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Contributor ⭐
January 26, 2018

Optum RX - STAY AWAY

  • January 26, 2018
  • 194 replies
  • 205242 views

If you go to a pharmacy and they hand you a prescription then tell you it cost $160, you have the choice of handing it back.  NOT WITH OPTUM RX.  Website said no co-pay.  Prescription recieved then credit card bill arrives with $160 charge.  Called Optum RX.  They will not accept any return nor issue any refund.  Called Regions Bank to dispute charge.  They refused to accept dispute but charge penalties and interest while reviewing my case and reported a late payment to credit bureaus.  The whole experience has been BAD!!!

194 replies

Contributor ⭐⭐⭐
January 27, 2024

To those having trouble you might try another avenue such as :1. goodrx for a savings coupon 2. DiRx Health for a ONE time annual fee for as many medications on their list that you need; refills included 3. Try one of the approved pharmacies listed on the CIPA Safe Pharmacies web site. 4. Cost Plus Drugs. Their fees are the actual cost of a medication + $5 shipping. Most of these do not accept insurance but you will often find that prices are cheaper than paying an insurance co-pay. 

Contributor ⭐
November 22, 2023

I received a prescription from optumrx last month. The receipt I received with it shows 0 balance due. When I talked to rep before it was shipped - he said rx was approved by insurance and did not charge me anything. Now I'm getting a bill for $3400.00 from Optum RX. Does anyone know if I can dispute this or do I just work out a payment plan with them?

Contributor ⭐⭐
November 22, 2023

Hmmm, that's a tough one. I am not an expert on this, and this sort of thing has not happened to me yet, but here's where I would start.

1. Whenever I speak with a customer service person, I always make a note of the date, time and the name of the person with whom I spoke. Armed with that information, you could call Optum and ask them what happened. Sometimes they have a record of the conversation. It also may be possible that Optum submitted the wrong information to the insurance company. Someone may have typed in a wrong code or incorrect drug information.

2. I would call the insurance company and explain what happened. Maybe you and they can verify that they received the correct information (or not). 

 

I hope this helps and that you get it resolved.

Contributor ⭐⭐
November 15, 2023

Wow. It would appear that there are lots of people who have had bad experiences with OptumRx. 

I am not one of them. Only once did I see a potential problem with a drug that OptumRx would have charged me a lot of money for (~$130) but my PCP's office fixed it for me and got the prescription canceled. Right after that, I removed my credit card information from my OptumRx profile so now, they have no way to charge me and, I assume they will not fill a prescription that costs money if I do not have a credit card on file. And, whenever my PCP prescribes a new med, I always check the cost with their office before they submit the order. 

OptumRx regularly contacts me (via text) saying I have Rx's that need to be refilled. But Optum Rx has NEVER automatically refilled a prescription for me. (I believe none of my prescriptions are on auto-refill). 

So, OptumRx sends me my drugs for free when I ask them to or when my PCP asks them to. For me, it has always worked that way and it has always worked for me.

It's unfortunate that "everyone else" is having such trouble.

Contributor ⭐
June 12, 2023

For sure. The worst pharmacy I have dealt with in my entire life! Stay away. And definitely don't give them credit card information!!! 

Contributor ⭐
April 3, 2023

OPTUMRX has improved their service since starting.

Contributor ⭐
April 7, 2023

Horrible company! They have a copay card on file for a very expensive arthritis medicine. They admitted to forgetting to apply the copay card, and we got a credit card charge for almost $2000! They say that they will (I hope) fix it within 4 weeks. Meanwhile, we need to pay our credit card bill when it comes due. At the very least, if they make a $2000 error, they should fix it ASAP to avoid my having to deal with interest and late charges on the incorrect credit card charge.

Contributor ⭐
April 3, 2023

My experience with a hormone drug - $124 for 3 mo supply.  Called Wal-Mart - $50; called Costco - $50 - as a member $25.  I called them & told them & rep tried calling Wal-Mart to check herself but couldn't get through - I called again.. anyhow - no results - I disputed the charge on my credit card (Citibank).  I was credited the full amount & will now buy from Costco.. I know Medicare says we have to have a drug plan.  No, really, I don't.

Contributor ⭐⭐
March 1, 2023

I have been reasonably satisfied with OptumRx for the past 2 and a half years. I did run into a hiccup at my last Drs visit. He prescribed a drug and when I looked at the records for my Drs visit (before I left the office), I saw the drug cost $130. I said, "What??". When I told the office staff that I did not want to pay that much for the drug, they looked up GoodRx prices for me and gave me choices. They said that they could not cancel the OptumRx order, but that the Optum Rx order would cancel if they sent the same prescription to my local pharmacy. I said, "DO THAT". So now, what I have learned is, if my Dr says I need a new prescription, I ask him to NOT submit the order until I can verify the cost. Problem solved.

Community Manager
November 26, 2022

 3 comments (11/26/22) Hi @SarahH845050 , thank you for sharing your experience. So sorry you had to go through this! Any "updates" for us? I am "stressing out" already over signing up NEXT June 2023. Way too many problems with Optum RX. 😱Nicole 

Community Manager
November 26, 2022

(2 comments) I am in Virginia but read the complaints in this Public Group. Yikes, something needs to be done. Some of us are on "fixed incomes" and need our meds to stay alive. Me, blood pressure and chlolestral. Nicole 🙂

Contributor ⭐
December 13, 2022

I think I can help you re: cholesterol med. Short answer - no one needs a statin. Vitamin D3 provides the benefit. 
Proof: All statins lower cholesterol. All statins EXCEPT Crestor lower the rate of heart attacks. All statins RAISE D3 EXCEPT Crestor. Conclusion: Stop talking statins and take D3. Better yet, go outside in the sun. Most people’s D3 levels are determined by sun exposure because relatively few take D3 supplements. Sun exposure creates, destroys, up-repulates and down-regulates twenty different things. Creating D3 is only one of those things and is the only one measured. D3 alone is unlikely to be the sole cause of the benefits we see in people with higher D3 levels since most of them go out in the sun. The few doctors who are on the cutting edge of health research recommend one hour outside at solar noon each day. “But if I go in the sun I’ll get malignant melanoma.” First of all, MM does not correlate to sun exposure. What does correlate is a severe sunburn FOLLOWED BY SUN AVOIDANCE. The sun causes cancer AND IT CURES THEM. How do we know? Because construction workers have a lower rate of skin cancers than the overall population. The above is the only explanation for the above. 

Contributor ⭐
November 26, 2022

I'm sorry you had such bad experiences. I have been with OptumRx for several years and love it. I get Levothyroxine (for thyroid disorder) at NO COST (with Medicare and United HealthCare supplemental) so I could not be happier. 

Contributor ⭐
November 16, 2022

Well after 2 years OptumRX is working better.  I guess they just need time to get their act together.