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Optum RX - STAY AWAY
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!!!
You’re right. In my previous experience working in the medical field getting prior authorizations for medication, all the pharmacist has to do is provide the insurance company with the ICD 10 code, which is the diagnosis code, and Medicaid usually will pay, at least in California. You also don’t have to use your insurance and look for a pharmaciy that takes Good Rx with a low co pay. You can save hundreds of dollars, seriously.
You can't use good rx if your on Medicare/Medicaid.
Wrong. There is no law that forces you to use insurance that you already have. You just have to tell your pharmacist to use the GoodRx coupon instead of your insurance. And, most amazingly, that coupon price can contribute toward your insurance deductible. See
@aruzinsky said There is no law that forces you to use insurance that you already have. You just have to tell your pharmacist to use the GoodRx coupon instead of your insurance. And, most amazingly, that coupon price can contribute toward your insurance deductible.
The actual wording in your link says the following:
If you purchase a medication with a GoodRx coupon and the drug is covered by your insurance, you may be able to submit your receipt to your insurer and count that towards your deductible. That way, you’ll still be able to take advantage of your insurance coverage later.
This applies to almost all types of insurance plans, including those from private insurers, commercial health exchanges, Medicare and Medicaid. You’ll want to contact your individual provider to find out what information they’ll need from you and how to submit it.
And if you follow the embedded link you will find . . .
Paying with a GoodRx coupon is considered an “out-of-network” purchase, and it’s up to the insurance company to decide if they’ll pay you back—or whether they’ll count it towards your deductible.
The "fine print" indicates this is not a sure bet. The hassle of trying to get your purchase to count towards the deductible may not be worth it.
I work with hundreds of Medicare beneficiaries every year and help them understand how to save $$ on Part D. There are several informational videos on my YouTube channel that discuss the mechanics of Part D and how to get the most value from your plan.
Years of working with insurance carriers in an attempt to get reimbursement for a non-covered claim reveal an uphill battle. More often than not the easy path is to take your savings and be satisfied.
Bark less. Wag more.
Well, see that others are unhappy with OptumRx for one reason or another, I too have, long ago with another group been displeased, on more than one occassion, speaking with Optum customer service (this excerpted from anothers reply-"called OptumRx to inquire and immediately found it difficult to communicate with a surly, impatient rep."). Though it cost more, I am using my local pharmacy, a more pleasant, helpful and less burdensom business to deal with.
It is a shame to have to experience this as the on-line system is suppose to be more advantages for the customer-both courteous, helpful, and financially.
I hope someone at AARP actually reads these comments. When a contracted company gets so many negative comments, it’s time to review the contract. It’s a pity when one cannot rely on an affiliation with AARP to provide quality.
I have used the AARP prescription discount program since 2005. AARP has changed its fulfilling pharmacy several times over the years, and most of them have been satisfactory. Not OptumRx. I will never order from this company again. For one thing, the web site does not function properly. I couldn’t even register, and I’m reasonably skillful with computers. But that problem pales in comparison to price gouging, unethical practices, and incompetent customer service.
On April 2, I called OptumRx to request a refill and was quoted a price of $29.98 for a 90-day supply – the same price I had been paying for a very long time. I was asked if I wished to use the credit card I had on file to pay this amount, and I said yes. A few days later, I went online to pay my credit card bill. There I saw the charge I was expecting, but right below it was another charge for $20.99. What is that, I wondered? I called OptumRx to inquire and immediately found it difficult to communicate with a surly, impatient rep. She finally referred me to a supervisor, who was much more pleasant but equally unhelpful. The supervisor said she needed to consult with other departments, making for a slow process and a long hold time. Finally she informed me that the price of the medication had gone up and that OptumRx had no control over that. She did apologize for the fact that I had been given no notice of the additional charge (which was not actually applied until two days after the original amount). The lack of notice deprived me of the opportunity to decline the refill, which I might well have done because the increase was so extreme and I was not in desperate need of replenishment.
Since I had not known of the additional charge and certainly did not authorize it, I turned to my credit card company for help. The card rep arranged for a conference call in order to try to resolve the issue. We waded through FIVE reps at OptumRx, one of whom finally managed to locate my account, but she flatly refused to issue a refund for the $20.99. It appears that OptumRx thinks it is okay to charge a customer for an amount the customer did not authorize. News flash: it is NOT okay EVER for anybody, anywhere, anytime, to charge a credit card without permission. The amount involved here is trivial, but the principle is huge.
Thank goodness this refill, which I did receive, was the last one on my current prescription. I will take my new prescription elsewhere. The AARP program is supposed to reduce consumer costs, not increase them. Compare the amount OptumRx says is my current copay, $50.97, with the cost at a local brick-and-mortar pharmacy, $29.95. Note that the local price is within three cents of the original quote from OptumRx. That cited “price increase” appears to have been no more than an excuse for stealing money. I think I hate a liar even more than a thief, but here we have both.
Judging by the efficiency of the customer service department, this company’s right hand doesn’t know what its left hand is doing. It seems far too likely, however, that sooner or later, one of them will be in your pocket.
I whole-heartedly agree. AARP should use their influence on this bumbling, incompetent organization. Their website is a disgrace and they should be embarrassed to display it compared to even the most basic online retailer. It seems that every transaction I've had with them has either resulted in deceit or incompetence. On my latest order, I got a phone message stating that there was an issue to which I needed to respond. When I did, I was told that I hadn't paid for the order. Well, their website will not let you PLACE an order if you don't pay up front. The Optum rep looked it up and said, "oh...I see it is paid". Several days later, I get an email stating that they have contacted my Dr repeatedly with no response - therefore they are CANCELLING the order. Well, my Dr sends me a message each time she approves a script. So, now they have lied to meTWICE on the same order. Then later, I get a second email saying the order will ship. Meanwhile their website gives no useful information on the order status reflecting any of this. PLEASE AARP!! Do something, as OptumRx clearly has no intention of improving their Customer service on their own.
Optum Rx Tells You Whatever They Think You Want to Hear- True or Not.......
This is the worst company I have ever dealt with either in person or online during my entire lifetime. They have told me various answers about the same insulin order daily while I telephoned them to inquire where my lifesaving drugs were. My insulin in expensive, and no one else will fill it after Optum has claimed the insurance payment- even if I offer to pay for it myself.
I asked the Optum agent if he used their service. I received perhaps the most honest reply from the company I'd ever had, "I only use Optum for things I don't really need, like allergy medication. I would never rely on them for a drug like insulin".
From the horses mouth. I received an emergency supply of insulin after my physician called my local Walgreens. My Optum arrived 3 weeks later via Fedex overnight mail, which I was charged for. NEVER AGAIN
BTW, I just received a response from them stating:
This situation is not ordinary and these incidents are not typical of us. We are very serious when it comes to our client’s satisfaction and have a zero tolerance policy in this respect.
Hahahahahahahahahahaha! They should read this forum!
I was so glad to see here that others are receiving the exact same treatment that I have experienced.
I was beginning to think it was just me.
The problem is when they don't notify us that the price has gone up. They just send it and bill our credit cards,then refuse to take the medicine back. Now we have to fight with Optum rx and credit companies. Optum should have it set so if the price is higher than previously paid,it sends a robo call to ask if we still want it. They know this.
I feel everyone's pain. I have been in the AARP UnitedHealthCare plan for less than a month and will be so glad when the next open enrollment period opens. I cannot believe all the hassles I have been going through this week with my very first prescription submitted by my doctor. Web site doesn't work properly, order being held for my approval even though I approved it several times. My credit card info is missing. Representatives don't speak English very well. I keep getting emails that my email address was changed....but I haven't changed it since I set up my account weeks ago. I am waving the white flag and will move on to another company.
I have the same problem with customer service reps insisting that there is no cc on file. It happens each and every time! Now, when I call I insist on staying on the line and waiting for however it takes for them to "miraculously" find the card. I would never call them if I could but each time I try to pay the monthly bill on the AARP it rejects me.
Be careful about storing your cc. They do not remove it after being asked to use only once. They store it and send you medications you didn't order or need. If a doctor sends in a refill, they automatically fill it whether you needed that refill then or not. This cost me $352 once when I had asked three times for them to NOT store my cc. My doctor was being proactive and put a new script on file. Optum filled it without asking, charged the cc they weren't supposed to have on file, and wouldn't allow me to return it. I went to my bank, cancelled the cc. and had them call Optum and get a rep on the line to discuss why they are able to use my cc without my permission. What a surprise! The rep was able to reverse the charges and let me return the medication. I think they do this to bill Medicare. Not enough people complain and they make money for drugs not needed or wanted. They also don't keep accurate records of relationship to the donut hole. So you may be paying more for your drugs because they say you are past the initial stage when you are not and increased costs apply which people don't argue with because their customer service is so bad. Again. Cheating Medicare for more dollars coming their way. BE VERY AFRAID OF OPTUM ONLINE
I agree. Not ONLY the credit card issue, there are soooo many other issues. Here is a review I wrote today on Yelp.
It will be with GREAT HAPPINESS when my year with OptumRx is done. They are the WORST PBM I have ever had to deal with. Their customer services reps are rude, condescending, do not understand customer service, and SPEW POLICY. Anytime a company has to cite, lecture and preach policy, it means they have NO CONCEPT of customer service.
Please understand, I worked in operations, sales, marketing, account services, etc. Within healthcare INCLUDING managing call centers. I also understand EOB, EOC, SPD, and as a member services supervisor I had to understand HUNDREDS OF PAGES of policy. Then HUNDREDS of different customer plans.
I am so thoroughly DISGUSTED with this PBM. AND one of the reps when I asked if I was allowed to speak, she then said yes. Then she went on to tell me about MUTUAL respect on the call. Again, I managed call centers in various industries. I also managed the call center Technology. As well as manged telecommunications. I manged restaurants, I waited tables. I have worked front line positions. I have worked I retail. In other words, they believe I have NO CONCEPT of mutual respect. Then MANAGEMENT NEVER even contacted me when this company completed screwed up. NOTE: I also reported to VPs and interfaced and routinely worked with EVP and C level individuals.
I keep getting all these almost threatening 'offers' to join Optum since I'm with United Healthcare, even though I've answered surveys, sent an e-mail, responded to phone calls, and even sent a letter via the USPS asking the solicitations to stop. I did this because about every other time I get an 'offer' I browse the internet to see if there are ANY recent good reviews on Optum. So far, its running 85% CON and only 15% PRO to use the service, so why should I join? I've stated that fact in all my communications to United Healthcare, but it hasn't seemed to do any good. I'm not sure if its a situation where the right hand doesn't know what the left hand is doing, UHC didn't do their due diligence in verifying Optum's accuracy and integrity in processing and filling prescriptions, or they just don't care.
As an informed consumer, its worth it to me to pay $6/each for 6 prescriptions every 90 days, or $144 annually at a local pharmacy to ensure I have the meds I need for several chronic medical conditions, instead of having to go through the stress of laissez-faire operators at a company who can't seem to process and delivery prescriptions as needed by chronically ill patients - even at supposedly $0 cost to me for all or most of my meds. (Another thing you can't find out unless you call one of the 2 different numbers I've been given over the last few year to call to sign-up for this 'wonderful' plan.)
How is it that AARP or United Healthcare can't seem to do anything about the slipshod way many patients' meds have been mishandled by this company?
While I don't always print out the invoice shown at the end of my ordering process, I do read it and jot down the total cost, order #, etc. to compare it with the e-mail confirmation I usually receive from the vendor within a few minutes of placing an online order. I then file the e-confirmation in a file folder until I receive the order, then compare the invoice enclosed with the order against the one in the e-mail.
Other replies about the process for dealing with your credit card company are correct. I usually spend about an hour printing out everything I have to back-up my narrative, then type exactly what happened when, with who, etc. in the body of the letter to the address shown on the back of my credit card statement for such complaints. It usually ends up being a 2 page letter with at least 2, to sometimes 4 other pages of attachments. I've done it at least 5 times over the 30 years I've had my one card. Each time they held the amount in limbo with no interest or fees accruing unless a resolution was made. Only in one instance did I end up having to pay the charged amount - approximately 3 months after it had first shown up on my statement.
I hope you have since cancelled your prescriptions at Optum and reverted to a local pharmacy. I shopped around in my rural area and have to drive 30 minutes to get mine, but I will NEVER sign-up for Optum. If it becomes mandatory in order to stay with UHC, I guess I'll be checking Cigna, Humana, etc. in coming years.
Wish I had done the same research you've completed but yes, I have since canceled Optum and reverted back to my local pharmacy. Hopefully others will get this message so United Healthcare and AARP either drop Optum or force them to provide basic customer service. Thanks for your note!
Good Rx is a wonderful service! Thank you for mentioning it. I think you still need to be enrolled in a Medicare D program in general but I’m going to sign up with the one that has the cheapest premium and use Good Rx as well. Too bad insurance companies rip off seniors, it’s a disgrace!
There is an official manner which you have to file a dispute with your credit card company - it is a legislated procedure to preserve your rights as a consumer. The procedure should be outlined by your credit card company on your statement or on their website - it tells you exactly the time limit to file, the address to send your disputed amount details and that the amount will be in limbo on your account until the dispute is resolved.
I believe if you have some proof from the Optum Rx website when you placed your order of the price that was shown and then filed an official dispute with your credit card company, you would have a good chance of recovery.
I don't use OptumRX but are you saying that when you place an order for an Rx with your account number/plan number that they don't give you a page confirming the order and the details like your price for it, where it is being shipped,when it will arrive, tracking info, etc.?
Now, this is the process for credit cards - NOT debit cards.