I'm another very unhappy, very frustrated CalPERS OptumRx customer. Their price for a brand-name med is $100.
Caremark's price was $40, which was bad enough. For one of my meds, THERE IS NO GENERIC. I too experienced immediate denial of another drug, saying that it required prior auth. But within 24 hrs they denied it again, not giving my doctor time to send in the prior auth form.
Finally they approved it, it was one of those $100 no-generic drugs. Fortunately I know a little about medicine so I went on line to see if I could find a substitute. I found a substitute, but it's 2 pills rather than one, which is OK with me. So the Dr sent in 2 Rx's.
They approved one but required PRIOR AUTH for the other, even though it's the same as part of the drug in the brand name. Again, after telling the doc it required a prior auth, they denied it within 24 hrs ON THE WEEKEND, not giving him a chance to send in the prior auth. This constitutes harassment of my doctor. You can imagine how much doctors like having their time wasted like that.
I called OptumRx & told them to send the prior auth form AGAIN, and now they've done that, but Optum told me I should have the Dr's ofc call ME when they get the PA form so I can call Optum to tell them the Dr has it and will be sending it ASAP. That's where it stands right now. If they deny this part of the drug again, I'll have to order it from Canada. PERS SHOULD PUT A STOP TO THIS HARASSMENT BY OPTUM RX.
The stress this puts patients under is likely to cause higher blood pressure and anxiety for which the patient may have to start taking a new med. FOR GOD'S SAKE, PERS: Make OptumRx change their customer service so that it's actually service!!!!!
Product or Service Mentioned: Optumrx Prempro Prescription Refill.
Reason of review: Pricing issue.
I liked: Drugs usually delivered fast.
I didn't like: Customer service, Policies, Increased price of non-generic drugs 150 pct, Chg xtra 4 brand when no generic, Paranoia abt opioids even tho theyre rxd.