Business Profile

Health Insurance

CVS Caremark

Headquarters

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Health Insurance.

Complaints

This profile includes complaints for CVS Caremark's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

515 total complaints in the last 3 years.
162 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

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

Initial Complaint
Date:12/23/2022
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.
12/15/2022 CVS Mail Order Delivery emailed me that the brand name medication, Bystolic Tab 5mg prescription number ********* is ready for shipment waiting for me to call to release it. I called (can't remember the date) only to be told that a generic brand will replace the Bystolic. This is the second time CVS plays with my medication, the first one, Dexilant, they also harassed me and the doctor to change the wordings on the prescription that is acceptable to them. They also accused me that the brand name Dexilant is my "personal choice"! They harassed me for 8 days plus weeks of delay, before they would release Dexilant, it was at the height of COVID 19, CVS stressed me out that my stomach bloated for 5 days, delaying my COVID 19 vaccination. CVS acts like God, changes prescription with no knowledge at all of my body's reactions to the generic drugs. So far, in my entire life, my doctor has only prescribed 2, ONLY 2, brand names, so CVS should stop treating me like I am imposing my "personal choice". All my maintenance drugs are generic, it is only when the drug (generic or brand name) creates some risks or more risks to my health, that I see my doctor for a different prescription. I also stop taking Dexilant because it was not effective so now I am on a strict diet to ease my acid reflux. So, CVS stop harassing me with my prescription of brand name drugs because it was legitimately prescribed by my doctor after consultation and base on my medical problems, not a personal choice. CVS is guilty of lying about their value of "health equity", NOT in my case.
Business Response
Date: 12/27/2022
Thank you for your recent inquiry to the ********** and ******************* Benefit Plan Pharmacy Program. We appreciate your patience while we reviewed your inquiry regarding generic substitution.

As outlined in the ********** and ******************* Benefit Plan brochure (RI ******) Section 5(f), Prescription drug benefits:

Generic equivalent drugs have the same active ingredients as their brand-name equivalents. By filling your prescriptions (or those of family members covered by the Plan) at a retail pharmacy, through the Specialty Drug Pharmacy Program, or, for Standard Option members and for Basic Option members with primary ******** Part B, through the ************ Prescription Drug Program, you authorize the pharmacist to substitute any available Federally approved generic equivalent, unless you or your physician specifically requests a brand-name drug and indicates dispense as written.

If there is a generic substitution available and you or your provider requests a brand-name drug, you will be responsible for the applicable tier cost-share plus the difference in the cost of the brand-name and generic drug. If the providers prescription is for the brand-name drug and indicates dispense as written, you are responsible only for the applicable tier cost-share.

Based on the information outlined above, it is recommended you discuss your prescriptions with your prescriber. As the prescribers office may be contacted from time to time for prescription clarification, you and the prescriber should collaborate on what your prescription needs are to be certain they are filled accordingly.
Customer Answer
Date: 12/27/2022
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,
May
Initial Complaint
Date:12/22/2022
Type:Billing Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
We have filed this same compliant before. Case#********.We have spent close to 50hrs on the phone with various companies that deal with our benefits. CVS Specialty, CVS Caremark and Cigna. We have not yet reached a resolution. The Summary: our family of pocket *** for the year is $7000. We have personally paid OVER this amount. However, because of the inability for CVS Specialty and CVS Caremark to work together in processing bills, this has not been accurately applied to anything. We have been sent to collections for bills from the hospital, and bills from Specialty totaling another $7000. Even though all companies can see that we have indeed personally paid all that we need to for the year, the bills have still not been reprocessed, and have now been sent to collections. We legally should not pay another $7000, nor can we continue to watch our credit scores suffer! This has been going on for almost a year. We hope to reach a resolution through BBB. Otherwise I guess the next step is to file a law suit.
Customer Answer
Date: 01/01/2023
I have not heard from the business in response to my complaint.
Business Response
Date: 01/09/2023
January 9, 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 **************** health plan, of
which the beneficiary is a member. This letter is in response to the correspondence we received from
your office on December 22, 2022. Thank you for the opportunity to address the members concern
regarding the billing of their specialty medications.

Upon review, we have verified that non preferred medication costs do not apply to the State of
Wyomings plan accumulators and the claims are being paid correctly as intended by the plan. We are
currently working with the plan to possibly have this plan updated to allow such claims to be applied to
the plans deductible and out of pocket maximum. All balances and collection calls have been placed on
a 90 day hold and there will be no delays in the member receiving any medications from our specialty
pharmacy due to billing disputes until this is resolved.

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: 01/10/2023
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 # ********.
Dear CVS,
Thank you for your response. We appreciate you putting bills on hold, however, we already paid all of our bills in full.
There are a few points we would like to make that will hopefully help to clarify things.
First, our conversations, letters and all communication with CVS and the company Prudent RX that works directly with CVS started in November and December of 2021. CVS and prudent had full details to our insurance plan, sent us letters in regards to all of our family specialty medications, telling us that with our new insurance plan, we would be paying $0 out of pocket for all of our specialty medications. We contacted Prudent RX, got signed up, contacted our doctors and had them in communication with CVS and Prudent to make sure all was set for the new year. However, after our first delivery of every single one of our speciality medications, we were hit with bills of thousands of dollars, which no one could explain. Over time, we were simply told that CVS and ******* had told us wrong and they would not actually be able to work with us. When we asked if we could change our insurance plan then, they said no.
Secondly, after ******* and CVS completely backed out of the $0 copay agreement and obligation (with no one able to explain why), we were scrambling to figure out how to pay and what to do. CVS was refusing to fill our daughters cancer medications, and after many phone calls, we were told that they never withhold cancer drugs and they were finally filled. We were assured that since she had already been on them for almost a year, they would be approved as preferred medications and be covered as such.

Thirdly, after paying over $8000 in bills, (Our out of pocket *** is $7000) CVS Caremark had no record of us paying anything to CVS Specialty. After hours and hours and months and months and many different case numbers and escalation teams, it was decided that we did in fact over pay on bills and we got a small amount refunded. We were told by ***** to stop paying bills because we had already overpaid and as CVS and ***** reprocessed everything, things would be straightened up.

Fourth, after things showed a $0 balance on both of our CVS Specialty accounts around mid 2022, we felt that things were taken care of, however, a few months later, bills suddenly showed up and we were being sent to collections. After months and months and hours and hours on the phone with CVS, no one could explain why. In fact, no one could even figure out that Prudent RX wasnt paying for everything! I had to have CVS Caremark get on a conference call with Specialty multiple times for CVS to even believe me that we paid from our credit card, not prudent RX since CVS Caremark cannot even see what we have actually paid! They dont have a record of that.

We were assured that our bills would not go to collections, (because they were in dispute) but they went anyway. Even after we were getting bills and phone calls from collections, when we called CVS, they assured us and a Cigna rep, that none of our bills were even in collections. Yet, we continued to get letters and phone calls asking us to pay our CVS bill that was in collections. This was a little disconcerting that CVS didn't even know that they had sent bills to collections.
Finally, In December, our credit scores were suffering and other providers were threatening to send us to collections so we dug deep into savings and payed over $6500 in medical bills on December 30 of 2022. Bringing the total paid close to $14,000 or more for the year.

So just to recap.
?We were promised by CVS and Prudent RX in 2021 that we would pay $0 for our specialty medications.
? After the new year started and we had received medications, we were billed for $1000s with no real explaination as to why.
? We were told the medications would be counted as preferred and that when we reached an out of pocket expense of $7000 we would have reached our *** and insurance would be covering at 100%.
?After paying over the $7000, we were still being charged.
? CVS Specialty could see this and so could Cigna. Yet CVS Caremark could not get their programs to communicate with Specialty. They still cant see what we have actually, personally paid out of our own pocket.
? Now we have paid close to $14000 and we would simply like to be refunded the amount over paid.
?We were told every time we called CVS Specialty and Caremark that our conversations were recorded for quality and training purposes so this should all be able to be verified.

We feel that since this has been going on now for over a year and since we were promised a $0 copay on specialty medications, CVS has failed to make good on its contracted obligations. We have verbally appealed, followed through, checked up and done everything in our power to do. Our next steps will be an insurance lawyer.
Business Response
Date: 01/24/2023
January 23, 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 **************** health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on January 11, 2023. Thank you for the opportunity to address the members concern regarding the billing of their specialty medications.

We understand the member is not satisfied with the information provided. In order to review the copay structure more thoroughly with the plan sponsor I will be reaching out to the Account Manager for the **************** to confirm that this isnt an error. All collection letters and balances will still be placed on.

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:12/09/2022
Type:Product 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.
I have submitted (5) several claims for reimbursement of a compound prescription and all of them have been denied on the Caremark Website (I don't want to upload them on here because of my personal information but will provide if requested). This is something that I use daily and order monthly. All claims have been submitted online, on your website it states complete and an explanation has been mailed. I received mailings requesting more information but nothing further. I have worked with two second level support rep that will assisted me. The first level support is absolutely useless!! I am being told that the compounds are not approved drugs but both second level reps said that they are approved drugs. My doctor can provide authorization if needed. I am asking for reimbursement or for all five (5) of these Rx for $66.00 monthly payments or to go toward my deductible. I also have two additional claims that I haven't been able to submit online because of the date, but the second level rep told me there is NO date time limit. I want this matter resolved to my satisfaction as soon as possible
Business Response
Date: 01/09/2023
January 9, 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 DeKalb ***************** health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on December 9, 2022. Thank you for the opportunity to address the members concern regarding the denial of their prescription claims.

Upon review, we have verified that the prescription was received from the members prescriber is a bulk chemical compounded medication. ************** are not covered under this plan. We requested a one- time exception from the plans account team and they denied the request to allow us to reimburse for the prescription that was paid for out of pocket by the member.

Finally, we understand the level of service the member received did not meet with their or our expectations, and we sincerely apologize for any frustration or inconvenience they 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

Customer Answer
Date: 01/10/2023
[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:12/09/2022
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.
TLDR: CVS had a glitch. I paid over $3500, and they refunded less than half.As a two-time cancer survivor, I must take various medications and cannot afford to miss more than 1-2 doses in a week. When my insurance changed from employer-paid to self-pay via COBRA, CVS's computer system had an unspecified error that meant my medication was no longer covered. To be clear, my insurance coverage never lapsed and I had reached my out-of-pocket maximum for that year already. Before this, I had 0% out-of-pocket responsibility. Because I was almost out of my medications I paid for them myself with a promise from the pharmacist that I would be refunded. This happened two months in a row and cost me over $3,500. After the system was fixed I submitted a refund request and received a check for less than $650. Several refills had been mistakenly labeled as duplicates, and few if any of the remaining medications received a full refund. Naturally, I disputed this amount, and after a few weeks, I received another check. This one was for less than $750. When I tried to dispute this again, I was handed to the representative who is paid to just tell the caller "No" in as many ways as needed, up to ignoring what I said. When I called another time I was put in touch with a consumer advocate, who told me that he wished things were different but there was nothing he could do. Apparently, it is company policy to only refund the discounted wholesale amount the company pays, and not the higher price an individual has to pay, despite the fact that the company is at fault for the problem. Most of the people answering the phone were incredibly helpful and friendly, and I understand they were merely messengers carrying bad news. The company policy itself is what is incredibly frustrating and abusive.Cancer is expensive, and if I had not been given money from friends and family to help pay for it my family would have $0 in our bank. This money was not just an inconvenience.
Customer Answer
Date: 12/20/2022
Neither myself nor my spouse have heard from the business in response to my complaint, either by phone, email, letter, personal contact, or otherwise. Since filing this complaint I have had no additional contact with CVSCaremark or any of their employees or representatives. I have not made any additional attempts to contact CVSCaremark, and to the best of my knowledge CVSCaremark has not made any attempt to contact me. The last contact that I recall occurred in November before this complaint was filed, when I made my most recent attempt to contest the amount of the refund provided.
Business Response
Date: 12/27/2022
December 27, 2022

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription benefits portion of the Builders FirstChoice health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on December 9, 2022. Thank you for the opportunity to address the beneficiarys concerns.

CVS Caremark has reprocessed the seven claims submitted for reimbursement. The claims were reprocessed, and the beneficiary will receive a check in the mail for $1,313.52 within **** business days.

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:12/08/2022
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am in need of a specialty medication that prevents me from going into labor early. I have secondary insurance which is ******** that requires this injection to be ran under medical. I am being told that they cannot bill it to medical. I have been working on this prescription since November. I have given my insurance information 4 times and kept being told over and over that they did not have the information. I spent 4 hours on the phone alone today. While having contractions. My secondary is telling me that this can be billed. I am highly upset that this is is putting me and my baby at risk.
Business Response
Date: 01/03/2023
6950 ****************************************************************************** | T: **************

January 3, 2022

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

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 December 9, 2022. Thank you for the opportunity to address the members concerns
regarding Caremark Specialty Pharmacy.

Upon speaking with ********, Office Manager at the prescribers office on December 13, 2022, she
advised that they no longer wished to proceed with obtaining the medication. The member confirmed
that this was accurate on December 13, 2022. The member also confirmed that she had no additional
concerns or needs to be addressed at that time.

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:12/02/2022
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.
For over two years I have had nothing but issues with this organization failing to close an account. My son who is now only four years old cannot get any of his life-saving medications through our family's insurance plan (separate from care ****** such as his Epinephrine, emergency inhalers, or any other medication in a timely matter because CAREMARK continues to create and renew an account within their organization using *******'s information without the authorization of a guardian (Me, his mother). I have spent hours on the phone on multiple occasions with members of the Caremark team connecting back and forth to several departments all of whom have failed to close my son's account. This organization's failure to close this unauthorized and unwanted account has caused my son and me emotional distress and health issues. I called my insurance company Wednesday, Nov 30th, 2022, to once again remove WellCare as his primary insurance account, and by Thursday I had to call again to have them removed. I was told by my insurance agent that ******* renewed his account with Caremark on 12/1/2022. All I have asked from this organization is to close the Caremark account under my 4-year-old son's name so he can stop having issues regularly with his actual insurance. I spent over an hour on the phone with several people from Caremark today 12/2/2022 to close and cancel the account and this matter has not been resolved.
Business Response
Date: 12/03/2022

December 3, 2022

BB
290 *********************************************, Suite 102
***********, ** 01752-4705

Re: 18517053

To whom is *** concern:

This letter is in response to the correspondence we received from your office on December 3, 2022. Thank you for the opportunity to address the member concerns as expressed in File no. 18517053

In accordance with directives implemented by WellCare, all member grievances will be addressed and responded to by the client. CVS Caremark has forwarded the concern to WellCare on December 3, 2022. Please reassign the members concern accordingly. Going forward all WellCare concerns should be sent directly to WellCare. WellCare will partner directly with CVS Caremark regarding PBM concerns. WellCare can be reached at:

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

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

Sincerely,

*************************;
Member Advocate

Customer Answer
Date: 12/03/2022
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 am not satisfied with this resolution because this is an ongoing issue with CAREMARK, not WellCare. CAREMARK continues to make an account for my four-year-old son and renew it. I have never made an account for him, and when I call to cancel, not one Caremark representative has been able to do so. I have never given CAREMARK the authorization to open and renew any account using my four-year-old son's information. This Caremark account under my son's name is fraudulent. I'm requesting that CAREMARK permanently close any account under my four-year-old son's 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: 12/08/2022
December 8, 2022

BBB
290 *********************************************, Suite 102
***********, ** 01752-4705

Re: 18517053

To whom it may concern:

This letter is in response to the correspondence we received from your office on December 5, 2022. Thank you for the opportunity to address the member concerns as expressed in File no. 18517053

In accordance with directives implemented by WellCare, all member grievances will be addressed and responded to by the client. CVS Caremark has forwarded the concern to WellCare on December 3, 2022. Please reassign the members concern accordingly. Going forward all WellCare concerns should be sent directly to WellCare. WellCare will partner directly with CVS Caremark regarding PBM concerns. WellCare can be reached at:

WellCare Health Plans, Inc.
Attn: Grievance Department
P.O. Box 31384
*****, ** 33631-3384
Phone: **************
Fax: **************
Email: *************************

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

Sincerely,

*****************************
Member Advocate
Customer Answer
Date: 12/12/2022
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.

Do not forward my complaint to WellCare. My grievance is with Caremark PHC, LLC. As I mentioned in my original and my last response my issue is with CAREMARK PHC, LLC. As I have already mentioned CAREMARK continues to create and renew an account in the CAREMARK system, using my four-year-old sons information. I have never authorized CAREMARK to use my four-year-old son's personal information. There is no way that my four-year-old son who cannot read or write is renewing an account with CAREMARK. No one else in our household has used or uses CAREMARK. CAREMARK is failing to take responsibility for the situation or resolve this issue. The solution that would be appropriate is for CAREMARK to permanently close the unauthorized account under my four-year sons name. When I contacted CAREMARK customer service in the past, no one had been able to close the account. Not only do I not authorize CAREMARK to use my sons personal information, but I have the right to permanently cancel the account.
Under the Terms and Conditions on the Caremark website, it states the following This Agreement is effective until terminated by either party. If you no longer agree to be bound by this Agreement, you must cease your use of the Service, including any access thereto. Your use of the Service is at your sole risk. If you are dissatisfied with the Service, its content, or any of the terms, conditions, and policies of this Agreement, your sole and exclusive legal remedy is to discontinue using the Service., If this Agreement is terminated for any reason, then:, CVS Caremark may immediately remove from the Service and permanently delete and destroy any Materials that you or others may have posted or submitted to the Service without any prior notice or liability to you or any other person.
Given this information which was quoted directly from the Terms and Conditions of CVS Caremark, why is It that when I call to cancel my four-year-old son's authorized account, your representatives have failed to terminate, delete, and destroy the account/service?

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: 12/27/2022
BBB
290 *********************************************, Suite 102
***********, ** 01752-4705

Re: 18517053

To whom it may concern:

This letter is in response to the correspondence we received from your office on December 12, 2022. Thank you for the opportunity to address the member concerns as expressed in File no. 18517053

In accordance with directives implemented by WellCare, all member grievances will be addressed and responded to by the client. WellCare also responds to all eligibility concerns. CVS Caremark has forwarded the concern to WellCare on December 3, 2022. Please reassign the members concern accordingly. Going forward all WellCare concerns should be sent directly to WellCare. WellCare will partner directly with CVS Caremark regarding PBM concerns. WellCare can be reached at:

WellCare Health Plans, Inc.
Attn: Grievance Department
P.O. Box 31384
*****, ** 33631-3384
Phone: **************
Fax: **************
Email: *************************

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

Sincerely,

*****************************
Member Advocate
Initial Complaint
Date:12/01/2022
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 Specialty ran my ***********pay card through their system and it was declined. They put it through again and again it was declined. I answered their request with the correct co-pay information and I sent it numerous times. I checked on my copay card on the orencia website and it was fine. Then CVS Specialty was that my **********pay card was declined. Again, I resent all information that I had. Then CVS tells me the the **********pay card went through ( I have no idea why it didn't the first time), BUT the orencia is still outstanding with a balance of $3000 + AND it's been sent to collections. I had NO idea. I was not notified about this change.I checked my co-pay card AGAIN, I called and spoke with an Orencia representative and she helped me immediately without any delay and she was so kind. She told me that my ***********pay card is fine, it's always been fine. But that when you run the co-pay in not once but twice and it was declined both times, entering the information electronically is no longer an option. CVS specialty is now required to call Orencia and speak with a rep to fix their mistake that they made back in FEBRUARY. I spoke with numerous billing and care people asking for help. No on would help. They said, "we don't make outgoing calls". I asked to someone else, a manager, supervisior, etc that can help me and she said the only thing she needs to recommend is the collections and she hung up on me. What was I supposed to tell Collections? Please return my account back to CVS specialty so that they can correct my mistake?Now I have NO choice in who fills my ************** for RA. I'm stuck with these imbeciles.
Business Response
Date: 12/09/2022
December 9, 2022

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription drug benefits portion of the Lockheed ****** Corp-LMC plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on December 1,2022. Thank you for the opportunity to address the beneficiarys concerns.

Upon review, the specialty pharmacy confirmed the beneficiary re-enrolled in the copay assistance and the balance was applied to the card on November 29, 2022, leaving a $5 beneficiary responsibility. The specialty pharmacy confirmed the copy assistance is now on the beneficiarys account and is paying correctly. The balance was also removed from collections on November 29, 2022 and the specialty pharmacy confirmed the collection agency does not report to the credit bureaus.

We value our members and remain committed to our purpose, helping people on their path to better health.Should you or the beneficiary have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,

***********************************
Member Advocate
Initial Complaint
Date:11/30/2022
Type:Customer Service Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
CVS not shipping medication,Every time I call they have different issues. Puts on hold/ transferring one ext to another and end call.On one ovation asked for extra money to release this medication. I need to take medication every day and now I am out of meds.I am out of medication
Business Response
Date: 12/09/2022
December 9, 2022

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription drug benefits portion of the Change Healthcare health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on December 4, 2022. Thank you for the opportunity to address the beneficiarys concerns.

Upon review, Caremark received a new prescription from the prescriber on December 1, 2022 which was written to allow for substitutions.The order shipped via **** tracking# ******-622698583 and was delivered on December 5, 2022.

We value our members and remain committed to our purpose, helping people on their path to better health.Should you or the beneficiary have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,

*************************;
Member Advocate
Initial Complaint
Date:11/28/2022
Type:Customer Service Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
CVS Caremark requires you to try 3 meds on their formulary. But because the medication I am prescribed by my doctor does not have a generic, they refuse to pay. My medication cost $300 a month now. I called their customer service line, they lost the forms that my doctor filled out for pre-authorization and appeals. I followed the policy, tried 3 different medications and they still will not approve. When I asked if they could explain my insurance policy, they gave me the run around and couldnt explain how co-pays work.
Business Response
Date: 12/12/2022
December 12,2022

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

Complaint # ********

To whom it may concern:

CVS Caremark administers the prescription drug benefits portion of the Northwestern Mutual Home plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on November 28, 2022. Thank you for the opportunity to address the beneficiarys concerns.

Upon review,we determined the medication in question requires a prior authorization to obtain coverage. A new prior authorization request was initiated and approved for 12 months on December 6, 2022. Additionally, the beneficiary is still in her deductible phase; therefore, she will pay 100% of the drug cost. Once the beneficiary meets her deductible, she will pay 30% coinsurance.

We value our members and remain committed to our purpose, helping people on their path to better health. Should you or the beneficiary have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,

***********************************
Member Advocate
Initial Complaint
Date:11/26/2022
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 child has been taking a medicine called Norditropin for a year. My insurance company asked me to have my medicine filled by *** specialty pharmacy. So I had a prescription for one month (Two 15 mg pens or Three 10 mg pens) sent to the *** pharmacy along with authorization for 1 month. My out of pocket maximum for a one month prescription is $500. My wife spent 80 minutes on the phone with several *** agents on the phone on 11/18/2022. She was told they would send ******* 10 mg pens for about $750 (Rx number ********). My wife agreed and provided payment information and notified them that we did not need education as we had been using the medicine previously. She was told the four pens would arrive on 11/23. They did not arrive and my wife found several messages on an unknown portal (we were never told to look at any portal), asking for duplicate information we had already provided. We communicated with *** on 11/24 and they told us they would send us the four 10 mg pens for a charge of $426. We were told ********* would arrive today on 11/26. My wife went to he local *** to pick up the prescription only to find they they sent one pen rather than the one month supply and wanted to charge us $426. One pens lasts 10 days. We have spent 3 hours trying to obtain a prescription for our child for the correct co-pay and cannot seem to get this done.
Business Response
Date: 12/09/2022
December 9,2022

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

Complaint # ********

To whom it may concern:

*** Specialty Pharmacy was the dispensing pharmacy for the prescription benefits portion of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on November 26, 2022. Thank you for the opportunity to address the beneficiarys concerns.

Upon review,we determined there was a manufacturer shortage for the medication in question.The beneficiary was allowed a onetime override to allow the *** specialty pharmacy to fill the medication, as he could not get the medication at the preferred pharmacy. The order was delivered to the beneficiary on November 23, 2022.

On November 29, 2022 the *** specialty pharmacy set up an overnight delivery to the beneficiarys home. The new order was delivered on November 30, 2022 via *** (tracking 1Z265561NT18927063). The claim from November 23, 2022 was reversed and reprocessed.

We value our members and remain committed to our purpose, helping people on their path to better health. Should you or the beneficiary have any additional questions or concerns, please do not hesitate in contacting me at **************.

Sincerely,

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

Customer Answer
Date: 12/12/2022
[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,

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

BBB Business Profiles may not be reproduced for sales or promotional purposes.

BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.

When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.

BBB Business Profiles generally cover a three-year reporting period, except for customer reviews. Customer reviews posted prior to July 5, 2024, will no longer be published when they reach three years from their submission date. Customer reviews posted on/after July 5, 2024, will be published indefinitely unless otherwise voluntarily retracted by the user who submitted the content, or BBB no longer believes the review is authentic. BBB Business Profiles are subject to change at any time. If you choose to do business with this company, please let them know that you checked their record with BBB.

As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.

Cookies on BBB.org

Complaints

Customer Complaints Summary

If you've experienced an issue

Filter and sort by

Sort by

Complaint status

Complaint type

Complaint statuses

Business Response

Customer Answer

Complaint statuses

Customer Answer

Business Response

Customer Answer

Business Response

Complaint statuses

Business Response

Customer Answer

Complaint statuses

Customer Answer

Business Response

Complaint statuses

Business Response

Complaint statuses

Business Response

Customer Answer

Business Response

Customer Answer

Business Response

Complaint statuses

Business Response

Complaint statuses

Business Response

Complaint statuses

Business Response

Complaint statuses

Business Response

Customer Answer

CVS Caremark is NOT a BBB Accredited Business.