CVS Caremark

Ordered my refill of Skyrizi weeks ago to have it delivered yesterday (scheduled to take it today). Didn't receive anything on the delivery date and got a text that evening saying there was a problem with the order and it was on hold. When I called, the person told me there was an issue with the copay assistance card, but that it had been worked out and my medication would be delivered the next day. Didn't hear anything from them today until 5:30 in the evening, when I got the same text about a problem with the order. I called, and the person who I talked to (who was actually super sweet and helpful) explained that the kind of medication I was on had been discontinued, and they had switched from 2 syringes to just 1. Meaning that I needed a whole new prescription and pre-authorization. They told me this on Friday evening, the day I needed to take my medication, after my doctors office was closed and wouldn't open until Monday. I was lied to throughout the entire process and wasn't told what was actually going on until it was too late for me to do anything. How was I even able to order a medication that was discontinued? Absolutely ridiculous and now I have to wait for the whole process of pre-authorization and shipping to get my medication that I needed to have had already.

CVS Caremark is awful. No one should ever have to deal with this. It constitutes abuse to the elderly.

TLDR: CVS had a glitch. I paid over $3500, and they refunded less than half.

As a two-time cancer survivor, I must take various medications and cannot afford to miss more than 1-2 doses in a week. When my insurance changed from employer-paid to self-pay via COBRA, CVS's computer system had an unspecified error that meant my medication was no longer covered. To be clear, my insurance coverage never lapsed and I had reached my out-of-pocket maximum for that year already. Before this, I had 0% out-of-pocket responsibility. Because I was almost out of my medications I paid for them myself with a promise from the pharmacist that I would be refunded. This happened two months in a row and cost me over $3,500. After the system was fixed I submitted a refund request and received a check for less than $650. Several refills had been mistakenly labeled as duplicates, and few if any of the remaining medications received a full refund. Naturally, I disputed this amount, and after a few weeks, I received another check. This one was for less than $750. When I tried to dispute this again, I was handed to the representative who is paid to just tell the caller "No" in as many ways as needed, up to ignoring what I said. When I called another time I was put in touch with a consumer advocate, who told me that he wished things were different but there was nothing he could do. Apparently, it is company policy to only refund the discounted wholesale amount the company pays, and not the higher price an individual has to pay, despite the fact that the company is at fault for the problem. Most of the people answering the phone were incredibly helpful and friendly, and I understand they were merely messengers carrying bad news. The company policy itself is what is incredibly frustrating and abusive.

Cancer is expensive, and if I had not been given money from friends and family to help pay for it my family would have $0 in our bank. This money was not just an inconvenience.

I hope that this review tells reviewers what a wonderful company this is. I became ill years ago and needed all kinds of medicine. The Hospital set this up for me so while I was ill I did not need to worry how I would get my medicine. Since they cost so much my insurance company worked along with Caremark to make sure that I received what I needed. One day I received a call from a Caremark representative that was so kind and professional. She set everything up over the phone. She sent exactly what I was supposed to get. They filled all of my prescriptions for years. They where so nice, they called me every month to let me know when my order would be delivered to my brothers house. They made sure that I did not have to worry about anything. They even called in my refills to the doctor so I would not have to do it. The representatives where so empathetic to my situation that sometimes they made me cry. I cried because I was so grateful for all there help and compassion during my time of need. I highly recommend this company if you need a mail order medicine service. They are tops. I have dealt with a few others that where no where as good as Caremark. If you know someone who may be in need of help spread the word. Caremark takes most insurances. If your insurance company won't pay for a certain medicine Caremark will do everything in there power to get a pre-authorization prior to calling you. They will contact your doctor and ask them to approve the medicine so the insurance company has no choice but to cover it. This is a wonderful caring group of people that care about helping you to recover. CVS Caremark pharmacy is on in a million. My experience with them has been one I will never forget. Thanks to there support I was able to recover without all the stress of worrying if my medicine would come every month. I give them 5 stars***** I hope this helps someone as it has helped me. They are hands down against the rest. I highly recommend them. www.caremark.com

Avoid this company at all costs they will do everything possible to avoid coverage. If I could give this company a negative I would.

I have a chronic condition which requires life-sustaining medication. I have lived with it for over 10 years, and I have always used mail-order pharmacies. I switched to new insurance this year, and I've been forced to use CVS Caremark. Recently, in trying to place a re-order, I asked if I could set up a payment plan, because even with insurance, it costs about $1k per round of meds. The first manager whom I spoke with assured me that this was possible; we sorted out the details, and he assured me that everything we discussed would proceed. And that my medicine would ship overnight in 24 hours. That was 10 days ago, and I still have not received my medications. I have followed up two more times, and spoken to two other managers (I hate to be such a Karen asking to speak to a manager, but it became clear that internally, the people who first answer the phones only have a limited view of my order history and profile). Both of these managers separately went into my account, finding errors EACH TIME, which accounted for the system continually holding up my order from processing, despite being told each previous time that my order was "resolved" and would ship within 24 hours, and no further action was required. I kept getting automatic calls telling me to call to confirm my payment, even though I was assured my order had bypassed the regular system. Each time, the manager would be so polite and apologize profusely, etc, and I would ask them to review the details with me thoroughly. It comes off as incredibly patronizing; just tell me the truth! And get it right! Finally, just now, I checked the system, and it says my order has shipped but with ground shipping. I certainly hope it's going to the right address. I am exhausted and stressed. I just want my medicine.

Every prescription has been wrong! The most recent was to be sent overnight and it was not! Causing me to not be able to get my medicine on time!

I called these people numerous times for a very important product that is very important. They kept making clerical errors and it is very upsetting.

Slow to process orders and website is hard to navigate. Took a week to process order after it was received

Too bad zero stars is not an option. If you need prior approval for a drug, even if it has been previously approved in the annual process, good luck. You have a better chance of winning the PowerBall. Caremark has been approving a drug for me for at least a year under a medical necessity. Time for renewal came and it was denied for some unclear reason this year. Nothing has changed. The "geniuses" in their medical department recommended generics or other alternatives, some of which have been recalled by the FDA due to impurity issues and resultant deaths of people who have taken the drugs on the recommended list. Others show dangers for people with my medical history, of which Caremark is aware. If they would do their job, they would know that the drug in question has no generic. But I guess I should take one of recommended drugs anyway since the sooner I die from taking a poorer quality alternative, the sooner they can quit collecting my premium and stop paying benefits. You cannot spend less than 45 minutes on the phone with these people trying to get to their issue and heaven forbid if you have to call back with a follow up, because the representative in the phone pool has to take half an hour to review your entire history again. Their decisions appear to be capricious and made without looking at the record of prior approvals for the same drug. This company presents as a wholly unprofessional company that prays on people's unwillingness to ask questions and get answers that make any sense. If I had an option, I would avoid these people I could. Based on their recommendations, I cannot see that they have my best health interest at heart. Although conclusory, it looks like the bottom line trumps health considerations. Would not be so hard to understand if this drug had not previously been approved. If Congress wanted to investigate what is wrong with the prescription benefit systems in this country, Caremark would be the poster child for them to start with. These are my opinions of this business based on my firsthand dealings with them, I hope your experience is better.

I called CVScaremark to refill a prescription as I have done in the past 2-3 years. Was told "ok" and cot a confirmation number. It did not come in the mail so I recalled. I was told my doctor would have to call them. I had my doctor call at the number provided by CVScaremark. The doctor called to tell me he called and that the medicine would be sent by mail.
It was not. I called CVScaremark again. Same story. Called doctor again. He called again. I got a recorded message on the answering machine that I could go to CVS, or any other pharmacy, to pick it up. Went to "other" pharmacy. They were told CVS had no record of any renewal or prescription. On 6/18/21 went to CVS pharmacy, they had no record of me whatsoever because I was dealing with the mail order portion of CVS and they do not talk to each other.
Got home and spoke to a Customer Representative who told me they had no record of the doctor calling and that there were zero refills. I told her the prescription label said otherwise. Her answer? "Impossible"
I asked for a Manager and spoke to "Susan". She said there was no record of any refill on the last prescription. I said I was holding the prescription label in front of me saying otherwise and would fax it to her. It seems they have no fax!
Every time I asked a question that required a "yes" or "no" response I got a story that did not pertain to my question. I asked what guarantee I had if the doctor called a third time there would be a different result. None.
I will not use them again and hope this will be of assistance you you in decision making, especially if the medicine is of a time important, life saving, nature.
I'd go less than one star, but there is not provision for that.

I only had 3 anastrozole pills left and I called and they had it at my door in 2 days. Unbelievable!

The website is not user friendly nor does it easily/accurately/consistently transfer over pharmacy orders so you can simply click to order. You have to go through hoops to get the script through the doctor and have the doc send it to Caremark [cause you sure as heck won't convince CVS to do it]

Good luck getting your meds from the pharmacy if you run out. I tried and was told refills weren't covered on a med I've been taking for around 14-15 years. Come to find out, they wanted a 90 day script from the doc which is exactly what I had. I ended up having to go to another pharmacy who couldn't fill it who sent me back to Caremark and to my doctor. Finally got the script [since the doc's the only efficient one in this mess] and they got it fumbled, sent to the pharmacy instead of mail order. Being disabled, I told the pharmacy not to fill because I couldn't get back out there any time soon. They ignored that. Finally got Caremark to untangle the mess and send my meds to me next day [at least that's what they said - waiting for it now]

Absolute WORST customer service from the reps. Got the 800 number, was told sorry this isn't the right line. Transferred to another rep who was not helpful. She didn't even grasp the issue at first, thinking it was a problem between brand vs. generic. No, that wasn't it. I usually try to keep my cool, but after repeating my situation 3-4 times, I was pissed. She tried to say I had to pay for next day delivery when this was their error. I had to ask for a supervisor. The supervisor, without hesitation, said they'd absolutely pay for next day delivery. Finally! Someone who gets it. I did tell her that they need to talk to their reps about being more helpful out the gate so calls don't have to go to supervisors when they can be so easily resolved.

I have two prescriptions which are brand specific. I have tried generic of these and they do not work for me. EVERY time I refill prescription, generic is sent and when I contact CVS Caremark, they will look back in my file and see that it says brand specific. Oh my bad, not sure how that happened, I apologize, etc... in the meantime, it may take 6 weeks to finally get the prescription filled correctly. This is even when I am refilling an existing prescription that may 3 refills left and instead of sending the prescription / brand specific, they will substitute generic.
If I could use generic, I would gladly do so AND I would do at local Walgreen's to avoid the hassle of this CVS-Caremark. The customer service people are condescending and LIE. They will say my prescription does not say brand specific when it does, they will my prescription expired when it clearly has not. Each time I call, I am usually on the phone for more than an hour. I explain the situation to the first person, they look at file then say I am going to transfer you to resolution team or Senior Team person, so I tell my situation again to that person. They will usually put me on an extended hold, then come back and tell me they need to transfer me to Pharmacist... another long hold. When I finally outlast them, they will tell me they are going to send me brand specific and a postage paid envelope to return the generic medicine to them. Usually I have to call yet again to get the ball rolling...
It is sooooo frustrating but the savings for these two prescriptions is the only reason I deal with the inept, incompetent, inefficient company. They are the worst! They manage to bungle my prescription each time I refill. It is mind blowing the aggravation this company causes me.

The needles that they will cover for injectable diabetes medications are terrible. They keep bending, meaning there was no way of knowing how much of the medication was even successfully injected. CVS Caremark said they would cover the more expensive needles -- that actually WORK -- if we got a prior authorization. We did that. It took TWELVE phone calls between them and the doctor's office and the pharmacy, but we got it submitted and approved. We DID WHAT THEY ASKED. It took over two weeks. It was approved, then the pharmacy said CVS was making us pay $71 for the same box of needles we paid $89 for over the counter.

I called to ask why since we had done what they asked. They said it was covered 55% because it wasn't the default needles covered by the plan (other words, but that's what it meant -- essentially because we asked for other than the generic, which DID NOT WORK). However, apparently for the base price that they will pay 55% of, they are using some mythical price that no one actually pays. Basically they are the prescription insurance version of those furniture stores that offer you "55% SAVINGS!" but it's of some jacked-up prices that no one pays anywhere.

By the way, this information was obtained after 15 minutes and three phone calls were used trying to navigate their absolutely horrible voice mail system that is designed to do everything in its power to prevent you from speaking to a live person and has the voice recognition capacity of a rabid squirrel. (And no, I don't even have a strong accent... I speak standard run-of-the-mill midwestern style English. I feel sorry for their poor workers who must deal with customers completely enraged by the horrid voicemail system. I had to apologize for how upset I was as the worker herself was lovely and helpful as she could be.) Can I charge them for the headache medications I now need?

I obtained CVS Caremark when my husband's company was bought by another larger entity & that's who they already used for their pre-existing employees. I allowed them to begin sending my medication refills immediately & after researching the cost of our insurance, our deductible, etc I promptly called them and told them in no uncertain terms to cancel my auto renew & delete my card. 3 mths later I received an e-mail saying that my order was sent out. So I called and asked how it was possible... crickets! Not an intelligent answer to be had. I was told there was no card on file, when I asked how the medication was being paid for then I was told it was charged to a card ending in ****. I asked for a supervisor, she spoke such broken English that I gave up & asked for HER supervisor. She took my information & said they call me because they're not on site.

The only information I got was that it was sent out & the payment was being processed. So they wanted me to wait for it to arrive, call back to dispute it, yadda, yadda, yadda to which I said that was an unacceptable option considering they were committing fraud.

The next day there was no call, amazing huh?

I called my credit card company & tried to file a fraud report, but they stated I had to wait for it to process... what? I need to let the fraud be completed?

I called back CVS Caremark to ask why I didn't receive a call. I was told they called & there was no answer or option to leave a message. Well, it's my cell phone... the one that's in my hand, so that's a lie!

The agent said that they deleted the order & will send a reimbursement check out via FedEx. Funny thing is they said it was already in the mail and couldn't be stopped... now it's miraculously stopped?

They were obviously just trying to charge me fraudulently and my complaint nipped it in the bud.

I wouldn't recommend using CVS Caremark at all! Their customer service sucks (I was in the process of being transferred several times & as a result I was hung up on & had to call back)!

Please read my entire review I'm all about the fact's.
Henkel US, or Aetna Insurance decided to switch my prescription coverage to Caremark. I have the usual problems (screwed up prescriptions, auto text messages saying I'm covered/not covered on the same day, filled prescriptions/not filled when I pick them up, etc) with my prescriptions that everyone has until last week. I'm 58 years old have auto immune disease, osteoarthritis, now degenerative disk disease that over the past few years has caused me to be on more medications 9 to be exact. I'm now able to control my pain and function as a normal person. I put weight on the most in my lifetime. I stopped drinking, I walk 3-4 times a week, I changed my diet, I lost 12 of the 70 lbs put on. My Doctor decided after a year of me working on myself to help because I'm now borderline diabetic and my cholesterol is getting to the point of medication, More Prescriptions. She prescribed weight loss medication. Denied. I was told to have my doctor file an urgent appeal so it would go through. Denied. I was told to call Henkel US Benefits Customer Service. The Benefits service representative transferred me back to Caremark. Another Caremark representative stated ALL weight loss medication is NOT COVERED. Final answer Caremark does Not Cover Any Weight Loss Medication, Zero.
I asked the representative why I had to take Numerous Medications to not have a stroke or heart attack or become a diabetic when ONE Weight loss medication could prevent it and possibly stop my blood pressure and some pain medication. I informed him that all the Weight Loss medicine is temporary (some are 3 months, some 6 months) that the medications available state it helps with your blood pressure, cholesterol, diabetes, pain, etc your overall health, along with the possibility to stop taking certain medications altogether. Isn't that what Henkel US would prefer!?! He said he didn't know why, I made sense to him what my concern was then stated it was Henkel US who decides my prescription coverage. So who decides Henkel US? Aetna? Caremark? I know it's all about money money to who exactly I don't know.
Who sits in the board room and decides what is really important for the employees, employees spouses, their kids to take preventative measures. To not continue paying the companies share of money.
I would think Henkel US would want this or maybe they don't.
Zero Weight loss medication coverage. Caremark's mission statement: To improve the lives of those we serve by making innovative and high-quality health and pharmacy services safe, affordable and EASY TO ACCESS.
Lie - Only if you are covered, after you go through pre approval which takes 72 hrs if marked urgent, 30 days otherwise. It Is Not Easy.

Wilmington, NC

I have had multiple spinal surgeries, with most of them being titanium fusions. I also suffer with Osteoporosis throughout my body. Until my pain specialist prescribed Nucynta ER, my pain levels were always around the level 10 mark. Nevertheless, I was still having to take Oxycodone 20mg every two hours to manage the pain. At my most recent visit, Dr Jakubowicz, (Piedmont Comprehensive Pain Management *******416), upped the Nucynta ER from 100mg to 200mg to prevent me from needing so much Oxycodone; nevertheless, CareMark has so far refused to approve the medication. They intentionally make it hard for the prescribing doctors, requiring them to wait on hold to the point that they have to hangup. CareMark should be put out of business for their practices. I'm sitting here in pain beyond my ability to withstand, while someone at CareMark sits behind a desk and play games with a certified, highly qualified doctor, who is specifically trained to understand how to treat patients who deals with chronic pain. My back, legs and arms feels like they are on fire. At this point I have reached my limit, wishing God would take me out of this painful body. If by chance anyone at CareMark takes five minutes to read this complaint, You Should Be Ashamed Of Yourselves for the way you treat your customers. If either of you have a heart, put yourself in the place of suffering patients and think about how you would want to be treated. When I called CareMark, they claimed they had sent a message to the doctor and waiting for his response. This is not true. My doctor is very responsive and checked again while I was on the phone, finding nothing from CareMark. This is CareMark's MO when they don't want to approve a medication. I went through the same thing when I resided in Florida. A different doctor, different medication with the exact same response from CareMark. They should be banded from this practice…

Our insurance plan changed from Walgreens to CVS Caremark as of 1/1/2014 for prescriptions (Rx) received by mail. An Rx that had been ongoing at Walgreens was deemed ineligible for refill by CVS Caremark without a Request for Preauthorization, to be submitted by the doctor who prescribed the medication, followed by a brand new Rx.

I worked on this for hours, speaking to one person after another at CVS Caremark, each of whom provided different, conflicting information about what was required to get a longstanding RX going again, then getting the doctor's office to submit a Request for Preauthorization, then confirming that it had been sent. By the time I called CVS Caremark to check on the status of the Request for Preauthorization, as they had instructed (and I had heard nothing from them), I had very little confidence that things would be going well. Sure enough, the rep that I spoke to advised that the medication did not require any Preauthorization (at this point I was not surprised to receive yet another conflicting statement from CVS Caremark), AND no Request for Preauthorization was on file for the insured (even though the doctor's office had specifically confirmed that it had been submitted a least two weeks prior to that date). That was the last straw.

WE GAVE UP ON USING CVS CAREMARK. We apologized to the doctor's office for wasting so much of their staff's time dealing with CVS Caremark, ultimately having no success, and we had the doctor's office send the Rx to our grocery store's pharmacy. I even called CVS Caremark back to have them note the file that if they ever locate the Request for Preauthorization that the doctor submitted, they are to do nothing with it. We do not want to spend any more time dealing with CVS Caremark.

Rx by mail is supposed to save time and money. Ultimately, we ended up filling the Rx paying cash, were deprived of the use of our Rx benefit while attempting to work with CVS Caremark, and wasted hours in the process. It doesn't get much worse than that.