My wife’s Physician prescribed Rx for Topomax has been denied.*We have submitted a pre...

GetHuman2044175's customer service issue with OptumRx from January 2019

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The issue in GetHuman2044175's own words
My wife’s Physician prescribed Rx for Topomax has been denied.*We have submitted a pre-authorization and it was denied. We have called the customer service line at least **-** times and get a different answer each time we call. Theses are a few responses: ** no problem, it will get filled at a tier rate **their is no recourse**there is a way the prescribing physician can release the DOW code on a specific website**the physician connotvrelease the DOW code - pharmacy has to do that and since your pre-authorization code is denied we cannot release.*My wife and I have been hung up on, put on hold and no one returned... on and on.*I am an employee with Mayo and definitely need some answers. We are not looking for a free Rx, just that we are not penalized because she can only tolerate a brand name drug (multiple trials w multiple Neurogists have proven that fact).*The policy as written categorizes this drug as a tier * - brand drug on the formulary. I am not understanding why we have to pay the retail and a penalty which amounts to about $**** per month (Of which we have paid for the last four months). All other insurance plans in prior companies have allowed the dispensing of this drug at normal rates and applying the out of pocket costs to the deductible. Optum Rx disallows all those benefits.*Please reconsider this decision.*Steven Robinson****-***-****
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OptumRx

Customer service issue
Reported by GetHuman2044175
Jan 26th, 2019 - 3 mons ago
I have an issue with OptumRx too
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Seen by 5 customers so far
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GetHuman2044175 started working on this issue
Jan 26th 3:41pm