Archived Is anyone else having problems with CVS/Caremark?

Status
Not open for further replies.
T

tinkerbell333

Former Team Member-Parolled August 2017
Joined
Sep 27, 2015
Messages
190
I have had NOTHING but trouble with our new prescription benefit administrator. They decided that they know better than my DOCTOR how I should take my medication. They seem to change their own rules when they like as well. They have preferred medications and won't pay for non-preferred even if that is what your doctor has prescribed. They make no effort to let people know this or contact a doctor to make that change. None of that process gets started until you try to refill your prescription.

I have a med that I am PRESCRIBED by my doctor to take every day, CVS/Caremark says that they think I only need 15 in 25 days and they will only fill 2 days early, ok fine I can deal with that. This month for whatever reason they say that I have to wait 27 days before they will fill.....WTF!

My son has been on a med for his breathing for years, with the old prescription plan the co pay was high (around $50 per month) but it worked well for him so it was worth it. CVS/Caremark says that they prefer another, similar med (which doesn't work for my son) and his doctor will have to switch him to that med or one other that is similar to the other 2. I find this out when I try to refill that prescription. They don't try to contact the prescribing doctor nor do they offer to fill it for a month until they can contact and get the prescription changed. Luckily I was refilling this prescription early and they were able to get it changed before my son ran out of his meds. This is HORRIBLE guest service! I feel like Target sold it's employees with health coverage down the river, as I'm sure that this was part of the CVS deal.

Does anyone know if there is any way to let Target Corporate know how poorly we are being treated by CVS/Caremark? I am not talking about the pharmacists/techs, most of them stayed at my store & they are all great. I want to let someone know how badly Target team members are being treated by the prescription administrators.

Thanks in advance!
 
We're switching pharmacies after being told that CVS doesn't have contracts with several drug manufacturers therefore they won't even be able to ORDER those drugs.
One was an essential drug for my kid with a disability.
 
Your doctor can do a prior authorization on the other medication. Unfortunately, every insurance puts the onus on the subscriber (employee) to know what is/isn't covered under the plan and you usually don't discover this until you go to refill the medication and they tell you it's not covered. The pharmacy should have gotten a reject stating a prior authorization was required for the existing medication and the doctor's office should have been notified of such. Unfortunately, some doctors would rather just change the med than deal with the insurance company.

And it's not just Target TMs, all insurance companies treat their subscribers that way. I've been fighting with mine (not Caremark) for over 2 months over my daily meds as well. I've been dealing with it for years with different insurance companies over different meds. Caremark is one of the worst, because they are one of, if not the ONLY PBM that also dictates that you can ONLY fill at ONE pharmacy (which happens to be the one they own.) IMO, that should be illegal, but the FTC has already ruled it isn't.
 
redeye58 said:
We're switching pharmacies after being told that CVS doesn't have contracts with several drug manufacturers therefore they won't even be able to ORDER those drugs.
One was an essential drug for my kid with a disability.
Click to expand...
AFAIK, there's only 1 manufacturer we absolutely CANNOT order, and that's NorthStar. Haven't heard about any others, but would love to know if there are....
 
tinkerbell333 said:
I have had NOTHING but trouble with our new prescription benefit administrator. They decided that they know better than my DOCTOR how I should take my medication. They seem to change their own rules when they like as well. They have preferred medications and won't pay for non-preferred even if that is what your doctor has prescribed. They make no effort to let people know this or contact a doctor to make that change. None of that process gets started until you try to refill your prescription.

I have a med that I am PRESCRIBED by my doctor to take every day, CVS/Caremark says that they think I only need 15 in 25 days and they will only fill 2 days early, ok fine I can deal with that. This month for whatever reason they say that I have to wait 27 days before they will fill.....WTF!

My son has been on a med for his breathing for years, with the old prescription plan the co pay was high (around $50 per month) but it worked well for him so it was worth it. CVS/Caremark says that they prefer another, similar med (which doesn't work for my son) and his doctor will have to switch him to that med or one other that is similar to the other 2. I find this out when I try to refill that prescription. They don't try to contact the prescribing doctor nor do they offer to fill it for a month until they can contact and get the prescription changed. Luckily I was refilling this prescription early and they were able to get it changed before my son ran out of his meds. This is HORRIBLE guest service! I feel like Target sold it's employees with health coverage down the river, as I'm sure that this was part of the CVS deal.

Does anyone know if there is any way to let Target Corporate know how poorly we are being treated by CVS/Caremark? I am not talking about the pharmacists/techs, most of them stayed at my store & they are all great. I want to let someone know how badly Target team members are being treated by the prescription administrators.

Thanks in advance!
Click to expand...

So just for fun this month they have changed the med my doctor prescribed to 15 in 30 days.....
 
If it makes you feel any better, I tried to look up my PA in my insurance company's system and apparently, I no longer exist! Couldn't even find the one that WAS approved when I searched by the case number :rolleyes: My username/password (which were saved in my keychain) are also no longer valid. I think they're trying to tell me something o_O
 
PharmaQueen said:
If it makes you feel any better, I tried to look up my PA in my insurance company's system and apparently, I no longer exist! Couldn't even find the one that WAS approved when I searched by the case number :rolleyes: My username/password (which were saved in my keychain) are also no longer valid. I think they're trying to tell me something o_O
Click to expand...

Yikes! Well I have the feeling that eventually they are going to say that I get 0 pills in 30 days. This med has a generic (which I use) I shudder to imagine how many circles of hell someone would have to go through if they were prescribed a medication that was very expensive.
 
Our issue isn't with Caremark either, just a particular generic brand Target ordered for us that CVS now says they can't order thru Mckesson.
 
Last edited:
Well my issues are completely with CVS/Caremark/whatever they're called and the very DAY Target announced their pharmacies were being bought out, I switched to a different one. Every time I have had my monthly scripts filled at a CVS it has been nothing but trouble. One time the CVS down the street from me actually lost my prescription that they had received a call for and filled not 30 minutes prior. The pharmacist was scrambling looking for it and never found it. That's really just the start of the problems though, from the long lines, rude employees, ugly looking stores, etc.

If I ever have to step foot inside a CVS again I think I'll need someone by my side who can deal with bullshit, 'cause I certainly ain't got no time for that.
 
Just because the CVS down the street had issues doesn't mean the C@T will. Remember, it's the same people working there. Yes, they may have stock issues like the other one did, but issues like losing scripts and stuff like that shouldn't happen if they didn't happen with the Target...
 
I have three meds that are now provided by CVS. If you read the meds that are covered in your plan you can see if the med is covered by CVS. Premium drugs always get a generic unless your doctor specifically states no substitution. If your doctor leaves it blank they will also do the generic so make sure that your doctor states to not substitute or option fill with a substitute med.

For specialty meds that are above premium like crestor for cholesterol you will need a pre-approval and your doctor should do that for you easily and it should be fast. I have worked with CVS for a terminal illness for my parent and personal illness for me and all I can say is read the fine print.

If CVS does not fill certain meds then ask your doctor to contact Caremark Specialty which is their higher up pharmacy and I bet it is covered there.

When in doubt always ask your doctor if the pharmaceutical maker will pay for the meds. It sure doesn't hurt.
 
I don't have ins through Target, but I use CVS. They were filling my prescription with a generic that I said didn't work for me and need the brand name. They ordered me the brand name no big deal. They said they could try and order it and when I went to get it, surprise, I had the brand name. Maybe it's because I went into the gross details of the generic side effects, lol!
 
thenutjob said:
I don't have ins through Target, but I use CVS. They were filling my prescription with a generic that I said didn't work for me and need the brand name. They ordered me the brand name no big deal. They said they could try and order it and when I went to get it, surprise, I had the brand name. Maybe it's because I went into the gross details of the generic side effects, lol!
Click to expand...
If you (or the doctor) request the brand, they legally have to fill it with the brand. Insurance may not cover it without a PA, but the pharmacy can't deny you the brand (except in cases where the brand is no longer available.) did they at least find out if it was covered and the cost before ordering? I hate when people insist on the brand until they find out it's ridiculously expensive or my coworkers order the brand before finding out it's not covered...then we're stuck with a ridiculously expensive (in most cases) Med we will probably never use!! (Not all meds can be returned.)
 
We stopped having our meds filled at the Target pharmacy because almost every time I brought in my son's routine medication (I have to get filled every 30 days and needs a new script every time) they would tell me they have to order it. My doctor cuts it close to when it was last filled so I can't wait a week. I started taking them to Publix. They never had a problem. Now we get a call 3 weeks ago that my husband's medication that has been filled there for a couple years can't be filled there now (we are forced to go to CVS). His is a preferred drug, my son's is a generic so does that mean I have to take it to CVS too? The Target CVS said it would take a week to order the meds again.

Just got off the phone with CVS Caremark and it appears that probably preferred and maintenance drugs have to now be filled at CVS. Others can still be filled at my Publix. I just wish I had this information in front of me, yes I would read all that benefits junk. Didn't get a packet this year and felt like I was flying blind.
 
Last edited:
Oi vey. Reading through this thread makes me very glad I'm still covered by my parents with Kaiser. And that I don't have any chronic medication requirements beyond Advil and Alcohol.
 
TallAPGuy said:
Oi vey. Reading through this thread makes me very glad I'm still covered by my parents with Kaiser. And that I don't have any chronic medication requirements beyond Advil and Alcohol.
Click to expand...

Same here........until I turn 26 and get booted from my parents' insurance. And of course I don't make enough money (between two jobs) to be able to afford my own insurance.

At least I have my health?
 
Justapeon said:
We stopped having our meds filled at the Target pharmacy because almost every time I brought in my son's routine medication (I have to get filled every 30 days and needs a new script every time) they would tell me they have to order it. My doctor cuts it close to when it was last filled so I can't wait a week. I started taking them to Publix. They never had a problem. Now we get a call 3 weeks ago that my husband's medication that has been filled there for a couple years can't be filled there now (we are forced to go to CVS). His is a preferred drug, my son's is a generic so does that mean I have to take it to CVS too? The Target CVS said it would take a week to order the meds again.

Just got off the phone with CVS Caremark and it appears that probably preferred and maintenance drugs have to now be filled at CVS. Others can still be filled at my Publix. I just wish I had this information in front of me, yes I would read all that benefits junk. Didn't get a packet this year and felt like I was flying blind.
Click to expand...
It depends on the Med and how Caremark categorizes your son's med. If it's considered a "maintenance med," you'll have to get it at CVS. They will usually only cover 2-3 fills before requiring the switch. The "best" part is that they don't tell the filling pharmacy until they deny it. Their categories make no sense, either.....for example, some ADHD meds are considered "maintenance," others aren't. Chances are, though, you'll probably end up having to switch them. Usually, if you have multiple rxs on file, the pharmacist will have it in stock. Or just have a talk with the pharmacy and let them know you will be filling it every month, and they can order it in time....
 
Status
Not open for further replies.

Similar threads

M
Paycheck problem
Replies
9
Views
631
Ashfromoldsite
Ashfromoldsite
T
With Target moving to BCBS does anyone know if gender affirming care will be as good?
Replies
3
Views
1K
dannyy315
D
F
HR ignoring all time off requests and availability
Replies
19
Views
900
allnew2
allnew2
D
What are my options with 401K after leaving?
Replies
8
Views
3K
Formina Sage
Formina Sage
E
New Team member with scheduling issue
Replies
5
Views
3K
eeeeeeeekimnew
E
Back
Top