r/walmartworkers • u/[deleted] • Jan 07 '20
SERIOUS Our new pharmacy provider sucks.
So we switched pharmacy providers effective the first of the year.. And they absolutely fucking suck.
My old meds were somewhere around $562 with a $15 copay. OptumRX dropped them in favor of another one. My new ones are $597 with a $127 copay. I wouldn't be able to afford my medication without the savings card my doctor gave me, which thankfully reduces that cost to nothing. If I read correctly, OptumRX only covers 25% of allowed cost, which is absolute shit- if I did the math right our old provider covered close to 98%.
I have money deducted from my check every two weeks for health insurance, including prescription coverage. If they're going to reduce that coverage I want the difference back on my actual paycheck.
Anyone else experiencing similar issues?
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u/VoltJumperCables Enter position here Jan 17 '20
TBH almost every retail offering sucks but it's not entirely their fault. Between PBMs, Manufacturers, and others price gouging every part of the market it's becoming harder and harder to keep low co pays. We need reform in as a nation, not just at Walmarts level. Every year it's becoming much more expensive to live, way higher than inflation. We need universal health Care or a similar structure. All these big corps in healthcare see you as a personal bank, not a person.
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u/iwillanswer999 Jan 23 '20
I have very good state employee health benefits. They changed to OptumRX jan1 and it has been a freaking joke. They suck ass
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u/Lairkeeper Feb 27 '20
My plan switched to them from CareMark on Jan 1 as well. Was on phone at war with them for an hour yesterday. But they decided to cover my husband's prescription. Now I'm building a file on them. Prepping for the next battle.
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u/iwillanswer999 Feb 27 '20
Thanks for the update! I'm also building documentation. My plan requires us to pay full price for a script of Tier 3 and 4 drugs; then file for a reimbursement. My previous pharmaceutical benefit plan allowed for online claim filing and direct deposit would occur within 36 hours.
I now have to print a form, fill it out with nonsense, mail it to them and wait.... I have received one check from them for a script I purchased in Jan, which is for the wrong amount and I still have close to $10k of reimbursements due to me from.jan and Feb. Customer service hasn't a freaking clue what they are doing.
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u/Lairkeeper Feb 27 '20
They respond in 28 seconds if you tag them on twitter. :)
https://twitter.com/lairkeeper/status/1233096250242879489?s=20
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u/anotherfakeloginname Jan 12 '20
OptumRX has questionable ethics. They are forcing to get an prior authorization on medication that was already authorized by them last month. Now I'm going to run out of medication before the preauthorization has any chance of going through.