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

516 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:02/07/2024
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.
Prescription medications that are needed for an ongoing condition are continuously denied and CVS Caremark is telling the neurologist to use the medications that have been proven not to work. The medications that are being denied have been proven to be effective and all but eliminated the problem, but due to their policies I am having these health conditions again.
Customer Answer
Date: 02/18/2024
I have not heard from the business in response to my complaint.
Business Response
Date: 02/26/2024
Good morning, please review the attached response letter.
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.
This is not a valid response to explain why preventative medications are not allowed. I suffer from a medical condition that has significantly worsened over the last few months and I am to the point that I am going to seek legal counseling for my pain, suffering, and lost wages due to this egregious policy.

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: 03/05/2024
Please see attached response.
Initial Complaint
Date:02/07/2024
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 went to the doctor on December 19 2023 for weight loss I have been on the medication Wegovy since Feb 2023, I have been trying to get my ** for it since my visit with no luck my doctor has sent over the PA more than 6 times. I still have not received anything. Everytime I call Caremark on the phone to get answers they are rude and very short claiming that they have not received enough info from my doctor which is a lie I was even in office with my doctor when she called. They are not making any effort to help which is highly upsetting considering that this medication will not be covered after April 1 2024 my doctor has reached out to them too many times and I still have nothing. CVS Caremark is the worst when it comes to handling PA and has the worst customer service. I just want my Wegovy at this point which doesnt seem like it will happen due to CVS Caremark and their negligence.
Business Response
Date: 02/14/2024
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, 2024. Thank you for the opportunity to address the members concern.

Upon review we have confirmed that the requested medication is covered under the members Plan with prior authorization. On February 8, 2023, the members prescriber submitted a prior authorization request for the requested medication. The prior authorization was approved until September 8, 2023.

On December 5, 2023 and December 22, 2023, a new prior authorization request was attempted to be initiated for the requested medication by faxing the criteria form to the members prescriber. Each request for a new prior authorization was auto-closed due to no response from the prescribers office.

On February 8, 2024, a new prior authorization request was again attempted to be initiated for the medication by faxing the criteria form to the members prescriber. On February 9, 2024, the members prescriber provided the required clinical information for approval and prior authorization was approved until September 9, 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,
*********************************
Member Advocate
Initial Complaint
Date:02/07/2024
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.
Every year this company screws something up as it pertains to their billing department. This year, for some reason despite me paying a large cost out of pocket for a prescription ($6,832.32) they did not apply that amount to my annual out-of-pocket *** as they should have. I have now had both my insurance company (Cigna) as well as CVS Caremark call CVS Specialty to fix it as well as wasting hours on the phone with them across 6 different phone calls and every week they say it will be fixed the following week and it never is. I continue to incur medical costs despite the fact that I should be at my out of pocket ***, due to the ineptitude of CVS Specialty's billing department.
Business Response
Date: 02/15/2024
February 15, 2024

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

Complaint # ********

To whom it may concern:

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

Upon review, the members payment was correctly applied towards the $6,850.00 deductible, per plan design.

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

Customer Answer
Date: 02/15/2024
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.
Again, this company does not seem to understand the difference between a Deductible and an out-of-pocket ***imum, despite me having provided them with the definition from my own insurance plan numerous times. The following below is directly from my Insurance documents:
Out-of-Pocket Expenses - For In-Network Charges Only
Out-of-Pocket Expenses are Covered Expenses incurred for charges that are not paid by the benefit plan because of any
Deductibles or Coinsurance. Such Covered Expenses accumulate to the Out-of-Pocket Maximum shown in The Schedule.
When the Out-of-Pocket Maximum is reached, all Covered Expenses, except charges for non-compliance penalties, are
payable by the benefit plan at 100%.
What that says is, any cost out-of-pocket spent towards Deductibles or Coinsurance should have been applied to my annual out-of-pocket *** as well, they both accumulate at the same time. You are in violation of the terms of your own policy, and frankly it is a little disturbing that I need to be the one to explain it to you. You applied my payment ONLY towards my deductible not NOT towards my out of pocket ***, which has now cost me over $2,000 additional funds out of pocket that I am going to have to try to reclaim from you. Both my Insurance company (Cigna) and your parent company (CVS Caremark) have called you several times to fix it. You are in the wrong here and need to correct this problem.

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: 02/28/2024
February 28, 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 21, 2024. Thank you for the opportunity to address the members concern.

Upon review, the member has a high deductible health plan and is enrolled in the PrudentRx program. Members enrolled in high-deductible health plans must fully satisfy their deductible before they are eligible for a $0 out of pocket. If the member has additional questions, PrudentRx can be reached at **************.

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: 02/28/2024
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.
Once again, this business is NOT listening. I am not enrolled with Prudent Rx. I paid for the medication with a credit card, out of pocket. Even if I had used copay assist, I live in ******** who passed the Copay Accumulator Bill SB-195 which makes it illegal for Insurance Companies to not allow copay *************** apply to their out of pocket max. In either case, your company is wrong. This issue needs to be fixed and you are on the wrong side of both the law and in violation of my policy. You will be hearing soon from the US **** of ***** who I have filed a claim with.
Good luck!

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:02/06/2024
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.
My 17 year old son is having hip replacement surgery on February 7th, 2024. *********************************** Orthopaedics PSC, attempted to obtain prior authorization for pain medication to be used after the surgery. After several attempts by myself and ******************* Orthopaedics PSC, CVS Caremark denied the authorization and said if I wanted the medication, I would have to pay for it out of pocket. CVS Caremark informed ******************* Orthopaedics PSC the reason for the denial was because of my son's age. This is discrimination and unreasonable to expect anyone to have hip replacement surgery with no medication. Patient care is not a priority for CVS Caremark and when my employer offers a different option, I will not choose CVS Caremark.
Business Response
Date: 02/20/2024
February 20, 2024

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 6, 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 February 1, 2024, the members prescriber submitted a prior authorization request for a quantity of 48 tablets of the requested medication for a 6-day supply which is not permitted under the members plan design.

On February 2, 2024, the members prescriber submitted a coverage exception request for the medication that was denied due to not meeting the plans criteria for coverage. The members plan only covers the requested medication when the member requires extended treatment for moderate to severe acute pain where use of an opioid analgesic is appropriate.

On February 6, 2024, a new prior authorization request was attempted to be initiated for the requested medication by faxing the criteria form to the members prescriber. On February 7, 2024, the members prescriber provided the required clinical information for approval and prior authorization was approved until March 7, 2024. CVS Caremark made an outreach to the pharmacy who confirmed the members claim was paid on February 7, 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:02/05/2024
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 1/29/2024 a prescription was sent by my provider to Amazon Pharmacy to be filled. I was notified that Caremark, my PBM, denied the claim stating that this was now a maintenance medication and it was required to be filled with CVS retail or mail order only. I have switched from CVS in all cases due to numerous failures and general incompetence when utilizing them. When speaking to CVS and my Employer benefits administrator service I was told that as of 1/7/2024 I am required to be a part of the "Maintenance Choice" plan which states that a 30 day prescription will be filled and anything after that is a maintenance medication and needs 90 day supplies. This is not consistent with the prescribing directions or prerogative of the licensed medical professional who wrote for the medication, making it that CVS is attempting to dictate and practice medicine without a license. It is a bait-and-switch to change plan terms after the start of the plan year. This is also an anti-competitive practice where CVS is steering business to them or requiring the consumer to pay significantly more money. Amazon pharmacy provides a superior service with faster receipt of prescription, filling, shipping and total delivery time. They also allow for transparency in pricing and operations, which Caremark does not.I would like CVS to honor the plan benefits in the ********** documents as agreed during open enrollment, for them to stop their attempts to dictate the practice of medicine without a license, to stop their anti-competitive practice of steering customers stuck with their PBM and instead provide a service worth using.
Customer Answer
Date: 02/20/2024
I have not heard from the business in response to my complaint.
Business Response
Date: 02/27/2024
Good Afternoon,
Please see our response to Complaint ID ********.
Initial Complaint
Date:02/05/2024
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.
Caremark has forced my wife, a Type I Diabetic, to jump through 1 unnecessary hoop after another. She has is being required to file a Tier exception form for her Omni Pod and the Dexcom repeatedly because they are trying to force her to get a libra, except she has had both the Omni Pod and Dexcom for YEARS. After THAT was denied, she was told she needs a prior authorization, even though they had been covering both these items for awhile. She repeatedly was told one thing just to have those things denied later, or not happen. She was told that things were sent to the Dr's ****** when they in fact were not. She had to repeatedly escalate things with representatives just to be told they wont talk to another department, or that it wasn't their job and wouldn't be able to do anything about it because it was another department. They then approved her Tier exception form, just to have it "revoked" the next day. They then declined the prior authorization because she had not tried the Libra yet, even though her Dr had specifically written that she needed to be on the Dexcom/Omnipod because it was a close loop system, and the Libra is a far inferior product, that does not work in a close loop system. She is now having to take insulin via syringe because Caremark has run her around so long, that she is out of her 3 month supply of dexcom/omnipods, even though she started this ridiculous process with plenty of time.
Business Response
Date: 02/09/2024
A Tier Exception for Dexcom was received on January 9,****. An exception was allowed due to the compatibility with Omnipod. An approval letter was mailed on January 10, ****. Another Tier Exception for Dexcom was received on January 10, ****. This request was denied as the request did not meet the ********** and ******************* Benefit Plans criteria. A denial letter was mailed on January 10,****. A Tier Exception for Omnipod 5 was received on February 6,****. The request was denied as the request did not meet the ********** and ******************* Benefit Plans criteria. A denial letter was mailed on February 6, ****. The request was rereviewed on February 7,****; an exception was made due to the compatibility with Dexcom. An approval letter was mailed on February 8, ****. A retail pharmacy submitted claims electronically for Dexcom on February 8, ****; the claim processed with a Tier 2 copay. A retail pharmacy also submitted a claim electronically for Omnipod 5 on February 8, ****; the claim processed with a Tier 2 copay. We apologize for any inconvenience this may have caused you and your wife.
Initial Complaint
Date:02/05/2024
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 called CVS Caremark 4 times. Regarding a prescription discrepancy. My son has been without medication for his condition for 2 weeks. I keep getting told my call has been escalated to a supervisor. 3 cases have been opened but no resolution for this problem that is delicate in regards to time and lack of medication for a child that cannot function without it. Supervisor continue to tell me someone will call me back and no one ever does. I am mentally drained. This is complete incompetence on their part.
Business Response
Date: 02/19/2024
Good Afternoon,
Please see our response to complaint #********.
Initial Complaint
Date:02/04/2024
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.
Cvs caremark is canceling my prescriptions. Changing my credit card expiration date because they have been using my original card on file for over a year. I called several times to resolve issue with CVS Caremark. And, they charged me a $450 upfront copay or I couldn't get my much needed medication. Someone is harrasing me, and they are participating with that harassment by canceling my prescriptions and changing my payment method that I have on file.
Business Response
Date: 02/13/2024
Response letter attached.
Customer Answer
Date: 02/13/2024
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 do not agree with CVS caremark because they were charging me $500 deductible to get Breo Ellipta. So I told them that I would pay the deductible through ********* in wich I did. CVS caremark would not send my prescriptions until I paid. After I paid ********* then they sent my medication. And someone changed my expiration date on my payment method.
They have been charging my card then I seen that my payment method was changed, so I changed it back. And they have been canceling my prescriptions that i meed to survive, becsuse in 2017 i was found in my house dead from asthma complications. I was bought back to life and put on life support. So, I would like to recieve my medication without Interference from CVS caremark. My previous employer told me that they would have my benefits cancelled. So don't help them by not giving me my medication. I called CVS Caremark several times about them canceling my prescriptions. Now they are changing my expiration date on my paynent method. I know that you won't do anything but this is just for my lawsuit showing that you did nothing. Here is a copy
***************************
Business Response
Date: 02/21/2024
Please review attached response.
Customer Answer
Date: 02/22/2024
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.
CVS caremark still didn't answer my question about why my payment method expiration date was changed and who changed it. I have been paying with this card and this expiration date for a long time, so who changed it? It is part of the harassment that they are doing to help my previous employer. We are paying CVS caremark to deliver lifesaving medication, not to harrase me. They have been canceling my prescriptions, wrong doctors number on file so that when they call they don't get an answer because that is not my doctor's ****************** collect Railroad retirement disability, so I have to take medication as prescribed
That Is why I cannot get my prescription
Because they want to show that I am not taking medication as prescribed. They send me a years worth of medication and say it's for 30 days then cancel my auto refill. Even if they give me a dedicated rep for 2 months the harassment will start after that 2 month period. I also made a complaint to consumer affairs about this same issue. I don't want to be found in my house dead again like I was in 2017. Tell them to stop harrasing me and send prescriptions as prescribed.
Thanks
***************************
Business Response
Date: 03/05/2024
Please review the attached response.
Customer Answer
Date: 03/06/2024
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,
*******
Initial Complaint
Date:02/03/2024
Type:Billing 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.
Being overcharged for medication that I have a savings card for so that I pay no more than $550 using the zepbound savings discount manufacture card.
Customer Answer
Date: 02/14/2024
[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:02/01/2024
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.
I had a mail order prescription filled Sept 29, 2023 for Zolpidem Tartrate 5 mg. I had been getting this drug by mail all year. I am not permitted to have any dyes in my drugs and CVS knew that as they were getting the drug from the manufacturer Aurobindo because it contained no dyes. The drugs they hand out in their pharmacy is from ***** and loaded with extra chemicals and many dyes that cause cancers, reactions and death. The Sept order for the drug came with the blue dye which I CANNOT TAKE! They admitted the mistake and sent me the correct pill on Dec 12, 2023. They then proceeded to bill me for the drug I cannot take and the correct drug. I called Caremark mail service on Feb 1, ***************************************************************************************************************************************** Even a supervisor refused to credit the charge. This is far from the first time they have made deadly errors with my medicines. How can they hold this huge monopoly on our drugs through *********
Business Response
Date: 02/02/2024
February 2,****

Better Business Bureau
5 *************. Suite 100
***********,** 01752
Phone:************

File number 21233063

To Whom it May ******************** letter is in response to the correspondence we received from your office on February 1, ****. Thank you for the opportunity to address the members concerns as expressed in Complaint ID: ********.

In accordance with directives implemented by WellCare, all member grievances will be addressed and responded to by the client. Please reassign the members concern accordingly. Going forward all WellCare concerns should be sent directly to WellCare. WellCare will partner directly with CVS Caremark regarding PBM concerns. WellCare can be reached at:

WellCare Health Plans, Inc.
Attn:Grievance Department
P.O.Box 31384
*****,** **********
Phone:**************
Fax:**************
Email:*************************

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

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CVS Caremark is NOT a BBB Accredited Business.