After months of filling my prescriptions, with the usual difficulty described by others, but filling them, I had a really terrible customer-service and pharmacy experience, wherein Optum reps lied and misrepresented both themselves and their policies. I spoke with Shanna Smith (714) 825-6832 of the president's office escalated customer service and it was resolved as she herself said, "they call the pharmacist area "the cage", ours should be in bigger cages."

But, the following month, only minutes after calling customer-service and being told all was well and I would get my scripts on time in two days -- I received a call from Ms. Smith who was extremely aggressive in sharp contract to her previous helpful tone, and she read me a statement saying that Optum had sent a note to my doctor "dictating" their policy of requiring a prescription for pain medications to contain 80% extentended release medication and no more than 20% immediate release.

I was in shock, at age 62, having broken my neck in the service of our nation and with several very serious resultant medical conditions, being informed at 5 PM on Friday that my prescription was being stopped, when everyone knows it is timed to be refilled only as it runs out, basically means that OptumRx was informing me to prepare to go into withdrawal, as there was not time to replace the medicines with another vendor before that would happen! [Note, I have a perfect record in every way, I take only a small dosage and have been praised by many doctors as a"perfect" full-compliance patient.]

The president's office was unable to explain further and refused to answer any question, but only red their short statement over and over. Then after an hour on hold, they conferenced in a pharmacist who said that "these medicines are impossible to get in Florida, Optum is your only option, follow the policy we "dictate" (they really use this word) or try to find another place to get your pain medicine, I doubt you will be successful." When I tried to ask any questions, again all he did was read a short script about the policy the "dictated". When I formally requested his pharmacy license number, he refused as did the president's office, even though state law requires he provide it.

Just a week earlier a pharmacist also with OptumRx had explained that for many patients short-acting pain medications are far better than extended release because they can be taken only when needed, thereby far reducing the required daily dosage and also significantly reducing serious side effects. But now, contrary to their own pharmacists' professional advice, OptumRx was "dictating" to me and to my very highly credentialed doctor only to prescribe long-acting medications!

Aside from the issue of dictating to prescribing doctors, why, after months of filling the medication on a regular monthly basis, did OptomRx deny the medication at the very last minute? What could they not have begun thirty days or even sixty days earlier. Why are they doing it in a manner tailored to put a bona-fide patient into withdrawal?! And why is their manner so aggressive and abusive of a sick patient, on the phone, with no explanation.

It all makes no sense at all. This is a company owned directly by United Health Care (regardless of their denying this) and really suggests that both organizations should not be in business in the United States.

Product or Service Mentioned: Optumrx Prescription Refill.

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Orlando, Florida, United States #936356

After 2 years of filling my pain meds monthly with Optum Rx I W's told the same thing. I too live in Florida.

I think its the worst thing they could do to us. Is this a new policy for everyone? Or are they just making things worse for Fl residents? Its bad enough that most pharmicies here wont fill narcotic scripts and the few that do are always out of everything.

What do we do? Since when is the pharmacy better at prescribing the types of meds we need than our own doctors? I THINK ITS ABOUT MONEY-WHY SHOULD THE FILL THE CHEAP IR MEDS WHEN THE CR MEDS ARE 1000 TIMES MORE EXPENSIVE!!! I was paying my 8.00 copay but my ER med after 3 monthswere 18.00 a pill!!!

Someone needs to help the people that truly need these meds. The druggies on the streets will still be on the streets and people like us will be in withdrel in bed!!

We are having the exact same problem. My husband is also 62 years old and has been a chronic pain management patient since 2000.

He is fully disabled.
He has steadily decreased the amount of pain medication he takes over the years. Years before and without pain medication, he is completely bedridden. It frightens our children so badly to see their Dad this way.

It's gut-wrenching for the entire family!
We have used the same pharmacy (CVS) at the same location for over 30 years (when it used to be Eckerd's).
We have never had a problem until 3 months ago. Our long-time pharmacist who my husband went to high school and college with, pulled us aside and told us the DEA had just left and threatened to suspend the pharmacists' licenses if they continued filling pain medication.
He said, "The day they came in, I couldn't believe I was in America."
We were forced to use the Mail Order Pharmacy Benefit Manager of our health plan (OptumRx).

After two visits, OptumRx wrote my husband's specialist stating they would no longer fill his prescription unless they reduced his short acting pain medication by one pill a day. It had just been reduced by 6 percent prior to moving to OptumRX. Why bother to see a specialist? Why don't we just allow pharmacists to write the prescriptions?

My father was in school well over a decade to become an otolaryngologist (ear, nose and threat surgeon). My pharmacist went to school for just five years. Yet, the pharmacies/pharmacists are now over-riding physicians and dictating the amount of medication OUR PHYSICIAN DEEMED APPROPRIATE. In our case, my husband has not see just one physician.

He is treated by several specialists and over the years we have been to see dozens at the Mayo Clinic, Duke, Bethesda, etc. Not one has ever disputed his need for pain medications or any of his other treatments (TENS Units, Accupunctuire, Chiropractic, etc,) We have contacted lawyer and lawyer to no avail but we're not willing to give up yet. The War on Drugs started by former President Richard Nixon is a FAILURE. Instead of getting drug kingpins, the DEA now targets physicians and pharmacists.

Pathetic! When will the public and our representatives wake up and realize ADDICTION IS A FAMILY DISEASE. Abusing substances is ONLY THE SYMPTOM of much more deep-rooted psychological issues that must be addressed at the FAMILY LEVEL. Some medications have been around a half-century or more - yet the DEA is just now targeting them for abuse; and pharmacists are passing this on to burgeoning senior population.

Why not take it up with the manufacturers ? The only thing that has been achieved through the WAR ON DRUGS is more prisons than schools; and the chronic suffering and lowered quality of life for people (particularly seniors) who have served our country and worked hard all of their lives!!!

I want to know how to fight this and what to do - aside from writing the CEO's, my congressman and representatives. Any ideas?
Florida, United States #862354

This post was great. I called her too.

Parkland, Florida, United States #793642

I also live in Florida and having a problem with Optumrx. I was in a very bad car accident years ago and when given my maximum medical recovery was told I could never hold a job involving standing or sitting.

Unfortunately being a widow in my 40's (not eligible for my late husbands social security)I have to work and this is affecting my livelihood My medication is almost impossible to find especially in my county and regulations state that it can't be filled outside my county so I turned to Optum. The first month went smoothly and now I am being told they won't fill for my doctor.

They said if another doctor had written the same thing it would be filled, keeping in mind it was filled the previous month. His license is in good standing and has no violations but did have a problem with a pharmacist there, so now he is on a "list" and I have received nothing but lies, including when my prescriptions were sent back-post marks don't lie but this company does


Holy *** we have UHC/UBH as our medical/mental health insurance and in NJ they just made the switch to OPTUMRX-today our first encounter with customer service was a DISASTER!!!!PRINCIPAL LIFE INSURANCE COMPANY SHOULD BE EMBARRASSED OWNING/USING OPTUMRX!

Alton, New Hampshire, United States #647714

I can't believe this company! I have just run into this situation myself, they are dictating 80% of my pain meds need to be long acting, do they even have the right to demand this?

They put my Rx on hold but never contacted my Dr, they received my Rx on 5-2-13 and after getting 6 different stories, I finally demanded to speak to a pharmacist who then informed me that they will "probably" fill this month since this is the 1st time they have even mentioned their so called 80/20 policy, but they need to hear from my Dr and they didn't bother trying to contact them until 5-7-13!! This is insane!!

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