Lake Hopatcong, New Jersey
Not resolved
1 comment

New to medicare and United Healthcare & OptumRX. Surprised to see that AARP, United Healthcare & OptumRX are seemingly 3 legs on the same table, which may be why it can't stand up to scrutiny.

Signed up in October 2015. Reviewed drug formulary to see which drugs they cover. My drugs were all covered by the insurance and OptumRX formularies. I had new prescriptions on all, with refills, so I didn't order anything until the doctor called in my prescriptions on 12/23/2015.

Messages began showing that Metaxalone was covered. So, where is my order right now, in the files. There were more messages and calls back and forth between Optum and me, and my doctor and optum, and me and my doctor, saying Optum needed this or that. Doctor needed to this or that.

I had to do this or that. Only party doing nothing is OptumRX. Turns out they pulled a bait and switch on me. The formulary was the reason that I chose United, who is recommended by AARP, whose mail order pharmacy is OptumRX.

My drugs were all on the Formulary when I enrolled. January 1, 2016, they changed the formulary to exclude Metaxalone. Had they filled it in December, I would have a 90 day supply. As it stands, I have nothing.

My doctor suggests an alternative. There are no appropriate alternatives on the formulary. Furthermore, the customer service is beyond horrible. They all speak English and yet, only appear to speak from a prompter, a script.

The different departments that they switch you to, know nothing more than the original rep. I have a serious condition that warrants specialty drugs. Neither the specialty drugs dept. nor the prior authorization department are worth the energy it takes to call them.

They have no personal adviser to take on a complicated, messed up system of errors and take responsibility to see it through, get it straightened out, resolve the issues, and make contact with the patient and/or the doctor to mediate the problems. This system is broken and these companies need to stop conspiring to make their system impossible for their paying clients to have success navigating. This system needs to take some pride in their outcomes for their clients, rather than take pride in doing nothing but agitate and switch formularys. How can they show formularys in October that will change in January without notice of intent.

This is a once a year decision.

They know you're stuck with them and take full advantage of that knowledge.

Reason of review: Bait and switch drug formulary and horrible customer service.

Preferred solution: Deliver product or service ordered.

I didn't like: Customer service, Order fulfillment, Cheaters.

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This is the worse customer service ever. I challenged a response from one of the representatives and she put me on hold for over 20 min.

I stayed on I till 30 mins so then I can go through the process all over again. This company sucks and raises prices all the time. UNREAL. Paychex was looking for an alternative so they can make their 3 Billion dollar profit.

Thank you Paychex. You suck just as much as this company.

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