OptumReviews of optumrx.com

After approximately three years as a patient of Optum Infusion Pharmacy, I have made the difficult decision to transfer my care to another infusion provider. This decision is not based on one mistake or one bad experience. It is based on a patient experience that has been remarkably consistent for three years. Patients who are sick should never be made to feel like a number. Whenever prior authorizations or changes in therapy have been involved, I have repeatedly found myself having to manage the process from the patient side: call for an update, wait, call again, email, wait again, and eventually escalate when I cannot get answers. Far too often, I have had to figure out for myself where something has stalled and then continue following up until someone takes action. Patients should not have to call, call again, email, escalate, and practically beg for updates about medically necessary treatment. An organization serving as many patients as Optum does should have systems in place to track a patient's care, identify when something has stalled, communicate between departments, and proactively keep patients informed. Even when there is no new information, a simple update telling a patient where things stand and when they can expect to hear from someone again makes an enormous difference. Instead, my experience has repeatedly been that if I don't initiate the communication, I often receive none. My current transition from SCIG back to IVIG following brain surgery was ultimately the final straw. Once again, I have spent an extraordinary amount of time making calls, sending messages, identifying problems, and trying to keep the process moving while I am getting weaker without my infusions. Patients dealing with significant medical conditions should be able to concentrate on being patients. They should not also have to function as their own authorization specialist, case manager, and quality-control department just to make sure their prescribed treatment continues. I do want to distinguish between Optum's system and some of the wonderful individuals working within it. Mary at the Charleston pharmacy has been absolutely amazing to me, and my nurse has been exceptional. I am genuinely sad to leave them. My criticism is not directed toward the people who have personally cared for me so well. It is directed toward a system that, in my experience over three years, has consistently failed to provide the communication and care coordination its patients deserve. Mistakes happen in every organization. What matters is having processes in place to catch those mistakes, correct them, communicate with the patient, and prevent people from falling through the cracks. After three years, I simply no longer have confidence in Optum Infusion Pharmacy's ability to do that consistently. Today, I began the process of transferring my care back to a previous infusion pharmacy. Patients deserve to feel cared for, informed, and remembered. They should never feel like just another number in a very large healthcare system. I am deeply disappointed that this has been my experience with Optum.

Optum RX is a joke. How this benefits the customer is something Im not seeing or understanding. They force you into 90-day supplies when a 1 month supply may be cheaper for some due to not being able to afford 90-day supplies all at once. This is bad business.

I suffer from migraines and have been on a medication before switching insurances and they want me to backtrack and go backwards to appease them by doing their step therapy when I already know what works for my migraines along with the fact that they won't approve anything.

They made sure I could not get my 3 month supply of critical medication. Hours and hours on the phone with dozens of people. Starting from square one every time. Same medication, 3 month supply. Every time I called, started again. Hours on the phone. Every time they asked for insurance authorization that was already sent. Every time they asked for doctor's prescription that was already sent. Any other industry and company would be bankrupt within weeks but this is the intentional USA system. THIS IS THE BUSINESS MODEL. They make sure you pay for insurance but you cannot get the meds you need, so you die earlier and their profits skyrocket. They won. I gave up. I am not getting the medication that would add a few years to my life. But dealing with this company is not a life worth living. I'd rather not deal with them and live 6 years less. Congratulations. If you work for this company, you are part of their evil empire. I hope you and your loved ones also suffer at the hands of medical insurance.

I set up my account with auto-refill for a medication. OptumRX did not alert me that they are out (and will be for a while) to it and now I am scrambling to get the prescription transferred or figure out an alternative. I am so disappointed by this service.

Optum is a piece of crap. I have been attempting to receive authorization for a medication for A YEAR. I began this process in May 2025 and I still have not received authorization despite all the tests and medical history I have sent in. It is 8/2026 and the longer I wait for this medication, the worse off my bones are. Growth hormone is one thing I will need lifelong and because optum doesn’t wanna cover it, my osteopenia is going to become osteoporosis which cannot be undone. They wanted an MRI of my pituitary gland I gave that to them, paid for most out of pocket, they wanted my growth hormone levels, they still wanted more, I went through a horrendously painful glucagon stimulation test, and not even a day after the test I RECEIVE A DENIAL. They didn’t even look at my data! 5 hours of blood draws for what? This is GROSS negligence and I have gotten a lawyer involved.

totally disturbing. I have been receiving home delivery for Nemluvio shots for at least a year, through Optum. Overall, they have been reliable and great when dealing with the specialty pharmacy. However, I needed a vacation override because I am leaving the country and need some shots to take with me. First they told me they were working on it and I took days of phone calls waiting for them to finish working on it. Next, they told me that it was denied because my insurance was expired at the end of the month, which is not true. When I asked them where I can fax proof of my insurance, they had no answers. When I called again and asked for a supervisor, she told me that it was allocated through CVS and it needed to be through Home delivery… Which it already had been for over a year. In other words, they were not willing to help, not willing to provide the medication that I need, and giving me the runaround instead of being honest which is that they didn't want to provide the extra shots. Money rules in this country and here is more evidence of it. Gross. The successful technique these days is to drive everybody insane so that they stop asking for the medication and give up. That is pretty much what happened here.

I'm on a specialty Rx. They require that I actually order it every month. Fair enough, it is expensive and they don't want to waste $ if I've been hit by a bus. They've been shipping to the same address for ~7 years. Their web site tells me it is an invalid address every month. I call, spend 10 minutes getting to someone who has to spend 10 minutes checking before discovering it has to go to the specialty pharmacy. Another long wait.... then they check my address and tell me it is invalid..... Most months it takes between 25 and 30 minutes to order what they've been sending every month. On the plus side, it has been several years since any of their reps openly lied to me. And almost as long since they couldn't ship medication on time. Avoid at all costs.