Health Insurance
CVS CaremarkHeadquarters
Find BBB Accredited Businesses in Health Insurance.
Complaints
Need to file a complaint?
BBB is here to help. We'll guide you through the process.
Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
01/29/2025
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
On 01/04/2025 I filled my prescription and my deductible was met. On 01/09/2025, the insurance went back and reprocessed the claim so that $3400.00 was taken back off of my deductible therefore $0 of my out of pocket is being met. I've spent over 10 hours on the phone trying to resolved this but the insurance is asserting that my plan has "true accumulations" which means that copay assistance would not apply toward deductible. However, my employer DOES NOT engage on true accumulations on their insurance plan. I have no documentation to show that they don't because none exists-it is not not mentioned in the plan language AT ALL. Please help me get the pharmacy to reprocess my claim correctly. I'm a cancer patient and I'm supposed to start with a new cancer center in about a week but I won't be able to if I can't get this issue resolved because I have an $8500.00 out of pocket max so even with copay assistance, I struggle to pay my medical/pharmacy bills.
Business response
02/04/2025
February 3, 2025
BBB serving *********************, *****, ************, and *******
5 Mt. *********. ************************* **********
Phone: ************Complaint #: 22823085
To Whom it May Concern,
This letter is in response to the correspondence we received from your office on January 30, 2025.
Thank you for the opportunity to address the member's concerns.There was a coding issue that prevented the members copay from applying to the deductible as
intended. The issue has been resolved. Several attempts were made to speak with the member and
provide them with an update.We value our members and remain committed to our purpose, helping people on their path to better
health. Should you have any additional questions or concerns, please do not hesitate in contacting me
at **************.
Respectfully,
****** ****
AdvocateCustomer response
02/04/2025
Better Business Bureau:
I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.However, it did take me over 17 hours on the phone to get Caremark to even believe me that there even was a problem. I had an appointment coming up with a new oncologist, almost had to miss it and I was very concerned that the frustration was going to cause a medical emergency for me.
Caremark did leave some messages to let me know that it was resolved but left confusing information that I was going to receive a check which will cause additional confusion because I never paid for the medication. The messages only leave a call center callback number and I won't spend another two hours starting over with a new agent.
Although resolved, I'm bitter about the fact that this happened.
Regards,
***** ******Initial Complaint
01/27/2025
- Complaint Type:
- Delivery Issues
- Status:
- Answered
*** delayed processing and shipping of medications. They have been unresponsive to multiple complaints and attempts to get information on delays.Business response
01/27/2025
We appreciate ****** ***** sharing his concerns and the opportunity to address them here.
In order to assist, we will need more information to proceed. Please confirm if the medications are being mailed through CVS Caremark mail service, or if mailed from a retail pharmacy, please provide the store location. Please also provide the order number.Customer response
01/28/2025
Order number ********** is the order number for ****** that I will have been out of for 3 days by the 29th my original complaint made it quite clear that this was mail order and not ordering from a store. As terrible as ********* is they still do a far better job the CVS Caremark.
Regards,******
Business response
02/04/2025
February 4, 2025
BBB serving *********************, *****, ************, and *******
5 Mt. *********. Suite 100
***********, MA 01752-1927
Complaint # ********
To whom it may concern:
CVS Caremark administers the prescription benefits portion of the PACIFICSOURCEHEALTH PLANS health
plan, of which the beneficiary is a member. This letter is in response to the correspondence we received
from your office on January 30, 2025. Thank you for the opportunity to address the beneficiarys
concerns.
The member signed up for auto refill/renewal on January 9, 2025, and at that time they were educated
on how the program works. The member received their order on January 29, 2025, via *** at 9:59am at
the front door.
The member will receive alerts approximately 23 days prior to running out of medication and the alert
will indicate the next processing date. If the member needs an earlier fill for any reason, they will need
to contact ************* at **************.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.
Sincerely,
*******************
Member AdvocateCustomer response
02/04/2025
The pharmacy did not fill or ship the medication in a timely manner. The pharmacy did not respond for a request for follow up. The amount used per day per the ** and total amount dispensed is not debatable based on instructions in the ** they should have filled it and shipped it sooner.
Regards,******
Initial Complaint
01/24/2025
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
Hello. I ordered *************** on 1/8 which is a medication that keeps stomach acid from burning my throat. Was shipped on 1/9, and we never received it. Out of medicine now, I called *** and they said they considered it lost in the mail since it was past the 10 business days. They said they could re-ship it but could not guarantee when it would arrive. So I had our doctor call it in at a different local pharmacy so I could pick it up. However I was denied since insurance had already paid CVS for the initial prescription that is now lost. We then made a 3-way call to CVS with my insurance **** so they could request that they reverse the claim they had made for payment, thus allowing me to get it filled somewhere else. At first I was told they could do this, but after several times on hold, ******* (from their senior team) told us that they had someone from my insurance that could help us (forgetting that we had a 3-way call with my insurance *** ALREADY on the phone and listening. My *** explained to her that BCBS (our insurance company) could not reverse their claim and that it had to be done by ***. ******* then said she was told by her superiors that it could not be done. I asked to speak with her superior and she said no problem and then disconnected the call. I gave her my call back number earlier in the call but she did not call back. So now even after paying I can not get my medicine or have it filled somewhere else unless I pay cash, which with GoodRx is over $400. Id like them to reverse the claim against the insurance so I can get my medicine OR just send me another 90-day supply of my meds no charge. I dont care Im just tired of being in PAIN!Initial Complaint
01/22/2025
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
CVS Caremark continues to interfere with the prescriptions that our family doctors and specialists have prescribed over the last year. It is now coming to a head with the refusal to refill my wife's birth control, citing needing "prior authorization." Her doctor and her have been fighting with Caremark, since the new year. Last year they refused her dry eye medication. It took over a month for her and her doctor to get those cleared. It is absolutely unacceptable that this company continues to drag their feet to save a **** while their patients suffer. Countless disconnected calls to customer service, deleted *****************************, etc. Someone needs to hold them accountable to their patients!! We have multiple interactions between our doctors and us, as well as calls to Caremark documented.Business response
01/29/2025
January 29, 2025
BBB serving *********************, *****, ************, and *******
5 Mt. *********. Suite 100
*************** 01752-1927
Complaint # ********
To whom it may concern:
CVS Caremark administers the prescription benefits portion of the ******* HEALTHINEERS health plan,
of which the beneficiary is a member. This letter is in response to the correspondence we received from
your office on January 22, 2025. Thank you for the opportunity to address the beneficiarys concerns.
An override was entered allowing the member to fill their prescription until July 24, 2025. The member
will receive the order via *** (tracking number 1Z74W0A6P225052440).
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.
Sincerely,
*******************
Member AdvocateCustomer response
01/31/2025
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Better Business Bureau:
I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
**** *******Initial Complaint
01/17/2025
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
At the beginning of January, I submitted a refill request for medication and CVS Caremark has failed to follow through on prior authorization in a timely manner which resulting in a delay in time sensative injections I take.Business response
01/27/2025
January 27, 2025
BBB serving *********************, *****, ************, and *******
5 Mt. Royal Ave.Suite 100
*************** 01752-1927
Complaint # ********
To whom it may concern:
CVS Caremark administers the prescription benefits portion of DIRECTV health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on January 17, 2025. Thank you for the opportunity to address the beneficiarys concerns.
The member spoke with ********************** on January 13, 2025, and was informed a prior authorization was needed for their medication.
The prior authorization was approved on January 21, 2025 and is valid until January 20,2026.
The members medication shipped on January 21, 2025 and delivered on January 22, 2025 via ***,tracking# 1Z7F7W57P238139161.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
*******************
Member AdvocateInitial Complaint
01/11/2025
- Complaint Type:
- Delivery Issues
- Status:
- Answered
I canceled an Enfamil prescription through the CVS Caremark app in November, and it should have been successfully canceled. However, on January 2nd, I noticed a charge from *** for this canceled prescription order. Upon checking the app, I found that the order had been shipped.I immediately called the *** team on January 3rd to address this issue and requested the shipment to be stopped. The customer associate informed me that this was a system issue and assured me that I didnt need to take any further action, as the charge would be reversed.Despite this assurance, the charge has not been reversed to date. I contacted the *** team again today and received a completely different response. I was told that I need to mail the package back myself to receive a refund.The package weighs over 80 kg, and since this issue was caused by ***s system error, I request that *** arrange for a door pickup and process the refund. The order number is **********. I also have recordings of both phone calls with *** for reference.Business response
01/27/2025
January 27, 2025
BBB serving *********************, *****, ************, and *******
5 Mt. Royal Ave.Suite 100
*************** 01752-1927
Complaint # ********
To whom it may concern:
CVS Caremark administers the prescription benefits portion of the ****** health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on January 11, 2025. Thank you for the opportunity to address the beneficiarys concerns.
On January *******, the member was reimbursed $667.25. This amount was applied to their credit card that was originally billed .
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
*******************
Member AdvocateInitial Complaint
01/10/2025
- Complaint Type:
- Billing Issues
- Status:
- Answered
I was charged $150 for ******* 5 mg tablets when the actual cost was $33.12. They charged me $600 for four prescriptions so they owe me $467.52.Business response
01/17/2025
January 17, 2025
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on January 13, 2025.
Thank you for the opportunity to address the members concern.
On January 13, 2025, a one-time courtesy refund was issued in the amount of ****** to the member.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.
Sincerely,
***** *******
Member AdvocateInitial Complaint
01/10/2025
- Complaint Type:
- Billing Issues
- Status:
- Answered
******************* continues to call me at ************. I never gave *** Specialty this number. My CVS account has number, ************, on it, not ************. On January 10, 2025, CVS Specialty called me from number, ************, at 8:28am, waking me up. CVS hung up as soon as I answered the phone. It's against the Telephone Consumer Protection Act to call before 9am. CVS owes me $500 per the **** for that call. Further, since I never gave number, ************, to CVS, and they are calling it without my permission, CVS must stop calling that number. CVS must add "************" to its "do not call" list. Remove ************ from my account as it has nothing to do with my CVS account and never will.Business response
01/21/2025
January 21, 2025
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on January 13, 2025. Thank you for the opportunity to address the members concern.
On January 14, 2025, the phone number in question was added to Caremarks do not call list. *** Specialty has also removed the phone number from the members account.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
********* *******
AdvocateInitial Complaint
01/01/2025
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
This is a complaint to make other patients aware of what goes on and to avoid CVS and CVS Caremark in. general. Caremark is my PBM and in order to get a specific prescription medication filled. I would have had to use other medications on a step edit list; as is common practice and expected. Whats NOT expected is that - The medications on their step edit list, have literally nothing to do with the disease state that the medication I required treated. It is absurd. I had previously tried to reach out to them through **************************, however; they decided not to respond in ANY meaningful way. Instead they said that they received my prescription information and gave me DATES that it was received?!This way it looks like they made an attempt and did everything correctly by answering the complaint. Which - shame on you BBB for allowing this. I responded with a follow up, saying their response did NOT address any questions or issues I was having, and they fully and completely ignored it. I guess my medication needs as a human and plan member ARE UNIMPORTANT. Given the state of whats going on with insurance in the US and how people are no longer satisfied with nonsensical answers from insurance corporations, I figured I would write back in and make it known that whoever is reading these complaints and responding is doing the absolute bare minimum just to look like they are responsive. I plan on bringing this to my companies attention as they frequently look to update their insurance plans and PMs . The overall dismissiveness and lack of concern for their patients well-being is despicable. That I could get an email back pointing out dates that my MD sent the script in - INSTEAD OF ADDRESSING THE ABSURD STEP EDIT THAT HAS NOTHING TO DO WITH THE SYMPTOMATOLOGY IS THE LOWEST OF THE LOW. Maybe we can get this in the public eye as well.Business response
01/14/2025
January 14, 2025
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on January 2, 2025. Thank you for the opportunity to address the members concern.
The requested medication is a non-formulary drug for the members plan and requires an approved coverage request. On March 26, 2024, the members prescriber submitted a coverage request for the requested medication and CVS Caremark faxed the criteria form for the requested medication to the prescribers office for completion. On April 1, 2024, the coverage request was auto-closed due to no response from the prescribers office.
On November 6, 2024, the members prescriber submitted a new coverage request for the requested medication that was denied due to not meeting the plans criteria for coverage. An adverse determination notice was sent to the member and their prescriber.
On November 12, 2024, a new coverage request for the requested medication was initiated that included the clinical information required for approval and the coverage request for the requested medication was approved until November 12, 2025.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
***** *******
Member AdvocateCustomer response
01/14/2025
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
In my last response I SPECIFICALLY said listing dates was not just hostile but did not answer any of my concerns and that the step edit medications did NOT treat what the condition that the non formulary drug was meant to treat. I was aghast and my provider was aghast at the choices which were unrelated to the disease state.
Its completely HORRIFYING that the response above yet again does not address my complaint AND WORSE - that it again lists dates which are hostile, and shows that nobody reads they are just checking a box.
Shame on you CVS! Shame on you ***** *******. I guess Im not worthy of anything other than listing out dates - so here - let me write a response you can use -
Thank you for bringing these step edit medication discrepancies to our attention. As you may know, we bulk contract with manufacturers to get the best costs and maybe there was oversight on our part as far as not being applicable treatment modalities for the step edit we are discussing. We will review.
Hope this help,
Regards,Sb
Business response
01/22/2025
January 22, 2025
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on January 14, 2025.
Thank you for the opportunity to address the members concern.
The members plan only covers the requested medication when the member has tried the formulary
alternatives covered by the members plan or the members prescriber provides a medical reason for
why the member cannot take the formulary alternatives. On November 12, 2024, a new coverage
request for the requested medication was initiated that included the clinical information required for
approval and the coverage request for the requested medication was approved until November 12,
2025.
We value our members and remain committed to our purpose, bringing our heart to every moment of
your health. Should you have any additional questions or concerns, please do not hesitate in contacting
me at **************.
Sincerely,
***** *******
Member AdvocateCustomer response
01/27/2025
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********.
Im mesmerized that this response, devoid of care and proper punctuation, came from a member advocate. **** in case you havent figured out yet - you are responding to the member. The BBB is not concerned. I am.
Again you have provided erroneous dates that have less than nothing to do with the reason I have written. You seem to think the members you should be advocating for are less than intelligent. You need to be advocating for formulary step edits that are relevant!!! Cream and gel DO NOT treat systemic conditions!
Id like an answer that addresses what my initial complaint was. Your **** quick and dismissive answers are not only insulting but irrelevant and at this point - gaslighting. Why would CVS Caremark POSSIBLY in any possible situation require a non systemic medicine be used to treat systemic issues????
Are your PBM negotiators not versed in the basics of human anatomy? This is not that difficult. Kindly answer the question. I understand if you are ill at ease with your job but do not take it out on me by ******* and providing a nonsensical answer of dates!
Regards,Sb
Initial Complaint
12/30/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
My husband is type I diabetic and has to take insulin to stabilize his blood sugar. He has been on ******* since 2005, and as of the beginning of this year, insurance switched coverage to *******. We were nervous for the switch because he has never used it before but it actually worked just fine. He went the majority of the year with no problems until we tried to refill his prescription in September. We were then informed that our insurance no longer covered ******* and that they only covered this brand called *****. We also then found out that there are no pharmacies that actually carry this prescription due to a nationwide back order. So the only way we can get his prescription is if we mail ordered it. We finally figured out how to get it and he used it with no problems for about a month. His insulin pump started getting clogged and would stop pushing the insulin through. We thought that it was his pump so we called that company and ended up getting a brand new pump and still had the same issues the same day he got the new pump. So we switched to a tubeless insulin delivery system called Omnipod. That didnt clog but it pushed about 200 units in one day and his blood sugar wasnt coming down. So he switched to manual injections and that wouldnt even bring his blood sugar down. Hes been between 300 and 400 for the last few days and hes been using about 100 units of insulin per day. We finally decided that maybe its the insulin brand thats not working. So we decided that maybe its just a bad batch so we tried to get his prescription filled for the terrible insulin but no pharmacies anywhere have it in stock and we called Caremark to have it mail ordered but they said that its not in stock for mail order either. So caremark only covers a brand of insulin that you can't get in person at a pharmacy and you can't get it mail ordered and caremark refuses to cover a different brand. If this goes on any longer, he will die.Business response
01/08/2025
January 8, 2025
BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************
Complaint # ********
To whom it may concern:
This letter is in response to the correspondence we received from your office on December 31, 2024. Thank you for the opportunity to address the members concern.
The requested drug is a non-formulary drug for the members plan and requires an approved coverage request. On December 23, 2024, the members prescriber submitted an urgent coverage request for the requested medication and CVS Caremark faxed the criteria form to the prescribers office for completion. On December 26, 2024, the coverage request was auto-closed due to no response from the prescribers office.
On January 2, 2025, a new coverage request for the requested medication was initiated at which time the prescriber provided the required clinical information for approval and the request was approved until January 2, 2026. Approval notices were sent to the member and their prescriber.
We value our members and remain committed to our purpose, bringing our heart to every moment of your health. Should you have any additional questions or concerns, please do not hesitate in contacting me at **************.
Sincerely,
********* *******
Advocate
Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩
BBB Business Profiles may not be reproduced for sales or promotional purposes.
BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.
When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.
BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.
As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.