Business Profile

Health Insurance

CVS Caremark

Headquarters

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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

514 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:02/17/2023
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.
I have an active policy and they keep telling me that in their system deposit shows expired. i called and better to verify with them that the policy is active nobody can change it in their system all they give me is to run around between the two companies with the three companies about who's responsible for changing it in there in the system .
Customer Answer
Date: 02/28/2023
I have not heard from the business in response to my complaint.
Business Response
Date: 03/10/2023
March 10, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the Health Net Superior health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on February 18, 2023. Thank you for the opportunity to address the members concerns.

Upon review, we have verified that an internal error took place that caused that members eligibility to be deactivated. An update was made to the account, and we are still researching the reason that this error was caused. The plan is active and is in effect from January 1, 2023 to December 31, 2023.

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

Sincerely,

***********************************
Member Advocate
Initial Complaint
Date:02/17/2023
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 wrote me a letter today stating that they would not be able to fill prescriptions for Insulin, wish my life depends on, if a balance was not taken care of. This is my first and final notice of an outstanding balance, and I would expect that they would collect interest charges on an outstanding balance, and not withhold medication that somebodys life depends on. This is an unacceptable practice. CVS. Caremark should not be withholding medication from people due to outstanding balances. It puts peoples lives in danger. I cannot go more than 48 hours without insulin.
Business Response
Date: 03/01/2023
March 1, 2023,

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the Reckitt Benckiser health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on February 17, 2023. Thank you for the opportunity to address the members concern regarding the letter the member received.

Upon review, we have verified that the letter sent to the member on February 15, 2023 was due to a declined or expired credit card on file. The order in question was shipped February 16, 2023 and was delivered February 17, 2023. The member has paid the balance due of $50 on February 20, 2023 and there is no balance on the account at this time.

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: 03/01/2023
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.

My issue is regarding the policy, not the incident or my personal circumstances.

1. In the event of an outstanding balance due of any amount, CVS caremark should not withhold delivery of lifesaving medication.
2. There should not be a first and final warning to pay the outstanding balance. Patients should receive reasonable and advanced notice of any expired payment methods on file.
3. It would seem more appropriate to charge interest on an outstanding balance rather than threaten to deny lifesaving medication.

Please consider the safety of patients, even though we don't have much agency of choice in terms of what insurance options employers provide or what insulin types and methods of delivery are made available through insurance coverage.

FAQ

Regards,
*****

Business Response
Date: 03/08/2023
March 8, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the Reckitt Benckiser health plan, of which the beneficiary is a member. This letter is in response to the rebuttal we received from the member on March 6, 2023. Thank you for the opportunity to address the members concern.

We have asked management to review this matter for 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,
********* Ridgell
*********************************
Member Advocate

Customer Answer
Date: 03/09/2023
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.
Asking management to review this matter does not resolve the issue. I will be satisfied when I see, in writing, that CVS Caremark has adopted a new policy not to endanger patients lives by denying access to lifesaving medication like insulin.
Friendly reminder that insulin is terribly expensive and the insurance plan only covers insulin obtained through specific avenues. This policy would not be so much a problem if

A) CVS Caremark were not the only path to getting affordable insulin. If I could as easily get Humalog or even the brand-preferred Novolog covered by purchasing it at a retail pharmacy, we would not be relying on this mail-order service so much to merit raising this issue as I am.

B) If the policy were to charge interest on the outstanding balance and continue to process orders for insulin, I would not be raising this issue. As a business owner I understand the frustration of late payments, and I regularly charge interest for outstanding balances and late payments. I would never withhold services from my clients if it would endanger their lives.

C) If my friends were not rationing insulin, going into debt, losing limbs, and becoming hospitalized because of policies like this which make insulin so difficult to access and afford, perhaps I would not be raising this issue.

I will not be satisfied until CVS Caremark changes this policy. This is CVS Caremark's opportunity to change the policy before public outrage inspires political movements for legislation forces the change. I am part of the movement that motivated *** ***** to lower its prices for insulin before further legislation forces companies to do so. We are persistent. Insulin affordability is only half the battle--accessibility has cost one too many lives.

PLEASE CHANGE YOUR 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,
*****
Initial Complaint
Date:02/16/2023
Type:Delivery 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've been receiving 3-month refills of an antidepressant and anti-anxiety medication from CVS Caremark via mail order for a few years now and the refills have often taken longer than expected. However, this month when it came time for my auto-refill (February 11), it never came. My doctor's ****** confirmed that they approved the refill request but the Caremark website indicated that the medication wouldn't begin "processing" until several days after (February 16)--which was several days after I should have received the medication. At this point, I was experiencing adverse symptoms from withdrawals from the antidepressant. When I called CVS Caremark to obtain clarity on the situation (February 14), the customer service representative disclosed that my medications were on back order, so despite the doctor's ******** to send the refill (February 10), they still didn't know when I would receive it (one of the medications was on back order until July). However, they indicated that I would have better luck having the prescription filled at a local pharmacy. This was the first I had heard about a shortage of my medications. Had I known in advance that there was a back order at CVS, I could have proactively changed the method by which I received my medications. In my view, the lack of disclosure and communication represents an egregious lack of consideration for consumers who are dependent on CVS Caremark's services for their medications.
Business Response
Date: 03/06/2023
March 6, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the ************** & Co. health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on February 16, 2023. Thank you for the opportunity to address the members concern regarding the delay of their mail order medications.

Upon review, we have verified that the prescription ending in ***** was received for processing on February 14, 2023. The prescription shipped on February 15, 2023(USPS first class tracking # **********************). On January 29, 2023, we received a refill request for the members prescription ending in *****. The prescription was out of refills and prescriber contact was needed to obtain a new prescription. A new prescription was received on January 31, 2023. On February 2, 2023, we informed the member and prescribers office that the medication was not in stock and on the manufacturers backorder drug list. The member obtained a 30-day supply of the medication at their local pharmacy on February 16, 2023.

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

Sincerely,

***********************************
Member Advocate
Initial Complaint
Date:02/15/2023
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.
Jan 3rd I've been waiting for medication I've been on for years. Today is Feb 15th. Told today it may take 7 more days on the low end. I went to the *** on ******** I went to CVS on ******* and Instagram. The customer service reps at CVS have no idea what's going on and I legitimately been getting a diff answer every single day. CVS Caremark mail in order is the worst! Lets start with 1, *** do you keep sending me emails that meds are being shipped but you still need prior authorization still? The Dr. has sent it over multiple times. Stop sending me those emails and telling me it should arrive soon when its not being proactively worked on. Hate that my job uses this service. ********* is so much better. If my Dr. prescribed me a medication WHY is CVS stepping in and declining it! Youre not my Dr. *** do you get the authority to say no when my ******** yes. Cannot wait to change medical at the end of the year. This is asinine, unfair and unsafe. Been on this medication for years and *** your wonky "Dr's" are telling me I cannot have it. People are dying as CVS decides to play God and interfere with a patient and their Dr. **** is the point of your personal the Dr then? Was told my Dr. *** needs to call back and make it a high priority. Everyone should be a high priority. It's life or death. He has called, sent and faxed forms since Jan 3rd. He is just as annoyed as I am. Now the geniuses at CVS added the a med that they took the liberty to decline TWICE to the current order for the new one. WHY are they adding the old one that they just declined twice to the new order? Incompetent people. They have have no idea what's going on and asked them to remove the declined meds already and it still shows as on hold with the current. ********* filled every single medication and cannot wait to leave my current provider. Hope CVS fails as a corporation because this is so ridiculous.
Customer Answer
Date: 02/27/2023
[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:02/13/2023
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.
This is my 3rd better business bureau complaint with CVS Caremark services. I am currently being blocked from transferring my prescriptions to ******* pharmacy. This is illegal and I demand that my prescriptions be transferred now that I have provided the new pharmacy with all of the required information. I will not be using my prescription coverage from CVS caremark ever again due to the complete and utter disregard for their customers and obvious focus on profit. I will be using alternatives means for discounted prescriptions so there is no reason for CVS to withhold my prescription transfer. I will file a complaint with the attorney general if my prescriptions are not released immediately. Their fax number is ************. I have 4 prescriptions that need transfer.
Customer Answer
Date: 02/24/2023
I have not heard from the business in response to my complaint.
Business Response
Date: 03/07/2023
March 7, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the Northwestern Mutual Home Consumer health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on February 13, 2023. Thank you for the opportunity to address the members concern regarding the request to have prescriptions transferred.

Upon review, we have verified that a request to have the members prescriptions transferred to their local pharmacy was received on Saturday, February 11, 2023. When the pharmacy attempted to call to request the prescriptions be transferred our clinical department was closed. The local pharmacy called again on February 13, 2023. Our clinical team reached out to the pharmacy on February 14, 2023 to confirm the prescription information for the four medications the member was requesting be transferred. We determined with their pharmacist that there were no refills available on any of the members medications and the prescriber would need to be contacted to provide new prescriptions. The local pharmacy stated that they would inform the member.

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

Sincerely,

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

Customer Answer
Date: 03/08/2023
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 a lie. ****** informed me that CVS refused to transfer the prescriptions that had just been sent by my doctor which forced me to have use cvs one last time. I should be refunded for those medications that I was forced to purchase through CVS. I ended up going a week without my medication because of CVS. I now have my prescriptions with ****** using goodrx . Please refund my prescriptions cost.

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: 03/13/2023
March 13, 2023

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the DeKalb ***************** health plan, of which the beneficiary is a member. This letter is in response the additional concern received from your office on March 8, 2023.

We do not have record of a ****** pharmacy contacting us. We originally spoke with a Wal-Mart pharmacy that requested the prescription transfer. The medications requested by Wal-Mart at that time were out of refills and new prescriptions were not received until February 14 and 19, 2023.

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

Sincerely,

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

Customer Answer
Date: 03/14/2023
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.
Costco reached out several times for prescription transfers, I had my doctor resend the prescriptions. Really should not be this difficult!

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:02/10/2023
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.
I understand that insurance companies automatically deny prior authorizations on the 1st go around because that's insurance companies ...but after being approved 2 years straight..of course after refusal ..for a severe asthma shot that is keeping my husband alive..during COVID..is suddenly not needed according to a pharmacy..I was never notified that the 2nd submission was denied..told that after it was refused again and resubmitted with more paperwork fr dr..it had been denied..why? Couldn't explain..I requested information showing I was ever informed of that and what does a pharmacy have to do with medical questions why am I not contacting my medical insurance.. ..This is malpractice..you are going to cut off a life saving medicine because as I was told the 1st year by them....it's so expensive.. I think you have a standard of care and as far as I'm aware you denied it for the 2nd time and notified or contacted no one.. I believe this is actionable.. I'm amazed at an insurance company that would refuse a life saving medicine a shot for asthma.. we're not talking about a narcotic .. And never notify the people involved I would like to know what their standard of care is and what they consider medically necessary.. also requested Copies of all documentation from the notification they claim March 2023 they mailed to me ..Which I know they didn't send out because I have folders of paperwork And I think I would notice a second refusal ..I have no doubt they will come up with something sketchy.. I would like all documentation on why it's not considered medically necessary why they approved it for 2 years maybe it was a different pharmacy I don't know if ********** switched to them my God if they did get away from them.. And also some kind of information on not having to deal with a prior approval if your doctor says it's necessary I shouldn't have to deal with this c*** from an insurance company I'm paying thousands of dollars to
Business Response
Date: 02/14/2023
We appreciate your patience while we reviewed your complaint regarding our member **********************

We are unable to process this request due to the Health Insurance Portability and Accountability Act, also known as HIPAA, passed by Congress in 1996. The portion of the legislation that deals with the Privacy of health information was implemented April 14, 2003. It requires health plans, providers and other entities involved with health care to ensure a patient's medical information is kept confidential.

***************** records do not show that you are appointed to act as their representative, which is required for HIPAA compliance. Please contact the patients **************** and Blue Shield plan for information concerning personal representatives. Once ********** and Blue Shield records reflect you as the personal representative you may resubmit the request.

In addition, the medication name was not provided.
Initial Complaint
Date:02/10/2023
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 rx required a prior auth in December. The pharmacy cancelled my ** request then cancelled my order and then I had to do the Prior auth between my insurance and my doctor and not the pharmacy which standard practice is the pharmacy initiates. Then the pharmacy failed to call and tell me my PA was approved and reschedule shipment. I had to constantly call and do this. In addition since January 11th, 2023 I have been requesting a copy of my profile notes and order notes and they have failed to provide. These are MY patient records and Im legally allowed to request and be provided these however theh are still failing to provide. EVERY time I call and ask for a supervisor for the liver *** Im told ******* or ****** will call you back. Every week I call and Im told this. And every week nobody calls me.
Business Response
Date: 03/07/2023
March 7, 2023

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

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 February 13, 2023. Thank you for the opportunity to address the members concern.

Upon review we have confirmed that the members request for account notes and documentation was escalated to our *************** On February 15, 2023, our privacy office mailed the required forms that need to be filled out and returned in order for us to appropriately handle the members request.

Finally, we understand the level of service the member received did not meet with their or our expectations, and we apologize for any inconvenience the member may have experienced. 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 or the member have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,

***********************************
Member Advocate
Initial Complaint
Date:02/09/2023
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.
Let me prefix this by saying CVS specialty doesn't care about my health care at all and I am willing and ready to file a lawsuit!Back in 06/2022, I was prescribed Cabenuva and was told by insurance that it needed to go through CVS. CVS kept saying they weren't able to fill it because they weren't contracted. This went on for 4 entire months. I was finally able to get them on the same page by the beginning of November.30 days later, I went to have the second dose administered but CVS says the medication needs a prior authorization when my insurance says it doesn't. I finally was able to have it delivered on time.Here we are two months later and now CVS has screwed me again. My insurance hasn't changed, nothing has changed but now, but CVS canceled my prescription and then sent the prescription back to benefits verification when it doesn't require anything.My Dr's ****** is now saying that I may have to go back to taking a daily pill so my entire quality of life will degrade dealing with CVS.I want a PHONE CALL from someone at corporate for an explanation. I shouldn't have go through this and it makes me sick. Please call me and explain why this is continuing to happen.
Business Response
Date: 03/01/2023
March 1, 2023

BBB serving Eastern *************, *****, ************, and *******
290 *********************************************, Suite 102
***********, ** 01752-4705

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 February 9, 2022. Thank you for the opportunity to address the members concerns.

Upon review, we have verified that a prescription was received from the members prescriber for processing by our specialty pharmacy. The medication was rejected by the members plan for prior authorization being required. A second prescription was received which then cancelled the previous request for processing. We assigned a single point of contact to the member who was in regular communication with the member until the members concerns were resolved. Our specialty pharmacy rep that was assigned to this case contacted the member on February 9, 2023 and scheduled delivery for the members medication to be shipped to their prescribers office. *** tracking number ***************** shows the members order was delivered on February 10, 2023 and the member had no additional concerns or requests upon being provided the confirmation of delivery.

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

Sincerely,

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

Customer Answer
Date: 03/01/2023
[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:02/07/2023
Type:Delivery 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.
Doctor ********** medication on Jan 19. Caremark contacts me days later to say that it is back ordered and to contact doctor with a replacement. But the replacements are also back ordered. I have to find out what alternatives ARE available and then contact ******* Jan 26 Dr fills new script for replacement medication. Feb 6 and the medication has not arrived and is not listed on the Caremark portal. As of Feb 7 still no action. Contact ********** again and they are handing, as family is completely out of medication. This is not an isolated incidence. Prescription orders are not put into the system for weeks. When there is a shortage, it's left for the patient and doctor to identify the replacement. Caremark is a large vertically integrated company covering an insurer (Aetna), a PBM, a mail-order pharmacy, and retail stores. Communication should be excellent, but it seems unable to communicate between its different arms, and even within just the mail order pharmacy there is a mess. I would switch, but my company provided Aetna insurance forces me to to use Caremark.
Business Response
Date: 02/17/2023
February 17, 2023

BBB serving Eastern *************, *****, ************, and *******
290 *********************************************, Suite 102
***********, ** 01752-4705

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the Teva health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on February 7, 2023. Thank you for the opportunity to address the members concern regarding the delays with processing their mail order prescription.

Upon review, we have verified that a prescription was received from the members prescriber for mail order processing. The medication that was prescribed was not in stock and could not be filled. A request for the prescriber to prescribe an alternate medication was sent electronically to the prescribers office. The alternate medication would be up to the prescriber, and we would have to verify availability at the time the prescription order was in process to confirm that it could be filled by our pharmacy. Unfortunately, there is a supply shortage nationwide right now and availability fluctuates greatly from day to day. Today we have no stock available for any generic brands of the members medication.

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

Sincerely,

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

Customer Answer
Date: 02/17/2023
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.
The nationwide shortage is acknowledged, and I am sympathetic that this puts a strain on business. My complaint is with CVS/Caremark's ability to communicate and coordinate to find a solution for the problem.
Asking the doctor to prescribe something else doesn't solve the problem, especially if there are multiple drugs and doses in that class that are in limited supply. Only CVS knows what alternatives are available and from where (mail order versus pharmacy, and which pharmacy). I would have to CVS to find what is available and then call the doctor to prescribe, then call back CVS to see if the order went through and if the drug is still available. Often there was a delay, and it was not clear if this was because of delays at CVS, failure of the doctor to send the form, or use the correct notation. If the doctor does not fill the form in the exact manner required, CVS will not fill, but you have to dig deep to find that information. e.g. going to the pharmacy and talking to the pharmacist in the evening when he has time to actually answer your question.
Even though I have degrees in chemistry and medical sciences and work in pharma, this is not easy. Multiply this by 5 family members and you are looking at long times talking to doctors, CVS, and pharmacies, and no drugs for weeks.
But NONE of this should be the patient's responsibility. And solutions ARE available elsewhere. When I worked with my local independent pharmacy, the pharmacist would call me if there was a supply issue, and would call the doctors office and arrange for alternatives, so I knew that i would get the drug or a replacement in time. But CVS is unable to do that. I would switch, but under my current insurance I have to go through CVS alone.
Regards,
*****

Business Response
Date: 03/01/2023
March 1, 2023

BBB serving Eastern *************, *****, ************, and *******
290 *********************************************, Suite 102
***********, ** 01752-4705

Complaint # ********

To whom it may concern:

Thank you for your additional concerns. We understand that this shortage is not something we could avoid. We are currently unable to check current stock levels and provide that information beforehand due to the quantity in stock changing daily. Additionally, your prescriber should be consulted in regard to switching to alternate medications due to the prescription shortage.

Again, we apologize for the current medication shortage as this is out of our hands and is something that is resolved as soon as possible. Should you or the member have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,

***********************************
Member Advocate
Initial Complaint
Date:02/07/2023
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 company switched from Express Scripts to CVS Caremark as our pharmaceutical administrator a few years ago. In the final year Express Scripts stopped covering the generic version of Adderall XR in lieu of the brand formulary. At the time I noticed the brand was more effective and released more consistently than the generic; this is critical as I have a sleep disorder that causes narcolepsy during the day. Caremark initially wouldn't cover the brand but over two years ago they changed course and having experienced the generic versus brand for a second time made it clear the brand is more effective for me. Fast forward to January 1, 2023 and CVS Caremark reversed their decision again; albeit in the midst of a national shortage of the compounds used in both the generic and brand formularies. Even in October 2022 "CVS said Thursday it was aware of intermittent shortages of generic amphetamine medication in the supply chain. The generic is still on backorder so I had to pay $460 out of pocket. *************** appealed but it was denied because brand formularies of Mydayis (another Takeda product ironically) and other ADHD drugs are covered. In my research I did not see any are *** approved for narcolepsy. I would bet ****** ended the kickback program to Caremark so they could maximize profits for Mydayis before generic versions can be developed. If this is the case, it is yet another example of drug companies colluding with insurance providers at the expense of patient well-being. Furthermore, one of the suggested drugs, ******* PM, is a drug taken at night and could very well make my sleep issues even worse. I would not be surprised if ******'s kickbacks to insurance providers to prioritize brand Adderall XR helped fuel the shortage of the generic version by monopolizing the supply of the underlying compounds, production of which has a hard cap under the ***. Just another example of inflicting patient harm under the guise of patient care.
Business Response
Date: 02/17/2023
February 17, 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 February 7, 2023. Thank you for the opportunity to address the members concern regarding the national drug shortage.

Upon review, we have verified that the members medication was previously covered as a preferred brand. As of January 1, 2023, the medication would no longer be covered without approval of prior authorization. A letter was sent to the member to advise of the formulary status change. A request for prior authorization was received on January 24, 2023 and was denied January 30, 2023 due to not enough clinical information being provided regarding trial and failure of covered alternatives. The plan has determined that an override may be placed due to the ongoing national shortage. The override is currently valid for January 1, 2023-February 28, 2023. If the member has paid out of pocket for any medications during this time due to the plan rejecting coverage of the brand name medication, the member may submit a prescription drug claim form with their pharmacy receipts for reimbursement by the plan. The member may contact customer care at ************** for more information on submitting a paper claim.

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

Sincerely,

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

Customer Answer
Date: 02/21/2023
[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 will only consider this response satisfactory if Caremark keeps its word about reimbursing me per the override. I filed the attached claim; however, I won't be shocked if they find some other excuse to deny it. I still have not received an answer as to why Caremark believes it has the authority to demand I try drugs not approved or indicated for my condition. I am also filing complaints with my company and EBSA to do my part in fighting back against PBM corporate greed at the expense of patient outcomes.

Regards,

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

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