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:11/02/2023
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 several complaints against CVS. First I have a prescription for ONDANSETRON ODT 8 MG TABLET. I need this medication for nausea which I experience everyday. I have been trying to fill my prescription since Oct 10 of 2023 and have contacted CVS several times to get it resolved. I am out of medication and suffering now. I was forced to get me prescription filled through CVS specialty because they stopped coverage in their box stores. I used to pick it up in store until they forced me to do otherwise or lose coverage. When I try to transfer it I cant get my medication. I literally have a MVHC pharmacy across the street that used to fill it in 3 hrs not 3 weeks. I cant go there because they refuse coverage even though Im paying for my insurance. I have also been shorted 4 pill of this medication in the past and never received them. Ive had my prescription bottles mislabeled. Ive had the pharmacy contact doctors without my consent to fill a prescription I no longer took and it was a doctor I didnt even see anymore. I ve been overcharged. Ive been given wrong prescriptions amounts as far as 30 day compared to to a 90 day amount. I want my prescription and I want to be able to go to another pharmacy and have my same coverage. I shouldnt have to wait for anything that is important to my health. I want an answer to where my 4 pills went ant why my bottles get mislabeled. I also have witnessed a pharmacy technician completely flip out screaming and starting to cry while filling prescriptions at that store. I want to go somewhere closer and have the same coverage.
Business Response
Date: 11/09/2023
November 9, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the ******* Palmolive health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on November 2, 2023. Thank you for the opportunity to address the beneficiarys concerns.

As a courtesy CVS Caremark has entered an override that will allow the medication in question to be filled at any in network retail pharmacy. The override is approved from November 8, 2023, to November 8, 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
Customer Answer
Date: 11/10/2023
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 # ********. I would like to know if there is a contact number or way to file a complaint with my employer in regards to this matter? Is there any provision in our company contract that protects employees? Ive literally had pills missing from my orders and Mislabeled stuff. I would rather have all my medications covered at 100% anywhere I choose and not be forced to use my local CVS. I literally have a pharmacy across the street from me that provides way better service and isnt as badly run a company. Ive had a ton of issues going back years with CVS. Look back at your district managers records any you should have records of my complaints.
[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: 11/16/2023
November 16, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the ******* Palmolive health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on November 13, 2023. Thank you for the opportunity to address the beneficiarys concerns.

The override allows the beneficiary to use *************. The override is approved from November 8, 2023, to November 8, 2024.

Additionally, the beneficiary can contact the ******* Palmolives HR office to discuss 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,
*****************************
Member Advocate
Customer Answer
Date: 11/16/2023
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.]
An override until **** is for only one of my medications is unacceptable. I would prefer to not use CVS at all because of the missing pills and mislabeled bottles and pharmacist screaming while filling prescriptions among other issues . Also I would like to get my Zofran as prescribed AS NEEDED .
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: 11/17/2023
November 17, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the ******* Palmolive health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on November 16, 2023. Thank you for the opportunity to address the beneficiarys concerns.

As a courtesy an override has been entered to allow all medications to fill at the ***************** pharmacy. Member can get a one-month supply of all maintenance medications at the in network pharmacy of their choosing.

Additionally, there are no quantity limit requirements on the medication in question. According to our records, CVS Specialty has filled the prescription with the quantity the members doctor ********************* 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: 11/18/2023
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
Hello,
I definitely would accept the offer of going to any pharmacy of my choosing but would need clarification on the rest of the offer. Most of my medications are dispensed in a *************************************************************** close to a $100 every quarter. With your last COURTESY override you stated that I would only get 30 day supplys of my medications at other pharmacies. This automatically removes me from getting the most of my benefits and is detrimental towards me costing me hundreds over the course of the year. If Im wrong in my understanding please explain. I should not be punished because of the situation at your stores. I should still be able to use all the benefits I pay for. If I can still get my 90 days at the same cost with the only change being location of my choice then Ill accept.
Regards,
***
Initial Complaint
Date:10/31/2023
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.
I have a prescription for Mounjaro for my Diabetes treatment. *** does not fill the prescription as written and is unable provide me my medication. They do not allow me to fill the prescription anywhere else and require me to use the *** pharmacy
Business Response
Date: 11/10/2023
November 10, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the *** health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on November 6, 2023. Thank you for the opportunity to address the beneficiarys concerns.

Upon review, we have verified the *** Plan has established a plan design for maintenance medications that requires members to use the specific in-network pharmacies or Caremark ************ Pharmacy for 90-day fills of maintenance medications, once the members have exhausted their 3 ***** fills of up to 30 days supply.

However, the plan design also allows members to opt out of the 90-days supply and continue to fill in 30-days supply. Our records indicate that as of February 14, 2023,the member has been opted out of maintenance choice plan design program.

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:10/29/2023
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.
When I contacted CVS Caremark in regard to being able to fill my prescription for Linzess for 90 days instead of 30 days I was told that this was not possible. I have a manufacturer's card that allows a 90-day fill at the same co-pay as a 30-day fill. For several months CVS Caremark overcharged me by filling the 30 day supplies instead of the 90 day supply that I found out from Aetna, the health insurance company associated with CVS Caremark, that I could IN FACT have if my doctor filled out a quantity limits prior authorization, which he has and would have at the very beginning if the representatives I spoke with at CVS Caremark informed me that was needed instead of SAYING NOTHING and forcing me to pay unnecessarily out of pocket. Their negligence has cost me over $300.00.
Business Response
Date: 11/09/2023
November 9, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the *** Health health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on November 1, 2023. Thank you for the opportunity to address the beneficiarys concerns.

Per plan design brand name medications can be filled for a maximum 30 days supply. *** Health approved a twelve-month courtesy override that allows the medication in question to be filled for a 90 days supply. The override was entered on January 26, 2023 and will expire on January 26, ****. Once the override expires the member will be required to fill the medication according to 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: 11/09/2023
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 did NOT address my complaint or concern about why several of their agents neglected to inform me of the plan limits override THEREFORE overcharging me for those months because I could have had 90 day fills being filled at the same cost as the 30 day fills.
CVS is only concerned about how much money they make NOT their patients, consumers or employees. If CVS WAS concerned about their patients, they would NOT have limitations that end up COSTING the patient more money in the long run. 90 day fills are historically CHEAPER than *********************************** generic medication is prescribed to the patient.

FAQ

Regards,
*******

Business Response
Date: 11/17/2023
November 17, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the *** Health health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on November 13, 2023. Thank you for the opportunity to address the beneficiarys concerns.

The claims from 2022 processed correctly according to plan design. The subsequent override was provided as a courtesy.

The override was extended until January 24,2025.

We have asked management to review this matter for coaching, training, and process improvement opportunities.

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: 11/25/2023
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 # ********.
The override SHOULD BE permanent as I will be on this medication for life and the ***********pay card will ALWAYS allow 90 day fills at 30 day cost! Also, CVS/Caremark advocates for 90 day fills for patients, so they should practice what they are preaching and allow ***************************************************************** generic if a patient needs and is continuously prescribed it by their physician. CVS (owner of CVS/Caremark) CLAIMS on a ******** post by *********************** (who has yet to personally respond to me) that this PBM keeps prescriptions affordable when in fact they do not as I was never notified of the possibility of a quantity limits prior authorization until I first contacted BBB for help, so for TWO YEARS prior to being told about it and finally getting it put in place, I was paying the 90 day price for ONLY 30 DAY fills....which is overcharging a patent ($300+) and NOT making things affordable or right by the patient.

FAQ

Regards,
*******
Initial Complaint
Date:10/27/2023
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.
My Dr has resubmitted 2 different pre-authorizations to CVS caremark and both have been denied. Now they want me to file an appeal. This is seriously affecting my health and well being they are playing god and they are not drs. Further they prescribed androgel to me in the past. They are most likely trying to get me to buy a less expensive product.
Business Response
Date: 11/08/2023
November 8, 2023

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on October 30, 2023. Thank you for the opportunity to address the members concern.

Upon review, the members prescriber submitted a coverage request for the medication in question on October 23, 2023 that was denied due to not meeting the Plans criteria for coverage. On October 30, 2023 the members prescriber submitted a 2nd coverage request for the medication that was also denied for the same reason. The prescriber then submitted an appeal request that was later retracted on November 1, 2023 as the prescriber chose a medication on the Plans formulary.

Our records show a paid claim for the medication at the local pharmacy on October 30, 2023.

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:10/27/2023
Type:Customer Service 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.
My doctor called in a prescription for a 90 day supply of Tresiba with a quantity of 30mL (2 boxes) and CVS Caremark is refusing to fill the prescription as written by the doctor. They insist on modifying the quantity or the day supply despite explicit instruction from my doctor.
Business Response
Date: 10/30/2023
The following prescriptions were filled based on the instructions provided by your provider:
Order filled February 2, 2023 and shipped February 5, 2023 -Inject 30 units subcutaneously daily as directed. Prescription quantity 2.0 x 15ml; two boxes were shipped and each box contained 5 pens with each pen containing 3ml.
Order filled May 15, 2023 and shipped May 18, 2023-Inject 30 units subcutaneously daily as directed. Prescription quantity 2.0 x 15ml; two boxes were shipped and each box contained 5 pens with each pen containing 3ml.
Order filled August 14, 2023 and shipped August 14, 2023-Inject 15 units subcutaneously daily as directed. Prescription quantity 1.0 x 15ml; one box was shipped and the box contained 5 pens with each pen containing 3ml.
Order filled October 27, 2023 and shipped October 30, 2023-Inject 20 units subcutaneously daily as directed. Prescription quantity 2.0 x 15ml; two boxes were shipped and each box contained 5 pens with each pen containing 3ml.
Please consult with your provider regarding the dosing directions.

Thank you.
Customer Answer
Date: 10/31/2023
[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:10/18/2023
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.
Based on when I can submit my refill for saxenda and the length of time it takes your company to process my pre authorization, there is ZERO possibility of me not missing doses of my medication. Every, single time my provider sends a PA it gets automatically denied stating that Im not enrolled in the required coaching program when I have BEEN ENROLLED in that coaching program for months already. However, it stays in the denied phase until I call multiple times, talk to about 20 different people and spend hours and hours of my life on the phone. All the while you are trying to figure out ways to erroneously felt my medication and it should be a criminal act.
Business Response
Date: 11/01/2023
November 1, 2023

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 October 23, 2023. Thank you for the opportunity to address the members concern.

Upon review, we have confirmed on October 18, ****************************************************************************** question, that was denied due to not meeting the Plans criteria for coverage. On October 19, 2023 an appeal was initiated by the prescriber, the prescriber updated responses to the criteria questions and coverage has been approved for 12 months based on the new information provided.

Finally, we sincerely apologize for any frustration the member may have experienced while speaking with our customer care team. Feedback has been provided to each member of our customer care team with whom the member interacted with in an effort to improve the level of service our members receive. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*********************************
Member Advocate
Initial Complaint
Date:10/17/2023
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.
CVS Caremark is violating patient rights to choose any pharmacy under my insurance plan. They blocked my prescription from being filled at any other pharmacy. I have to call them first to opt out. They can only do one opt out at a time. They made me choose which prescription to do that day. I used to have my prescription called into the pharmacy and pick it **. In 2023, it took me 3 calls to CVS Caremark to opt out a single prescription. It took me 3 pharmacies to finally get it filled at **** Club (CVS, ********** and CVS Caremark) cant fill a generic birth control prescription. They claimed a shortage exists, but there isnt a shortage. **** Club had no problem and they have the same supplier. I started refilling my medication August 4, 2023. I didnt get my refill until Sept 27, 2023. The hoops CVS Caremark creates and their lack of knowledge on filling a prescription that costs $0.00 with insurance cost me more time spent between them, the pharmacy, and insurance running test claims trying to figure out why they wont fill my prescription and kept blocking it. UMR needs to sever ties with CVS Caremarks criminal activity around bullying people to CVS pharmacies when they cant fill the prescription. I have a right to choose and shouldnt have to call CVS Caremark first. The ***************** sued over this. ********* should have the right to choose their pharmacy by where they have their prescriptions called in by their doctor, not a PBM.
Customer Answer
Date: 10/28/2023
I have not heard from the business in response to my complaint.
Business Response
Date: 11/08/2023
November 8, 2023

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 October 23, 2023. Thank you for the opportunity to address the members concern.

Upon review, we have confirmed that the members Plan has created a plan design that allows its members two ***** fills at any in-network pharmacy, after which the member is to fill at a CVS retail or mail order pharmacy. However, the Plan also allows members to opt out of this plan design. Once a year, a member may opt out of this plan design for all their maintenance medication.

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:10/17/2023
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.
There is a fraud with my name and social security. They are saying I have had an account with them and I have never signed up with them. I asked them to show me proof of an inactive account and they refuse to send me a letter of inactive. I believe this may be fraud. Please help.
Business Response
Date: 11/03/2023
November 3, 2023

*****************************
**************************************************************

Case number: BBB 20742281
Member name: *****************************
Member ID number: XXX-XX-XXXX
Date grievance received: 10/24/2023
Regulatory complaint number: REQ-COMM- 1337702

Dear *****************************;

The Better Business Bureau notified ***************** Life & Health Insurance Company (Anthem) that you have contacted them stating the following:

There is a fraud with my name and social security. They are saying I have had an account with them and I have never signed up with them. I asked them to show me proof of an inactive account and they refuse to send me a letter of inactive. I believe this may be fraud.Please help.

After reviewing your request,***************** Life & Health Insurance Company (Anthem) is requesting clarification due to you stated- there is a fraud with my name and social security.
They are saying I have had an account with them and I have never signed up with them.

Desired Settlement:

Help getting a letter proving I am no longer active or a list of who were the health care providers so I can investigate if this is fraud.

Anthem needs clarification,as to whether you have or have not you have been a member of ***************** Life & Health Insurance Company? Have you received any type of document(s),correspondence, etc. from Anthem? If so, can you please provide the requested information in order for Anthem to review.

Sincerely,

*******************

*******************
Grievances and Appeals Analyst
Grievances and Appeals
Initial Complaint
Date:10/09/2023
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 will start by saying this complaint will be a copy and paste against *****, Caremark and CVS since I feel they were all equally at fault for what happened. I have Cigna health insurance with Caremark prescription insurance. I scheduled an appointment for a Covid vaccine at a CVS. Both Cigna (under medical) and Caremark (under prescription) denied coverage of the Covid vaccine. When I asked what it would cost me out of pocket at CVS I was told CVS had a policy against allowing me to get Covid vaccine when paying out of pocket. Between insurance and CVS we spent hours on the phone trying to figure out what was going on. The only remotely useful answer we got was an off-the-record comment from someone at one of the companies telling us that they were fighting over who was responsible for a $40 administrative fee. No one else in hours of calls would/could tell us anything useful about next steps, actions to take, or why it was happening. Caremark is affiliated with CVS so that is insane. We have decent insurance provided by a large corporation so that not covering it is insane. ***** is widely regarded as an international medical crisis so not being able to get vaccinated is insane. This is literally the only platform I have to make a complaint related to medical issues outside of a lawsuit, not like I can file a ****** review. Im not even sure what I want as a resolution other than to get vaccinated, but I want this complete denial of critical medical care on record with an independent agency. The only other option I have is to **** but that would require damages which literally means that in order to fight this I have to first GET COVID and suffer damages.
Business Response
Date: 10/23/2023
October 23, 2023

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on October 13, 2023. Thank you for the opportunity to address the members concern.

Upon review the medication in question is not covered by the Plan.

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:10/09/2023
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 continued to deny a medication that My Dr. has prescribed to me because there is no generic form and they say its non-formulary drug. Thats no correct. It is what this drug is used for but they do not want to pay the price on it. They first denied it because I havent tried other medications first. Again this is not true. Caremark has been my pharmacy since 2006 and literally has a record on every single ***************************************** that I have ever taken and the ones they have denied me. So my appeal letter that needed to be done lays out the exact medication that Caremark gave for me to try before this other medication and points out that all they had to do was check their records as proof that I have already tried these other medications. They denied me again for the second time. So I called them back & asked why. I was told they never received the appeal letter from my Doctor. So I asked them why I was denied a second time. I got a supervisor who said that they did receive an appeal letter from my doctor ****** on the **************. That is a lie. I faxed them my appeal letter on the ************** because customer service told me to do one too. Only to be told they wont cover the medication now due to having the wrong diagnosis code. This is also not true according to my doctors ******. Its been over a month now with no medication and now Im stuck still in limbo waiting for a third appeal. There seems to always be a never ending excuse as to what next needs to be done to try to get my medication. This is the fourth time Caremark has overridden prescriptions that my Doctor has prescribed to me. I do not understand how a pharmacy can dictate on what medications I can take for my medical conditions. Their appeal process is meant to be time consuming & confusing in hopes that you just give up.
Business Response
Date: 10/17/2023
October 17, 2023

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on October 10, 2023.Thank you for the opportunity to address the beneficiarys concerns.

We are unable to locate the members account. We respectfully request the members full name and date of birth, or Caremark member ID in order to investigate and respond to this complaint.

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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