How CVS Caremark Puts Patients at Great Risk

03.17.11

Last summer I was diagnosed with Rheumatoid Arthritis. I went to see a rheumatologist after the pain in my hands became so unbearable that I was taking ambien and handfuls of Advil while attempting to uncurl my hands and sleep with them under my stomach. The Advil helped with a bit of the pain, the Ambien allowed me to sleep through worst of it. Sometimes. I was plagued with fatigue and felt depression moving in as my ability to function lessened.

I guess what I’m saying is that RA wasn’t about me feeling achy. It was ruining my life and my family’s life.

Untreated Rheumatoid Arthritis leads to the deterioration of bones, with many sufferers requiring joint replacement surgeries and many more ending up wheelchair bound.

Since August we have tried chemotherapy. It didn’t work. Steriods were useful, but the side effects are very difficult to manage. Simponi offered me relief after just a few months and now that I take it combined with hydroxychloroquine. There are parts of the day where I forget that I have RA. I’m looking forward to having a whole day when nothing hurts.

In October of 2010 I received a letter from United Healthcare. It says in part:

We are pleased to inform you that your prescription for Simponi pen Injector [I corrected their spelling on this one] has been approved for coverage…. is approved for coverage until 10/19/2011.

Simponi is approved for a year

I’m attaching the letter for everyone to see. It is on a United Healthcare Letterhead. Since October I’ve been going to my local pharmacy and picking up my Simponi without issue. Since I hadn’t changed insurance from 2010 to 2011 I had to reason to believe that my prescription status would change. Looking at this letter no one reasonable would believe their coverage expired at the end of the year. On January 20, 2011 I returned to my local pharmacy to get my Simponi. The pharmacist was apologetic. “It’s not covered.” She said.

I stood at the pharmacy blinking back tears. I had a choice to make, my physical well being or my fiscal well being. I chose my physical well being and slapped down a credit card. Simponi costs more than $1,990 for a single dose. I decided that my health was worth nearly two thousand dollars.

To make a very long story short United Healthcare had switched pharmacy providers at the beginning of the year but no prescription cards were ever sent out. No prescription information is listed on UHC health cards. No letters saying “your preapproved prescriptions are no longer valid” were issued. All that was left was me standing at a pharmacy afraid to be sick.

When I got home with my medicine I called United Healthcare and I was advised that the new pharmacy provider was CVS Caremark. Up until January of 2011 I didn’t know that CVS was anything but a retail pharmacy. In my mind it’s the place you go at 2 am when your kids have croup because they’re open 24 hours. CVS is not the place you go on purpose, and it most certainly is not a trusted pharmacy in my neighborhood. The good folks at United Healthcare informed me that I’d have to get my medicine in the mail from CVS.

Really.

Apparently the Simponi pen (which incidentally must be refrigerated) needs to be delivered to my home by the UPS guy. Everyone knows that UPS is much more reliable than a pharmacist.

In addition to the half dozen medications I take to control Rheumatoid Arthritis I have three known serious drug allergies. Each of the medications has a long list of possible side affects as well as a long list of interactions. I’m not popping a tylenol here, this is serious stuff. CVS has given me the terrible choice of a vending machine style pharmacy or poverty.

Moving forward CVS Caremark has graced me with coverage of the Simponi pen for six months, but again only from their mail order pharmacy, and there will be no reimbursement on the pen I had to buy myself in the beginning of the year. Naturally I appealed this decision and the Notice of Action included this paragraph:

Your appeal for reimbursement of Simponi is denied. This medcation requires prior authorization prior to being covered under your prescription benefit plan. Speciality medications must me filled though a Caremark Specialty pharmacy. There are no exceptions regardless of the circumstances.

My experience with Medco was the exact opposite of my experience with CVS Caremark. Medco gave me a year of medicine where CVS gave me six months. CVS Caremark ultimately will cause more paperwork, more doctors visits and more expense for a company who thinks that they are geting a “deal” with them.

I should add that on February 8, 2011 my family received our Prescription Drug Program cards.

CVS caused me to give up two full days of my life to spend on the telephone with them. I won’t even begin to try and tell you who is answering their phones. CVS Caremark is leaving me unreimbursed for two thousand dollars worth of medicine that they know and I know that I need and that I’m entitled to under the plan. CVS has completely dismissed the need for pharmacists and assumed that medical needs can be tended to with shipping labels and telephone trees.

CVS Caremark is attempting to monopolize the supply chain, by providing insurance as well as the delivery of medicine. With CVS Caremark the consumer is left with bad and worse options. Having a pharmacist know what medicines you are taking, and what the possible interactions are is a critical part of healthcare. CVS Caremark has appointed UPS and FedEx as pharmacists and outbound marketers as overseers.

I’m going to pick up the phone and get a mail order pen for this month. I have huge doubts about CVS’s ability to deliver.

I’m going to beg you to please keep this in mind if you’re a benefits manager. I know that Human Resources and Benefits is a very important part of any business. CVS Caremark has so complicated the process of getting proper healthcare your employees will lose time at work if they are forced to deal with CVS Caremark.

  • http://lisaiversen.com/ Lisa Iversen

    Thank you for taking the time to write this story. Visibility of experiences like yours is an essential part of changing the current health care landscape. When I’ve had similar ones, my impulse has been to send a bill to the company to reimburse me for the time/energy I’ve expended. Thanks again for your post.

  • JoanneH

    Jessica, is your health insurance through an employer? If so you should get your HR department involved. UHC most definitely should have let people know about the change to the pharmacy benefit early on. This is especially true for people who have pre-certified medications. Your HR person may also be able to help you get that one month you paid for taken care of. That’s part of what I do at my job (as a Benefits Manager). Unfortunately, we can’t usually control it when an insurance carrier changes pharmaceutical providers. It’s also unfortunate that you are being forced into mail-order if that isn’t right for you. That may be an initiative done by your husband’s company.

  • Shira

    We need way more posts like this to bring to light the problems with the current healthcare system. Kudos to you for writing this. Most people have no idea how severely broken the system really is.

  • Michele

    I am assuming that the insurance is through your husband’s employer. The majority of group plans are self insured, in which case the employer is paying the claims and not UHC or Caremark (and the employees share in the cost). We have UHC and we do get a pamphlet every year that lists the drug classifications. RA drugs are specialty drugs and most group plans have it set up so that specialty meds are delivered to you to cut out the cost of the retail pharmacy. Specialty med programs are also set up to have a customer care person reach and and contact the insured with any questions. If there is a broker who assists the HR dept that broker is making thousands of dollars in commissions and is there to help the HR person with employee issues. Have them do the legwork for you. They will be able to do the complaining that a letter was not sent out and that you are out of pocket.
    P.S. Chances are there is someone who is finding out that their Rx costs and/or circumstances are more favorable now with Caremark than Medco. When a switch is made to a new provider there is always a % of those who are happier and those who are unhappier.

  • Ellie764

    Thank you for this. While I don’t spend near the same amount as you do on meds. I do spend nearly $250 a month (and that is with prescription coverage). I won’t discuss how it took to fight the cinsurance company to approve each of my medications and how much money I paid out until my meds were approved. Something has to be done. These companies just can not decide to stop covering certain meds or determine how a patient can receive the medication. This is a very scarey slippery slope.

  • Elizabeth

    Ah, yes. And the Republicans and Tea Party folks will continue to insist that “no one is going to come between me and my doctor” in this, “the greatest healthcare system in the world.” I struggle nearly daily dealing with problems like this pertaining to my child with severe seizures. It’s exhausting and soul-crunching. Take care of yourself –

    • http://www.mothercraftcoaching.com Carley Knobloch

      Exhausting and soul-crunching— I agree. When dealing with my son’s issues years ago and fighting my health insurance company about care that every doctor said he needed, I wanted to put my fist through a wall. Our health care system is broken and criminal. Sending you hugs, Jessica… and you too Elizabeth.

  • Wendorfa74

    You most definitely should have received paperwork from UHC about the pharmacy change. Typically, we receive paperwork around September regardless of whether or not we plan to change health plans. Open enrollment is in October, which sort of makes it odd that they gave you the letter stating that as if Medco was going to be around come the first of the year.

    Have no fear though, before our family had Medco we had Caremark through Blue Cross. I never had a single solitary problem with Caremark.

  • http://babyrocasmama.myvidoop.com/ Shan @ Last Shreds Of Sanity

    Jessica, while what CVS is doing isn’t wonderful, the fault truly lies on the shoulders of your health insurance company. THEY made the decision to go with whatever Rx provider was cheapest. They determine the formulary of drugs that will or will not be covered. It is not really CVS’s fault.

    United Healthcare does not have a great reputation for being patient advocates. They are, like most health insurance providers, all about their bottom line. As long as theirs is healthy, they don’t care about the actual patient’s well being. And the Universal Healthcare Bill has all of them running scared and disallowing whatever they can before it takes complete effect.

    I would be calling UHC and your husband’s HR department about this and leaving CVS for another day.

  • Guest

    As much as your praising Medco they are not any better than CVS Caremark or any of the others. Every time I go to the doctor to get medicine to relieve a cold, I constantly have to call the doctors office because Medco refuses to pay for anything but generic. Medco is so cheap they harass my family members about changing their meds to generic because it is cheaper for Medco, but not what the doctor is prescribing. A family member recently ordered meds from Medco directly explaining to them and even faxing over a prescription for Requip? the non-generic form, they sent her the generic pills which is not what she ordered.

    I do hope things work out for you.

  • Chamele

    Jessica, I have used CVS sicne they bought up all the local “Mom and Pops” here. I have a medication I need regularly to manage chronic back pain. I just called — this morning– to have my medication transferred. This is absolutely INSANE— THIS is what our healthcare system has become? My hope is that you will continue to fight this through United Healthcare! THEY are the ones to blame as well. Peace on your journey– I know too well how painful it can be!

  • http://twitter.com/MindiCherry Mindi

    This seems more to be an issue with your insurance provider, and not an issue with CVS Caremark. Your provider made the choice to go with (what they thought) a cheaper, more cost-efficient prescription service. Our insurance did the same thing about 15 months ago and, while it isn’t fun, it seems to be the wave of the future.

    But to blame it on CVS seems wrong…they didn’t make this choice..your insurance company did!

  • http://twitter.com/MindiCherry Mindi

    This seems more to be an issue with your insurance provider, and not an issue with CVS Caremark. Your provider made the choice to go with (what they thought) a cheaper, more cost-efficient prescription service. Our insurance did the same thing about 15 months ago and, while it isn’t fun, it seems to be the wave of the future.

    But to blame it on CVS seems wrong…they didn’t make this choice..your insurance company did!

  • Jenna

    I am so sorry you had to go through this Jessica :(
    While I know all too well about prior authorizations, it is ridiculous that they are attempting to say you will not be reimbursed for what you were forced to pay. I also think it is nuts how so many people are supposed to rely on “mail-order” pharmacies. My step-sister has MS and was in a fight with MEDCO for a medicine that was necessary for her to be able to function. The poor girl had to beg her father for the money to be able to get her medicine. And with that, the “mail-order” on numerous times wasn’t delivered directly to her but left in her apartment complex’s office, no note on her door, and her not home from class in time to get her meds picked up and refrigerated. While I think I go through hell with my medical, I have no reason to complain when it comes down to situations like this. :(

  • GRH

    I think you you are misinformed. The pharmacy does not make decisions on the PA – the formulary and decisions including how long the drug will be approved for are made by your insurance company and not CVS Caremark or Medco. I think if you are writing a blog, you should ask appropriate questions and publish correct information since this can be easily conveyed to you by the pharmacy or your insurance company. The pharmacy facilitate the process of getting the Prior Authorization of the drug, but ultimately your insurance company (United HealthCare) sets the rules.

    Retail Pharmacist Consultant
    GRH

  • Slm528

    Hi Jessica. I came across your blog today. I work for the Caremark division of CVS Caremark and I am very surprised you are not being reimbursed for the retail fill. I say this because every prior authorization record has an effective and termination date. My client, Blue Cross, allows me to adjust the effective date to the date of a rejected claim to so the pharmacy can rebill us and reimburse you or you submit a claim to us and we reimburse you directly. Whether UHC allows that would need to be researched. Also, UHC has the option to sign up for Maintenance Choice, which allows patients the choice of picking up their mail order drugs at a CVS or having them home delivered (sort of the whole premise behind the merger of the 2 companies). Again whether UHC elected this benefit would need to be researched, which I would need your approval to do so. Let me know…

  • Rph

    If you were truly informed about your prescription coverage as you should be, then you would know that is obviously the result of: 1. faulty commmunication process by UHC, or, 2. You not taking the time to read your open enrollment materials. My guess is it’s the latter if the two. A colossal change in benefits such as this would have been communicated in a timely manner and typically all open refills and PA’s would be transferred. So, my guess is the blame lies on you or your employer’s HR Dept. Maybe you should just appreciate the fact that you have insurance that covers a $2000/mo drug, unlike many others. You really should do your research before you place blame on the messenger.
    RPh

    • http://jessicagottlieb.com JessicaGottlieb

      I think that your comment embodies all that is wrong with insurance.

      How much fine print is the consumer expected to read?

      Since when am I supposed to feel “grateful” that my insurance covers medicine I need to function “unlike many others”? To me it sounds like we should all be pissed that everyone doesn’t have access to biologics. FYI medical disability costs everyone a hell of a lot more than $2k/mo

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  • Tami

    This story is way too familiar to me. I am STILL waiting after a month for cholesterol medication that CVS Caremark claims is lack of cooperation on the part of my doctor. I was in my doctor’s office today and saw the fax with my own eyes that she sent to their Fast Start mail order pharmacy department. As a consumer what recourse do I have? Stop paying my health insurance benefits? All I have left to do is obtain copies and threaten them with a lawyer? It’s absolutely ridiculous. So in the meantime my cholesterol goes untreated, my heart disease gets worse and CVS Caremark meets or exceeds their bottom line? It a few cents less a month for me to get this prescription filled at a CVS pharmacy but my plan dictates that being a “maintenance medication” it must be filled through mail order. It’s good to know that my life is worth CVS Caremark saving a maximum of $12 dollars a year.

  • BSchultz2004

    Actually, what you are saying is the exact opposite of true. It of course is sad that you have a condition that requires a specialty medication. But to lie about and slander the employees of Caremark could cause you to get sued. You should be careful about assumptions, they are almost always wrong. The people that answer the phone at CVS Caremark specialty department are all licensed pharmacy technicians, just like the person behind the counter at your pharmacy. There are several pharmacists on staff for each specialty team, and several RNs as well for someone having a medical reaction and not in need of pharmaceutical counseling. The UPS driver puts a box near your door. A box that was packed by, again, licensed pharmacy technicians, under the supervision of Pharmacists, just like your local pharmacy. The only difference? Some of these medications have to be kept at specific temperatures, some have to be handled with special care and while wearing protective equipment or while use flowhoods. The technicians at your local pharmacy? They have no training in these matters and have none of the special equipment. These machines and refrigeration systems cost thousands and hundreds of thousands of dollars. The ability to operate them comes from training and hours of tutorials and safety procedure training, all of which, again, your local pharmacy can not provide their employees. CVS Caremark does provide that and they have some of the best trained staff anywhere. When you call in for your RA drug, you speak specifically to a RA team member. Meaning this licensed technician has taken advance training on RA specific drugs and symptoms. This team member knows as much, if not more, about your medical needs than you do. Since they all took the time and the training to learn about your needs as a patient, you think you might take 5 minutes to learn how their pharmacy operates before lying all over the interenet about them??

    • http://jessicagottlieb.com JessicaGottlieb

      “But to lie about and slander the employees of Caremark could cause you to get sued. You should be careful about assumptions, they are almost always wrong. The people that answer the phone at CVS Caremark specialty department are all licensed pharmacy technicians, just like the person behind the counter at your pharmacy.”

      1. Those folks answering the phone are a step above the phone bank in India, or maybe a step below, but certainly they are not who I want to talk to. Sue me for saying that idiots answer the phone at insurance companies. That would be fabulous, then everyone who answers the phone for your company would have to take an IQ test to prove I’m liar.

      2. I don’t actually use CVS pharmacies because I don’t want to get my medicine from a pharmacy technician. I want to deal with a pharmacist so I’ve sought out smaller stores with one or two pharmacists and one or two techs, that way I can deal with the pharmacist and worry less about errors and bad advice.

  • Bschultz2004

    And on another note, this merger you are complaining about so much because it inconveniences you is very likely a godsend to other employees. When Caremark takes a contract they agree to provide whatever medications are on the formulary that the company hiring them provides. Often, because of the availability of certain specialty meds and the discount Caremark can offer, many before unapproved meds get added to the formulary. Meaning some companies might add in fertility meds for employees trying to conceive, drugs that were not offered before. Also, many companies add on life extending medications for other treatments, like HIV and Hepatitis, because of the savings that Caremark can provide them across the board for all of these medications. So just because you could get your medication at a corner store before does NOT mean that everyone on that insurance plan was able to get their medications at all or conveniently before the change. Once in awhile it is important to look outside yourself at the world around you and not wonder about how this might be inconvenient for you, but instead how it is a blessing for someone else.

    • Igore123

      I can tell by the way you speak you are probably a fill technician for CVS, and have been drinking the corporate Kool-aid. I have tried Caremark CVS’s mail order for temperature sensitive products and they failed to safeguard the products consecutively, even after I warned them to take precautions, I know I caught it, time to RMA back the trashed product. As for any price savings, my so called 20% share is more than retail at most stores, by more than 10% of retail, this is on a common generic drug, what is CVS Caremark doing price wise to more unique drugs? And if CVS Caremark is so mindful of the public wellbeing, why are they being repeatedly being investigated by the FTC, SEC and members of congress?  I think it is time for more investigations like the FDA aimed at CVS Caremark.

  • Groovieyes

    At $2000 a shot I would be greatfull to have anybody pay for that.  It seems you need a ”dose” of reality along with your Simponi. 

    • http://jessicagottlieb.com JessicaGottlieb

      What “reality” should I be in search of? Having medical insurance leaves people without access to medicine?

      You’re not making a whole lot of sense to me.

  • Anonymous

    I’ve used CVS Caremark’s home delivery for over a year for Enbrel and now Simponi. They ship one day and Fed Ex delivers the next. The people who have dealt with me for the most part are very conscientious, pleasant and efficient. I requested that Fed get a signature, after Fed Ex left a shipment in the heat. CVS Caremark gets high marks from me.

  • Anonymous

    Insurance is definitely confusing, especially for people, such as yourself, who do not deal with them on a daily basis. Unfortunately, since you had the medication filled at the retail level, meaning in your local pharmacy, they will not cover it at all. In spite of the company knowing that you need it, as well as you knowing that you need it, they will STILL not cover it just because it was filled at retail level, unless yet another prior authorization is done through them. A prior authorization is when your local pharmacy contacts your doctor, who must then contact your insurance company to see if they will approve the claim. It is a very tedious process, and it is not limited to only CVS/Caremark. Actually all insurance companies require such a thing if a medication is not on their formulary. The prior authorization you receive from your previous insurance provider does not transfer to the company that follows as your coverage. The whole process must be done all over. The company also probably requires it to be filled via mail order since it is a maintenance drug, meaning you will not be coming off of that medication, like you would with say, an antibiotic.

    I am also surprised that they would even cover it through mail order. There are plenty of people who NEED medications/procedures done, who have insurance that don’t cover it at all, or there are people who simply don’t have insurance. I’m sure there are people out there who have medications that are more expensive than $2000 per shot. I am not trying to belittle your case, but there is always someone who has it worse out there.

    And yes, there are a lot of people who are not familiar with the fact that even though CVS/Pharmacy and CVS/Caremark are both under the same company (CVS), they are two separate entities. So prescriptions are not easily transferable between the two entities. And as another example, a CVS/Pharmacy cannot view your profile/medications filled through Caremark and vice versa. They use two separate systems.

    What Bschultz said is absolutely right. Many times you must get it filled through mail order/specialty pharmacy for these types of medications because local pharmacies usually do not have the proper equipment to store such items, nor training, or protective wear.

    Igore – yes, there can be mistakes made with the handling of the medication, but everyone is human… even though to you that may not be an excuse. It has nothing to do with drinking “corporate Kool-Aid”. It has to do with understanding the inner workings of local pharmacies, mail order, and specialty pharmacies.

  • Adamwyr

    FYI, CVS/Caremark doen not make the rules, they only enforce them. The rules for what is covered and how it is covered is guided by either your employer or health care plan. CVS/Caremark is only the prescription drug manager. Do research before you complain.

  • Heather

    Speaking as someone who works at CVS, what Adamwyr says is true. We just fill the prescriptions. Any stipulations or limits come from your insurance provider, which you admitted is United. United is the one giving you 6 months of medication, and United is the one requesting that you use the CVS mail order program. And also, UNITED is the one who won’t reimburse your OOP charges. There’s that old phrase, “Don’t shoot the messenger.” This is exactly what you are doing. Instead of placing the blame with your insurance provider, where it belongs, you have decided to blame the retail pharmacy filling your prescriptions. And, while they might be the easiest target, I suggest you speak to United if you want anything to change.

  • http://samslaw.org/ Gene Mcginnis

    Be cautious with CVS. They have threatened my son’s health by publishing online. My son worked at CVS in Tampa and was shot twice during a robbery. When CVS would not take care of his needs after being shot I published the issue through a website and was threatened by a corporate CVS attorney that they would become bad people if online publishing didn’t stop. There is true evil in the leadership of that company. My son is still in a wheelchair and in constant pain, unable to work.

  • Oscar18

    Caremark, not off to a good start, somebody needs to be held responsible.  The Federal Goverment just changed to using Caremark for mail order pharmacy.  Even though I have prescriptions with refills, they are not refilling them timely.  Anthem Blue cross is who I pay my premiums to and when you call them for help they have no responsiblity dont you jusl love it.  One big RIP OFF.  This whole system needs to change and someone needs to be held responsible for this continued abuse of consumers.

  • James Harding

    I used Caremark for two years for prescriptions for both myself and my wife.  I have no complaints.  I also have no complaints about the retail CVS pharmacy that we use – for over 5 years – with relationships so strong they know both of our names and ask about our children.  

    I’m sorry to hear about your problems.  I don’t think anyone can make universal claims about companies (good like mine or bad like yours) as we deal with people who can be both professional and helpful  (my experience) or unprofessional and uncaring (your experience).

    I also have no complaints about my insurance company – who has paid exactly what they promised in their policy, and kept all promises they have made to me over the phone.  They also handle any enquiries I have quickly and giving me the benefit of the doubt before another provider or even their own policy.

    Again, sorry you don’t have the same experience.  I just want to point out that it isn’t that way for me.

  • None

    I am having the same experience (drug and company).

    A useful drug, but unaffordable.

  • Tormented M.S. Sufferer

    A year later, and I’ve just had the similar misfortune of being switched from Medco to CVS/Caremark. They are doing almost the exact same thing to me for a drug that I take for my MS. Without it, I may no longer be able to drive or even walk up my stairs safely. Medco had given me a prior authorization for it. CVS/Caremark refuses to approve it, no matter how medically necessary nor how much my life will be destroyed without it. It’s like talking to robots. I’ve never dealt with a worse pharmacy “benefit” manager. I am now faced with the prospect of paying $1,000 for a 1-month supply, or having no quality of life. Eat or walk. It’s cruel beyond belief. 

    By the way, did you hear about CVS/Caremark being accused of using hot blowdryers to take labels off of returned medications, including ones that needed refrigeration, and then repackaging them and selling them again to other unsuspecting customers? Google “CVS/Caremark is evil” and you’ll turn up all kinds of fascinating things.

    • http://jessicagottlieb.com JessicaGottlieb

      My heart hurts for you. I’m so sorry. I hope you find a quick resolution and are able to stay well.

      • Tormented M.S. Sufferer

        Thanks Jessica. Things are still bad. I’ve never dealt with a more callous bunch of people than CVS/Caremark. The last denial letter they sent me was the typographical and written equivalent of screaming in someone’s face. They said that there is no approved medication to treat this particular symptom, and therefore they won’t approve this medication (which has been a godsend in treating this debilitating symptom for the past 2 years). I am now going through some kind of “external” review done by a doctor picked by CVS. It’s a farce. 

        As for the people saying it’s not CVS that decides what to cover, that’s not exactly true. They have latitude in interpreting what meets the standard for “medically necessary” for a prior authorization. In my case, the drug I’m taking is used very frequently off-label for M.S. Medco approved it as medically necessary once my doctor confirmed why I was using it and that it worked. CVS/Caremark won’t consider it and have turned down every appeal, no matter what evidence, doctor’s letters, research paper etc I’ve sent because it is off-label, and therefore, according to them, not medically necessary by definition, no matter what I nor any of those other things say. A CVS employee coordinating my latest appeal (who just told me yesterday that the latest doctor’s letter and paperwork I’d been told to gather and still in the process of procuring won’t matter because my case has already been forwarded on without anyone having told her) told me on the phone that CVS/Caremark interprets the definition of “FDA approved” differently from Medco.  

        • http://JessicaGottlieb.com Jessica Gottlieb

          This is crazy making.

          Medco approved it as medically necessary once my doctor confirmed why I was using it and that it worked.

          That in and of itself should be approval. You have MS not insomnia. It’s like people stop being human when they make these policies.

  • alphabrenna

    I have had nothing but trouble from the Caremark Specialty Pharmacy since my insurance switched to them in January.  Like other commenters, Caremark insists the only delay in starting medications is that they have not received communications from my doctor despite the doctor’s office being able to produce a paper trail for me that clearly proves the opposite (read: Caremark is lying).  I can only hope for the best, but I don’t think I will get it.  

  • iceaco

    I’m switching to CVS/Caremark due to my company’s insurance company so I was just checking how reliable they are, not like I have much choice, but just to be ready to whatever comes at me.

    Tried to scan anything that would invalidate the blogger’s argument, but most of the negative replies I see are either nonsensical, or lack of knowledge of the poster of the situation, maybe not in the general pharmacy sense but not the situation.

    For example, to the person saying that they worked at CVS, why are you telling the blogger to complain to United? United doesn’t handle prescription insurances anymore. At least in my case the subscribers got transferred to Caremark/CVS _which_ is an insurance provider.

    And you know that the ‘best trained staff’ stuff is a gimmick right?
    I worked at two companies.
    First one’s training lame, employee well being sucks.
    Second one’s training nonexistent, employee well being good.

    Though I don’t have to deal much with customers much though so it might be different.