Optum RX - STAY AWAY

[SarahH845050]

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!!!

[m155186b]

Whom do I complain to about the BAD customer service at OPTUMRx? I have been trying since January 3, 2020 to get my Rx moved from CVS to OPTUMRx. Here I am leaving for Wave 1 and I still don't have my medication and I am out. OPTUMRx does not have:
Decent voice recognition system on automated system…..keep having to repeat information
Information given in automated system does not transfer over to customer service representative. I have to tell them all information again, this make 3-5 time of repeating myself.
Mail order is a mess, I can only get 30 day supply and not 90.
Can we switch to CVS again?

[PeggyW881599]

Optum (or UnitedHealthcare, which owns Optum) actually called me and assigned a personal rep for me to contact anytime I had a problem. She figured out what was causing the problem (there was an erroneous indication on my record with them that I would not accept the generic equivalent) and fixed it! While she didn't OK my posting her direct line she did say I could give you the corporate 

number 800-343-4227 so a case can be assigned to her (Patricia Esparza) or other corporate agent. She is very helpful, competent and empathetic but it appears the core issue still exists, poor training of the frontline call center staff.

[JimJ439704]

How did you ever get them to do that for you? 

I almost never reach someone who can understand me or that I can understand. If I ask for a US call center - something that works immediately when I reach an English as a 2nd or 3rd or 4th language call center when calling UHC - I always get the same slurred jumble of whatever they are trying to say.

They constantly repeat the same lines over and over 'we're so happy you chose Optumrx' etc and lately have taken to start asking me when my next doctors appointments are and other none of their business questions.  They butcher my name which they also repeat endlessly.  

I would pay extra to reach a US call center where people could understand what I am calling about.  

The US should mandate that all medicare call centers and medicare prescription service call centers are based in the US.

[JazzGirl9]

Hi again 

Did you call 800-971-7658? Just wondering. 
Nina

[JazzGirl9]

Hi Jim

I know, it's more than terrible. I think calling from a Dr's office made a difference. When you call, do you get an option that asks if you're a patient or calling from a Dr's office? If not, I can call where I used to work to see if I can get that number for you. So sorry you're having trouble. It is unconscionable for anyone not to be able to get their meds. As far as outsourcing... don't get me started. They also have a ridiculous cookie cutter thing they have to go through and you HAVE to tell them you want to speak to their manager, and be persistent. If their manager doesn't help, insist for customer service and don't let them intimidate you. If I were you, I'd switch to Express Scripts any day. They are always polite, helpful and knowledgeable. They transfer you to whom ever can help you. I've even spoken to a pharmacist to ask if there was another pharmaceutical company that made a med I take because the one I was taking bothered my stomach. They gave me a lot of options and I did research on google to see what other people say. You're Dr can indicate on the Rx what brand you want. Also,  If you're on a controlled substance, you can only get a months worth no matter where you go because insurance will not pay for more. Hope this helps and let me know if you need that phone number. 
Nina 

[JazzGirl9]

Your Dr should be able to send your prescription anywhere where you are covered whether it's CVS or Optum. Does your Dr send yours electronically? Most do and it's easier for them. Just tell the office or Dr where you want it to go. As far as complaining, I'd call customer service if you can reach them. Please don't wait until you're out 😞 

[RN362636]

With a United Healthcare ADVANTAGE plan the choice is OPTUM only. However there are other options that are often less expensive than an insurance co-pay that are worth checking out: CostPlus Drugs, Goodrx coupons, Costco pharmacy, Kroger (Dillons) Health Savings Club, CIPA certified pharmacies, etc. They don't take insurance but the cost is often less than the insurance co-pay. Why should a co-pay be more than a cash price? Most don't know that if you go to a local pharmacy that they are not allowed to tell you that a script would cost less if you just paid cash; you must ASK them what the cash price would be. That doesn't seem right to me either but that is the way the drug industry controls their profits. Our whole system is broken and is in need of many changes which actually help the public instead of the industry profit.

[crabpaws]

Another reason NOT to enroll in a Medicare Advantage plan rather than original Medicare. While Medicare Advantage may seem cheaper, you can bet the insurance company has figured out a way to get at least as much money out of you as the Medicare premium would have cost. And some of those ways will be a very unpleasant surprise, especially if you need specialist care or an expensive operation. The insurance company is not your friend.

[SpringIsHereVA]

@crabpaws , I have Original Medicare since 2023 (age 67 this year 2025) and SO GLAD you posted this!!!  👍  Why? Now I know to NOT change. Take care, Nicole  👵

---

[*** @crabpaws wrote 4/23/25:

Another reason NOT to enroll in a Medicare Advantage plan rather than original Medicare. While Medicare Advantage may seem cheaper, you can bet the insurance company has figured out a way to get at least as much money out of you as the Medicare premium would have cost. And some of those ways will be a very unpleasant surprise, especially if you need specialist care or an expensive operation. The insurance company is not your friend. ***]

---

[PMDL57]

I don't know what to do. Can someone help me.

I've been on tramadol for over 20 years for my fibromyalgia and arthritis.  I hurt all the time but it makes my life bearable. As I work full time in retail all my life. I have three adult children, two wonderful grandsons and great friends that keep me busy in my life.

Optum RX now once to limit my pain medicine and send me to pain management. They lied on my phone and told me my doctor sent a referral to send me there. Which she didn't they asked her for one 

My problem is I have friends in pain management and the stuff they're dealing with still don't help their pain. I have come up with many techniques to help my pain not be so bad all the time. Plus I don't have to pay a $2,000 a year copay to do it. Because they won't be paying my co-pay or deductible I will be. What gives them the right to tell me to go to pain management and to limit my medicine. 

I'm just called my doctor to find out how I can get my medicine without being limited to getting one week at a time and go visit her one week at a time. Cuz I can't afford that.

What are my rights.? I don't want to call Optum RX after hearing all the problems you all have. What should I do now? Thank you for listening prayers to all. Pam

[RN362636]

Kroger (Dillons) Health Savings Club near me has a reasonable price. I have asked my doctor for lower dosage pills, say 50 mg and get double the amount if I need 100mg which is sometimes less expensive than the higher dosage. I have also gotten twice the dosage needed and cut them in half to get twice the amount for a better price. This only works for pills, not capsules. Prices sometimes vary greatly depending upon dosage.

[CKM816]

I have fibromyalgia as well, and have tried a lot of prescription medications to no avail. I ended up going to a physician who is focused on holistic medicine, and she has helped me A LOT. She recommends using an herbal medicine called 'Tranquility' which you can get on Amazon. I take 2 capsules 4x/day and it really helps. There is another herbal medicine called 'GABA' which works well and is also available on Amazon. Same dosage.  You can even take them together if you are really suffering,  but I find I rarely have to do that. 

I would also recommend that you check into getting a blood test called 'MRT'. It tests to see if you have food sensitivities that could be making you suffer. Food sensitivities are not food allergies. I did it as did 2 of my friends with other horrible problems (they were not diagnosed with fibromyalgia,  BTW) and we all had problems with different foods.  If I stay away from those foods I feel much better! 

There is also a book called 'Prescription for Nutritional Healing' which has been my bible for almost 30 years. It's a wonderful resource for lots of ailments, and is updated regularly.  It combines traditional medicine with herbs, supplements and diet and has helped me with my many health issues.  

Lastly, opioids are not a good solution for fibromyalgia.  Get help weaning yourself off of this drug and try changing your diet and using the herbal medicines that I  have mentioned.  And if you don't want to spend money on the MRT test then look up 'Anti-inflammatory Diet' online and follow that as closely as possible.  I went to a pain management doctor 20+ years ago after a spinal fusion,  and all the meds did was make me a zombie.  Diet and herbal medicine is more effective and not addictive. 

Good luck! 🤗

[c393452w]

That's a waste of time.

[GailL1]

---

@PMDL57 wrote:

I don't know what to do. Can someone help me.

I've been on tramadol for over 20 years for my fibromyalgia and arthritis.  I hurt all the time but it makes my life bearable. As I work full time in retail all my life. I have three adult children, two wonderful grandsons and great friends that keep me busy in my life.

Optum RX now once to limit my pain medicine and send me to pain management. They lied on my phone and told me my doctor sent a referral to send me there. Which she didn't they asked her for one 

My problem is I have friends in pain management and the stuff they're dealing with still don't help their pain. I have come up with many techniques to help my pain not be so bad all the time. Plus I don't have to pay a $2,000 a year copay to do it. Because they won't be paying my co-pay or deductible I will be. What gives them the right to tell me to go to pain management and to limit my medicine. 

I'm just called my doctor to find out how I can get my medicine without being limited to getting one week at a time and go visit her one week at a time. Cuz I can't afford that.

What are my rights.? I don't want to call Optum RX after hearing all the problems you all have. What should I do now? Thank you for listening prayers to all. Pam

---

This isn't the fault of the pharmacy - New Guidelines have been issued by the CDC on the prescribing of opioids and related pain meds for those with Chronic pain - This differs from those who have cancer-related pain or are at the end of their life from cancer or other painful conditions.

CDC GUIDELINE FOR PRESCRIBING OPIOIDS FOR CHRONIC PAIN - Factsheet 

Tramadol is similar to an opioid (narcotic) analgesics.  It is a controlled substance and thus is regulated.  There is a risk for abuse and addiction, which can lead to overdose and death. This is why your pharmacy wants you to be re-evaluated by your doctor.  The doc will evaluate you to see if something else will work that is not so addictive - pharmaceutical, medical or physiological - or a combination.

I don't know about Tramadol per se but sometimes there is an addiction offset to other addictive meds that the doc can also prescribe.

Yes, your doc may ask you to work with a pain management specialist  He may want you to try other methods of pain control in addition to weening you off the Tramadol slowly.  If you are kept on this medication, most likely you will have to see your doctor more often for refills. 

Nothing against you or your pain, health care providers did it wrong previously and now they are having to reevaluate their patients.

You are like millions of others - prescribed a pain medication as an easy fix to whatever - many of these people are now addicts or they may be no longer with us.

20 years on this medication - time for a review - there maybe something better for you depending on your chronic problem.

[RN362636]

Oh my, she has been taking it for 20 years with success and hasn't overdosed. The government and pharmacies need to stay out of the doctor patient relationship. My mother is 86 and not a good surgical risk for a ruptured disc and her doctor gives her pain medicine but the pharmacy didn't want to fill it because she has been it on a regular basis. Are you kidding me!! She has legitimate pain and all the physical therapy or whatever isn't going to fix her problem...she needs and deserves pain control. Unfortunately, what sometimes happens is that when a patients pain medication is cut or eliminated they will reach out to illegitimate medication off the streets and then they don't really know what they are getting. It may be mixed with Fentanyl or something. It is those who most often overdose. The other thing that makes no sense to me is getting a patient to quit pain medication by getting them into a Methadone program. That is just legal synthetic heroin. Is that really better than taking pain medicine?

[JazzGirl9]

I totally agree with you!! I spent 45 minutes with customer service and a pharmacist on the phone today. I am in the middle of choosing a Medicare D provider and I was appalled at what I was told. I just retired and I worked in the medical field for over 25 years. One of my jobs was to get prior authorization for patients mediation so I know the ropes and what constitutes good medical care. I take a particular medication and one of companies who manufactures it makes a product that causes side effects and makes me sick. I was told I had no choice of pharmaceutical companies to choose from. I would get whatever they had on hand for the day or week or whatever!  I asked if it mattered if it made me sick and was told I could try to get a prior authorization for brand name. Ha ha... what a joke. Medicare will not pay for brand names, even if you’re dying on the street and even if the medication is brand name only. You have no idea how long I have spent on the phone arguing with an idiot or idiots who want to practice medicine without a license and give someone something THEY think would be an appropriate substitute. No no! I spoke to Express Scripts today and they take these things into consideration and had more than 6 pharmaceutical companies to choose from. I’m not sure how their prior authorizations go because Medicare keeps changing their formularies but I’ll go with a company who cares if I get heart palpitations from a medication and have a pacemaker anytime! 

[p218181h]

The WORST pharmacy ever. Refused to refill a prescription and flat out lied to me about trying to contact me and the doctor. I’ve had nothing but trouble with them since my first encounter. Horrible horrible company. Someone should investigate them. 

[hpbob]

My doctor prescribed a medication which was very pricey and I was able to use Optum Rx to find an alternate more affordable medication. I am sure it helped that   my Optum Rx profile is set not to autofill any prescription  but to wait for me to make an order.  I was able to take the information I got from Oprum Rx back to my doctor and got him to change my prescription to the cheaper medicaiton.

[SusanK442205]

I am totally fed up with this company. Will be changing Part D in October. Have had this company for 3 years. They have screwed up more scripts than I can count. I have spent endless hours with them and United healthcare. They are all the same outfit. STAY AWAY is correct. They have billed my card when not approved to. Caused overdrafts in my bank. Sent drugs when not ordered. Now there is a disputed charge and they said they would remove but will not. Bad outfil all around. AARP should be better at helping us sort this out. Get a new company. Things really went downhill more with Optima in the past 6 months. So something has changed there..Whether foreign drugs or mismanagement.

[w161299c]

Totally agree with all! This company is horribly inefficient. Something needs to be done.

[w161299c]

I just had another nightmare experience with Optus RX. Without a doubt, they are the most woefully inadequately run business ever. Hours on the phone with people who cannot answer questions. Here was my question...would you please email me instead of calling me when you need prior approval? The answer was ‘I’m not sure.’ No kidding, the idiot actually said that. I am absolutely outdone with them. But it appears we have no recourse. What would it take to get support from AARP on this?

[aw6946]

I do NOT think AARP cares.

1. Look at Wikipedia, AARP undercut having a better universal healthcare for citizens. I don't believe in a single payer system for many reasons (1st of all the other options FUND Medicare's shortfalls).

2. They are a marketing company. Even with their Tax-aide program, they are now collecting more and more data FROM YOU. 

BEWARE OF AARP. I am not a member anymore.

[robertheller]

Fully agree -- the service has deteriorated sharply.   Instead of fulfilling my recent oprder, AOPTUM RX cancelled the entire prescription!

Back to your neighborhood pharmacy!

[MorganP676745]

I have just had yet another unpleasant, time consuming and frustrating experience on the phone with optum.  In the last 2 months there have been so many, it has consumed a total of 20 hours, with no resolutions.  I have even called United Health Care to try to give them feedback on the lack of accuracy, efficiency, and resolution  in the information they give their customers.  There have been more instances than I can recount here.  After spending yet another hour on the phone with UHC trying to straighten out a mess optum made of my statin and blood pressure meds, I gave up and decided to hit the on line sites to give accounts of their horrible service.  One of the last encounters even consisted of an employee asking me if I had ever talked to him before.  I said no and he said there are 10,000 empIoyees at optum and how should he know what any of them had told me in the past. I should give him a chance to solve my problem.  When I told him the problem he said I had called the wrong #, (Even though I was transfered to him by another optum employee) and he hung up on me.  This after I waited 45 moniutes on hold to talk to a human.  I was surprised to see how many reports of similar issues other people have had.  While it was reassuring that I wasn't crazy and not alone in this pain, I was disgusted that they continue to get away with this horrible service.

Buyer beware!  Don't use them!  They can't get it right.  And we are the ones that suffer.  Also, shame on United Healthcare for associating with them and using them to manage their prescription plan.  And Shame on AARP for having their name used in connection with them.

In this day of on line ordering and impersonal purchasing, the loops that are built into this system are trapping the consumer, giving us no way to resolve problems, talk to coherant human beings and removing our ability to problem solve.  What a sad state for all of us.

[JimJ439704]

Had a medication order a couple of months ago they decided to ship fedex for no reason but they sent it signature required. 

The fedex man ran up the front stairs left a note on my door and ran back to the truck - they won't call - he didn't even ring the bell.  I could see the back end of the truck as he drove away. I was able to get fedex to have him return and that time I was lucky enough to get him just as he was leaving ANOTHER note on my door saying no one came to the door.  I'm on the third floor and cannot reach the first floor in that kind of time.

I spent well over an hour on the phone with Optum that day telling them fedex delivery isn't going to work for me but since talking to anyone at Optum is like talking to a door here we are again they shipped this next order out Federal Express AGAIN. 

I just got off the phone with someone at Optum - after the phone system asked me several times for different identifying information - the rep who was an obvious English as a third language employee started asking me the same information all over again.  Then AFTER I explained the situation they asked me for the name of the prescription - I said its the only thing whose status on my account is 'in delivery' then they explained that a signature is necessary to which I stated BUT NOT SPECIFICALLY from Fedex. 

A USPS delivery could be held at the Post Office which I'm two city blocks from and I could sign there getting it at 9am when they opened.

That apparently is WAY TOO MUCH for Optum to process so tomorrow I will sit outside my house ALL DAY - because the delivery window is anytime before 8pm and wait for a refrigerated medication that if it doesn't make it to me will GO BAD.

Incompetence personified. 

[bc12559187]

I have been dealing with this company for 18 months. More often than not, they tell me that an order is in process, when it will ship and arrive but it does not arrive. So I have to go online, check to see if I can determine what went wrong, wind up calling customer service, get little to no useful information, elevate it to a supervisor, get different information, speak to their web team and get yet different information. Almost every order I place takes over 90 minutes of my time.

Their system is supposed to send confirmation of orders via email and text message and is supposed to send notifications if anything is delaying an order. I NEVER have received even one notification for the 12 times orders did not ship and customer service never can tell my what went wrong.

I manage from the East Coast of the US the care of my mother and also my sister who live in Arizona. In virtually every case that I place an order, I have to spend more time on the phone with OptumRx than would be the case if I were to drive 30 minutes round trip to a local pharmacy, wait 20 minutes for the order to be filled, package it up, address it to my mother or sister, drive 10 minutes to the post office, wait 10 minutes to be served, and drive 10 minutes back home.

I am in search of another mail order pharmacy that accepts her insurance and will switch in a heartbeat. OptumRX has the worst customer service I ever have experienced. By the time I get off the phone with them, I am trembling with anger.

[JimJ439704]

---

@bc12559187 wrote:

I have been dealing with this company for 18 months. More often than not, they tell me that an order is in process, when it will ship and arrive but it does not arrive. So I have to go online, check to see if I can determine what went wrong, wind up calling customer service, get little to no useful information, elevate it to a supervisor, get different information, speak to their web team and get yet different information. Almost every order I place takes over 90 minutes of my time.

Their system is supposed to send confirmation of orders via email and text message and is supposed to send notifications if anything is delaying an order. I NEVER have received even one notification for the 12 times orders did not ship and customer service never can tell my what went wrong.

I manage from the East Coast of the US the care of my mother and also my sister who live in Arizona. In virtually every case that I place an order, I have to spend more time on the phone with OptumRx than would be the case if I were to drive 30 minutes round trip to a local pharmacy, wait 20 minutes for the order to be filled, package it up, address it to my mother or sister, drive 10 minutes to the post office, wait 10 minutes to be served, and drive 10 minutes back home.

I am in search of another mail order pharmacy that accepts her insurance and will switch in a heartbeat. OptumRX has the worst customer service I ever have experienced. By the time I get off the phone with them, I am trembling with anger.

---

Same here my blood pressure must be sky high after dealing with them.  I'd wager there is a high incidence of stroke or heart attack with people that have to deal with them.  I can immediately tell I have reached someone who doesn't understand English from what I believe is a Philippines English accent.

[LeslieB401708]

Twice OptumRx has sent medications to my husband and I that have not been requested.  Today my husband received a text message that OptumRx had reached out to his doctor and sent a refill of a medication that he has plenty of and did not order.  He called Optum and, after listening to a recorded sales pitch, tried to tell the rep that he did not request and does not want this medication. She wouldn't listen, kept talking over him, and to top it off, kept calling him "Ma'm" because his name is Dana.  Needless to say, sending medications not requested and billing Medicare should be a fraululent activity and I think they try to get away with it.  The deductible for this will be declined through our credit card company and the medication will be refused and sent back to Optum.

[aw6946]

My recommendation:

Start calling United Healthcare AARP enrollment line in your state. Let them know you will NOT be renewing.

Additionally, I am starting to wonder if they are in violation of Medicare rules. Does anyone know an attorney or an advocate agency? 

It won't let me paste link. Search Modern healthcare CMS fines 17 rx...... it lists MN UHC in that article. 

Even if they have an agreement on their website or app agreements to terms to use, if they do not let you OPT out of prescriptions:

1. YOU didn't approve and/or you did NOT give dr authorization to do so,

2. or they told me by not keeping credit card on file then no rx would be sent (baloney they did anyway), they told me to follow their rules BUT didn't matter.

I think they are violating rules! 

I didn't renew. Call YOUR local MEDICARE AARP line and start to complain. 

[d797006l]

Has anyone had a problem with receiving a bad batch of drugs? I switched to Optum after joining United Healthcare a year ago, to save money. I receive two drugs from them, one a name brand which I haven't had any issues with. The other is atenolol/chlorthalidone, a generic med which I've taken for years and had no problem with (combination blood pressure and diuretic med).  At the same time as my last refill of atenolol, I noticed that it had basically stopped working....my blood pressure shot up and my feet started swelling badly. I went to my doctor and got a different prescription for both ailments, filled them locally, and they cured the problems immediately. This has me really wondering, since it's quite a coincidence that both drugs so immediately stopped working just as I switched to this new refill. Hopefully a coincidence is all it is, but being a generic and very likely coming from some third-world country, I'm really wondering if I got a refill of either expired meds or not what they were advertised to be.........