Reviews

Review Details

• Review fromJoel G

  Date: 06/13/2025

  1 star

  Joel G

  Date: 06/13/2025

  They honestly don't know what they are doing over there and don't even know their own policies. We were required to get a prior approval from our doctor in order to get a prescription. It was denied, which was odd because the previous insurance companies we had never denied it. They needed more information about other generic drugs we tried but, in the meantime, we were forced to take a generic drug we knew didn't work well. We provided all the information we needed and, when I called to check on it, they said that it shouldn't have been denied because we were grandfathered in from our previous insurance. They approved it but said there was a penalty payment because it was a name brand. They said this could be waived if we showed proof that other medications didn't work. Again, we provided all the information they required and, again, they said they still needed more information. This went on for months of us talking with Ventegra, them telling us they need more information, us going to our doctor, and the doctor providing everything they asked for. Finally, after talking with a supervisor, they said they never could waive that penalty fee. They had us jumping through hoops for several months all the while very seldom getting the proper medication. I understand it is part of the policy but, being told that it could be waived if we provided all the documentation leaves me to believe they are not well versed in their own policies and do not know what is going on.

  Ventegra, Inc., A California Benefit Corporation

  Date: 06/20/2025

  Thank you for taking the time to share your concerns with our Ventegra team through multiple phone conversations prior to posting your review on the BBB website. We are truly sorry to learn about the challenges you faced and sincerely apologize for the frustration and disruption this situation has caused. We understand how disheartening it must have been to feel like you were jumping through hoops for several months and not consistently receiving the medication your wife needed.We recognize that you were initially told prior approval was required and then informed it should not have been denied due to the prescription being grandfathered in from previous coverage. We also acknowledge that while you were working to provide all the documentation requestedmultiple times and in good faithyou were told the penalty fee could be waived, only to later learn that it could not. This miscommunication is understandably frustrating, and your concerns about inconsistent messaging and clarity around our policies are absolutely valid. For this, we offer, and ask you to accept, our most heartfelt apologies.Before your BBB posting, our team had the opportunity to speak with you, and we appreciate the detailed account you provided. Your persistence helped us identify where our process failed to meet your expectations, and for that, we truly regret the inconvenience and apologize again. As part of our follow-up, we also shared additional information that may not have been previously known, such as the availability of a generic version of the drug in question.Since then, our team has reached out to you several times in an effort to offer clear information, answer your questions, and ensure we're taking the right steps to bring clarity, transparency, and resolution to your situation. After speaking with you on June 19, 2025, we were truly heartened to hear you say that you very much appreciated our efforts to satisfactorily resolve this issue. It means a great deal to us to know that our care and attention brought you some peace of mind. We also assured you that youre always welcome to reach out to us directly with any questions or concerns. Were genuinely pleased that you felt satisfied with the resolution, and we remain here for you should you need anything further.Please know that we have taken this situation seriously and have extensively reviewed this internally and implemented additional measures to help ensure a better experience moving forwardnot only for you, but for others who may be navigating similar challenges.Thank you again for your feedback. Please know how much we value your trust and were deeply committed to earning it, and maintaining it, now and always.

• Review fromBrandi M

  Date: 10/02/2024

  2 stars
  Ventegra took over pharmacy management for my insurance company this year. They have denied 2 migraine medications that I need to function and work as an ER nurse. After many phone calls and appeals, I have been able to get one of the medications. I dont know why this company thinks they know better than the neurologist I have seen for many years what medications I do or do not need. The denial they sent was a scam as it said I have to try and fail more than one type of medication to be approved. Well I have tried many and failed as I have had migraines since the age of eight. Further, I truly feel sorry for those with less health literacy trying to get medications with this company because I have a Masters in nursing and an undergrad in public health education and still cant get anywhere. I am grateful for the medication they do cover and the temporary authorization for one year on one of the medications. Thank you- ****** *****

• Review fromKim P

  Date: 09/09/2024

  1 star

  Kim P

  Date: 09/09/2024

  Getting the medication your ** wants you to take is like pulling teeth ! You jump through their hoops but they lose paperwork or want you to take a med they must be getting a kickback from that doesnt work as well as what your doctor wants you to be on !

  Ventegra, Inc., A California Benefit Corporation

  Date: 09/12/2024

  We are truly sorry for your experience and understand the frustration and disappointment you may be feeling. While we sincerely appreciate this feedback, it lacks the pertinent details we would need to determine whether this is a legitimate situation for us, or if instead, (1) it involves another party involved in coverage, or (2) if this issue is even applicable (the patient may not be eligible or the drug may be excluded from coverage by the benefit). In general, the patient, you, has the right to receive any medication prescribed by any provider, but the issue revolves around who pays for the medication. Ventegra provides a service to employers who deploy our products and services to manage the healthcare benefit for their eligible employees and dependents. The cost of the benefit is paid for by the employer, and coverage is dependent upon how much the employer wishes to pay for the selected benefit. Ventegra simply administers this benefit as defined by the employer. There are other alternative solutions in the market by manufacturers, other pharmacy providers, discount card solutions, loyalty programs, etc. that a patient could access to get any medication they desire. We encourage you to contact us if youd like us to provide more specific details to address this particular issue.