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

515 total complaints in the last 3 years.
162 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:02/14/2024
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 have been trying to find an GLP-1 agonist to help with liver damage caused by obesity. My *** prescribed Wegovy which was denied 4 times with PAs citing that it is not covered. Out of curiosity i checked my formulary under weight management. To my surprise ****** is covered under my policy. I contacted CVS CAREMark to discuss this with them or find a injectable that would be approved. Long story short i spent 30 minutes going around and around.I have called them multiple times and they keep on telling me if it is in the formulary it will be approved. So I have explained to them every way possible that it was denied despite being in formulary. I then asked what medications would be covered. All they could tell me was my provider needs to call and look at the formularySo, told my *** that they needed to call this illusive PA number that I was informed the *** should have. Today my *** reported that they were on the phone with the primary number who would not share the PA ********** number for almost an hour. They finally gave up after being on hold for 30 minutes.My obesity is not the result of poor self control or lack of will power. I was sexually assaulted as a child among other traumas that i am working through. This is not me wanting a short cut to loose weight. This is me needing help to get healthier...
Customer Answer
Date: 02/25/2024
I have not heard from the business in response to my complaint.
Business Response
Date: 03/05/2024
March 5, 2024

BBB serving ******* *************, *****,************, and *******
5 *************. Suite 100
***********, ** 01752-1927

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 14, 2024. Thank you for the opportunity to address the member's concerns.

Upon review, we have confirmed that the Plan excludes the requested medication from coverage. On December 27 and 28, 2023,the members request for coverage of the requested medication was denied

On December 29, 2023, the prescriber submitted an appeal request that was also denied due to plan exclusion. On January 5,2024, prescriber initiated a new coverage request for the requested medication that was denied due to plan exclusion.

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

*********************
Advocate
Initial Complaint
Date:02/13/2024
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.
Company has denied every single drug my doctor sends. They did give me a list to send back to the Dr of ones they might cover, then denied all those too. Reading other complaints, this seems to be how they operate. They bill themselves as "health care" but in reality they could care less about your health, just their bottom line. Millions of Americans were forced to buy coverage or be fined, and this is the "care" we get.
Customer Answer
Date: 02/24/2024
I have not heard from the business in response to my complaint.
Business Response
Date: 02/26/2024
Please review our attached response.
Customer Answer
Date: 02/27/2024
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
They are addressing one medication they denied. What about the FIVE others? Over 2 months of then dragging their feet to save a buck, no regard for MY health or MY money they take.
Regards,
****

Business Response
Date: 03/05/2024
March 5, 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 February 27, 2024. Thank you for the opportunity to address the members concern.

On February 15, 2024, the members prescriber submitted a coverage request for a second medication that was denied due to not meeting the Plans criteria for coverage. The Plan only covers the second medication when the member has a diagnosis of type 2 diabetes mellitus.

The members prescriber has only submitted two coverage request that were both denied because the member does not have a diagnosis of type 2 diabetes mellitus. The other medications requested by the member were rejected at the pharmacy because they require an approved coverage request or are excluded from coverage under the Plan.

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

Sincerely,
*********************************
Member Advocate
Initial Complaint
Date:02/13/2024
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.
Around the time of early January, a CVS Caremark employee lied to me about opting me out of Maintenance choice for my medication. I asked point blank if I was opted out, and they said yes, only for escalations to tell me I was still opted in when I called back. I strongly suspect that Maintenance Choice opt outs are measured against employee performance, because why else would they have lied? Maintenance Choice requires customers to only use CVS caremark for their prescriptions after filling two 30 day prescriptions at a non-CVS location. All customers are opted back into this at the beginning of every calendar year. Penalizing employees for listening to a customer demanding to be opted out is a moral hazard that will inevitably lead to this kind of adversarial relationship between client and representative.
Business Response
Date: 02/27/2024
February 27, 2024

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 13, 2024. Thank you for the opportunity to address the members concern.

Upon review, the member was opted out of the Maintenance Choice Program for the 2024 plan year effective 1/10/2024.

Additionally, an opt out option is part of the members plan design.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health.

Sincerely,
*********************************
Member Advocate
Initial Complaint
Date:02/13/2024
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 am writing to file a complaint regarding the handling of my prescription medication by CVS Caremark, under my insurance policy through my employer. I have encountered a significant issue with the prescription processing procedures mandated by CVS Caremark.On Feb 12, ****, I attempted to fill a prescription at my local CVS pharmacy, located at ******************************************************************************. Despite the medication being available in stock, I was informed that it could not be processed and dispensed at the pharmacy due to requirements imposed by CVS Caremark's insurance policies.My insurance policy dictates that all prescriptions must be processed through CVS Specialty, a division that exclusively handles mail-order prescriptions. This policy has resulted in unnecessary delays and inconvenience, as I am unable to obtain my medication promptly from the local pharmacy.I find this policy unreasonable and burdensome, as it restricts my access to necessary medication and undermines the efficiency of the prescription fulfillment process. It is frustrating to know that the medication is readily available at the local CVS pharmacy but cannot be dispensed due to insurance requirements.I urge you to investigate this matter promptly and address the inefficiencies and constraints imposed by CVS Caremark's prescription processing policies. Such policies should prioritize the convenience and well-being of customers while ensuring efficient and timely access to medication.Please inform me of the steps that will be taken to resolve this issue and provide updates on the progress of your investigation.
Business Response
Date: 02/19/2024
February 19, ****

BBB serving Eastern *************, *****, ************, and *******
********************************************************************************************************************************************************

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 13, ****. Thank you for the opportunity to address the members concern.

Upon review, an override was entered to allow the member to fill their prescription at a CVS Pharmacy. The member provided confirmation that they picked up their medication.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health.

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

Customer Answer
Date: 02/20/2024
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.
This does not change the fact that I went through HOURS on the phone with the company. By the time I made the complaint, I wasted 8 hours and it impacted my health by not receiving my medication on time. If CVS will not be providing compensation, I will go through other avenues.

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:02/12/2024
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.
Caremark/CVS has a website for customers to request medicine refills. I have the same four medicines and the same delivery address for five years. I need the three month supply every three months. The doctors are the same. The prescriptions are up to date. There is a large positive balance on the account to pay the ***************************** does not accept requests for refills from me because there is no credit card on file. I have a problem where I cannot talk on the phone, but I can and do message them on their website that I need my medicine, address is the same, payment is already with the company. I have tried for six weeks this time and I am out of medicine. The customer service people are polite and direct me to order through the website. I do not know what else to do.
Business Response
Date: 02/27/2024
February 27, 2024

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 13, 2024. Thank you for the opportunity to address the members concern.

Upon review, we have confirmed that Caremark.com requires a method of payment on file to place orders via the website. The member can use the ********************* on Caremark.com to request orders be placed using the credit balance on the account.

We value our members and remain committed to our purpose, bringing our heart to every moment of your health.

Sincerely,
*********************************
Member Advocate
Initial Complaint
Date:02/12/2024
Type:Customer Service 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.
CVS Caremark has not been processing my employer provided prescription coverage correctly. Myself and my healthcare advocate Sharecare have proven that there is a coding issue on CVS Caremarks end. My plan is supposed to process preventative and maintenance medication differently from any other medicine. Preventative and maintenance medicine is supposed to bypass the deductible and all I pay is a co pay for a 3 month supply through CVS mail order. I have been trying for months to get this fixed and CVS Caremark has not showed any urgency in fixing this issue despite myself and Sharecare calling them almost every day. I am now going on 7 weeks of not being able to fill my meds because of this error in THEIR system and I keep getting passed around and delayed and no one will fix their error. Me and or my husband have been on the phone with them nearly every day since January 1 yet they still havent resolved the issue.
Business Response
Date: 02/28/2024
please review the attached response.
Initial Complaint
Date:02/12/2024
Type:Service or Repair Issues
Status:
ResolvedMore 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.
CVS Caremark has not been processing my employer provided prescription coverage correctly. Myself and my healthcare advocate Sharecare have proven that there is a coding issue on CVS Caremarks end. My plan is supposed to process preventative and maintenance medication differently from any other medicine. Preventative and maintenance medicine is supposed to bypass the deductible and all I pay is a co pay for a 3 month supply through CVS mail order. I have been trying for months to get this fixed and CVS Caremark has not showed any urgency in fixing this issue despite myself and Sharecare calling them almost every day. I am running out of medicine and this is a time sensitive matter that needs to be addressed as soon as possible. We have spent countless hours and days trying to get this resolved and CVS Caremark doesnt seem to care.
Customer Answer
Date: 02/24/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

Better Business Bureau:

I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.

Regards,

*************************
Initial Complaint
Date:02/12/2024
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 am in desperate need of my 50mg mini Enbrel medication. My doctor prescribed it, my insurance NALC/Cigna approved it but CVS specialy keeps giving me the runaround constantly saying they are waiting for the approval, which is not true as it has been given, confirmed by my insurance. These people are horrible to deal with. I need help.
Business Response
Date: 02/26/2024
Please see our attached response.
Initial Complaint
Date:02/12/2024
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.
Request the filling of my chronic disease medication You know, if we let the facts speak for themselves, It will paint a very clear picture of the situation:1. My company changed insurance to your company on 1/1/24.2. I have a number of medication that I usually get 3 months supply including the medication denied.3. I tried to fill the 90 day supply for all my medication and they were all successful, except for the one medication 4. I was told by one of Wellnet staff that a "prior authorization" was done on my behalf to CVS Caremark and that it would take 24 - 48 hours on Monday 1/29/24. 5. My doctor also put in a "prior authorization" on Tuesday (1/30/24) and was denied by CVS Caremark due to the 90 day supply requested.6. Another "prior authorization" was put in a day later again by my doctor for the 30 day supply and was denied again because my reading was not greater than or equal to a pre-determined percent. 7. We have been told to provide the "original" A1C from over 3 years ago would need to be provided from my previous doctor since I have been told that the decision was my reading was not greater than or equal to a pre-determined percent.8 However, as I tried to explain to Wellnet staff. The reason why it was lower is due to the medication that was denied and therefore that denying a medication for a chronic disease that has no cure does not seem right at all and will eventually revert back to a higher percent with time. I have a device that I have been using for years to check my levels multiple times a day.9. It seems a non-medical decision was made to deny a drug for a chronic disease that has no cure.What is a Chronic Disease?A disease or condition that usually lasts for 3 months or longer and may get worse over time. Chronic diseases tend to occur in older adults and Can Usually be Controlled but NOT Cured. ********************************************************************************* Please treat as urgent No Phone Calls,Pls
Business Response
Date: 02/23/2024
February 23, 2024

BBB serving Eastern *************,*****, ************ and *******
***************************************************************
Phone: ************
Fax: ************

Complaint #********

To Whom it May ******************** letter is in response to the correspondence we received from your office on February 12, 2024. Thank you for the opportunity to address the members concerns regarding their denied medication.

Upon review we have confirmed that the requested medication is covered under the members plan with prior authorization. On January 29, 2024, the members prescriber submitted a prior authorization request for the medication that was denied due to not meeting the plans criteria for coverage. The plan only covers the medication when the member has a diagnosis of Type 2 diabetes or a history of an A1C greater or equal to 6.5 percent.

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

On February 12, 2024, the member submitted an urgent appeal request that was also denied due to not meeting the Plans criteria for coverage. The member did not provide any documentation of a diagnosis Type 2 diabetes or a history of an A1C greater or equal to 6.5 percent.

On February 14, 2024, CVS Caremark made an outreach to the members past primary care provider and obtained approvable A1C labs for the member. The prior authorization was approved until February 14, 2027.

We sincerely apologize for any frustration or inconvenience that the member experienced. We value the member and are confident that future service will consistently reflect our commitment to our purpose, bringing our hearts to every moment of your health. Should you or the member have any additional questions or concerns, please do not hesitate in contacting me at **************.

Respectfully,

*********************
Advocate
Customer Answer
Date: 06/02/2024
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 Answered.

I tried to refill my prescription in March/April and till today, I still cannot get a refill of my chronic disease medication.

Business Response
Date: 06/24/2024
June 24, 2024

BBB serving *********************, *****, ************, and *******
5 Mt. **********Suite 100
*************** 01752-1927

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on June 3, 2024.Thank you for the opportunity to address the members concerns.

Upon review we have confirmed that the requested medication is covered under the members Plan with prior authorization.

On April 23, 2024,and April 25, 2024, the members prescriber initiated a prior authorization request for the requested medication that was aborted because the prescribers did not provide necessary information.

On April 29,2024, the members prescriber initiated a prior authorization request for the requested medication. CVS Caremark faxed the criteria form to the members prescriber for completion. On May 5, 2024, the request was auto-closed due to no response from the prescribers office.

On June 6, 2024,a new prior authorization request for the requested medication was initiated with the clinical information necessary for CVS Caremark to complete the review. The prior authorization was approved until June 6, 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,
*****************************
Member Advocate
Initial Complaint
Date:02/12/2024
Type:Service or Repair Issues
Status:
ResolvedMore 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.
Have had ***** refilled for years and for a three month supply receiving a quantity of 3 for 90 days. On 02/05/2024, received text stating: You have 3 RX due for renewal. Order first starting with AN, estimated cost *****. I answered yes and then only received a quantity of 1, but charged 90 00. Since quantity was changed,, I should have been notified prior to filling. This happened last year and was given a credit. Called this year and won't give credit since got one last year But never bothered to tell me last year that we could add statement to only refill a 3 month supply. If they had, this would not have happened again. This is a rip off that should never happen
Business Response
Date: 02/14/2024
According to your Prescription History, CVS Caremark has not dispensed Anoro. Please clarify the patient.
Customer Answer
Date: 02/14/2024
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

Regards,
*******

Business Response
Date: 02/26/2024
Thank you for clarifying the patients name. We verified ************************* was charged correctly based on the Standard Option mail order benefit. Please refer to the ********** and ******************* Benefit Plan brochure (RI 71-005),Section 5(f), Prescription Drug Benefits:

These are the dispensing limitations:

Standard Option: You may purchase up to a 90-day supply of covered drugs and supplies through the Retail Pharmacy Program. You may purchase a supply of more than 21 days up to 90 days through the ************ Prescription Drug Program for a single copayment.

A refill reminder was sent to ************************* on February 5, 2024 for AN. An Order Received Confirmation notice was also sent on February 5, 2024 regarding Anoro Ellipta 62.5-25 AEP stating we have received the following prescription order and are working to fill it.

A letter was sent to ************************* on February 7, 2024 regarding Anoro Ellipt Inh 62.5-25 ***** Ea stating we filled your prescription , but the quantity has changed. The letter also advised the following prescription has expired or there are no refills left. We reached out to your doctor for a new prescription. They approved the refill, but for a smaller amount of medication. ********** February 8, 2024, a notice was sent to *************************** advising Anoro Ellipta 62.5-25 AEP has shipped. The notice also advised the prescription has a new number because we received a new prescription from your doctor. ********** February 12, 2024, ******************************* contacted CVS Caremark advising the incorrect quantity was received for of receiving incorrect quantity for **** Lassiters, Anoro Ellipta. ******************************* was advised a 1x Bulk Up credit could not be provided as it has previously been utilized. A request was sent to obtain a new prescription for a 90 day supply from the provider. ********** February 12, 2024, ************************* requested to place a comment on the account advising never fill medication under 90 days; a comment was placed on the account per ****************** request.

A new Rx request was faxed to the provider on February 13, 2024.

An eRx was received from the provider on February 14, 2024 for Anoro Ellipta Inh 62.5-25. The prescription is too early to be refilled. On February 14, 2024, a notice was sent to ************************* advising ************* 62.5-25 AEP was requested for ****** too soon; however, it will begin processing on March 1, 2024.

A new Rx request was faxed to the provider on February 15, 2024.

An outbound call was made to ************************* on February 17, 2024 advising a fax has not been received from the provider.********** February 23, 2024, a notice was sent to ************************* advising Anoro Ellipta 62.5-25 AEP will begin processing an March 1, 2024.

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CVS Caremark is NOT a BBB Accredited Business.