Business Profile

Health Insurance

CVS Caremark

Headquarters

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Complaints

This profile includes complaints for CVS Caremark's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

536 total complaints in the last 3 years.
175 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

Initial Complaint
Date:07/28/2025
Type:Customer Service Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am writing to formally address the ongoing issues I have encountered with CVS Caremark concerning the denial of my GLP-1 medication, despite proper documentation being ************ May 2025, a Senior Prior Authorization Specialist from CVS Caremark acknowledged during a two-hour phone conversation that my GLP-1 medication should be covered. During this discussion, it was confirmed that the appropriate primary diagnosis code had been provided by my physician. However, despite this acknowledgment, my prescription was later denied, with Caremark claiming that no diagnosis code had been submitted.Subsequently, my physician appealed the decision and resubmitted the same documentation in June 2025. This time, the GLP-1 medication was approved, and the prescription was filled.However, on Sunday, July 27, 2025, I received another notice indicating that the medication was once again being denied. Upon calling CVS Caremark that same day, the customer service representative confirmed that the diagnosis code had indeed been submitted, yet the denial still stands.I have been diagnosed with type-2 diabetes, and my physician has prescribed this GLP-1 medication to help maintain my blood sugar levels below 6.5, in accordance with medical guidelines. The ongoing denials and contradictions in Caremarks responses suggest a breakdown in the process and a failure to properly manage my ******* is evident that CVS Caremark is not adhering to proper procedures, and I believe this situation reflects both an abuse of the process and a lack of transparency in handling my case.I kindly request that this matter be reviewed again, and that the denial of my prescription be reversed without further delay.Thank you for your attention to this issue. I look forward to a timely resolution.
Customer Answer
Date: 08/08/2025
[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
Date:07/25/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On July 17, 2025 I received my mailorder drug for a 90 day supply of Vevye. There were 2 bottles sent to me. I called the company and asked for my 3rd bottle. They said my insurance would not cover it. I said what do you mean then why call it a 90 day supply? Pharmacist went on to say supposedly 200 drops in bottles at 2 drops per eye for 30 days it equals 160 drops. No way can you get that many out of a bottle. I then called my other pharmacy and asked what the manufacturer recommends 1 bottle will last for. The reply I got stated 1 bottle = 30 days. I called Caremark again. This time told me I was right and they would send another bottle right away. Except they didnt. I called a 3rd time. I was Transferred all around and heard many stories. I told them the manufacturer recommends 1 bottle for 30 days and how can they get away with saying something different. I told them they should be transparent and say things upfront because no where did it say 2 bottles for 90 days. I would never have purchased that. I asked for a refund for the 3 rd bottle they said no way. I asked for a 3 rd bottle. They said they would not do that at all. I feel scammed and misled. They should not be allowed to do this. It was a phone order and at no time did they say the quantity. Only a 90 day supply.
Customer Answer
Date: 08/05/2025
I have not heard from the business in response to my complaint. I contacted the business 3 times in response and they gave a lot of inaccurate responses of why they thought they should call a 30 day supply a 45 day supply regardless of what the manufacturer called it. They refused any kind of resolution I offered. A partial refund. An extra bottle that would make it a true *********************** BS. I ordered over the phone and was not told it was 2 bottles. I truly feel scammed and taken advantage of. This is the shorter version
Sincerely, ***** *****.
Business Response
Date: 08/06/2025
Thank you for giving us the opportunity to address the beneficiarys concerns regarding their prescription drug coverage with FEP Part D Prescription Drug Plan (PDP). This letter is in response to your correspondence dated 07/26/2025.

Based upon our review, the beneficiary expressed dissatisfaction that when they received their order for eye drops, it was only two bottles for a 90-day supply. The beneficiary stated that when they called ************** they told them they would send a third bottle, but an order was never processed.

On 07/10/2025, the CVS Caremark *********************************** Pharmacy) began processing the beneficiarys prescription for a 90-day supply of the eye drops. We confirmed that the prescription was written for two drops in each eye daily, or four drops per day. The prescription was translated to two bottles and shipped on 07/11/2025 via the **************************** (****). The order was delivered on 07/17/2025. The beneficiarys prescription was for four drops per day for a 90-day supply, for 360 drops total. We confirmed with the ************ Pharmacy that the two bottles contained 200 drops each, or 400 drops total, and as such, the two bottles would cover the 90-day supply, if taken as prescribed. There was no error in the amount dispensed by the ************ Pharmacy, so another bottle could not be sent, nor could the requested third bottle be reimbursed by the pharmacy.

On 07/17/2025, the beneficiary contacted ************* regarding their ****************************. The ************* Representative (CCR) transferred the call to the Clinical Team to better assist the beneficiary. The Clinical Team confirmed that the prescription was translated correctly per the number of drops in each bottle.

On 07/21/2025, the beneficiary contacted ************* regarding their ****************************. The *** reached out to the Senior Team for assistance and stated that the beneficiary was shorted one bottle. The **** assisted in submitting a reship order for the requested third bottle. However, no reship order was created. The beneficiary should have been transferred to the Clinical Team for further explanation. To ensure the beneficiary receives the highest level of service, the Plan requested the ************* Supervisors review the call and provide coaching and/or retraining for the CCRs.

Please contact me with any questions regarding this response.
Customer Answer
Date: 08/06/2025
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.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
*****
Hello, this is a response from ********** where I was getting 1 bottle for 30 days! How can CVS Caremark just say 1 Bottle equals 45 days?? Out of the blue? These bottles only last 25 days btw.
I wrote to them after being railroaded by CVS Caremark. They then tried to blame the eye dr ********* writing the prescription wrong. Seriously. Response from PhilRx as follows:
Thank you for contacting PhilRx.
Hello *****,

Thank you for contacting Patient Support. We are happy to clarify.

We have confirmed the 2 indicates the volume which is two milliliters (mL). The 2mL does make the amount received as only a 1/3 or so full, but we have been reassured by the manufacturer that one bottle of 2mL for a 30 day supply is the correct dosage.

The manufacturer has informed us that each bottle contains a total volume of two milliliters (mL), equating to 200 drops per bottle. While it may seemingly appear to be challenging to extract every drop, one bottle's supply exceeds 30 days.

The recommended usage involves applying one drop in each eye twice a day, resulting in a total of four drops daily. Over a 30-day period, this accumulates to 120 drops. The manufacturer has noted that an additional volume of 80 drops is still there even if it may be challenging to extract every drop.

The manufacturer cautions pressing too hard when dosing as many people are used to water based eyedrops. As a result, there could be a significant loss of volume. Vevye should drip out with very little effort. They go on to recommend to apply the product carefully in front of a mirror or ask someone to apply.
We recommend contacting us at ************, option 3 and we will gladly transfer you to our pharmacist for a consultation with any additional concerns.

Please let us know if you have any questions and hope you have a lovely day!

Very Respectfully,
Emman
Patient Support Specialist
***** *****
Business Response
Date: 08/27/2025
We will work with the member directly.
Customer Answer
Date: 08/30/2025
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.
I have talked to the company extensively prior and they were done with me They still are not offering any satisfactory solutions which leads me to believe they only want to be done with the BBB and drop me again. They can provide an answer through this arena if they are serious about working toward a solution.
The rundown - 1 bottle =30 days by manufacturer and my previous company. They send me 2 bottles and claim its a 90 day supply with a lot of lame excuses. Sounds like a scam to me.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
*****
Initial Complaint
Date:07/23/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On 7/15/25 my doctor, Dr *********** sent in a renewal for my Zepbound. I found out that CVS/Caremark arbitrarily made the decision that starting 7/1/25 they would no longer cover Zepbound and would only cover Wegovy, a different medication. I was given no advanced notice of this, nor given time to research the alternatives. I previously paid a $100 co-pay and the price increased to $1280. I was able to use a discount card from I believe Savingcard or something else the pharmacy had access to. The price was then $900. So in the span of less than one month, my prescription, that was working very well for me with limited side effects became 9 times more expensive. I understand cost savings, but I dont understand how a company can just do that without a notice period to give people time to plan. Plus, Caremark just change to covering Wegovy without consideration if that prescription would cause issues for the insured. Additionally, I use ************* which is under the same parent company as CVS Caremark so either way, CVS is making money at my detriment.
Business Response
Date: 07/24/2025
Good afternoon,
PBM Response File#********
Thank You.
Initial Complaint
Date:07/22/2025
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
A doctor sent a prescription for me to CVS Caremark. I was unaware they were sending it to Caremark mail order, as opposed to a retail pharmacy. Caremark shipped out the medication to me without confirming any method of payment or that I agreed to fill the medication with them (as my copay would be much cheaper through a retail pharmacy). Suddenly months later, I received a bill that I was not expecting. Even though they did not have my method of payment, they just sent out the medication to me and expected me to pay without any consent. When I called and told them they should have applied the charge to my copay card, they refused to apply a prior charge to the copay card (only future ones). However if they had confirmed my method of payment before just shipping it out to me, that information could have been provided to them ahead of time. When stating that they did not receive my approval for this medication to be filled by them and sent AND billed to me, they stated that they feel they do not need my approval, and because they received a prescription from a doctor's office, their practice is to just sent out the medication and expect the patient to pay without confirming ahead of time. I have never heard of another mail order pharmacy that will send out the medication without confirming approval from the patient as well as the shipping address, and payment information. This completely inappropriate and unacceptable.
Business Response
Date: 07/30/2025
July 30, 2025

BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on July 22, 2025. Thank
you for the opportunity to address the members concern.

Upon review of this complaint, we confirmed the order was filled April 7, 2025. The prescription was
sent to CVS/Caremark mail order pharmacy by the members doctor electronically. We provided a
notification via phone call to the number we had on file at the time of the order. Prescription received
by doctors at mail order are processed as a doctors order and sent out to the member. In the event a
doctor submits a prescription to the wrong pharmacy, its not classified as a doctor error for our
purposes. Our mail order pharmacy does not accept manufacturer coupons and thus claim can be
processed with the reference coupon. The medication was filled correctly based on the prescription, and
notification was attempted via the communication preferences we had on file. We found no error in the
filling of the order, or the information provide to the member during contact with customer care.
The return request was beyond the time frame returns would be allowed, and member contact information
being out of date does not reflect a Caremark error that would allow for a post 90 day return exception.
We recommend in the future that member keep notification preferences up to date with correct contact
information. This can be done by calling the phone number on the back of the members card, or
through the plan website. We also recommend the member confirm with the doctor where the
prescription should be sent. No credit will be applied to the member account for the cost of the
medication, and a return can not processed at this time. The balance of ***** remains and can be paid
by either logging on to the plan website and making payment or calling customer care to pay over the
phone.

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 Advocate
Customer Answer
Date: 08/05/2025
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.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
As stated, the prescription and charge was not approved by me. You made an attempt to call my number but did not reach me, which is NOT an acceptance or the shipment and charges. It is incredibly poor behavior and unethical as a pharmacy to just send out prescriptions to patients without their approval AND without confirming their method of payment, and then just demanding payment. As stated several times, you did not receive approval or any confirmation of method of payment, so that is not the fault of the recipient if you want to irresponsibly send things to patients in that manner. This response is unacceptable, and the incredibly poor and unethical policies of CVS Caremark will be reported to the pharmacy board.

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
Brittany

Business Response
Date: 09/02/2025
September 2, 2025

BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on August 12, 2025. Thank you for the opportunity to address the members concern.

Upon review of this complaint, while we understand the members frustration the prescription was submitted to our pharmacy and filled as a doctors order. We attempted to contact the member with the contact information we had on file. We have confirmed an invoice was sent with the order detailing the cost. Post 90 days and with no identifiable Caremark error we are unable to grant the request for a credit to the members account for the balance due or issue a return envelope. We advise members to keep their contact information up to date and can check the status of the account through the plan website.

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 Advocate

Customer Answer
Date: 09/02/2025
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.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]

It seems you do not speak with each other over there or on take appropriate notes in the system. I called again with the third party company that has the copay card that CVS Caremark should have used. But as stated, due to terrible practices and errors on CVS Caremarks end, the copay card was not properly used. I spoke with a supervisor, ***, who confirmed that my account WILL in fact be credited, due to how poorly and inappropriately this was handled by CVS Caremark. As a prescriber myself, Im appalled at CVS Caremarks practices. It is completely inappropriate to just ship out medications to patients without FIRST confirming their correct address/contact information, method of payment, and that they actually approve of you shipping it to them. I have worked with countless other mail order pharmacies, and none of the others have such poor practices. Not only does this leave unexpected bills on patients, but also increased risk for medication errors due to incorrect deliveries, etc. So since CVS Caremark has been so unhelpful and unethical with these practices and responses, I will also be reporting this to the pharmacy board. CVS Caremark should be ashamed for these lazy and unethical practices, and should strive to do much better than that. But this is an incredibly disappointing experience and exchange.

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
Brittany
Initial Complaint
Date:07/21/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
CVS Caremark told me that medication Wegovy was not covered under my plan and that medication Mounjaro was covered. Tried for a week to get that accepted only to find out the support *** misled me with the wrong information and Mounjaro is not covered. Then a second *** told me that Wegovy would be covered only to find out days later that information is also wrong. After speaking with a supervisor both ***s misled me on what medications are covered on my plan. Terrible support!
Business Response
Date: 08/04/2025
August 4, 2025

BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on July 22, 2025. Thank
you for the opportunity to address the members concern.

The first requested medication is excluded under the member's plan. On July 18, 2025, the members
prescriber submitted a coverage request for the first requested medication that was denied due to plan
exclusion. An adverse determination letter was sent to the member and their prescriber.

The second requested medication is a formulary drug for the members plan, however, it requires a
review of the plan elected drug specific prior authorization criteria prior to coverage. On July 16, 2025,
the members prescriber submitted a coverage request for the second requested medication that was
denied due to not meeting the plans criteria for coverage. An adverse determination letter was sent to
the member and their prescriber.

On July 17, 2025, the members prescriber submitted a coverage request for the second requested
medication that was denied due to not meeting the plans criteria for coverage. An adverse
determination letter was 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,

***** *******
Member Advocate
Customer Answer
Date: 08/05/2025
Yes, their response is correct. But when I called for those medications ahead of time they told me they are covered under my plan. This happened multiple times, only to find out my prescription was denied after submitting it. When calling back and talking with a manager my wife and I learned that those multiple people told us the wrong information. The one *** said for sure I'm covered because he has done this for a long time and is on the medication himself. They have very untrained unprofessional employees. Very terrible experience that most likely will never be solved. Many complaints online with others having the same experience. My complaint isn't about the process, its about the company and employees. You would think the medical industry would warrant better clarity to patients. Makes a person wonder how many people this company has affected. They should not be in the medical industry. Very misleading staff and company. And of course, their reply didn't mention the real problem. Only that they sent letters. Again, its not about the prescription. Its about the CVS Caremark staff giving patients the wrong information.

Business Response
Date: 08/28/2025
August 28, 2025

BBB serving *********************, *****, ************, and *******
****************************************************************************************************************************************

Complaint # ********

To whom it may concern:

This letter is in response to the correspondence we received from your office on August 5, 2025. Thank you for the opportunity to address the members concern.

The information provided on July 15, 2025, indicated that the requested medication was covered under the members plan, which was accurate. The first requested medication is excluded under the member's plan and is not eligible for substitution.

The information provided on July 17, 2025, was inaccurate information. The second requested medication is excluded by the members plan. Any appropriate colleague coaching will be provided.

With respect to the two calls on July 21, 2025, accurate information regarding coverage of the first requested medication was provided 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 Advocate
Initial Complaint
Date:07/14/2025
Type:Order Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Recently, I was diagnosed with Vestibular Migraine and Hearing Loss by Drs. ******** and ******. For the vestibular migraines, I was prescribed a new medication, Nortriptyline, starting with 10 mg and then increasing to 20 mg. This required me to stop taking Trazodone at night for sleep. Instead, my sleep doctor, Dr. ****** prescribed ******** 10 mg for 30 days. However, Aetna insurance only covered a 20-day supply. As I adjusted to the new medication, my doctor advised me to increase ******** to 20 mg per night. As a result, I used up the first 20 pills sooner than expected. On July 11, 2025, Dr. ***** then wrote another prescription for a 30-day supply of ******** 20 mg. Aetna refuses to approve the medication, risking another insomnia crisis like the one I had a few years ago that landed me in the *** Also, as I need hearing aids due to a medical condition, Aetna should approve them as soon as possible. I want ***** to prioritize patients' needs over profits and approve my medication promptly, as often as my doctor determines necessary. Their refusal puts me in a position where I cant sleep at night for several days, leading to depression and despair, so severe that I already feel the only solution to my health problems is to end my life instead of living like this.
Business Response
Date: 07/16/2025
Dear ******* *********:
Please see our response to complaint # ******** for ****** *****-******* that was received by us on July 14, 2025. Our Executive Resolution Team researched the concerns, and I would like to share the results of the review with you.
Upon receipt of your request, we immediately reached out internally to further research the concerns. After further review it was determined that the medication was approved for a 30-day supply with a $0 copay. Outreach was made to the member regarding this, member was made aware of the ************ where the medication is in stock at. Member stated he would make outreach to the prescriber to have a new prescription sent to the alternate CVS. Regarding the hearing aid concerns. After reviewing the members claims, no claim was found on file that has denied or rejected the hearing aids. However, the member does not have hearing aid coverage as he is over the age of 22. The members plan covers hearing aids as follows: Hearing aids are limited to one per hearing-impaired ear every 36 months for members under the age of 22. Members over of the age of 22 are not covered for any hearing aid related services. Hearing aids are subject to the plans deductible and coinsurance. The member is eligible for a hearing aid discount. The member can find this information via the plans benefit guide at ******************************************************************************************************* hearing aid benefits are found on page 18. The members concerns have also been forwarded to our Resources of ***************** to address his concerns regarding his health, outreach attempts were made to the member on July 15, 2025, the member did not answer, another outreach attempt is scheduled for today July *******.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. ************** concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at ********************************
Sincerely,
******** *.
Executive Analyst,Executive Resolution Team

Customer Answer
Date: 07/16/2025
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.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
According to information that I have researched in regards to my coverage, it states that hearing aids are covered as long as there is a medical diagnosis for the loss of hearing. I do have a letter from my doctor stating such a medical diagnosis.

FAQ

Regards,
******

Business Response
Date: 07/30/2025
July 30, 2025

BBB serving *********************, *****, ************, and *******
5 Mt. *********. Suite 100
***********, MA 01752-1927

Re:Complaint # ********

Dear Sir/Madam:

CVS Caremark administers the prescription benefits portion of the North Carolina State Health Plan For Teachers & State Employees-NCSHP 1 health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on July 14, 2025. Thank you for the opportunity to address the beneficiarys concerns.

The medication in question required an override, per plan design. The Account Manager inserted the override, and the medication pays through at a $0.00 copay. The member has been contacted by ***** **** with the Presidential Response Team on July 17, 2025, at 9:23am.
The Presidential Response Unit resolved the prescription benefit portion of members complaint, and the medication was filled on July 16, 2025.

The member was also inquiring about a medical concern, which ***** **** with the Presidential Response Team discussed with the member over the phone on July 15, 2025, and member would need to reach out to his medical plan for further assistance, as this is not a prescription item.

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 Advocate

Customer Answer
Date: 07/31/2025
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.
I do accept the business response regarding my medication; however, I would like to ask for an answer to my complaint about my medical need for hearing aids the business doesn't want to cover. In the past I contacted someone who told me something like "we will not pay for your hearing aids even if you fill out the reimbursement form."

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
******

Business Response
Date: 08/11/2025
CONFIDENTIAL AND PROPRIETARY
FOIA EXEMPT DO NOT DISCLOSE
August 11, 2025

BBB serving *********************, *****, ************, and *******
5 Mt. *********. Suite 100
***********, MA 01752-1927

Re:Complaint # ********

Dear Sir/Madam:

CVS Caremark administers the prescription benefits portion of the North Carolina State Health Plan For Teachers & State Employees-NCSHP 1 health plan, of which the beneficiary is a member. This letter is in response to the correspondence we received from your office on July 14, 2025. Thank you for the opportunity to address the beneficiarys concerns.

The medication in question requires an override, per plan design. The Account Manager inserted the override, and the medication paid through at a $0.00 copay. The member had been contacted by ***** **** with the Presidential Response Team on July 17, 2025, at 9:23am. Member was also made aware that his additional concern needs to be addressed through his medical plan. The member will need to reach out to the Benefits and Claims number on the back of their Aetna card ************.

Presidential Response Unit has resolved the members Prescription Benefit Manager portion of this complaint. Member will need to reach out to their Aetna medical plan for Hearing Aides.

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 Advocate
Initial Complaint
Date:07/13/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
My doctor had order a prescription through caremark I looked it it up and told my doctor the price was to high for me . I notified caremark through chat and told them to cancel it before they filled the order . I again told them later that day and told them to cancel it and they completely ignore me saying it was to late I had notify them before it was filled and ship and still they had excuses . I know they could have stopped it before it was shipped and didn't now they are charging me ****** in which it will be taken automatically through my bank and check . I am on social security and can't afford that much when a generic brand would cost me $.0 dollars.
Customer Answer
Date: 07/24/2025
I have not heard from the business in response to my complaint.
Business Response
Date: 07/28/2025
PBM Response File#********
Customer Answer
Date: 07/28/2025
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.]
They stated they sent a mail tag to return the item but if you see in the conversation it was denied due to insurance regulations as of today I have not opened the package yet . I was told if I send it back it will be destroyed and I still wouldn't get a refund .

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
****

Business Response
Date: 07/29/2025
PBM Response File#********
Customer Answer
Date: 08/04/2025
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.
I have not received the mail tag so I can send the medication back .
Business Response
Date: 08/04/2025
PBM Response File#********
Initial Complaint
Date:07/12/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
CVS Caremark pulled a drug that I have been taking off the formulary mid year SOLELY for financial reasons, much to their own benefit because they struck a deal with another pharmaceutical company that does not offer the same drug. Their only alternative is offering a less effective drug that has been shown to cause more negative side effects. This has caused disruptions to the care and health of likely thousands of people, myself included. This decision was not based on evidence, but on financial reasons without an acceptable alternative for patients that are unable to take the drug they are offering. They are forcing people to take this drug and prove that it causes them side effects rather than taking pre-existing health conditions and medical concerns into account. By switching to this drug, many people are forced to start over at a lower dose which has its own set of implications. This change is not only affecting patients, but it is putting a strain on providers who are now forced to jump through hoops to get alternative options approved through multiple prior authorization attempts, appeals, just to justify why a patient who has been successful on the medication they were taking, which was previously a covered drug, should continue to stay on it. Most of these attempts are then denied by the company. This is not only having an effect on physical health but mental health as well. CVS Caremark should be ashamed at the stress they are putting on their patients and the potential health repercussions these patients will face in light of their decision to do this.
Business Response
Date: 07/23/2025
July 23, 2025
Better Business Bureau
5 Mt. *********. Suite 100
***********, MA 01752-1927
Complaint # ********
Dear Sir/Madam:
CVS Caremark administers the prescription benefits portion of the ************ and Presbyterian
Hospital health plan, of which the beneficiary is a member. This letter is in response to the
correspondence we received from your office on July 12, 2025. Thank you for the opportunity to address
the beneficiarys concerns.
The medication in question will be removed from the standard formulary drug list effective July 1, 2025.
The Members prior authorization will be in effect until June 30, 2025, then will transition to the
alternative drug until the prior authorization expires October 22, 2025. If the Member would like to
continue with current medication, they will need to request a formulary exception and obtain approval
for the medication to be covered beyond June 30, 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 Advocate
Initial Complaint
Date:07/11/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
CVS Caremark in June of 2025 told my doctor a prior-auth for Toprol XL was not needed. This was erroneous they later claimed and that it was meant for generic and not brand, but I need the brand. The doctor then submitted it a 2nd time and it was denied. Then a third time they submitted it and are being told to put the generic, but the point of the prior auth is for medically necessary brand. I've done this prior auth for 10 years with CVS caremark and i need this medicine for my heart. I am a member of ********************* serving our country and could use some assistance getting this resolved before it impacts our national security.
Business Response
Date: 07/22/2025
July 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 July 11, 2025. Thank
you for the opportunity to address the members concern.

The requested medication is not covered unless the plan-elected non-formulary exception criteria is
completed and the requirements for coverage are met. On July 7, 2025, the members prescriber
submitted a prior authorization 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 July 16, 2025, a new prior authorization request was submitted for the requested medication that
included new clinical information, and the request was approved until July 16, 2026. An approval
notification was 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,

***** *******
Member Advocate
Initial Complaint
Date:07/11/2025
Type:Delivery Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Cannot get my prescription refilled. I was getting my ********** shipped to me then they stopped. I contacted support and did not get any help. Resolve this or i go with someone else!!
Business Response
Date: 07/15/2025
PBM Response File#********
Customer Answer
Date: 07/17/2025
[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,

****** ********

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