Not resolved

OptumRX has been paying for a particular generic medication that comes on a "card" for months. Per my plan, there is no charge for this generic formula. All of a sudden, this morning my pharmacy tells me that my refill will be $68.15 because OptumRX has refused to pay ANYTHING on this prescription.

So, of course, I get on the phone to Optum...and was told that the reason they won't pay the claim is because the pills come pre-packaged on a card...that if they were in a bottle, they would pay!!! They have been being coming on a pre-packaged card for months! WHAT DIFFERENCE DOES IT MAKE!? It's exactly the same medication!!

So I called the pharmacy back. After they finished laughing, they "reran" the script as if it were in a bottle, and sure enough, it went through at NO CHARGE!


Product or Service Mentioned: Optumrx Prescription Refill.

Reason of review: refusal to pay for RX that has been covered in the past.

Preferred solution: I want a sensible explanation as to why this RX was refused....because it is on a card and not in a bottle is not sensible..

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