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After OptumRx took control of United Health, they started to drop pharmacies from their networks citing they want a closed network. No offer of contract was even allowed.

This happened to NYS Medicaid Choice programs and Oxford. In the case of Oxford, no notice was given. NYS Medicaid was contacted and said that they have no control over OptumRx's decision. Bottomline is that OptumRx is competing with the other major insurance companies to grab clients but reduce costs by reducing access.

In addition, they cheat their clients by making them pay the full copayment even though the calculated cost is less. They then deduct that from the pharmacy's fee. For example, the contracted price for Drug A is $4.00 and the patient's copayment is $15.00.

They tell the pharmacy to collect the $15.00 copay (via adjudication) and then they subtract $11.00 from the pharmacy's account. Other PBM's usually would just they the pharmacy to charge the patient $4.00 and end of story.

Reviewer is in unhappy mood. Please immediately contact the author of this review to discuss poor customer service of a product or service. OptumRx needs to read this review and look into the issue (if any) according to poster's claims.

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Anonymous
Minneapolis, Minnesota, United States #1248116

OptumRx has been doing patient clawbacks; you unfortunately are not the first patient this has happened to and you will not be the last. My suggestion: file a complaint with your state Attorney General's office.

What OptumRx is doing to you is basically charging you an additional amount for an insurance premium you have already paid for, and that is tantamount to theft.

Please do not sit back and let them take money from you and thousands of others across the country. I am a pharmacist consultant, have been in the business for 46 years, and have never seen pharmacy benefit managers this bad before; the only benefit they are interested in is their own.

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