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.
164 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

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

Initial Complaint
Date:04/03/2023
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 take Vimpat for epilepsy. Every year I pay ~$2800 for the first 3 months, which is applied to my deductible (which resets July 1). I refilled Vimpat on Sept 29, 2022. The cost was $2836.44. I paid this, believing it was being applied to my deductible. However, a generic for Vimpat had become available. CVS Caremark changed their policy re: Vimpat, so $2457.86 was a brand penalty. *** did not inform me of this change.In Dec 2022, I was charged $967.68 for one month's supply. I called *** to query this. The *** rep didn't tell me of the policy change re: ******, nor that I had been charged a brand penality in Sept and again in Dec, and didn't correct me when I stated that I believed I had paid most of my deductible. (The rep said it was b/c of the refill date.) The pharmacy applied a Vimpat coupon. In Jan, I was told the cost for my 3 month refill was ~ $2800. Again, I disputed the charge. The pharmacy investigated and found out I had been charged a brand penalty in Sept. I called *** and was told to get my doctor to fill out a *** form. The doctor said the *** form requires a reason to take the brand name instead of the generic. This isn't the issue. Now that I am aware of the generic, I switched to it. I called back *** and was escalated to the senior team, who filed a request for a one time reimbursement. They told me I would get a callback within 72 hrs. No one called back. A week later, on Feb 20, I called again. I was escalated by the senior team to someone higher. That person filed a reimbursement request and said she would call me within 4 days. No one called back. I then sent a certified letter to *** on Mar 9. I asked for a response via mail. I have not received a response. Due to CVS Caremark's failure to inform me of the policy change re: ****** (both at the time the change occurred, and in Dec 2022 when I called to query the high cost), I am asking for a one-time reimbursement of the Brand Penalty charge of $2457.86 that I paid on Sept 29, 2022.
Business Response
Date: 04/11/2023
April 10, 2023
Better Business Bureau
5 *************. Suite 100
*********** ** 01752-1927
**************
www.bbb.org/**/**
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 April 4, 2023. Thank you for the opportunity to address the members concern regarding
the request for reimbursement.

The Plan has denied the members reimbursement request. The Plan advises the member to contact the
dispensing pharmacy, UC Atrium Pharmacy at ************ for a resolution.
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: 04/12/2023
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.
I was glad to receive a response from CVS Caremark, but was saddened that it took an official complaint through the Better Business Bureau to receive it.
I spoke with ***************** today (April 12th, 2023) and he explained that my request for a one-time Brand Penalty exemption was being rejected by the *** account managers for the ********************** plan. I asked to speak with an account manager and was informed that they did not speak to members. I asked ***************** why CVS Caremark did not inform me of the change in policy regarding Vimpat and he told me that it wasnt a change in policy. The policy was always that they would only cover the cost of the generic if one was available. What had changed was now there was a generic available. I explained that changing from covering the cost of an expensive medication to not covering the cost of the medication felt like a change in policy to me, and that I believed CVS Caremark had a responsibility to tell me this. ***************** said it was the pharmacys responsibility to inform me that a generic was now available. I asked if he could call the pharmacy while I was on the line so we could all discuss the situation together and he said that was not possible.
I then called the ** Atrium Pharmacy. They reviewed their notes. They do search for a generic when refilling any medication. There was no indication they found a generic option in September, 2022 and they confirmed I was not offered a generic option in September 2022.
From my perspective, this situation involves a multi-billion dollar insurance company that is not taking ownership for failing to inform a member that they were no longer covering the full cost of an expensive medication. It appears that only CVS Caremark was aware of the generic - neither the pharmacy or I had been informed. I dont think it is right that I am bearing the cost of this lack of communication that has resulted in this surprise *********
I have written to my US ************ ******************** for advice on how to handle this situation moving forward. As I explained to him, all I am asking for is that CVS Caremark issue a one-time reimbursement of the Brand Penalty charge of $2457.86 that I paid on September 29th, 2022. I do not expect CVS Caremark to cover the additional cost of Vimpat moving forward. Now that I am aware there is a generic, I have switched to that.
Regards,
*******************

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: 04/18/2023
April 17, 2023

Better Business Bureau
5 *************. Suite 100
*********** ** 01752-1927
**************
www.bbb.org/**/**

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 rebuttal we received from the member on April 13, 2023. Thank you for the opportunity to address the members concern.

On April 13, 2023 a second outreach was made to the ********************** health plans management team requesting a one-time exception to reimburse the member. The request was denied.

Upon further review, the prescription for the member was written for the brand medication only and did not allow for substitutions. The prescription was processed as written by the prescriber. The prescriber would need to submit a new prescription to allow for substitutions.

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,
*********************************

Customer Answer
Date: 04/19/2023
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.
Thank you for investigating this issue further. Early on in the process, one of the *** representatives that I spoke to suggested this might be the reason that I rececived Vimpat instead of the generic. However, when I called the doctor's ******* they pulled up the prescription and said it was not written in this way. They said the prescription allowed for the generic.
I am sure you can understand that it is frustrating for me to hear two conflicting accounts of the prescription when I cannot see the evidence either way.
Could you please send me the evidence you have that leads you to state that the prescription was written for Vimpat only?
Regards,
*******************

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

FAQ

Regards,
****
Initial Complaint
Date:04/03/2023
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 DONT KNOW HOW THE **** THEY FOUND MY INFORMATION THEY SENT MAIL RECEIVED MAIL FROM THEM WITH MY INFO ON IT AND WHERE THEY GOT IT FROM THIS IS UNACCEPTABLE ITS NOT RIGHT AT ALL I DID NOT GIVE THEM MY INFO NOR DID NOT GIVE THEM PERMISSION TO OBTAIN MY INFO THIS NEEDS TO BE TAKEN VERY SERIOUSLY SND INVESTIGATING THRY HAVE GOT NO DARN RIGH TO OBTAIN AND HAVR MY INFO WITHOUT MY CONSENT AND KNOWLEDGE THATS ILLEGAL
Business Response
Date: 04/14/2023
April 14, 2023

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

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 April 4, 2023. Thank you for the opportunity to address the beneficiarys concerns.

Upon review, CVS Caremark is the pharmacy benefits manager for the plan. Caremark received the members information from the plan. The letter that was mailed to the member was informing him that a prescription was being recalled by the manufacturer. CVS Caremark is unable to opt the member out of this type of mailing.

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: 04/14/2023
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.
which the beneficiary is a member. HE IS NOT A MEMBER ********************* AND NOBODY DOES NOT LIVE BY THAT NAME AT THAT RESIDENCE. NOBODY DOES NOT HAVE ANY KIND INSURANCES. THAT FIDELIS CARE CONTINUES TO HARASS BY CALLING AND SENDING MAILS THEY WERE CONTACTED MANY TIMES BUT THEY DO NOT COMPREHEND. AND THEY THAT CVS WHATEVER NEEDS TO STOP SENDING MAILS AND OPT THAT PERSON ********************* OUT NOBODY LIVES BY THAT NAME.

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: 04/20/2023
April 20, 2023

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

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 April 4, 2023. Thank you for the opportunity to address the beneficiarys concerns.

Upon review, **************** manages all eligibility concerns and can confirm the information on the members account. The beneficiary can call Fidelis directly at ************. Please note that as of April 1, 2023, CVS Caremark is no longer the prescription benefit manager for ****************.

The beneficiarys plan is now managed by ******** NYRx. The beneficiary can call ******** NYRx directly at ************.

Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,
*****************************

Member Advocate
Customer Answer
Date: 04/20/2023
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.

This is NOT ********************** There are NO beneficiary is a member. by the name *********************. ********************* IS NOT beneficiary is a member.. They/he has passed. They thatfidelis care were contacted a lot of times that fidelis care and they dont understand and continue to harass and they were told there are no members /beneficiaryby the name *********************. Bbb were contacted ,department of health and attorney general and they that **** frdelis care and that CVs Caremark continue to harass by sending mails and calling !!!!! They dont understand that there is NO beneficiary/member . How many times they were contacted that **** frdelis care they so stupid they dont comprehend that again there is no beneficiary is a member by the name ********************* and to stop and do not call and do not send harassing.
And that cvs caremarkthere is NO beneficiary is a member. by the name ********************* and DO NOT send mails and do not call.

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,
Ayhan.
Initial Complaint
Date:04/02/2023
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.
CVS Caremark is the most incompetent pharmacy in existence.Over a month ago, i asked them to tell me what exactly CGM device is covered and i notified my doctor. More than a week after my doctor called in the script, they tell me the device ordered is no longer in existence. They said they would notify the notify and they didnt. When i called to follow-up on the status of my order, i was informed that they dont have a script for the right device and ofcourse no one called the doctor. I called the doctor and he order the right device. Then they send me just the sensors and not the READER. When I called to find out why the reader wasn't sent, i asked to speak to a supervisor (because none of their agents know what they are doing, they sound like they've been sleeping all day), the supervisor ****** tells me the reader is not covered but the sensors are. The most assinign think i've heard. I asked ****** to transfer the reader script to a local pharmacy (as he told me that it could be filled by a local pharmacy under medical insurance). He did do that but I told him I'm not paying for the sensors until I can the reader and he said that was fine. In the meantime, my doctor ordered additional scripts which Caremark did not fil (and have not filled) until I pay for the sensors. This is disgusting about this pharmacy and they need to be shut down. I want them fill my current prescriptions asap and shouldnt charge me for them due to their incompetence
Business Response
Date: 04/12/2023
April 12, 2023

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

Complaint # ********

To whom it may concern:

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

Upon review, the requested device is not available at Caremark mail order. It is covered under the medical portion of the plans benefits. The member can go to ********************************** to find Durable Medical Equipment providers in their area.

Separately, the medications have shipped with an invoice, *** tracking number 1Z6F21971312759854.

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: 04/12/2023
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

Regards,
*******
Initial Complaint
Date:03/27/2023
Type:Delivery 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.
On March 25, 2023, I received a letter from CVS Caremark informing me that I no longer had the ability to order 90-day Prescription Drugs in the *****************. The letter is attached in full for reference.In researching this topic, it appears to be related to Oklahomas ** ****.HOWEVER, OK State and its Insurance Commissioner appears to state that this restriction is NOT IN THE *** and is A MISREPRESENTATION OF THE ** **** by CVS Caremark.Subsequently, CVS Caremark (from public information I Googled) appears to stand by their position restricting OK State residents from the 90-day mail order supply.How can this be? And it appears that some behind the scenes battle between OK State, its ** **** and CVSs response (perhaps their interpretation) is going to leave a lot of customers in OK State in a very problematic, and likely even more expensive, situation for the daily medications.OK State and OKs BBB needs to take this up with CVS Caremarks **************** and demand either a retraction or clarification to all customers.
Business Response
Date: 03/30/2023
March 30, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the ******* Employees Health Benefit Plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on March 27, 2023. Thank you for the opportunity to address the beneficiarys concern that their maintenance medications may no longer be filled at mail and/or retail for a 90-day supply.

To ensure compliance with Oklahomas enforcement of the Patients Right to Pharmacy Choice Act against out-of-state plans, Caremark has temporarily disabled the 90-day fill program for impacted ******** residents. Caremark is in the process of making system enhancements before reinstating 90-day fill programs for the impacted plans.

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: 03/30/2023
[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:03/24/2023
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.
Please just send me my medicine! Two weeks ago I started trying to get a prescription filled for Corlanor through cvs Caremark. The process has gotten more and more convoluted. No one I speak to has any idea what is going on. The latest issue is a transcription issue with the prescription which doesnt make any sense because my doctor called it in and it says that in the report! So if theres a transcription issue its your guys fault and you need to figure it out!! Because its a new prescription I have been told it will take 5 days just to clear, thats after they can get yet another prescription from my doctor. At this point my doctor has sent in the prescription 3 times. The last woman I spoke to said she can see on her end that I have two prescriptions for this med sitting waiting and that they look correct I.e. right dose, right number of pills and days. So she doesnt know what the transcription issue is. I spoke to a ***** from the senior team who was useless and only left me messages after 530 pm long after my doctors and other offices have closed and she never had good news to deliver. She eventually gave up and passed me off to someone lower than her who was even more over their head and after an hour and a half I had been transferred 3 times. Once by a woman named ******* who put me on hold for 25 minutes without telling me she was transferring me. PLEASE HELP. This medicine is extremely important for my health even one day without it is awful.
Business Response
Date: 03/27/2023
The prescription has been retranslated is in the final stages of processing; the order is set to ship Urgent Next Day delivery.
Customer Answer
Date: 04/05/2023
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.] they did nothing to solve my problem I spent 2.5 weeks getting the stupid medication filled and they wont even tell me what the hold up is

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,
Caitlin

Business Response
Date: 04/11/2023
We received a request to transfer a prescription from a retail pharmacy to the mail service pharmacy on March 21,2023; the transfer was completed on March 23, 2023 and the order shipped on March 24, 2023. The standard order processing and shipping time is up to 10 business days.
Initial Complaint
Date:03/23/2023
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.
On 11/7/22 my Dr administered a drug from CVS Specialty. The doctor ****** guaranteed there would be no bill from CVS SPECIALTY due to a ***** that the Dr ****** applied for. I have requested CVS to contact the Dr's ****** regarding the bill but they refuse to. The bill was over *******. But now it's $1165.44.
Business Response
Date: 04/05/2023
March 29, 2023

Better Business Bureau
5 *************. Suite 100
*********** ** 01752-1927
**************
www.bbb.org/**/**

Complaint # ********

To whom it may concern:

CVS Specialty Pharmacy was the dispensing pharmacy for the prescription benefits portion of the members health plan. This letter is in response to the correspondence we received from your office on March 24, 2023. Thank you for the opportunity to address the member concerns.

Corrections were made. The members responsibility is $0.

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:03/22/2023
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 tried to appeal to have brand Adderall approved and covered by my insurance. My doctor has written an appeal letter and fax it over. This was in January of 2023. Caremark stated that they did not receive the appeal letter via fax, and that I should try to fax it again. I did so in March 2023, and Caremark has stated once again that they have not received the fax after confirming the fax number several times.I need this medication to be covered by my insurance due to the side effects of generic adderall. I get very nauseous, lightheaded, fatigue, and very foggy brain. Caremark has continued to say they have not received any appeal letter via Fax. I have now been dealing with this for three months (January-March 2023). I need Caremark to find this Appeal Letter that I have faxed over twice now and approve coverage for the medication I need.
Business Response
Date: 03/30/2023
March 29, 2023

Better Business Bureau
5 *************. Suite 100
*********** ** 01752-1927
**************
www.bbb.org/**/**

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the American Airlines health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on March 22, 2023. Thank you for the opportunity to address the members concern regarding drug coverage.

Upon review, we have verified that the members prescriber submitted a coverage request on February 2, 2023 that was denied the same day due to not meeting the Plans criteria for coverage. There was no record of any appeal being submitted. We reached out to the prescribers office, they confirmed they did not submit an appeal request. On March 29, 2023, we reached out to the member and an appeal request was initiated at her request. The appeal is currently being reviewed.

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:03/21/2023
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.
My son needs a physician administered injection that CVS Specialty Pharmacy has failed to fill. Per my medical insurance that type of medication must be billed under my health insurance. CVS specialty pharmacy keeps sending the claim to my prescription vendor; and its being rejected. My sons ********** has received an authorization from my insurance company approving the medication; CVS has received the authorization numerous times as well. I have spoken to numerous reps over the phone & thru chat who will advise the med will process thru medical only for them to send it to my pharmacy vendor in which it will reject. My son needs this medication & needs to start taking it as soon as possible since its time sensitive with his growth.
Business Response
Date: 03/22/2023
March 22, 2023

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

Complaint # ********

To whom it may concern,

CVS Caremark is in receipt of the above referenced complaint. However, we cannot address the members concerns due to the lack of information on any claim, including prescription number and patient full name and date of birth or plan member ID. Once that information is received, we can address the members complaint.

We value our members and remain committed to our purpose, helping people on their path to better health.

Sincerely,

***********************************
Member Advocate

Customer Answer
Date: 03/22/2023
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

Regards,
*******
Patients name: *****************************
DOB: 05/10/2012
Prescription: Lupron Depot Inj ***** mg

Business Response
Date: 03/26/2023
March 26, 2023

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

Complaint # ********

To whom it may concern:

CVS Specialty Pharmacy was the dispensing pharmacy for the prescription benefits portion of the beneficiary is a member. This letter is in response to the correspondence we received from your office on March 22, 2023. Thank you for the opportunity to address the beneficiarys concerns.

Upon review, the medication in question was incorrectly processed to the members pharmacy benefits. The medication has now been processed through the members medical benefits and is scheduled for delivery on March 28, 2023. ******** was confirmed with the members doctors office.

We recognize that there were opportunities for additional training and coaching for our staff. Feedback has been provided to each member of the customer care team with whom the member interacted with. Please note that our goal is to ensure that our valued customers receive only the highest level of customer care.

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:03/21/2023
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.
Continued issues with *** Specialty Pharmacy and staff. After repeated requests not to send prescriptions that have not been paid for and requests to NOT ever maintain credit card information on file or charge it with out explicit authorization. They continue to do so. They now (for the first time 3/21/23 after many staff advising differently prior to this) tell me they cant charge a card until the product has shipped. With prescriptions that can run up to $25,000 dollars every 6 weeks this is simply not acceptable. They said their system is not able to do that, but they can manually change the expiration date of the card. Last week we found out the copay assist card cannot be used toward the deductible in this state and therefore we would need to pay $2,327.92. The *** representative said 3/15/23 that they would need to charge the card, so gave them a card and confirmed it would be charged that day and they would not maintain it on file (they confirmed that was correct). However they did not charge the card until 3/21 and only for $200 (which they did not receive approval to do so). Received a message stating there was a balance of $2,127.92 and the product has shipped. When we called them (and after speaking with at least 3 staff) to try and resolve. They still had that credit card on file and charged it. When I asked why they had it on file-was told they couldnt remove it (and why they manually changed the expiration date when asked -in an attempt to avoid the card being charged again). This process is unacceptable and creates hardship, and undue stress. They should be required to authorize payment prior to automatically shipping a product. Its not like you can return the prescription for a refund if you cant afford it.
Business Response
Date: 03/26/2023
March 26, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the **** employee health plan,of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on March 22, 2023. Thank you for the opportunity to address the beneficiarys concerns.

CVS Specialty called the member on March 22, 2023 and addressed his concerns. The agent asked the member if they would like a refund to the credit card that was charged and the member said no. The credit card has now been marked as inactive. CVS Specialty educated the member that if they add the credit card using the online CVSspecialty.com account then the card will only be active for 5 days then automatically inactivated. Member was satisfied with the outcome of the phone call.

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:03/15/2023
Type:Delivery 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.
In January our company changed mail-in pharmacy providers from Express Scripts to CVS Caremark and the Specialty pharmacy. We were told that the change would be seamless and that our medications would not be interrupted, and any specialty meds that had prior authorizations in place would be honored. The first thing that happened in January when it was time to fill my Enbrel with CVS was they had to get prior authorization, so my medication was delayed. in a couple of days my medication was sent and then a gain in February with no issues. March refill came about and I waited for my scheduled delivery on March the 8th. No delivery was made, I received a text message saying it was delayed due to prior authorizaton being needed. Today 3/25/23 I call and am told that no one has even requested the prior authorization or more information from my soctor that they keep saying my INSURANCE says they need! The request was supposedly faxed as I was talking to them on the phone. Then my doctor has to send the info as urgent as well as call and give verbal authorization as urgent, then I have to call and order medication that I ALREADY ordered 15 days ago! I am waiting to see if my doctor even recieved this like I was told, as they have done nothing but lie to me for the last two weeks saying that my doctor had not responded to requests, when CVS NEVER asked for anything!!! The prior authorization department as CVS has caused a great deal of stress by not doing their jobs.Do the right thing and send my Enbrel that I HAVE PRIOR AUTHORIZATION ALREADY AND STOP BLAIMING INSURANCE AND THE DOCTOR when it has been CVS all this time! The onl;y acceptable outcome is send my medication and DO NOT LET THIS HAPPEN AGAIN!
Business Response
Date: 03/24/2023
March 24, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the *** Energy employee health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on March 15, 2023. Thank you for the opportunity to address the beneficiarys concerns.

Upon review, the medication in question has been approved for coverage from March 16, 2023 to March 16, ****. The medication was shipped on March 17, 2023 and delivered on March 18, 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
Customer Answer
Date: 03/24/2023
[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. However, the assistance that I FINALLY received was after a multitude of people being involved in the process. ONE person needs to work through client issues and concerns and get them resolved without lying about what has or hasn't been completed on the end of CVS/Caremark. An example is that I was told a request for a PA was put in, but when I contacted them about it for the umpteenth time, I was finally told that no one had actually asked for a PA from my physician. CVS/CAremark just kept telling me dr had not responded to the request. Get your customer service together and stop making the people that pay your wages feel that they are doing the wrong thing by asking for their medications to be filled. Not thrilled with being required to use CVS/Caremark AT ALL.

Regards,

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

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