Optum Avis 478

Up until 2026, I have had nothing but good experiences with OptumRx. However, it has been a nightmare attempting to get my medications this year. There is a serious problem with insurance information being updated in your patient portal/chart. I spent the entire month of January trying to get them to update my insurance as I knew my medication requires a prior authorization and I needed to get that process going so I wouldn't experience a gap in my treatment. My insurance was not updated until February with my infusion being scheduled for the second week of February. On the day my medication delivery was scheduled for, it never showed up and I received no communication that it would be delayed or not coming. I called the next business day and found out they had not even started the prior authorization process. It makes zero sense that they would have scheduled a delivery for my medication (almost a month prior) without having it approved by insurance. Now it is the week of my infusion (my migraine symptoms start to worsen the two weeks before my infusion is due) and I had to cancel my infusion appointment because I have no medications. My delivery is now over a week late and it is not the fault of insurance. We put a rush on the prior authorization with my insurance and it was approved the same day that all the documentation was submitted by Optum. Two days later, Optum is still claiming to not have received any information on the approval when I have confirmed with insurance on multiple occasions it was sent to Optum and my provider. Somehow my provider has received this approval, but Optum hasn't? When I called to let Optum know of the approval, they were rude and told me that it doesn't mean anything because they have their own processes to approve medications and they still have no record of it. I've also been told my representatives that this is occurring with many patients this year because they are way behind in updating insurance information. You can call Optum and talk to representatives, but getting a hold of someone who actually can do anything is impossible. I was told on multiple occasions I would be getting a call back or that it is being escalated to the supervisor. It took me calling over and over again to get a call from my patient navigator. While he is very nice and seems to care, with this being a problem with so many Optum patients, there is really only so much he can do. This is a problem with the system itself and it is costing so many people their health and quality of life. Not only do I go to college full time, but I also work. Before this medication, I had to drop out of school because my migraines were so bad. I am terrified this may happen again with how symptomatic I have become, which has only been worsened by the stress of trying to get my medications. I never leave reviews, but this experience has truly been terrible. I feel very invalidated when I explain to representatives that I need someone to call me back to communicate something because I need this medication. Many don't realize or try to minimize the impact migraines can have on someone's life. I don't recommend using OptumRx until they get the major issues in their system figured out. I am very discouraged, in pain, and dealing with other migraine symptoms that are only getting worse. This whole thing is a joke and entirely unacceptable for a pharmacy and healthcare company.

Literally the worst customer service I have experienced in my life. Had to contact them TWICE to get a return label MAILED (??? It's 2026... email it!!!) and in the meantime I had to pay for my meds out of pocket at my local pharmacy because the lack of return label meant my insurance had not been refunded or their bottom of the barrel generics. I've wasted hours of my life on one mistake, which was working my rear end off trying to transfer my rx to them only to then spend even MORE time trying to return and cancel my rx with them. Avoid ths place like the plague.

My company just switched to OptumRx as our PBM Jan 1st, and it has been an absolute disaster in my experience. They require a Prior Authorization for a generic medication I have been stable on for 18 years. Then they deny the PA because of a Step Therapy requirement. The 3 alternatives they require in the step therapy are all significantly more expensive than the generic. You can't talk to the people making the decision, only the robots that are reading from the computer.
Warning to all company benefits departments considering this PBM -- run away as fast as you can, unless of course your goal is to piss off your employees.

AWFUL.

They continually deny coverage for people who need certain medications; the service agents remain unknowledgeable, relying on outdated guidelines. The C-suite only cares about money in their pocket.

I think they should be sued for fraud and unethical behavior. I can't describe how much I hate this company.

I have had to deal with OptumRX for several years and I am amazed how it is even possible to screw up orders so many times. Autorefill not refilled. Autorefill comes 1 month late. Meds NOT on autorefill are sent... My doctor says its a big challenge to get the prescription through to them too. I am now going to the local pharmacy even so I have to drive there, wait and pay more. It is reliable. It is very important medication...

I made a big mistake with switching to optum RX. I have already had express Rx. Thought I would try optum RX.... no one speaks English... haven't gotten my mail order yet. YIKES 😳😬!!!!! Have I made a big mistake??????

I did a price check to see how much my medication would be to transfer to Optum. It was $463. for 90 day supply. That was much better than what I was paying at my local pharmacy. By the time I made the transfer and was going to pay for my prescription, it was $973. for 90 day supply. I cancelled my prescription and went back to my old pharmacy. Their customer service is very confused.

Over the past two weeks, I have made multiple calls and spent hours on hold to resolve what should be a fairly simple request. Hold times generally start at 20 minutes. Requests for a call-back don't come as promised. Yesterday and today i have logged over 2 1/2 hours of phone time and have been routed and re-routed to different people who ask me to start again at the beginning. Twice my call was disconnected. This pharmacy has been consistently bad and as a result I will be changing insurance providers so that I don't have to use this pharmacy anymore.

I’ve been trying to switch over 16 prescriptions at a total of $15,000 per month over to Optum RX for two years. They require the patient to go over every single medication with them rather than just call my pharmacy and have all of my prescriptions transferred over to them like every other pharmacist does. When I switched from Rite Aid to CVS all I had to do was tell CVS to call Rite Aid and get all my medication. Optum refuses to do that.

I am required to use Optum for my insurance and they are the absolute worst company. They auto charge my card even when they tell me no card is on file, the staff there is totally clueless, and they send the wrong medication. Getting someone there to even correctly read back your doctors orders is extremely challenging. This has to be like the easiest job in the world and yet these people can not manage.

I just got off the phone with not one but two reps from OPTUM RX home delivery. I asked for a prescription override because I am going on vacation and needed an advance script on meds. I was connected with Quintina who was absolutely WONDERFUL! She went above and beyond to help me! We were placed in a three way call with another rep who was in Atlanta. She had to override the script dates in order for me to receive my meds. Unfortunately I didn’t get her name but she was fantastic in getting it done for me! I owe these ladies a huge amount of gratitude! I can now go on vacation without worrying above having enough drugs throughout the entire trip! Thank you thank you OPTUM for employing such dedicated and qualified reps to get this override done for me! I appreciate all of you!

They were pretty alright until about a year ago when my doctor prescribed me Marinol to treat nausea. They didn't have it. Then they wouldn't cover it. Then it was covered but they couldn't fill it because it was a controlled substance. Then they would fill it but it needed to be specially ordered and I needed to wait 39 days. They also stopped covering nicotine patches which I think is weird considering pretty much all insurance covers them now. Today they denied my new blood pressure medication saying it isnt covered. I'm not sure why it isnt covered. I think if you use a ton of your benefits with them and they are consistently approving your claims on your entire policy (medical, dental, vision, etc) they have the tendency to start denying claims. That's what it looks like. The people over the phone are ridiculous. Don't know what they're talking about. Transfer you around and you get nowhere. Express Scripts is much better.

My RX went generic, and I called them to make sure my next refill would be generic, my doctor said they did not need his permission. The person, who hardly spoke English, assured me it would be generic. Today, they sent me a notice that they were processing a refill and the cost would be $208, which was twice the cost of my last order! Again, I called and had to wade through their menu and got another person who hardly spoke English. I told her to cancel the refill, cancel my RX and cancel my account. She assured me she would. I am still waiting for the charge to be canceled, they never shipped the meds, but the charge is still pending. Walmart filled the RX for $31.96 that they were trying to charge $208 for. I do not trust this organization in filling orders for my meds. Never again.

I have an Optum FSA and they request documentation for almost every charge made on the card working with this bank is the absolute worst. They deny charges just to deny charges it has nothing to do with whether or not they are actual medical services.

OptumRx mail order pharmacy policy of routinely auto refilling customer prescriptions against customer wishes. A process problem that their automated system defaults to auto refill either on customer refill request or physiciani new prescription. Extremely annoying having to call , complain to have auto refill cancelled only to have it reactivated the next month.
Is senior management trying to fatten their bottom line by defaulting this choice causing ongoing customer dissatisfaction / frustration? Do they not care because they have a captured customer audience due to their pharma contract with United Health Care? Yeesh. So frustrating. Big pharma healthcare intermediary / Corporate America at its worst

We have been patients at this facility for many years and have always been satisfied with the doctors and staff. Recently we met Shane, assisting patients at the front entry. He is so very concerned, considerate and surely welcoming. Thank you, Shane, for your compassion and ability to make us feel welcome.

GIVE 0 STARS CHARGE YOU WHATEVER THEY WANT MAKE UP INSURANCE CALLED ATLANTIC STAR I NEVER HEARD OFF!! WHEN MY DAD HAS DEMENTIA! THEY DONT CARE OF ELDERLY! THEY OVER CHARGE FOR DRUGS THAT ARE GENERIC LIKE I AM STUPID! THEY DONT CARE! I WILL COME BACK! THEY JUST SEND DRUGS TO YOUR HOME WITHOUT YOUR CONSENT!

Dealing with Optum has made me sicker. My medication never arrived, though it was marked delivered. So I called to get new pills. The agent said they were coming. Then ,,. nothing. Next agent said the order was canceled because they were delivered! Then she said an investigation found the tracking number was wrong and she said i should get my pills the next day. Well.., no!!

This clinic is a disaster!
I've been a patient at this clinic for less than a year, and the experience has been terrible. Once, I needed to see a rheumatologist, and I insisted several times that they give me the referral two months before the appointment, but I missed the appointment because they never sent the referral to the clinic. The second time, I experienced severe neck pain. They ordered an MRI, which I had on December 29, 2025. I've repeatedly asked my primary care physician to review the results and give me a referral to a specialist, and as of today, January 10, 2026, I still haven't received a response. Meanwhile, I'm still in excruciating pain, and it's getting worse!

I was provided with an order number by Optum Rx and was led to believe that my prescription had been successfully processed and sent. However, after repeated follow-ups and verification attempts, it became clear that the prescription was never processed, never filled, and never shipped, despite the order number being generated and communicated to me.This raises serious concerns about accountability, transparency, and potential fraudulent business practices. AVOID this pharmacy. Do NOT trust them.