total that I paid for the Enbrel for that service date. The Amgen Support *** and I spoke to *** Specialty billing escalation once in May, three times in June, once in July and then again today without resolution. Today I was told that a check has been cut to Amgen Support / Connective Rx and that the ledger can be corrected in 7 days. However, I have been told "another 7-10 days" every single time I've talked to them so I don't have a lot of faith in this. I also see that as of right now, the *** ledger is still not corrected. So to summarize, I was overcharged by *** Specialty and their ledger was left uncorrected since the issue was unresolved for 3 months while I paid interest on a charge card that I had to use to make this purchase initially. I have spent approximately 10 hours on the phone to attempt resolution.Business response
08/26/2024
August 26, 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 SYNCHRONY RX health plan,of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on August 9, 2024. Thank you for the opportunity to address the beneficiarys concerns.
The claim in question is being reprocessed. The member can contact the point of contact assigned to their account, ****************, ********************************.
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
08/09/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
The insurance company is demanding a prior authorization from my doctor asking why I need a medication that was prescribed to me. I needed to get this medication filled asap and because the insurance company is demanding these thing it has now taken a full week and I still do not have it. A doctor is the expert on what a patient needs not the insurance company. It should not be legal for an insurance company to demand out of the doctor what my necessity for needing the drug is and how long I will need to be on it. Insurance is the biggest legal scam in the world. You are forced to have it and the one time I need it i extorted into jumping through hoops. So I asked them to waive the prior authorization for the first script so I can go ahead and get it filled in a timely manner and that will give everyone time to get my paperwork in order so when I need to get it refilled I don't have to go through this again. They refused. So I am asking a for a full refund for what I have currently paid in Health insurance which is $450.00Business response
08/26/2024
August 26, 2024
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on August 7, 2024. Thank you for the opportunity to address the members concern.
The requested medication is covered by the members plan with prior authorization. On August 9, 2024, a prior authorization request was initiated for the requested medication. The prior authorization request for the requested medication was approved until August 9, 2027.
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,
*********************************
AdvocateInitial Complaint
08/07/2024
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Answered
My account with CVS Specialty Pharmacy has been self-pay since 2022, when I switched jobs and CVS Caremark became my prescription insurance provider. I had been enrolled in co-pay assistance through AmGen for my prescription, Otezla. When I discovered they don't allow co-pay assistance payments to apply to your deductible, I un-enrolled from the co-pay assistance card and switched to Direct Manual Reimbursement through AmGen so I could still get some help with the cost of my medication as it's very expensive. I took the co-pay card account number off my CVS Specialty billing account in 2022 and put my account on self-pay. That worked fine for the remainder of 2022 and all of 2023. Then for some reason in ***uary of 2024, CVS took it upon themselves to reach out to *********Pay assistance (without contacting me first and without my consent). Somehow the co-pay card was reactivated (again, without anyone talking to me and without my consent) and they paid for the first couple fills of my medication of 2024 and drained my assistance account. I didn't realize this until I called CVS to inquire as to why I hadn't received a bill for my 1/3/24 fill. I've now been trying to get this fixed with CVS since Feburary and it's August. They completed messed up my account. I've paid them $3,079.97 now for that *** fill and they've told me everything was fixed, but it was NOT because now I'm having trouble getting reimbursed through the direct manual reimbursement since CVS didn't refund what they paid incorrectly through co-pay assistance. I'm at my wits end on this and if I had the time and resources to involve a lawyer, I would. This is the worst company I've ever had the displeasure of working with. None of the employees are helpful, they pass you around, don't look at the multitude of notes on accounts, etc. I'm beyond frustrated and angry. This needs to be corrected NOW.Business response
08/19/2024
August 19, 2024
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on August 7, 2024. Thank you for the opportunity to address the members concern.
As of August 15, 2024, the claims from January 3, 2024, and January 31, 2024, that utilized the copay assistance program were reversed and rebilled to reflect the member paid out of pocket for those dates of service.
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,
*********************************
AdvocateInitial Complaint
08/06/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
Previous complaint ******** 5/18/24 resolution was accepted that CVS speciality made billing error and it was corrected 5/28/24 for ******* adjustment. They were to refund my insurance *******, copay assistance ******, and patient assistance *******. It has still not been done. I am now being told I will have to pay ******* out of pocket and submit a reimbursement to Dupixent due to CVS Specialty has taken over 180 days to refund my patient assistance and copay. I have calls to them end of May telling me to give them one month to resolve. Calls in 7/15/24 (representative *****) that she took care of reversing back charge to co-pay assistance. CVS account balance on 7/18/24 showed 0.00 balance. Then, ******* showed back up along with calls and statements that I owe them a balance on 6/2/24, 6/8/24, and 7/4/24. Call again to CVS 7/29/24 and spoke. with **************** and he said they were transferring balance back to patient assistance card for resolution. Called CVS on 8/5/24 during normal business hours requesting call back and no return call. Call to CVS on 8/6/24 and after 3 attempts was able to reach a representative. Transferred me to Cara * and she indicates since it is over 180 days that they have to issue a check to Dupixent and refund check to Dupixent sent 8/1/24 but no check number. ******** with ******** now says once they receive the check I will need to refill script and pay out of pocket and request for reimbursement to pay me back. After a brief hold, ******************** up and we were not able to reconnect the call. Verified with ******** with Dupixent CVS should have sent refund check to P.O. Box *****, ********************** Attn: *******************.Please assist as this is unacceptable for this to have gone on this long and so much time spent by me and others (BlueCross, Dupixent) to try to make them correct the mistake they made (previous resolution with ********************************* Advocate).Customer response
08/17/2024
I have not heard from the business in response to my complaint. I have continued to call them weekly. I called on 8/16/24 to follow up and they originally said they sent check to Dupixent 8/1/24. Now, they said they mailed check on 8/15/24. They are completely dishonest. I have zero confidence that they will revolve this issue. Only communication I get is weekly statements, texts, and phone calls that I need to pay them the balance that they owe to me or my copay assistance card through Dupixent.Business response
08/19/2024
August 19, 2024
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on August 7, 2024. Thank you for the opportunity to address the members concern.
Upon review, the refund was approved by management. The check for $4,884.41 was mailed to Dupixent.
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,
*********************************
AdvocateInitial Complaint
08/02/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
CVS Caremark and CVS Specially don't care about people's lives been trying for over a month to get my Chemo pills for Cancer and they got a verbal approval from CVS CAREMARK, and they still won't send anything because in their system it didn't show anythingBusiness response
08/22/2024
Please review the attached response.Initial Complaint
08/02/2024
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Answered
I've used CVS's prescription mail order service twice now, and both times have had fulfillment and shipping problems. Most recently, my psychiatrist sent over a prescription for Adderall on July 26th. 5 days later on July 31st, (2 days before my medication runs out) my psychiatrist (not me) received a notification that the prescription could not be filled due to backorders on the medication. Next day, August 1st, we submit for a new prescription of a different dosage. On August 2nd, they confirmed my prescription (my last dose had just been used). I called to request expedited shipping per a prior ***** recommendation. Upon calling, the *** advised it would cost ME $23 to expedite the shipping (despite it being THEIR problem with having medications on hand and not notifying me in a reasonable time frame). They also said they wouldn't be expediting the processing time, which they said can take 5 days. So I'd have to pay $23 for them to send my medication out 5 days after I've already run out of my medication due to their incompetence and poor business practices.Business response
08/19/2024
Please review the attached response.
Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩
BBB Business Profiles may not be reproduced for sales or promotional purposes.
BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.
When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.
BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.
As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation.