Business Profile

Health Insurance

CVS Caremark

Headquarters

This business is NOT BBB Accredited.

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Complaints

This profile includes complaints for CVS Caremark's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

517 total complaints in the last 3 years.
163 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:04/24/2024
Type:Order Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am writing to the BBB to dispute the denied appeal for the prior authorization and exception to the formulary for the medication, Compounded Atropine Sulfate Ophthalmic Solution 0.02%, which was prescribed to my daughter, ************************ for the treatment of Degenerative Myopia, bilateral, ICD H44.23. The appeal was denied on 04/24/2024.On March 22, 2024, I spoke with ************** from CVS Caremark and was advised that compounded drugs require a prior authorization along with documentation as to why the medication must be compounded and a statement of medical necessity along with supporting medical records. This documentation was submitted by my daughter's prescribing ******* ******************* when he submitted his second request for a prior authorization and an exception to the formulary for Low Dose Atropine, opthalmic solution 0.02%. Dr. ******** second request for a prior authorization and an exception was denied. Research has shown that Low-Dose Atropine reduces myopia progression by about 50%. There is no commercially available atropine ophthalmic solution at a 0.02% concentration. These drops need to be compounded. Please note that my CVS Caremark rx plan formulary does not include a form of atropine sulfate ophthalmic solution that has the 0.02% concentration. My rx plans formulary only includes Atropine Sulfate 1% ophthalmic solution, which would be much too strong of a dose to treat Degenerative Myopia.
Customer Answer
Date: 05/05/2024
I have not heard directly from the business in response to my complaint.
A pharmacist from the Caremark ******************************* ******, contacted my daughter's doctor's ****** and told them that there is a commercially available Low Dose Atropine in the strength of *****%. Caremark sent ****************** a prior authorization form for this specific version of the medication. The manufacturer is ImprimisRx and the **** is *************.
The Caremark pharmacist misinformed my doctor's ******. This is not a commercially available product. It is a compounded medication made by a specific compounding pharmacy, ImprimisRx.
The prior authorization for **** ************* was approved but the contracted rate through our Caremark rx plan is $37.50 whereas the cash up front price from ImprimisRx is $40 for a 30 day supply, so the prior authorization approval did not help us get coverage for **** *************.
I spoke to *****************, a Caremark senior resolution specialist, on 05/02/24, and she tried to transfer me to someone in the Caremark ******************************* but no one would speak directly to me. ***************** told me that the reason why **** ************* was coming up as not being covered even though the prior authorization was approved is because a Tier Exception form would need to be filled out for it and submitted by ******************. ******, the Caremark pharmacist, had not sent the Tier Exception form to ******************.
Please ask Caremark to expedite the approval of the Tier Exception for Atropine Sulfate *****% Ophthalmic Solution Preservative-Free **** *************.
We will also need Caremark to send a Prior Authorization form and Tier Exception form to ****************** for Atropine Sulfate 0.05% Ophthalmic Solution Preservative-Free, **** *************. ********************** plan is to increase ******'s dose to 0.05% by mid-June, if ****** can tolerate that dose.
My request is to have **** ************* and **** ************* covered at the same copay as that of Atropine Sulfate 1% Op Solution, **** ***********, for which the copay under our plan would be $5 for a 30 day supply. As stated previously, the 1% strength of this medication would be much too strong to treat degenerative myopia. Please note that I am requesting both prior authorization and tier exception approval for these medications because our Caremark formulary does not include a commercially available equivalent of Atropine Sulfate *****% Ophthalmic Solution Preservative-Free or of Atropine Sulfate 0.05% Ophthalmic Solution Preservative-Free.

Business Response
Date: 05/17/2024
May 17, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on April 29, 2024. Thank you for the opportunity to address the members concern.

On March 15, 2024, and April 6, 2024, the members prescriber submitted coverage requests for the requested medication that were both denied due to not meeting the plans criteria for coverage.

On April 12, 2024, the member initiated a non-urgent appeal for the requested medication that was denied due to not meeting the plans criteria for coverage.

On April 30, 2024, the members prescriber submitted a coverage request for an alternative medication that was approved until May 1, 2025.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate

Customer Answer
Date: 05/20/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
My complaint against Caremark remains unresolved.
You said on April 30, 2024, the members prescriber submitted a coverage request for an alternative medication. ****************** did not choose this option for the PA form. This form was created by ******, a pharmacist from the Caremark Prior Authorization department. ******,the pharmacist, contacted my daughter's doctor's ****** and told them there is a commercially available Low Dose Atropine in the strength of *****%, if the patient would be interested. ****** sent ****************** a prior authorization form for this specific version of the medication. The manufacturer is ImprimisRx and the **** is *************.

The Caremark pharmacist misinformed my doctor's ****** and me! This is not a commercially available alternative product. It is a compounded medication made by a specific compounding pharmacy, ImprimisRx, which does not accept CVS Caremark insurance! The prior authorization for **** ************* was approved but the contracted rate through our Caremark rx plan is $37.50 whereas the cash up front price charged by ImprimisRx is $40 for a 30 day supply, so the prior authorization approval did not help us get coverage for medication. This NDC is not part of the formulary so getting a PA for it was useless!
On 05/06/24, I spoke to ******************, another Caremark senior resolution specialist, trying to figure out how I can get the Atropine Sulfate, preservative-free, ophthalmic solution *****% covered on the front end so that I wont have to pay up front and then submit. ****************** told me that I should try to fill the rx for the product at Akina Pharmacy, which is a compounding pharmacy and is in-network with Caremark. I had ****************** call in an rx for Atropine Sulfate,preservative-free, ophthalmic solution *****% to Akina Pharmacy, but Caremark denied the coverage.

On 05/09/2024, I spoke to *******, Caremark Case Coordinator, to try to find out why the rx coverage was being deinied. I proceeded to be on a futile phone call with ******* for 2 hours! He told me that the rx ****************** called in for Atropine Sulfate,preservative-free, ophthalmic solution *****% to Akina Pharmacy (as per ****************** advice) was being denied because coverage of the individual ingredients was being denied, which include Atropine Sulfate powder and Sodium Chloride 0.9% solution.

Since ImprimisRx does not take Caremark insurance, please create an override for the limited distribution. I would like to be able to fill this medically necessary rx at an in-network compounding pharmacy like Akina Pharmacy in ********, *** If Caremark does not like the pricing at Akina Pharmacy, please suggest another in-network compounding pharmacy that has a sterile lab and specializes in making this medication.
Please let me know if I could instead use, for example, Enexia Specialty Pharmacy, which is in-network with Caremark, in *************, *********
I am asking that my copay be similar to the copay for Atropine Sulfate, ophthalmic solution 1%, which is a $5 copay for a 30 day supply. Please note that there is no commercially available brand name or generic equivalent in the Caremark formulary for Atropine Sulfate, preservative-free,ophthalmic solution *****%.

Regards,
Liza

Business Response
Date: 06/11/2024
June 11, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on May 29, 2024. Thank you for the opportunity to address the members concern.

CVS Caremark administers the prescription benefits portion of the members Plan. In accordance with the Plan, the member or their prescriber may submit a tiering exception to request to receive a qualifying medication at a formulary price. On May 31, 2024, the members prescriber submitted a tiering exception request for the requested medication that was approved until May 31, 2027.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate
Initial Complaint
Date:04/22/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On April 19, 2024, I ordered my speciality fertility medications from **** with cvs speciality pharmacy. On a recorded line, I was told the price for my two medications was $14.96 with my insurance. I had a credit card on file. I placed my order and was told my credit card would be charged $14.96. I called around 4:45pm to confirm my order had shipped. At that time I was told my order was actually more than 10 times the amount that **** told me. I was dismayed. Cvs has access to my credit charge and would be charging my card a different amount then I was quoted. This is deceptive. This could make my bank account insolvent due to the error cvs has made. Also, management told me weeks ago that my two medications would be $14.96 when I requested a quote. I ask that I not be charged for this medication and if I need a refill that I am able to order it immediately with no waiting period.
Business Response
Date: 04/24/2024
CVS Specialty Pharmacy spoke with you regarding your complaint and will follow-up with you regarding the final outcome.
Customer Answer
Date: 04/24/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
Please confirm the final resolution with me and the bbb. I was charged an amount which was not what I was quoted initially $14.96. I request that the quoted amount be the final amount charged to my credit card. Thank you

FAQ

Regards,
Javiere

Business Response
Date: 05/06/2024
Your current balance with CVS Specialty is $71.26 which includes a balance of $14.96 from your previous fill dated April 20, 2024 and a refill dated April 30, 2024 which brings the total balance to $71.26. Please contact CVS Specialty at ************** if you have any questions regarding the balance due.

Thank you.
Customer Answer
Date: 05/07/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
This is not what I was told by billing I am paid in full $14.96 and ***** for the most recent charges to date I have not received the requested receipt for the charge from 4/29
The pharmacy had the wrong expiration date on compounded medication and provided me the wrong needles for a medication
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
Javiere
Initial Complaint
Date:04/20/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
In 2023 CVS Caremark made an error where they had my family deductible and my personal one. I was told in December that they were going to issue me a refund estimating to be between 300 and 400 dollars. They have been giving me the runaround for almost 5 months. They keep saying that they are working on it and that I should have my refund soon. I need your help and my refund please. I am not sure what to do.
Business Response
Date: 04/25/2024
April 25, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on April 11, 2024. Thank you for the opportunity to address the members concern.

Upon review, coding updates specific to 2023 and 2024 plan accumulations were recently completed for **************** INC. All impacted members will receive communication from CVS Caremark. If the member has additional questions, they can contact CVS ************* at **************.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate

Customer Answer
Date: 05/03/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********.
Their response is incorrect. Nothing was changed by *******. CVS Caremark had my family deductible as my personal in error. I hit my personal deductible in August 2023. Ive been told by multiple people at your company that my refund is on the way. It has been 6 months or more. You owe me a refund.
Please process ASAP

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
********

Business Response
Date: 05/13/2024
May 13, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on May 7, 2024. Thank you for the opportunity to address the members concern.

We understand that the matter is time sensitive. As previously communicated, all impacted members will receive communication from CVS Caremark. The member can contact CVS ************* at **************.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate

Customer Answer
Date: 05/13/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
I have called multiple times and have not received resolution. I just need the refund I am owed due to your company having my personal deductible as my family and my family as my personal. Please issue my refund.

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
********
Initial Complaint
Date:04/20/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Carinahasneverinherlifehadtoreturnaprescription On14April2024Carina'sdoctorsentaprescriptionrefillrequestbymistake toCVSHealth1CVSDriveWoonsocket,RI02895 -asCarinahasneveraskedCVStoreturnaprescription CVSagreedtorefundthepriceoftheincorrectmedicine andpayforitsreturnshipping onconditionitisaonceinalifetimeservice Thereisnowarestrictiononheraccount refusingtoallowhertoreturnmedicineforanyreason Carinaneededhermedicineandwasforcedtoaccepttheterms inanemergencysituation Resolutionrequested Carinawantsthenow-********************************* medicineremovedassheisinnowayresponsiblefortheerror *********************************************** orforacorporation'sgreedandlackofcompassion
Business Response
Date: 04/22/2024
At CVS, our goal is to be a trusted partner in our patients healthcare. As such, we appreciate ************************* sharing her concerns and the opportunity to address them here.

In order for us to properly research the transactions, we would need more information such as the store location this occurred in, the prescription (Rx) number, ******************** date of birth, and permission to pull and review ******************** account.
Customer Answer
Date: 05/12/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
Here is following information as requested

* Place purchased: www.CVS Caremark.com- mail order
**************

* Prescription number: RX# ********* SYNTHROID TAB 100MCG

* Date of birth: 2 February 1964

* I ************************* give permission to CVS Caremark to pull and review my account
to resolve this complaint

Resolution requested:
****** had an urgent need for her medicine and was forced to
agree to the conditions placed upon her including a lifetime restriction
against returning medicine
****** wants to be removed from the lifetime restriction placed on her
for returning the medicine in question - ****** was in no way at fault
and she should not have to pay for someone else's mistake
Thanks

*************************
Business Response
Date: 05/13/2024
A refill request was received on April 12, 2024. Several attempts were made to the doctor's ****** based on the refill request; however, a response was not provided. A new prescription was received by the doctor on April 14, 2024; the order was filled in good faith based on the prescription provided by the doctor. ********** account has been credited as the medication was returned. Please consult with your doctor regarding the prescription they provided the ************ Pharmacy based on your request.
Customer Answer
Date: 05/14/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ
******'s main request for resolution is to have the lifetime ban on further medicine returns removed which the company's response does not address - ****** should not be the victim of someone else's mistake and / or corporate greed - the response from the business is unacceptable
Regards,
Carina
Initial Complaint
Date:04/18/2024
Type:Product Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
We had a prescription filled on 1/22/24 and had a $5,000 copay. (We also were automatically enrolled with PrudentRX, when we have been told by Caremark that we need to actively enroll. We do not agree with their practice of making us enroll in copay assistance, only for Caremark to take the money instead of it being used by the patient for large copays.) None of our $5,000 deductible has been applied to our Out of Pocket Maximum. Since they implement a copay accumulator adjustment program, all our expenses are literally out of our pocket. We have called many times and spoke with Caremark for many hours trying to resolve this with no resolution. Multiple times they told us they would call us back with a resolution, but they never have. We have even been told (incorrectly) by their senior representative department that that Out of Pocket Expenses don't begin until after the deductible has been met. This has now impacted our ability to get refills and other unrelated prescriptions. This is in direct contradiction to our insurance plan. This date of service was 3 months ago and we are in limbo still waiting on this.
Customer Answer
Date: 04/29/2024
I have not heard from the business in response to my complaint.
Business Response
Date: 05/16/2024
Attached is our response.
Initial Complaint
Date:04/18/2024
Type:Product Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Order# ********** I have had the worst experience with CVS Caremark regarding orders.My first order I had shipped to a store thinking I would just get it at the store, apparently that is not how that should have worked but nobody ever called to inquire or update my shipping information.I called to request a prescription discount card to be added to my account and the first girl I spoke with back in Feb took my info but it didnt save or wasnt entered.Monday 4/15 I called to add the card and was advised my prescription should adjust when shipped, then called Thursday 4/18 and was told with mail orders the card may not be applied. How does a big pharmacy pick and choose how to handle clients orders?I have not been able to get my order in store, so I have to go through the online Caremark pharmacy to be told as a consumer your basically at our mercy on what we choose to do with your requests.I tried to put an email in on their website to have a paper trail only for it to tell me Sorry, an error has occurred while processing your information.I tried refreshing, selecting different options with my submission to get the same message each time.
Business Response
Date: 05/03/2024
May 3, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on April 18, 2024. Thank you for the opportunity to address the members concern.

On April 18, 2024, the customer care representative explained to the member that there are no guarantees that the copay assistance card will work through mail order. If the member needs to be sure a copay card is applied, we recommend they fill the medication at a local retail pharmacy.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate
Initial Complaint
Date:04/17/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I was approved for ****** in August 2023 but the medication has been on a shortage and I could not fill my prescription due to the shortage so when the medication shortage was easing up I called CVScaremark to see they could help me fill the prescription and they said for me to get my doctor to send Another request just to be denied due to the medication not working for me but I never got the chance to take it and my doctor has sent in the prescription again and I have talked to several people there and it is the same run around I pay dearly for cvscaremark and I am so disgusted with the lack of concern they have for their members and calling them is no help they want my doctor to call again I believe my doctor has jumped through every hoop they have given to the point my doctor does not want to deal with them. I have a right to take the medication my doctor prescribed for me without having to call and get no resolution. Wegovy is in my plan and I pay for the highest insurance just so I dont have to deal with all the hoops I believe cvscaremark makes it hard to get your medication just so people will give up and not bother fighting for it.
Business Response
Date: 04/30/2024
April 30, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on April 18, 2024. Thank you for the opportunity to address the members concern.

Upon review, on August 1, 2023, the members prescriber submitted a prior authorization request for the medication that was approved until February 27, 2024.

On April 1, 2024, the members prescriber submitted a prior authorization request for the requested medication that was denied to due not meeting the Plans criteria for coverage.

On April 18, 2024, the members prescriber submitted a prior authorization request for the requested medication that included new clinical information and prior authorization was approved until November 18, 2024.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate
Initial Complaint
Date:04/16/2024
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I recently submitted a formal complaint to the Better Business Bureau (BBB) regarding an issue I encountered with CVS Caremark. Despite providing detailed documentation, the response from CVS was perplexing; they claimed to be unaware of the situation I described and denied attempting to bill me for any services or products. In an effort to resolve the matter proactively, I had already closed all my accounts associated with CVS Caremark and settled any outstanding balances.Contrary to my expectations and the steps I took to clear my name and accounts, I was shocked to find that my case was abruptly closed by the BBB without a satisfactory resolution. Adding insult to injury, I have now been informed that my account has been turned over to a collection agency. This action is not only unwarranted but also deeply unfair, as it unjustly affects my credit score.Given these circumstances, I am urgently seeking assistance from the Better Business Bureau to intervene and help find a resolution to this distressing issue. It is imperative that this matter be resolved swiftly to prevent further damage to my credit history and to rectify the injustice that has occurred.I received a collection notice on April 16 2024
Business Response
Date: 05/03/2024
On 09/17/2023 Caremark made an outreach to the member's phone number on file advising of the new prescription and requesting consent to process and ship the order. Consent was given by the member or someone within the member's household. The order was filled and shipped on 09/17/2023. The order copay was $39.50. Additionally, on 10/11/2023 Caremark received an order refill request via text messaging. The order was filled on 10/11/2023 and shipped on 10/12/23. The order copay was $39.50.

The member currently has a total balance due of $79.00 for both orders. The member can contact Caremark ************* at ************ or visit ****************************** to make a payment. Upon payment, the letters will discontinue from Caremark. Once payment is received the collections agency will then be notified of the paid balance.
Customer Answer
Date: 05/03/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
Dear Caremark ************* Team,
I am writing to formally dispute the charges and notifications regarding prescription orders that were reportedly processed and shipped on September 17,2023, and refilled on October 11, 2023. According to your records, these orders have incurred a total balance due of $79.00. I must insist that these transactions did not occur as described, as I had previously called to cancel these orders and was assured by your representative that my account was fully settled and cleared.
Furthermore,I had explicitly canceled all future orders to prevent any unauthorized transactions. Despite these precautions, it appears that CVS has processed these orders without my consent. This practice is concerning and seems to unfairly target elderly customers, taking advantage of their trust and potential unfamiliarity with digital communication methods.
Please review the records of my phone calls to your service center, where I made clear requests to cancel these orders and all subsequent prescriptions. I trust that upon review, you will find that these charges are erroneous and will take immediate action to rectify this issue.
I would appreciate confirmation that my account has been corrected and that any collections actions initiated against me will be immediately ceased. I am prepared to escalate this matter through legal channels if it is not satisfactorily resolved promptly.
Thank you for your immediate attention to this serious matter. I expect to hear from your team within the next 5 business days regarding this dispute.
*********************

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
******

Business Response
Date: 05/07/2024
CVS Caremark shows no record of the member calling in September or October to cancel those shipments. CVS Caremark shows member got a consent to ship text on 9/17 and approved the order via text. Again on 10/11, CVS Caremark shows that a text was sent to the member advising it was ready to be refilled and text was received back allowing the refill. Member never called to cancel all future orders. Member authorized these orders via text. Our investigation confirms that the member is not due a refund.
Customer Answer
Date: 05/08/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or
It appears that Caremark has not fully grasped the nature of the issue, which has been a persistent problem from the outset. I am not seeking a refund; rather, I am requesting the cessation of incorrect charges and collections for services I never received. Despite having a comprehensive discussion with a representative who confirmed the cancellation of all charges and the clearing of my account, the problem persists. It seems Caremark is struggling with significant procedural inefficiencies, a concern that is unfortunately well-known among its users. They have erroneously referred my account to a collections agency despite my efforts and confirmation that I owe nothing. My goal remains simple: I want the erroneous charges removed and the unfounded collection process halted.

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
******
Initial Complaint
Date:04/16/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I began my calls to CVS Specialty pharmacy in Feb. of 2024. I filled my special drug for the first time for they year 2/2/2024 at this time they charged my copay card $4,708.84 my copay assistance is with Benlysta GSK. I filled the script again on 2/29/2024 They charged my copay assistance 4, ****** for a total of ********. They are not honoring the Illinois legislation HJ0054 banning co-pay accumulators in the state of ********. I have made endless calls to CVS stating the legislation and been told that I am correct and they will send notice to correct. I have spoken to complex billing on several occasions regarding my deductible not being credited despite my insurance tell me (cigna) that is is indeed met they even called and I was told that resolution would be made and the charges would be corrected. I filled my script on in March and was charged $4,379.82 despite my deductible of 5k and my out of pocket *** of 7k and over payment of *******. The associates at caremark that in billing (3) of them have told me I am absolutely correct an they will enter a email to correct the situation. It has been 2 months since I started this and it has not been corrected. I have a over $4K bill and can't get my next refill as they are not applying my co-pay correctly and following Illinois legislation. The associates are sympathetic and have told me they understand but cannot help me fix the issue. I have been told ***** hours, no call back, then 3-5 business days no call back. Today I was told 3-4 weeks and to call every day because nothing will be done. I feel for patients who can't continue meds despite having private insurance and the associates at CVS that can't help the patient receive life saving medications. There is no alternative for me but this medication. I believe that Caremark is incorrectly billing patients, copay programs not applying correctly to deductibles and out of pocket ***es causing the patient to pay out of desperation to continue their medication. This is my situation.
Customer Answer
Date: 04/29/2024
I have not heard from the business in response to my complaint.
Business Response
Date: 05/01/2024
April 29, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on April 17, 2024. Thank you for the opportunity to address the members concern.

The plan reviewed this case. On March 28, 2024, the plan determined only the actual costs paid by members will be applied to deductible and maximum out of pocket amounts. The member can access plan information at Caremark.com.

Additionally, our records show the member received the medication in question on April 3, 2024.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate

Customer Answer
Date: 05/02/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answer: Caremark is not following the legislation present in ******** HJ0054 no documentation or follow up with me directly has taken place to explain why they do not need to follow this legislation

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
****

Business Response
Date: 05/16/2024
May 16, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

Thank you for your email dated May 7, 2024. Caremark appreciates the members follow up to our response dated May 1, 2024.

We have asked management to review this matter further.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate
Initial Complaint
Date:04/16/2024
Type:Order Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
***** is a disgrace and their polices are becoming worse and worse. They contract with CVS Caremark for prescriptions - another horrific company. Generic Vyvanse, along with other ADHD medications, are in a nationwide shortage. This is a VERY well-known issue. The pharmaceutical company that makes the Vyvanse brand is playing games with pricing while the generic is completely unavailable from 12+ suppliers after only a few months of generic availability. The cost is outrageous. ***** had told CVS Caremark there are NO alternatives for the drug under my plan. They will not approve a DAW 8 override to dispense the brand when generic is not available. My only option is to pay a ridiculous price for the brand or do without medication that keeps me from losing my job. I cannot function normally on a daily basis without it. It has changed my life for the better. ***** couldn't care less. It's all about the almighty dollar. I pay A LOT for insurance and I have the best Aetna plan my company offers. No one should be put in this position when a generic is not available ANYWHERE in ANY DOSAGE. The only other option they offer is to ask the doctor to try another medication that is available. VYVANSE is the one that works for ME. I've tried others and they do not help. To make it worse, they require prior authorizations for nearly everything anymore. If my doctor ********** a specific medication or diagnostic test, then it should be approved AS WRITTEN. They are delaying patients from getting treatments and testing they need. They put the power to authorize or deny in the hands of nurse practitioners at CVS Caremark. I see specialists to treat me appropriately. Insurance companies should not be permitted to make these decisions for me. This company and others are running doctors and patients ragged. DO THE RIGHT THING, AETNA and approve DAW 8 for this drug. It is not a patient's fault a generic is not available and it is wrong to make it their issue.
Customer Answer
Date: 04/28/2024
I have not heard from the business in response to my complaint.
Business Response
Date: 05/01/2024
April 29, 2024

BBB serving *********************, *****, ************, and *******
***********************************************************************************************************************************************-4705

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on April 17, 2024. Thank you for the opportunity to address the members concern.

The member can contact the plan to request an exception for the brand medication cost, or work with their physician to select another medication from the drug class.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Advocate

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