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!!!

[RN362636]

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. 

[tdk000]

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?

[JerryS109]

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.

[JerryS109]

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.

[MarkD875698]

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

[m155186b]

OPTUMRX has improved their service since starting.

[MarkD875698]

Well I can't imagine them being worse then they are now. 

[JohnV946481]

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.

[sherb50]

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.

[JerryS109]

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.

[Anonymous]

 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 

[Anonymous]

(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 🙂

[j633226b]

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. 

[RN362636]

  Where in the world do you get your information? Who is this supposed "cutting edge" doctor? I'm sorry but I disagree with most of what you say. The recommendation that sun exposure or vitamin D is a cure for high cholesterol or to prevent melanoma is absolutely incorrect! 

[aruzinsky]

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@j633226b wrote:

... All statins EXCEPT Crestor lower the rate of heart attacks. ...

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Wrong.

https://www.reuters.com/article/us-heart-crestor/astrazenecas-crestor-cuts-deaths-and-heart-attacks-...

"The 17,802-patient study was stopped more than two years early by independent safety monitors because the benefit from 20 milligrams of Crestor daily was so pronounced -- 142 heart events with Crestor versus 251 on placebo."

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@j633226b wrote:

Better yet, go outside in the sun.

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Unless you live somewhere like Nevada, California, Hawaii or Florida, you can't get enough sun in the Winter to provide D3 because it is too cloudy and you have to cover yourself with clothing to protect yourself from cold.

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@j633226b wrote:

Most people’s D3 levels are determined by sun exposure because relatively few take D3 supplements.

---

I doubt that that is true during the Winter because milk is fortified with D3, 2400 IU/gal, 

[drbad]

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. 

[m155186b]

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

[DennisF788680]

100% agree with "stay away."  Horrible, deceptive, money stealing organization.  These people took it upon themselves to contact my physician and ask her to write a new prescription for an old one that had expired.  They never informed me of what they were doing and the only reason I found out was because I got an email saying they were filling my prescription!  I called and managed to get it canceled but they then went to ANOTHER prescription ans asked my doctor for a new prescription, again without my knowledge!  Also, every time a prescription goes in they put it on automatic refill without informing me.  When I complained about this practice, their response was that they don't do it!!  They basically said I was a liar while they outright lied to me!  STAY AWAY!!!  

[hh1415]

  I completely agree with the Stay Away approach.  After my usual pharmacy decided to close I transferred a couple of prescriptions to OptumRx.  What a mistake.  Since they had a list of all my prescriptions they decided on their own to reorder the rest without my authorization.  I called, wrote, emailed, and messaged to cancel those.  On the sixth try they finally cancelled. 

 Using my law school knowledge, I looked up the laws.  There are no laws that I found that prevent pharmacies from attempting to refill a prescription.  There should be.  These people are hard to deal with and should be avoided.

[cranky4]

They'er not the only ones doing this. 

[PinkyC958299]

Optum are money savers (For United Health Care) Not spenders. They manage claims and attempt to reduce them. Meaning that they DO NOT make money by increasing costs (Ordering more expensive items or increasing spending). That's not what they are in business for; They are trying to cut costs for United Health care and other insurance carriers who outsource their claims management service. DO NOT TALK TO THEM"

[GailL1]

Don't think it is a law but it is a pretty common procedure - some of the mail order fillers will opt a beneficiary IN automatically and then the beneficiary has to opt-out.  Just gotta read ALL that small print - no matter how small it gets (that's where we need a law !)

Medicare.gov - Using Your Drug Plan For the First Time

from the link:

Automatic refill mail-order service for prescription drugs

Some people with Medicare get their drugs through an “automatic refill” service that automatically delivers prescription drugs before they run out. To make sure you still need a prescription before they send you a refill, drug plans may offer a voluntary auto-ship program. Contact your plan for more information.

[fotogo3]

 I’ve never received an “automatic refill” until recently. I never approved it.  This is a new procedure with OptumRx. It’s simply a money generating scam. Funny that it’s the most expensive meds they send out. 

[GailL1]

@fotogo3 

What I wrote in my post of 11-07-2021 was from Medicare not OptumRx.

[hh1415]

Thanks for your response.  OptumRx didn't enroll me in an automatic refill.  The website shows the automatic refill option on each individual drug in the prescription list and no prescriptions are "checked".  They just took all the prescriptions I ever had and (re)ordered them.  They know the prescription list because they are related to the health insurance provider, Unitedhealth. They had asked about two of them when I talked with them at the time my requested order was place and I said "no, I don't need them".  They ordered it anyway.  This seems to me underhanded and unscrupulous even if it's not illegal. 

[RN362636]

 United Healthcare owns Optum. And they pay AARP over a BILLION dollars according to IRS financial reports be able to use the AARP brand as a marketing tool. Pretty slick. So when it comes to AARP really wanting to help lower drug costs where do you think their loyalty lies? The words conflict of interest come to mind.

[RobertaK589442]

 I don't buy into anything promoted by AARP anymore. I tried The Hartford and Consumer Cellular and they are both a rip-off. Hartford quadupled my premiums after the first year and Consumer Cellular has the worst customer service ever, even while advertising that they have the best. They put you on hold for hours trying to speak to a live agent. So it doesn't surprise me that Optum is associated with AARP. If you want to get your prescriptions cheaper, go to GoodRx. They have a great website that compares prices from all the pharmacies in your area and also gives you discounts.

[JerryS109]

Hi @RN362636. You say in your post  that they (Optum) "...pay AARP over a BILLION dollars according to IRS financial reports". I assume you have seen and read those reports yourself. Could you provide a link to or info on how to access these IRS financial reports? I would like to see how the IRS reports those payments from Optum to AARP. 

[GailL1]

You can always lodge a complaint about them with Medicare.

I have never worked with them directly but they do a tremendous amount of work for various government agency health plans like at the VA Community Care .

IN this thread there are several complaints like the one you made - Maybe  they do it to keep their STAR-Rating because "Getting Needed Prescription Drugs" is one of the measure areas for Part D plans - both free standing and MAPD.

Go figure ? !