Mission Hills,Kansas
Not resolved
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My Dr. lowered my dosage of meds for my kidney transplant.

I was told it was not on my plan to purchase meds locally. My Dr. wanted me to take the new dose that evening. I was told I could do it.

I paid for a refill for another med and paid for the new RX. The local pharmacy called me and told me I needed to call and request the new meds. I had done that. I even paid for them.

The rep told me the pharmacy could call them, and they would get it. I called back to Optum, explained my situation. The representative put me on hold, and then accidentally connected me into the conversation with the resolution specialist. She told me my plan did not allow me to buy locally.

She put in a request for an override, so I could get them locally. She told me to call back in an hour to see the status of the override request. I did. The rep put me on hold.

Came back and said the help desk.. the dept the override request went to said the local pharmacy should have called the help desk. I told her the pharmacy did call and they were told I needed to request the Rx is filled. She put me on hold.

She came back and said the help desk says to check your plan.. I said, the resolution specialist told me it is not on my plan to buy locally. She requested an override in two places to get my meds for tonight. My Doctor wants me to start them tonight.

She put me on hold. I waited 30 minutes, and the phone rang. Another woman in another department picked up. She looked at my file, and said I needed to talk with someone in the specialty pharmacy.

I was put on hold. Another representative answered, and she informed me I needed to call the insurance company for the override. I asked to speak with a supervisor. The supervisor came on the line, and she told me I needed to request the override from the insurance company.

I was very angry.. I had been dealing with this since3:30 pm, it was now 6:30. I asked why the resolution specialist who worked at Optum would have put in a request for an override and would not have told me I needed to do it. Long story short..

You CANNOT always TRUST what they say. I ended up buying a 10 day supply locally for $68.00. I was told I could not be reimbursed. I think if I am mandated to purchase my meds via mail-order.

They should be mandated to deliver them when needed or I should have the option to have coverage locally when my Dr. wants a change for my health

Product or Service Mentioned: Optumrx Prescription Refill.

Reason of review: Poor customer service.

Preferred solution: Change the policy. Allow customers to have meds locally when a change is made to med regimen, or be able to deliver via mail that day..

I liked: Some reps who tried to help.

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