Business Profile

Health Insurance

CVS Caremark

Headquarters

This business is NOT BBB Accredited.

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Complaints

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

Customer Complaints Summary

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:02/07/2025
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 told ********************** to stop calling me at ************. CVS called me from ************ on 2/7/25 at 9:46am. If *** wants to reach me, it can do so via e-mail.
Business Response
Date: 02/14/2025
February 14, 2025

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 10, 2025. Thank you for the opportunity to address the members concern.

Upon further review, the member was being contacted by the ************** Program. The phone numbers in question have been added to the enterprise wide Do Not Call list.

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

Sincerely,
********* *******
Advocate

Customer Answer
Date: 02/16/2025
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.
After filing this, I got a call again from CVS...at 8:15 in the morning! CVS owes me $250 for the call under Michigan law.

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

FAQ

Regards,
*******

Business Response
Date: 02/19/2025
February 19, 2025

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 18, 2025. Thank you for the opportunity to address the members concern.

As previously stated in our response on February 14, 2025, the phone numbers in question were added to the enterprise wide Do Not Call list. Our research indicated no phone call attempts to the member since February 11, 2025.

Additionally, the outbound calls that were placed to the member on and prior to February 11, 2025, were not automated or telemarketing calls. The calls were from live nurses of the ************** Program designed to help members find the answers and support they need to manage their health care needs and maximize their overall health status.

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

Sincerely,
********* *******
Advocate
Initial Complaint
Date:02/07/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I HAVE E BENEFIT CARD ON FILE THROUGH ******. I WAS RECENTLY CHARGED $60 UNITED STATES CURRENCY. THE BENEFIT CARD IS ON FILE, AND IT ASSIST IN MAKING THE MEDICATION AFFORDABLE DROPPING THE PRICE DOWN TO ZERO DOLLARS AND ZERO CENTS. I WAS RECENTLY TOLD I WAS CHARGED BECAUSE THEY DID NOT HAVE MY BENEFIT CARD. I RECENTLY TALKED TO SUPERVISOR ******* *., AND HE SAID HE TOOK CARE OF THE ISSUE, THAT HE FOUND MY ASSISTANCE PROGRAM AND MADE SURE IT WAS ON MY FILE, AND PROMISED ME ON A RECORDED LINE THAT THE $60 WILL BE REINBURSED, AND I WOULD NOT HAVE TO WORRY, BECUASE HE MADE SURE MY BENEFIT CARD WAS ON FILE FOR FUTURE REFILS AND ANY ISSUES. I CALLED AGAIN AND AS PER REPRESENTIVE, THE SUPERVISORS REFUSE TO TAKE YOUR CALL AND I HAVE TO TALK TO BILLING. ******* FROM BILLING SAID WE DO NOT HAVE YOUR BENEFIT CARD ON FILE AND WE ARE UNABLE TO HELP UNTIL WE GET THE BENEFIT CARD. WE THEN TALKED TO ******* FROM ESCALATIONS TEAM WHO SAID WE WILL CREDIT YOU, WHICH WAS NEVER DONE YET. I THEN ASKED TO TALKED TO A SUPERVISOR AGAIN, EVEN TALK TO SUPERVISOR ******* S WHO MADE THESE BROKEN WORDS AND PROMISES OR ANY SUPERVISOR AND WAS UNABLE TO BE ALLOWED TO SPEAK TO A SUPERVISOR OR ******* S (SUPERVISOR). I WANT MY REINBURSEMENT IMMIDETIALTY BCECAUSE IT CAUSED ME TO HAVE AN OVERDRAFT IN MY ACCOUNT AND GOT CHARGED $60 OVERDRAFT FEE. I WOULD LIKE THE TOTAL OF $120 TO MY ACCOUNT, $60 FOR THE CHARGE OF MEDICATION, AND $60 FOR THE OVERDRAFT FEE. I STILL HAVE NO REINBURSEMENT. I ALSO WANT THIS BUSINESS LOOKED INTO WHY THE SUPERVISORS REFUSE TO TAKE CALLS AND HIDE, AND WHY BROKEN PROMISES ARE GIVEN OVER RECORDED LINES.
Business Response
Date: 02/10/2025
Thank you for contacting BBB about your recent experience. At CVS Pharmacy we value your feedback, and your experience is very important to us.

I am writing with hope to obtain additional information about your correspondence. I would greatly appreciate your time in providing more details around your prescription and the department you spoke with to better serve you. Please confirm if your prescription is handled by a retail location, CVS Specialty, CVS Caremark or another team within CVS.

Once we receive this information, I can have someone reach out to you to discuss your experience.
Customer Answer
Date: 02/11/2025
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

CVS SPECIALTY. Nothing resolved or discussed to move forward in anyway. No refund issues still after multiple promises. I had my ambassador call from revoke and she spoke to Spoke with ******* *. ************. Billing line his extension 103 7076. On 2/10/25 at 3:30pm. Called by ******* from pfyzer my enbassador for the medication pfyzer. He said a manager was going to call me that night on 2/10/25. Not one phone call given from management either. Thats a total of 3 lies and broken promises by cvs Specilty

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

FAQ

Regards,
****

Business Response
Date: 02/14/2025
February 14, 2025

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 13, 2025.
Thank you for the opportunity to address the members concern.
As a courtesy, Caremark Specialty is providing the member with a $60 refund. A paper check is being
issued. Please allow 7-10 business days to process the refund.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.

Sincerely,

***** *******
Member Advocate
Customer Answer
Date: 02/19/2025
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

no check was received by this company. I been checking and checking the mail service with no results

FAQ

Regards,
****
Initial Complaint
Date:02/03/2025
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.
Hello, I have been trying for months to settle an issue I've had with CVS Specialty egregiously overcharging for fertility medication, and refusing to answer questions about what they were costing me each time I called CVS Specialty and Caremark. Examples of CVS Specialty Overcharging: - ********* 900 IU 4 orders cost me $10,492 at CVS Specialty. Since I found out how much CVS Specialty overcharges for this medication, I have filled it at 3 other pharmacies in **, paying $2,800 for the exact same brand of medication, dosage and quantity. How does *** Specialty justify a $7k profit on one order? I have a hard time believing *** Specialty pays more for these drugs than small independent pharmacies - ******* 75 **************** $5,890 at CVS Specialty. Since I found out how much CVS Specialty overcharges for this medication, I have filled it at 3 other pharmacies in **, paying $2064 for the exact same brand of medication, dosage and quantity. How does *** Specialty justify a $3k profit on one order? I have a hard time believing *** Specialty pays more for these drugs than small independent pharmacies - Ganirelix 6 syringes cost me $1,324.93 at CVS Specialty. Since I found out how much CVS Specialty overcharges for this medication, I have filled it at 3 other pharmacies in **, paying $450 for the exact same brand of medication, dosage and quantity. How does *** Specialty justify nearly a $1k profit on one order? I have a hard time believing *** Specialty pays more for these drugs than small independent pharmacies I am upset that this information was hidden from me, and I have now blown through my entire fertility benefit on medication from CVS Specialty. As stated above, I requested this information multiple times from CVS Specialty and Caremark, and also asked for accumulator information from my health insurer (UHC) that never included pharmacy claims due to *** not providing the claims information to ***. Please contact me with a plan to resolve this.
Business Response
Date: 02/06/2025
February 5, 2025

BBB serving *********************, *****, ************, and *******
5 Mt. *********. ************************* **********
Phone:************

Complaint #: 22893826

To Whom it May Concern,

This letter is in response to the correspondence we received from your office on February 3, 2025. Thank you for the opportunity to address the member's concerns.

Our records show, the plan has been in contact with the member about this matter. The member should direct all questions to the plan. The plan phone number is found on the back of the members ID card.

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

Respectfully,

****** ****
Advocate
Customer Answer
Date: 02/06/2025
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.]
The plan has not been in contact with me, and in fact, ****** (the resolutions specialist involved in my case) has not responded to any of my messages this month. This is unacceptable. My employers benefits team is involved as well now, as no one from Caremark will help!

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

FAQ

Regards,
*********

Business Response
Date: 02/18/2025
February 18, 2025

BBB serving *********************, *****, ************, and *******
5 Mt. *********. ************************* **********
Phone:************

Complaint #: ******** - Rebuttal

To Whom it May Concern,

This letter is in response to the recent rebuttal submitted on February 10, 2025.

Caremark customer care and CVS Specialty can assist the member with order placement and order status. All other questions or concerns should be directed to the members plan.

The plan has setup a single point of contact with the member. The member can contact the plan with the phone number found on the back of their ID Card.

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

Respectfully,

****** ****
Advocate
Initial Complaint
Date:02/01/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
CVS Caremark does not fully disclose estimated costs of medication. I was told on a phone call to CVS Caremark that if I switched my medication to a preferred pharmacy, then the cost would go from approximately $1,300 to $400, which was an absolute LIE. The preferred pharmacy that I was told to utilize is ***, which said my insurance wouldnt cover it. The *** Weight Loss Program is an absolute crock of s*** with no reliable information to be found ANYWHERE. If you call, you will have to call MULTIPLE times and be fed misinformation. Because I was told my prescription was going to be approximately $415, I spent the remainder of the difference between the original $1,300 I was quoted and the new price which was NOTHING BUT A LIE. I now do not have enough money to purchase said medication based on a lie from a CVS Caremark representative that is obviously incompetent or lies! How can a company get away with spreading such false information and jeopardizing their consumers health. I request that the call records to CVS Caremarks customer service department be pulled an investigated for fraudulence.
Customer Answer
Date: 02/12/2025
I have not heard from the business in response to my complaint.
Business Response
Date: 02/14/2025
February 14, 2025

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 1, 2025. Thank you for the opportunity to address the members concern.

During our review of the members interactions with our customer service team, we identified areas of improvement and have asked management to review this matter for coaching, training, and process improvement opportunities.

Additionally, information about the Weight Management Program is available at **************************.

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,
********* *******
Initial Complaint
Date:02/01/2025
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.
CVS Caremark stalled my prescription being filled in December. They didn't notify me that they were stalling it, nor why they were stalling it. The pharmacy informed me a few weeks after I first requested the prescription to be filled that CVS Caremark had denied it, claiming I needed a prior authorization. The pharmacy then worked with my doctor to get this completed. By the time this was completed it was the evening of December 31st and I was unable to pickup my prescription that day. So when I went to pick it up during the first week of January, my cost had gone from $0 to $47.96. When I contacted CVS Caremark to explain to them that their delinquent communications had resulted in this increased cost for me, I was put through a message series with 6 different "customer service ***** who didn't read previous messages and gave me information that wasn't even relevant to my questions. CVS Caremark did not notify me my prior authorization had expired, they then stalled my prescription being filled, and I have zero doubts this system is setup this way to make them more money and continue to deny their customers ******************** in order to increase their profits. I want CVS Caremark to reimburse my $47.96 and to ensure that when their "prior authorizations" (which are ridiculous in the first place) expire they notify their customers of this issue.
Business Response
Date: 02/14/2025
February 14, 2025

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on February 1, 2025. Thank you for the opportunity to address the members concern.

The requested medication is a formulary drug for the members plan and requires prior authorization.
The member had an approved prior authorization for the requested medication on file until November 16, 2024.

On December 31, 2024, the members prescriber submitted an urgent prior authorization request for the requested medication that included the clinical information required for approval and the prior authorization request was approved until December 31, 2027. An approval letter was sent to the member and their prescriber. CVS Caremarks records show a paid claim for the requested medication on January 24, 2025.

Additionally, the members claim of $47.96 for the requested medication was applied to their 2025 deductible amount. Once the members deductible is met, the member will be responsible for 20% coinsurance for the remainder of the plan year.

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

Sincerely,
********* *******
Advocate
Initial Complaint
Date:01/31/2025
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 submitted claims only 3 times with CVS caremark, and all of them get declined. My ***** insurance provider *** told me I can get reimbursed by CVS caremark for my medication and covid test. Then I submitted 3 claims in Dec, 2024. 2 of the 3 claims are for covid test I purchased on local ****************, and I get declined. 1 of the 3 claims are drugs I was prescribed in ***** as a cure to my emergency dummy pain. The reason they declined is because "US doesn't have the medicine". Firs of all, I was traveling at that time, and cannot come back to ** to get a US medicine at that time. Second, the health provider in ***** using their professional judgement to decide the best medicine for my symptom. The Chinese medicine works better than all the available US medicine in *****.
Business Response
Date: 02/10/2025
February 10, 2025
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on January 31, 2025.
Thank you for the opportunity to address the members concern.
Effective May 12, 2023, OTC COVID-19 test kits (with or without prescription) are no longer covered by
the plan.
Additionally, the member submitted a paper claim request with no NDC (National Drug Code). The
medication is not available domestically. As a result, the paper claim request was denied.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.
Sincerely,
*******************
Member Advocate
Customer Answer
Date: 02/10/2025
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.
According to my plan, the reimbursement of a drug is not going to get denied because the drug is not available in the **. Im using a PPO medical plan, and the coverage is not restricted in the ** only.

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,
Yan

Business Response
Date: 02/20/2025
February 20, 2025
BBB serving *********************, *****, ************, and *******
5 Mt. *********. Suite 100
***********, MA 01752-1927
Complaint # ********
To whom it may concern:
CVS Caremark administers the prescription benefits portion of the ********** health plan, of which the
beneficiary is a member. This letter is in response to the correspondence we received from your office
on February 11, 2025. Thank you for the opportunity to address the beneficiarys concerns.
Th member is requesting reimbursement for Covid tests that were covered under the plan through May
21, 2023. Additionally, the prescription that was filled out of the country, was an over-the-counter
purchase and does not have a United States equivalent. As a result, these requests for reimbursement
were denied.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.
Sincerely,
*******************
Member Advocate
Customer Answer
Date: 02/20/2025
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

The prescription filled out of the country is not an over-the-counter one. By assuming it is an over the counter and ignore the prescription is not a good attitude. You said, as long as the drug doesnt exist in the **, then the reimbursement will be declined, can you quote the insurance agreement for this?

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,
Yan
Initial Complaint
Date:01/29/2025
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.
On 01/04/2025 I filled my prescription and my deductible was met. On 01/09/2025, the insurance went back and reprocessed the claim so that $3400.00 was taken back off of my deductible therefore $0 of my out of pocket is being met. I've spent over 10 hours on the phone trying to resolved this but the insurance is asserting that my plan has "true accumulations" which means that copay assistance would not apply toward deductible. However, my employer DOES NOT engage on true accumulations on their insurance plan. I have no documentation to show that they don't because none exists-it is not not mentioned in the plan language AT ALL. Please help me get the pharmacy to reprocess my claim correctly. I'm a cancer patient and I'm supposed to start with a new cancer center in about a week but I won't be able to if I can't get this issue resolved because I have an $8500.00 out of pocket max so even with copay assistance, I struggle to pay my medical/pharmacy bills.
Business Response
Date: 02/04/2025
February 3, 2025

BBB serving *********************, *****, ************, and *******
5 Mt. *********. ************************* **********
Phone: ************
Complaint #: 22823085
To Whom it May Concern,
This letter is in response to the correspondence we received from your office on January 30, 2025.
Thank you for the opportunity to address the member's concerns.
There was a coding issue that prevented the members copay from applying to the deductible as
intended. The issue has been resolved. Several attempts were made to speak with the member and
provide them with an update.
We value our members and remain committed to our purpose, helping people on their path to better
health. Should you have any additional questions or concerns, please do not hesitate in contacting me
at **************.

Respectfully,
****** ****
Advocate
Customer Answer
Date: 02/04/2025
Better Business Bureau:

I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.
However, it did take me over 17 hours on the phone to get Caremark to even believe me that there even was a problem. I had an appointment coming up with a new oncologist, almost had to miss it and I was very concerned that the frustration was going to cause a medical emergency for me.
Caremark did leave some messages to let me know that it was resolved but left confusing information that I was going to receive a check which will cause additional confusion because I never paid for the medication. The messages only leave a call center callback number and I won't spend another two hours starting over with a new agent.
Although resolved, I'm bitter about the fact that this happened.

Regards,

***** ******
Initial Complaint
Date:01/27/2025
Type:Product Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I contacted CVS Caremark because my wife was unable to pick up her prescription from CVS. The customer service representative explained that the issue was caused by an incorrect date of birth listed in their system, which prevented her from receiving the medication. I then asked if I would be reimbursed for the cost if I paid for her prescription out of pocket. The representative assured me that any out-of-pocket expenses would be fully reimbursed.The amount of the purchase is ****** which is the amount I'm looking to be reimbursed.I purchased the medication on December 27, 2024. CVS Caremark sent me a letter denying any financial reimbursement without any reason.
Customer Answer
Date: 02/07/2025
I have not heard from the business in response to my complaint.
Business Response
Date: 03/06/2025
March 6, 2025

(Via Manage BBB Complaints System)
Better Business Bureau
5 Mt. *********. Suite 100
***********, MA 01752-1927

Re: ***** *****
Your Case No. 22865775

Dear Sir/Madam:
This ****** is in response to the correspondence we received from your office on January 30, 2025, and the complaint filed by ***** ***** (the Member). Thank you for the opportunity to address Mr. ***** concerns.
Our records show that Caremark reprocessed the Members claim on February 20, 2024. The Member should already be in receipt of the reimbursement.
We value our members and remain committed to our purpose, helping people on their path to better health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.

Respectfully,
****** ****
Advocate
Initial Complaint
Date:01/27/2025
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.
*** delayed processing and shipping of medications. They have been unresponsive to multiple complaints and attempts to get information on delays.
Business Response
Date: 01/27/2025
We appreciate ****** ***** sharing his concerns and the opportunity to address them here.

In order to assist, we will need more information to proceed. Please confirm if the medications are being mailed through CVS Caremark mail service, or if mailed from a retail pharmacy, please provide the store location. Please also provide the order number.
Customer Answer
Date: 01/28/2025
Order number ********** is the order number for ****** that I will have been out of for 3 days by the 29th my original complaint made it quite clear that this was mail order and not ordering from a store. As terrible as ********* is they still do a far better job the CVS Caremark.

Regards,
******

Business Response
Date: 02/04/2025
February 4, 2025
BBB serving *********************, *****, ************, and *******
5 Mt. *********. Suite 100
***********, MA 01752-1927
Complaint # ********
To whom it may concern:
CVS Caremark administers the prescription benefits portion of the PACIFICSOURCEHEALTH PLANS health
plan, of which the beneficiary is a member. This letter is in response to the correspondence we received
from your office on January 30, 2025. Thank you for the opportunity to address the beneficiarys
concerns.
The member signed up for auto refill/renewal on January 9, 2025, and at that time they were educated
on how the program works. The member received their order on January 29, 2025, via *** at 9:59am at
the front door.
The member will receive alerts approximately 23 days prior to running out of medication and the alert
will indicate the next processing date. If the member needs an earlier fill for any reason, they will need
to contact ************* at **************.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.
Sincerely,
*******************
Member Advocate
Customer Answer
Date: 02/04/2025
The pharmacy did not fill or ship the medication in a timely manner. The pharmacy did not respond for a request for follow up. The amount used per day per the ** and total amount dispensed is not debatable based on instructions in the ** they should have filled it and shipped it sooner.
Regards,
******
Initial Complaint
Date:01/25/2025
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 the last 10+ years Ive been having issues with CVS Caremark specifically for engaging in ethical behavior for the specific and deliberate purposes of padding their pockets with money that is not intended for them but for me. I have a co-pay assistance card with Trial Card (Gilead Advantage) for the specific purpose of paying my deductible and any co-pays so that I can receive my medication for free. It is for the patients benefit only! (Me) Im approved for up to $7200 which should be more than enough to cover my $3300 deductible and $150 monthly copay. The issue is that they bill the co-pay assistance and drain the full $7200 and then come after me for the $3300 and co-pays of $150. Thhey wont apply it to my deductible and take all the money for themselves which is a violation of the *** for the co-pay assistance as its for the patients benefit only. For many years I have fought CVS Caremark in getting my medication, Ive reached out hundreds of times to them while they gave me the run around. Every year I spend 100s of hours fighting to get my medication. Every year eventually the issue gets resolved and they promise to never fight with me again. In 2024 they promised me that my co-pay assistance had been forever removed from my account and that they would never bill them again. I have to pay the charges upfront on my credit card then submit to the co-pay assistance myself for reimbursement so that it applies to my deductible and I can then pay the $150 the rest of the year. On 01/01/2025 I requested a fill of my medication at the cost of $1862.55. I was supposed to be billed and subsequently pay and get reimbursed from co-pay assistance. I received my medication but did not receive a bill and it showed $0 online and nothing applied to my deductible.
Customer Answer
Date: 02/04/2025
I have not heard from the business in response to my complaint.
Business Response
Date: 02/14/2025
February 14, 2025

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

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on January 27, 2025.
Thank you for the opportunity to address the members concern.
On January 24, 2025, the refund to the copay assistance card was completed. The copay assistance card
information was removed from the members account. The member can check the account balance on
the specialty website. Member has been assigned a single point of contact within Caremark Specialty.
The new point of contact will reach out to the member.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.

Sincerely,

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

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