Caremark Avis 

CVS Caremark, the pharmacy provider for my insurance company, made it nearly impossible to fill my son’s ADHD medication for almost two months.

My son has taken the same medication for years. Before enrolling in my insurance plan, I verified that the prescription was covered. During the first month of coverage, we were able to fill it at a local pharmacy without any issue. But when it came time for a refill, everything fell apart.

The local pharmacy told me coverage was denied because they had the medication, but it was made by a manufacturer CVS Caremark supposedly did not cover. I called my insurance company, and together we called CVS Caremark. Their representative told us they only covered the medication from one specific manufacturer and gave me two local CVS locations that supposedly had it in stock. I went to both pharmacies, only to be told they did not have it, it was on backorder, and they had no idea when it would be available.

After more calls with my insurance company and CVS Caremark, I was then told the doctor could call the prescription into the CVS Caremark mail-order pharmacy. I went to the doctor’s office, and the doctor called it in while I was sitting there. A week later, I had not received any update or copay request, so I called again. This time, CVS Caremark said the prescription could not be called in by phone and had to be sent electronically or mailed in. No one could explain why we had been given different instructions previously or why the doctor was not told that when he called.

By that point, nearly three weeks had already passed. I asked if they could make a one-time exception and approve the same medication from another manufacturer, since this was causing a serious delay in my son’s care. I was told there was nothing they could do. I then had to return to the doctor’s office for another prescription. Since the doctor does not use electronic prescriptions, I mailed it myself.

Another 10 days passed with no update. When I called again, I was told CVS Caremark had canceled the prescription because they ran it through under a manufacturer not covered by my plan. They claimed it was automatically canceled and mailed back. Only then did they tell me the doctor needed to write the specific manufacturer name and drug code on the prescription. This information should have been provided several calls earlier.

Every call took two to three hours and ended with a different set of instructions. No one took accountability. No one seemed able to provide clear, consistent, or correct information. Meanwhile, my son was left without a medication he has relied on for years.

In the end, nearly two months later, I had to get another prescription and, through a personal connection, found a hospital pharmacist who was finally able to help. CVS Caremark’s customer service, policies, communication, and internal processes were abysmal. This was a miserable experience that showed a complete lack of accountability and disregard for the real impact these delays have on patients and families.

This is the biggest scam Insurance co. out there! I'm forced to pay their premiums through work insurance and they refuse to pay for the medication prescribed by my Dr. forcing me to pay out of pocket!

I am writing to share my personal experience with CVS Caremark and to express my frustration with what I believe has been a confusing, inconsistent, and unnecessarily burdensome process for obtaining my prescribed medication.
Over the past several months, I have repeatedly encountered delays, conflicting information, and administrative obstacles while attempting to obtain medication prescribed by my physician. What should have been a straightforward process became a prolonged series of phone calls, paperwork, and communications between my doctor’s office and CVS Caremark.
One of the most frustrating aspects of my experience was learning that medication I had previously received was suddenly subject to new prior authorization requirements. In other instances, I was informed that coverage limitations or authorization requirements had changed, requiring additional documentation and approvals. These changes occurred after my treatment plan had already been established by my physician, creating uncertainty about whether I would be able to continue receiving the medication I needed.
Throughout this process, I often received different answers depending on whom I spoke with at CVS Caremark. I was instructed to have my physician’s office submit specific forms, only to later learn that additional forms, different authorizations, or further documentation were required. Each time new requirements emerged, I had to contact my doctor’s office again, and their staff had to spend additional time attempting to satisfy CVS Caremark’s requests.
As a result, I found myself caught in a continuous cycle between my physician’s office and CVS Caremark. Information was frequently inconsistent, requirements appeared to change, and responsibility seemed to shift from one party to another. The process was not only time-consuming but also stressful, particularly because it involved medication that my physician had determined was necessary for my care.
After going through this experience, I have little confidence that this letter will result in meaningful change. It is difficult for me to believe that the concerns of individual members receive the attention necessary to correct systemic issues that continue to affect access to prescribed treatment. While I hope that CVS Caremark leadership takes these concerns seriously, my experience has left me skeptical that meaningful action will be taken.
Unfortunately, individuals like me often feel as though we are at the mercy of a system over which we have little control. Decisions regarding coverage, prior authorizations, and medication access can have a significant impact on our lives, yet the process can feel opaque, unresponsive, and disconnected from the realities faced by those who depend on these medications.
I am sharing this letter because my experience has left me concerned about the efficiency, transparency, and accountability of the process. My hope is that CVS Caremark will take steps to improve communication, reduce unnecessary administrative hurdles, and ensure that individuals are not subjected to avoidable delays in accessing prescribed treatment.

Disgusting service. Prescription delay.
I ordered my prescription Thursday 21st and was told will get it in two days. But today is 26th and still nothing.
This is an outrage!!!!

Absolutely the worst online pharmacy on the planet our union switched over to them and it’s the biggest mistake they ever made. We now have a petition going to go back to “OPTUM” and have enough signatures to do so. CVS denied my daughter seizure medicine. We had to fight tooth and nail and go through three appeals so that my daughter could take her medicine so she didn’t have seizures and die. every single person you speak to at CVS has a they don’t” give a shit attitude” about your issues.. other members have had their heart medicine denied diabetes medicine denied. Everything is a denial with them. Whatever you do do not use them. They do not have a single positive review all their reviews are one star or less. run from this Pharmacy as fast as you can!!!!!

Our insurance switched to Caremark and it is a living hell. You CANNOT access any human customer service. All of these companies using AI Chatbots is infuriating. You can't call in and talk to a human, It is nothing but a looping hell of recorded backrooms. I will miss Express Scripts for the rest of my life, they always had incredibly helpful people on their customer service line, Caremark is the absolute worst in customer service. You're dealing with real humans with real health problems, and you can't provide a single human to answer phones. So much for "care"

Caremark Prior Authorization Experience –
I am writing to document a distressing experience I encountered with Caremark’s prior authorization process for a longstanding medication. My medication, which I have taken for years, normally costs around $4 with a savings card, but this time the cost was unexpectedly close to $2000 due to a prior authorization requirement.
The process became a nightmare due to multiple failures and communication issues:

I was advised that my doctor needed to change the DAW (dispense as written) code to facilitate approval. Despite emailing the doctor’s office and offering to assist, no action was taken by the doctor’s office, and Caremark staff did not follow through.
Caremark representatives initially claimed they could waive the need for a letter of medical necessity, but later insisted the letter was required. They marked the case as urgent and said it would be reviewed in a few days.
Three days passed with no fax received by my doctor, and I was left without medication.
Multiple calls revealed that Caremark failed to fax the necessary letter, and staff exhibited unprofessional behavior, including speaking over me, displaying irritation, and providing inconsistent information.
The supervisor finally admitted that the fax was never sent, and I was told the waiver of the letter was due to a change in coding without informing my doctor or me.
Throughout, I received no proactive communication from Caremark about these updates, leaving me in a vulnerable and distressing position without medication.

This experience reflects poor communication, lack of accountability, and unprofessional conduct by Caremark staff, causing significant inconvenience and stress. I hope this summary can assist in addressing systemic issues within the prior authorization process.

Caremark has had a noticeable decline in quality over the last 2 years. I get one of my medications through the specialty pharmacy, and a prescription for a 30day supply of medication takes at least 40 days to fill. Expediting shipping does not resolve this, and it feels like a cost saving measure that hurts the client. Outside of specialty, the revised formulary and reliance on AI has made ADHD ubtreatable. Generics switch monthly when they are even in stock, which pretty much everyone except insurance companies now acknowledge isnt the best for clients health. Previous successful meds that have been removed from the formulary cant get pre auth'ed, leaving me stuck with a terrible prescription plan until next year. All of this took place in January, 3 months after open season enrollment at my company. Caremark used to be great, now the ravages of time seems to have dimished them to a crumbling husk. Ive never had a real affinity for a company one way or the other, but the state of Caremark in 2027 feels less like a profitable business and more like a crumbling statue in a Percey Shelly poem.

The only reason I’m giving one star is because Trustpilot doesn’t allow a negative star! CVS and CVS Caremark is only in the business of driving up stock prices. They are abysmal when it comes to keeping their customers healthy!
I have been diagnosed by multiple physicians with severe obstructive sleep apnea (OSA). I was prescribed Zepbound which almost immediately stopped my snoring, so much so that I no longer required the use of a CPAP. Then CVS decided they were not going to cover Zepbound and that everyone would be moved to Wegovy (which they have ownership). I was not on Zepbound for weight loss, rather it was to mitigate my OSA. Now I’m back on the CPAP and all related symptoms have returned. Terrible company! The fact that they don’t even respond to the overwhelming bad reviews tells you all you need to know about CVS.

One of the biggest things I hate about CVSCaremark is the fact that I was told by three representatives that I had to be on GLP-1 shots as they tried telling me it was part of my husband's insurance plan. It's not. I was on a different medication for weight loss.

Not only did they send me 10+ letters insisting my doctor gets me on these shots they also called my doctor's office telling them they wanted a preauth sent over. Today I had enough of the back and forth and told them I DON'T AUTHORIZE any of it and to stop bothering me and my doctor's.

The representative even admitted that it was a misunderstanding with their end and she'd resolve it . I'm being made to look like a fool to my doctor's office because they keep going back and forth.

Frustrating and disappointing.

On 2/20/26 I contacted Caremark to have my medication pre-authorized. As I was can only get get 3 months without authorization for more. Every year it the same thing. I was told by the CSR that pre-authorization was not needed this year. I asked her if she was sure and she said she checked every month for the rest of the year and it was OK.
Sure enough, when April refill is processed I have to pay for the prescription since there is no guarantee as to when it will be approved.
I believe this company does everything it can to make processes more difficult to save money at their custom expense.

My doctor prescribed medication on the 7th, on the 14th i get a text from CareMark saying there is a problem with a prior authorization from the doctor. This is for a situation where i have had surgery and medication for a year and a half. How do you get prior authorization for a situation in existence for over a year and a half? Why am i notified a week later?

The amount of time one has to spend on the phone for getting medications that are taken daily for refills, or changes is ridiculous. It literally takes less time to go to the pharmacy every 30 days then try to get a 90 day from them... for multiple medications. Plus the app is worthless and literally only notifies you and you still have to spend 15-30min on the phone to get anything done.

CVS Caremark knows they have a captive audience since so many companies (like my employer) use Caremark for prescription coverage for their employees. I am going through menopause and take a generic medication for estradiol -- this is not something I take because I am not taking care of my body, but due to a natural progression for women. My first 3 prescriptions were fine, but the 4th refill has been a nightmare. My doctor submitted my prescription on March 9 to the CVS Caremark mail order service that is required for recurring prescriptions. Caremark said the prescription was out of stock and asked me to wait a few days. I did. Then they emailed my doctor and asked if there was an alternative. She said yes, I could use the name brand. CVS Caremark submitted a prior authorization for the name brand to CVS Caremark, who denied the coverage on March 24. The prescription reverted back to generic, and the mail order pharmacy was still out of stock, so without asking us what we'd like to do, CVS Caremark just canceled the prescription entirely. I called around local CVS pharmacies and located two pharmacies in the metro area that currently have the generic patch in stock, but the pharmacists can't request a transfer because the prescription was canceled by CVS Caremark because they were out of stock. This happened on Friday, doctors don't work weekends, and my doctor is out of the office for spring break. I am out of patches now, it's been 3 weeks of time wasted with Caremark, and their customer service makes me think they hired people who like to make people's lives miserable and then trained a bot to simultaneously waste a person's time AND infuriate them while never resolving the issue. They claim they can not reverse the cancellation, so I just have to wait until my doctor is back, get a new prescription, and hope the local pharmacies still have the patches in stock at that time. The customer service is awful.

Not once have I received medication on time since I was told I had to mail order medication. The last straw was them cancelling my Rx without notice. I am now almost two weeks without my refill.

Given the overwhelming negative reviews, it seems to me they just don't care about people. They know people are stuck with them so we can all just deal with it. I will be actively petitioning my employer to change companies before open enrollment. This company is the worst.

To deal with CVS caremark you must be aware of coverage and exclusions. I requested refill mid Feb. which was denied. They should have informed me I needed a new PA (keep track of when they expire, because they won't tell you.) Spoke to 5 or 6 reps including escalation. Each told me something different. I knew better and advised them. They will promise the world to get you off the line. Ive been out of my med for nearly 2 weeks now. Seems like training is lacking. We are forced to use this service. They need to do better.

There are so many problems with their algorithms designed to deny or restrict coverage. This applies to many classes of medicines, but our family has had problems with asthma inhalers and medicines for type II diabetes (Rybelsus). Their so-called. appeals process is a joke, and largely a waste of time.

Generic drug cost went up $160. Called to complain and see if cheaper to go through another pharmacy. Customer service said no and told me it should actually be $500 more. Explained I was looking at their own bill and I was upset it was $160 more... person was reading wrong information. Caught them 2x reading bad info. What in the world would a senior do? No supervisor available to talk to. Horrible experience. Been on same generic for 10 years. It should be getting cheaper as my other generics have...not going up by 3-7x!!! They don't care if we skip or ration meds. Cleveland clinic and Caremark don't want to keep anyone over 50 alive.

Horrible company to work with. Constantly lose things, make it extremely difficult to get the medications you need to live. They don't communicate well. I am so disappointed my company switched to this pharmacy provider. There is no excuse for the level of incompetence.

I'm in the middle of pre auth limbo/HELL for medication I've been taking for SEVEN years for my chronic health condition. I'm on my 5th or 6th call along with several back and forth with my doctor. The insurance company would save money by kicking these crooks to the curb and provide their clients with their reqiured medication. It's ridiculous to put patients health and well being into someone's hands who is NOT a doctor. I now understand why they have lawsuits in litigation and new ones pending.