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PBMs: Medco settles state complaints, but pretty cheaply

Medco today settled its ongoing lawsuit with several state attorneys-general at the relatively modest cost of $30m. The stock rose slightly on the news, although there is an another ongoing Federal lawsuit, that TCHB has covered before. While this looks like a kind of business as usual story of “company gests caught with hand in taxpayer cookie jar, company pays fine, stock goes up as investors are happy fine isn’t bigger”, some of my more jaded readers have been poking into the details. Matt Quinn writes about a different Medco settlement with Massachusetts:

    Maybe I’m missing something, but it appears that Medco only had to pay back part of what it stole from the state of Mass:

    “Medco Health Solutions will pay Massachusetts $5.5 million to settle allegations that the company cheated the state while it managed prescription drug benefits for nearly 200,000 state employees and retirees, according to documents expected to be filed in US District Court today.”

    “Over the course of the contract, Medco passed along about $9 million in rebates, but kept another $10 million, the state alleges.” So, steal $10, pay back $5.5… Not a bad deal.

    And, of course, this plot to make Medco millions of dollars was dreamt up and executed by a few “rogue employees”:
    “Medco officials have acknowledged that the company had isolated problems with “rogue employees” at a mail-order pharmacy in Tampa, but said those problems were quickly corrected and did not affect drug costs.”

Of course this is nothing to the “business opportunities” those PBMs and their rogue employees will be looking at when they get to run the Medicare drug program after 2006.

I suspect the lawyers, state AGs and the DOJ have jobs for life.

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54 replies »

  1. Medco wants us to do things there way well I am sick and tired of the bull shit we all need to get together and do not accept mail order so we can save money like the so call say. Its a way for them to save money not for the customers to save. We need to make them pay for the way they have ripped us off. Everyone needs to get out of mail order and find out how much it costs if you would have to pay regular price for medication not co-pay example Wal-mart one of your cheeper pharmacys would charge a 100.00 for drug A
    (example) were as wal-greens would charge 250.00 for the exact drug. Well I am so sick and tired 0f MEDCO
    ripping me off that now I am now using the pharmacy that cost more for the drug Wal-greens of course or
    even a local pharmacy they would have to pay more
    out of there pocket to cover my meds. We all need to bond together and use the pharmacy that charges more for medication so they can feel how it hurts us to be ripped off.

  2. I hear from an excellent source that MEDCO has a dispute on it’s hands, they require the Pharmacists to process an Rx in under thirty seconds. One of them has blown the whistle.

  3. MEDCO is an un-ethical company, due to miss-information a months premium was over paid, after many calls (all promising to refund)they refused the repayment. I appealed they then stated that the mistake had been made by others not MEDCO, so they would not refund.

  4. INCOMPETENT THIEVES!!
    My Dr. wrote a Rx for me. I told him the generic caused more drowsiness and irritability so he crossed out “generic allowed” and signed his name above “Dispense As Written” AND circled it. Although I normally get generics to save money, I should not have to suffer increased drowsiness from a generic medicine that does not work the same as the brand. Medco sent me the generic. When I called, and was transfered FIVE times, (re-telling the same story) I was told by the Pharmacist that the Dr. had not signed for Brand. This is a blatant LIE.
    I’m a certified Pharmacist Technician and know how to read a Rx. The RPH told me she would contact the Dr. and I said. “but it’s already been filled for generic”. She stated, “if the Dr. writes for Brand, then they’ll fill it for the $35 copay”. A week later, I tried to use my debit card and it was overdrawn. Medco had filled the brand and charged me $463.00!!! Don’t ever give Medco access to your bank account. Medco is stating that I requested brand, NOT the Dr. The second RPH admitted the Dr. had written for brand, but it was also signed on the generic and although it was crossed out, they interpreted it to mean generic. Even though BRAND was circled?! That money was going to be used for college tuition. Now I have 180 days of a medicine I occasionally use.

  5. Oh my gosh. This company is terrible. Watch out for the little disclaimer at the bottom of emails confirming that they are sending you the medication that it will be automatically refilled in 90 days. I called in and told them I did not want anything automatically refilled and low and behold 90 days later a package showed up on my door. I called them and told them I would send the unopened package back to them and that I wanted a refund. They refused. So they can send you RX without your permission and if they have a credit card on record, will charge you for it without your premission as well. As if that’s not bad enough, I have been on the same dosage of thyroid medication for about 7yrs. After being forced to switch to getting it from Medco, my thyroid horomone levels are now off the chart, so I also seriously question the quality of the drugs that they are sending out. At the very least if you are forced to use them as I was, get regular rechecks on whatever medical condition that you have to make sure you don’t end up with more health problems than you started with.

  6. I have sent Medco only one prescription. It was for eye medication. I was new to their service on 1-1-10. I sent them a check for $15.00 to cover three months supply. They sent a brand name when a generic was available. I talked to their Tampa office and they said they would send a mailer for me to return it. They did not. I went back to the doctor and got another prescription which I took to a local pharmacy. They filled it with the generic brand. The generic only costs $5.00 per month while the brand name would cost me over $50.00. I wrote Medco several letters which they would not answer by letter. After writing one letter they sent notice that they were sending a three month refill. I did not request a refill. When it arrived I took the original unsealed bottle of medicine and placed it in a priority mail envelope along with the refill which was still unopened in their own mailer. They received it and signed for it. The signature was a J. Winter. Medco refused to refund my $15.00 and after billing me $96.26 several times they turned it over to a collection agency.

  7. You must read this board if experience or evaluating Medco (hence, the following are key words that I hope will help those who google medco find this page: medco review medco complaint medco frustration medco problem medco reviews medco experience medco vs. cvs caremark

  8. AVOID AVOID AVOID AVOID AVOID What a completely poor customer satisfaction and order process this company has. They act like they are fulfilling widgets, not personal health products. Their employees and pharm techs are less than empathetic(to put it mildly) when addressing their opportunistic process to take advantage of their clients by just tapping their medical reimbursement cards. I would be embarrassed to work it this company.

  9. I called the corporate office and would not get off the phone until my problem was resolved. Forget customer service.
    Phone: 201-269-3400, tell them you have a problem you cannot get solved through normal channels.
    I couldn’t care less if I make someone’s day miserable by calling and calling and calling. I’m paying my premiums, I am entitled to whatever my plan says.

  10. I’m writing another in a series of letters to Medco today for being inappropriately billed for medication that I did in fact have prior authorization for and now has been rejected on 4 different occasions – each time for a different reason (even the claim rejections are inconsistent!)
    I echo all of your frustrations and glad I found this site; did not know about the legal issues Medco had prior to this but it does not surprise me…does anyone know of any still pending?
    And does anyone even know who to complain to “properly” in this organization? Whenever I call Customer Service and have asked to speak to a manager or have looked on the web for clarity, Medco does a great job of keeping things on a first name basis and passing you from one rep to another.
    So many wasted precious resources of lost time, productivity and money for doctors and patients dealing with endless rolls of red tape…it is sickening and Medco and companies like it want you to become so overwhelmed that you give in – please don’t!

  11. I am not surprised to see this webpage with all the comments and story about MEDCO being sued. MEDCO is now the #1 worst experience I have had with healthcare organizations! While the people i deal with on the phone are always sweet and try to be helpful. they have bungled every step in getting my prescription filled! The first fax my doctor sent mysteriously “went missing” – I saw him fax it! Then the second one i had to call three times before someone found it registered in the system. then it took two weeks for the meds to arrive – after I received 3 calls with people asking to check my address – even at 9pm at night! then it arrives and instead of 3 months I get 1 month supply and it is the generic after my doctor and i stipulated several times that it needs to be the brand as the generic does not work for me! They think they are being clever – well Medco, in today’s world of marketing where your brand is no longer your ad but rather what is said about you in forums like this, you better rethink the “worry free fills” tagline because you have caused me enormous worry and stress and i will sit again for weeks trying to get this sorted, without my prescription! thanks for nothing. you need new leadership. i wish i had checked the internet before using your services.

  12. I have never used this company for my prescriptions, yet they sent a letter to my doctor telling him i was getting a controlled substance from another doctor, a doctor that i have never been to, and now I am being droped by my pain specialist because of this letter.
    How did they get my name? I have been told they fill prescriptions for 90 days at a time, I have never received prescriptions for more than a months supply.
    I am afraid someone has stolen my identity,

  13. My doctor subscribed Chantix to stop smoking. I went to Walgreens to get the first script filled and then sent it to Medco for the refills. Walgreen gave me a lot of literature on the meds including dosages and schedules. You increase the dose over several days to full dose. When it was time for refills Medco sent me the first day dose at one tab per day. It was 1/4the the perscribed dose. They told me to take 4 tabs at a time and they would send the correct dosage. Instead of the correct dosage I got a letter stating they had fulfilled their obligation for filling the script even though it was wrong and that I would have to pay $156 to get the correct dose and that I would have to pay that amount as long as I took the medication. My Doctor complained they didn’t do as prescribed, but Medco didn’t care. You can’t trust these people. If you get a wrong script fill DO NOT keep it or pay for it. They will send you a postage paid return envelope to return the script. Send it back and demand the correct script. I have had them change dosage amounts before, but they usually corrected it once I complained. This time they did not.

  14. I too have had a run-in with a witless wonder from Medco. When she called, she told me in no uncertain terms that I was going to have to pay a new fee of $50 instead of the $25 I was co-paying for my diabetes insulin. She actually told me I was being penalized for not taking their ‘offer’ of perscriptions by mail. AND that I needed to ‘avail’ myself of Medco’s on site pharmacist to manage my perscriptions and educate me about my use of Lantus and how to manage my diabetes. Like my doctor hasn’t got a say in the matter anymore and that the next time I filled my perscription for insulin it was going to go from my having to pay $50 to $75 as a penality for not using Medco’s perscription by mail service. United Healthcare manages our perscription plan along with Medco.
    I further told this extremely rude woman that I did not want my perscriptions sent to my home address because I didn’t want the people in my neighborhood knowing what kind of medicines I was taking, and that I have a very bad situation where people take my mail and I’d not be guaranteed that the medicine put in my mail box would get to me… She assured me that the meds would be delivered right to my door. Well, what if I didn’t want my delivery person knowing my business either or I wouldn’t be home when the meds were delivered? Or they left my Lantus on the front porch and it froze because my delivery person didn’t ring the door bell but just threw the box on the porch and took off?
    They of course there was the discussion of letting them have access to my credit cards or bank accounts… Another ‘penalize’ term popped out of this woman’s mouth.
    I told her “there I’d be, no medicine and they would have taken my money out of our account and for what?”
    One other thing, I’m sure I’ll be penalized even more now because this woman told me-eventually-that the phone conversation was being recorded. This woman, to my mind, was threatening me every time she told me I was going to be penalized by not allowing them to call me and counsel me on what they thought I needed to know about managing my diabetes instead of listening to my doctor.
    We pay an outrageous amount each payday for this insurance and to have Medco representatives call me and threaten me for not letting THEIR pharmacist give me medical advice and tell me what I can and can’t take for medicine after my personAL physician and I have already CAREFULLY gone over my perscriptions and treatment to control my diabetes… GET REAL MEDCO AND UNITED HEALTHCARE!!!

  15. I have had continuous problems with Medco and my current prescription. My Dr got prior authorization with a faxed letter from Medco for my prescription. It’s a hormone treatment to prevent preterm labor, as I had PTL at 26 weeks for the first three pregnancies and it kept me from going into labor with my fourth child. I am now pregnant with my fifth and the dr prescribed this to keep the baby in to term. This saves the insurance company lots of money, as preemies in the NICU are quite expensive.
    However, when I went to get the script I was repeatedly told that I am not on the insurance. Then I was told that I needed prior authorization (although I had it in my hand.) Medco insisted that it was not from them, they did not authorize it. Then I was told that there was prior authorization but the pharmacy is not permitted to fill it, although they were permitted to fill it last time. Then I was told (again) that I was not on the insurance. Then I was told that I was, but that the pharmacy NEVER requested of Medco to fill the script. I was standing right there as they did it repeatedly and even called the company- yet there was no record of the call. Eventually Medco said that YES I am insured YES I have prior authorization and YES I can get it at that pharmacy. So I received it, and it was not for a full month!
    My OB called them and said that I needed two boxes and I am going through the same thing again (just yesterday.) Five times they told the pharmacy I was not on the insurance. Then they said that the prescription was not to be filled at that pharmacy (even though I had just filled the same prescription there two weeks ago or so.) The pharmacy said the insurance has no record on file of my using them for the last script. I called Medco myself and they told me that the problem is that I need prior authorization (although I had it.) Then they said that they can’t cover two boxes, they will only cover a 31 day supply. But the box only has 18 days worth. I HAVE to have two boxes or there is not enough. And I HAVE to have it EVERY DAY to prevent preterm labor. I need prior authorization AGAIN for an additional box but said that it will only be given in the amount of 31 days. They do not give a care that the box cannot be opened and dispensed in 31 dosages.
    And what does UHC say? They have nothing to do with prescriptions, it’s all with MEdco. If Medco can’t help you, you’re up the creek. So to the Medco employees who said blame it on your insurance company? Medco IS the insurance company.

  16. Last year I kept track of all of my prescription and the count of each order. I had noticed my prescriptions didn’t seem to be lasting as long as I felt they should when my father told me he had Medco years ago and they constantly cheated him. My refills averaged two tabs shorts per monthly refill. I insisted on 30 day refills since there was no price break for the 90 days they wanted and it would cost me another $100 to see the Dr and get the script rewritten. Bottom line, last year 4/5ths of my scripts filled were short at least two tabs. The remainder were short at least one tab. BE SURE TO COUNT YOUR TABS. THERE IS A REASON THEY WANT AT LEAST 90 DAY SCRIPTS. IF YOU HAVE TO TAKE TWO TABS A DAY THAT WOULD BE 180 TABS TO COUNT TO VERIFY YOUR ORDER.

  17. Just had my own run-in with Medco. They are the preferred drug supplier for my UHC health plan.
    My wife received a call from Medco, and suggested that they could save us money on our prescriptions.
    Interestingly, they knew about every prescription my wife had, and the physicians that prescribed them. I’m sure the lawyers have that loop-hole covered…
    Back to our savings. They indicated they could save us plenty in co-pays, but my wife clearly stated our plan was about to change, and she needed to talk to me first, so NO, DON’T SHIP IT was the answer.
    Funny. The agent clearly knows more about my wifes health care, because a few days later, we received our first shipment of medication.
    My wife called and complained to the agent, who indicated they could not take the drugs back. She protested, and demanded to speak to the agents supervisor, who suggested we would have to submit an appeal in writing to UHC. Bah!
    I called a couple of days later, and talked to an agent at UHC, who had no knowledge of this appeal process, and insisted that Medco would need to be contacted directly, as UHC had nothing to do with the dispersement of medication. I contacted Medco, and was informed that it wasn’t my wife that authorized the shipment, as they initially charged, but the physician.
    I can only guess they contacted the physician, and acquired a prescription for these drugs, and had them shipped to our home! This absolutely baffles me, and my wife is now contacting our physicians to demand they stop this, and find out who authorized it.
    This also seems highly unethical, and that the physicians should watch their back, since I’ll be calling my lawyer soon.

  18. Generic medications are a great way to keep your prescription drug costs down. I’ve seen ads on TV for Caduet. It has two ingredients. One is Amlodipine and the other is Atorvastatin. With my RxDrugCard I can get 30 tablets of Amlodipine for $9 and 30 tablets of Simvastatin for $9. I’ll bet they are charging more than $18 for this new drug! The unthinking public is going to pressure their doctors into giving them something just because it’s new, when something old or generic would do the job for cheaper.

  19. My company contracted with UHC/Medco by mail this year.
    I am fairly healthy, I usually only visit the Dr. for annual well woman exams. I only take two prescription meds, but have recently been notified that one of my meds will be a tier 3. Cost is an important factor to me. My Dr. has expressed dissatisfaction as to how some bozos on the 19th floor of a corporate insurance company can dictate how and at what price she may treat her patients.
    I pray that my employer does not contract with them again.

  20. As to poor customer service, there’s certainly no excuse for that. As to drug changes though, you want full control over all of your health care decisions, but not the financial responsibility for those decisions?
    Interesting.

  21. Medco is amazing:
    1) Won’t fill scripts even though doctor prescribed and both Costco and CVS filled them.
    2)Even on refills they try and get Dr. to change to a generic even though there isn’t one for Lunesta and they were told NO twice already.
    3) Don’t advise when they are delaying sending refill for above reason.
    4) Change dates of script receipts online so it appears they are not late. Latest re-order is now 2 weeks and only one out of 3 received.
    5) The customer service people I have dealt with are generally nice and usually fix the issue but why do I have to call several times for a simple reorder??
    Not once have they sent out a new or refill in time advised. They hold scripts as ransom. I have contacted State attorney Generals office, BCBS, Employer as I have had it with such poor service. Obvioulsy they didn’t learn with last set of fines, must try again.

  22. I just finished writing a complaint letter to Medco and firing my doctor. Based upon a letter from Medco, they contacted my doctor and he authorized a switch from a medication previously prescribed to one that Medco recommended. In my opinion, this is a violation of the doctor/patient relationship.
    We need to start a massive letter-writing campaign against Medco. I urge you to write to your insurance commissioner, the governor and your state legislature to complain about this type of practice. Talk to your doctor and tell him/her that you will not tolerate acceptance of “speaking engagement”/travel junkets and gifts from drug reps in exchange for pushing certain drugs.
    Drug companies and insurance companies are going to continue to take away our right to make decisions about our own health care until we do something about it. It’s great to vent on a blog about the problem, but it’s not going to change unless you take action. Stop being a victim and demand that your elected officials stop pandering to the drug and insurance companies and do something for their constituents for a change.

  23. I have only been dealing with medco for a short time. My company recently changed from Express Scripts to Medco and of course the drugs that were covered before are not covered now. I called their customer service and was told that my prescription would be covered at a lower co-pay and to go back to the pharmacy and have them call the pharmacy help number, which I did and they said it is not covered under the lower copay, I talked to the pharmacy help line while I was there and they started there script on formulary and I told them I was already aware at how it work and I just talked to customer service and they told me it was covered. She told me that it did not show that I had called and maybe my file wasn’t updated yet… hello how long does it take a computer to update file the second you hit save???? so she said all she could do is transfer me to my customer service and she did sorta…. she transferred back into a recording that kepts asking me for my prescription number which I didn’t have and I could never get an operator. So I left the pharmacy and went back to work to call my customer service again only to find out that yes I did call earlier and no the prescription is not covered under the lower copay and now I will have to pay $155 a month for a prescription that was covered by Express Scripts and there is NO GENERIC. On another note it seemed that their “pharmacy” customer service was NOT located in the UNITED STATES!!!!

  24. Medco is screwing me too. They sent a prescription that I did not authorize and now say I must pay for it!

  25. I am an RN who has been in the healthcare fraud business for 28yrs. MEDCO was at the top of my list for fraudulently filling prescriptions not as ordered, and dispensed as they saw fit. Unfortunately, I also have Medco for a prescription provider. They have NEVER reimbursed me for the scripts ordered by my MD, or properly reimbursed the pharmacy for the scripts filled by them for my use. It is impossible to get either Medco or the insurance carrier to properly pay for the drugs as ordered as DAW and on their formulary. So, if I can’t get scripts ordered,not dispensed properly and charged for at the actual non-insured rate, fixed or get reimbursed properly, then the AG’s office on Medicare fraud should prosecute Medco at a much higher level than they did in 2004.
    UHS insureds, John Alden, and so many others have been cashing in on the non-reimbursed co pays, so they are as complicent in making the fraud work. The insurance company that insures the individual or corporation collects the premium,the insured gets NOTHING from the coverage, except pays for the script himself. It’s the employer or self insured with coverage through carriers that carry on this atrocious massive pharmaceutical fraud. Where are the $$$$ today from drug co-pays the carriers collect???
    dhallRN.healthsave@cox.net

  26. The BlueCross/BlueShield move to Medco is a fine display of imcompetence. All the prescription information was transferred from Caremark to the Medco database, but no one bothers to notify patients about drugs that will require a new prior authorization until the patient tries to get a refill on a prescription that had been previously approved for Caremark. Then, rather than making this a simple two-way communication between Medco and the doctor, they require the patient to get in the middle to call the doctor and have him/her waste time re-filing the information. This is either phenomenal incompetence in thinking ahead and in custome relations or it is designed to discourage filing of prescriptions! Either way, the attitude is “make the consumer responsible for our business ineptitude” and let’s save a few pennies by having customers and doctors waste their time rather than do things efficiently.

  27. Before you send in an Rx to Medco, be sure that you exactly what your doctor has ordered and what the dosages are.
    I recently changed employers and unfortunately ended up with Medco and United Non-HealthCare both of which have turned out to be a joke! Between the two, it is absolutely the worst coverage I’ve had in over 35 years of employment.
    Upon changing to Medco my doctor had written the same script for a medication that I had been taking sucessfully for several months to aleviate a post operative side effect. The correct doesage was a 1Gr. tablet once (or twice) a day. Medco called and asked if they could provide it in packet form. At the time I thought the packets were like dose packs (which would need to have the individual tablets removed from a package), which I’ve had mail order Rx to do on occassion. When the 90 day order arrived, it was in two large boxes each of which had (90) 5Gr “single dose” packets of granular powder that is to be mixed with liquid to drink.
    — The directions read: Take one of the 5 Gr packets twice a day —
    Not realizing the perscription was not the same doseage that my doctor had written, I took the two 5Gr packets twice a day for over a month before I returned to my doctor for a physical and explained what I believed to be some recent (unexplained) symptoms. He began reading the meds and doseages back to me (while searching his mind) and as soon as he said one or two 1Gr tablets – it dawned on me what was going on.
    MEDCO HAD NOT ONLY CHANGED MY Rx, THEY INCREASED THE DOSAGE 5 to 10 TIMES WHAT I SHOULD HAVE BEEN TAKING!!! NEEDLESS TO SAY – MY SYSTEM IS STILL MESSED UP!!! >>>>THANKS FOR THE HELP MEDCO<<<<
    CHECK EVERYTHING YOU GET FROM MEDCO, IT MAY EFFECT MORE THAN JUST YOUR WALLET

  28. My recent experience with MEDCO hinges on lunacy and explains why our healthcare costs so much more. I had enough medications and in trying to stop automatic shipment of a medication, I sent 2-3 e-mails requesting not to mail out any prescriptions automatically. In spite of this I received a shipment that I had not ordered and did not need for a few more weeks. I rejected the package unopened and requested to reverse the co-pay charges. MEDCO explanation was that they don’t do this since the immediately fill-in orders upon receipt of a doctor’s prescription or as soon as I am eligible within 14 days of running out of the medication. all this is welll and good and paved with good intentions to provide prompt service. MEDCOm said that the medication is not returned to stock nor redispensed — it is destroyed! Guess what? the insurance company is billed for full value, the customer is stuck with a medication that is not required and/or pay the co-pay. I think the consumers have to renege. What it means is the full cost of the medication is way beyond what MEDCO really pays for it, I think.
    1. Remove the doctors authority to prescribe any but serious and dangerous medications
    2. Fix the percent profit over cost that a medical manufacturer or a dispenser can bill the insurance company.
    3. Most medications do not need any big smarts to prescribe… just read the book from the medical manufacturer.
    4. Eliniate all copays for medications or doctor’s visits and need for a PCP. There should be only patient doctor relationship. One does not need a family doctor to be stumbling block.
    I would like all consumers to rally on this and kill the fiasco with the system.

  29. Medco and Specifically Dave a Medco Pharmacist,
    I have some specific comments to make about Medco.
    First off Medco seems to feel that they know what is best for one to take and not my Primary Care Physician.
    Case in point, My PCP ordered Ambien CR for me.
    I took the prescription to my local pharmacy. When I went back to pick up the prescription, I got told by the pharmacy that Medco rejected the prescription saying that they (Medco) would not cover the prescription.
    When I contacted Medco, the excuses started coming. The first excuse was that my wife had picked up the prescription. The second excuse was that I had already had the prescription filled and that was why they rejected the claim.
    Finally my local pharmacy contacted Medco again, trying to get approval for the prescription. This time the truth came out, Ambien CR is not on there formulary list and hence they will not fill the prescription.
    Prior to the above mentioned problem, I was getting my prescription for Nexium through Medco.
    I had refills left on my prescription so I contacted Medco in order to get a refill.
    Before I state anything else, I have to say that when I placed my request for a refill of Nexium that I had an AR Balance(Accounts Receivable) Balance with Medco in the amount of 50.00.
    When I did not receive my refill I contacted Medco to inquire about the refill.
    I was told that my prescription had been cancelled.
    When I asked who cancelled my prescription, I was informed that my Gastroenterologist had cancelled the prescription. When I talked to my Gastroenterologist Office I was told that no one had cancelled the prescription nor had anyone in the office been contacted by Medco.
    When I confronted Medco with the information that I had received from the Doctor’s Office, they (Medco) finally admitted that they (Medco) had unilaterally cancelled the prescription with out my Doctor’s permission.
    It amazes me that Medco did this to me in regards to the Nexium as the Prescription was written by a Physician who has had personal problems with Medco in the past.
    Now regarding when you send an e-mail to Medco, you get an e-mail response from an e-csr.
    From the majority of e-mails that I have received from the e-csr’s, I have a feeling that all they do is cut and paste from various letters that they have on there computers.
    George

  30. Moo?
    Moo Moo Moo Moo Medco?
    MOO?
    Medco = Moo
    M = Moo
    E = Moo
    D = Moo
    C = Moo
    O = Moo
    ergo…
    MOOOOOOOOOOOOOOOO!
    🙂

  31. I am amazed at the replies to the blogs on this site by MEDCO employees. They have ignored the complaints and simply lashed out at their customers. Great public relations. I received a MEDCO add in the mail today and after reading these blogs, will look for my prescriptions elsewhere.
    And for the record, MEDCO had to pay damages to customers from several states for not providing the products oredered. The last payment to customers was $5.5 million.

  32. If there was a rating out for Medco and it was on a scale of 1 for the worst in customer service I would rate them there. They about as helpful as talking to a wall. They say they called my doctor about a prescription and they really didn’t I told them there thankful this medication isn’t life threatening to me to have as I wouldn’t never be a live to receive it. YES OUT OF HERE WITH MEDCO

  33. I have been reading comments on this board to see if anyone has the same problem with medco that I have. I can’t believe I am the only one with this problem. The problem is when I send my new prescriptions to medco in their self addressed postage paid envelope, they never receive them. I always have to send them signature required at fifteen dollars a pop. I know the post office has a lot to be desired, but I can’t believe that they loose the all of these scripts in the regular mail. I am filing a mail fraud complaint with the post master general. What solutions have any of you tried to solve with these problems with medco, give us some ideas and we will do the same. One person complaining won’t do much, but if we have some numbers complaining to attorney generals, and AMA’s and our individual carriers maybe we can make a difference.

  34. I am writing on behalf of my dad, Wallace Solo. He is a 79 year old widower. Since the new Medicare plan went into effect we have had nothing but problems with my dad’s prescription drug plan through Medco. Up until that time, my dad’s railroad retirement drug plan was free, with payment of co-pays, since his retirement at the age of 60. Railroad retirement was forced to sell the plan with the changeover (Medicare Part D or whatever). He was confused about how this new process worked. I still am, too. He was signed up with Medco, and continued to pay co-payments for his prescription drugs, getting them through the mail. Last winter he was suddenly dropped from coverage. He was given no warning. When we inquired they said he had not paid his bill. HE NEVER RECEIVED A BILL! My dad always pays all his bills as soon as he gets them! He was allowed to pay them a lump sum of about $900 dollars to get reinstated, and to pay for the coming months. A few months ago, my dad was again cut off from his Medco coverage. They said it was because he did not pay his bills. He paid everything they sent him, but it now turns out that he was only sent bills for co-pays. He would never miss a bill he was asked to pay! It looks to me that they set him up to be able to drop him. At one point, one of the representatives told me over the phone that Medco had petitioned Medicare to stop coverage for my dad the first time, and had to wait to drop him until they got the approval from Medicare over the summer, at which time they dropped him again.
    This is very stressful for my Dad, who had a heart condition and takes a lot of medication. The first time, he had to pay out of pocket about $900, and was reimbursed when he was re-instated. The bills are piling up again, as he has had to pay hundreds of dollars for medications. What it looks to me like is that Medco purposely neglects to send bills to vulnerable customers who cost them too much money, then uses that as an excuse to drop them from coverage.

  35. I feel for everyone complaining. MEDCO is making too many errors, some intentional and some unintentional, for the reasonable patient/customer safety. As noted by one person above, be sure to get a name (they will only provide a first name because they know they’re doing something wrong), note the time and date. I have a friend that has experienced many problems with MEDCO and has also recorded all conversations with MEDCO personnel for the past six months. This will help with any $50,000,000 class actions or publication on utube.

  36. Trying to maintain my sense of humor, I have decided that MEDCO stands for “Make Everything Difficult, Confusing and Obtuse”(Funk & Wagnalls def for obtuse: adj, Lacking acuteness of intellect or feeling; insensible).
    Our insurance plan elected MEDCO for “maintenance” prescriptions in September 2006. If a patient has been diagnosed with a condition that requires ongoing, perhaps life-long medications, as unfortunate as this may be to “maintain” a reasonable level of health, at least there is hope…but we must have these drugs handled by the MEDCO mail-order plan…unless we want to spend our retirement fund to obtain the same.
    I have been informed that NOT taking or abrutly Not taking either of these medications for any length of time can possibly cause great harm including death to myself. If I miss a day’s dose, no huge harm. If I must go for many days or weeks, there are dangerous consequences. I respect this fact.
    I have recently (from September 4 and onward) requested of my two doctors that my medications be renewed via fax to MEDCO for the two drugs I need daily. I have been told that faxes have been sent. Meanwhile nothing has shown up on my “order status” at MEDCO. I have called MEDCO Member Service numerous times to no satisfaction as to what is the trouble or how to resolve the problem.
    MEDCO Member Service reps…when I can actually get to humans…give me different information and/or explanations. None have been rude to me, and I have not been rude to any thus far. This might change soon!
    (REAL HANDY TIP HERE!) If anyone reading this has had the same frustration trying to get a live response from MEDCO Member Service, merely respond, “NO” to having enough supply of your drug on hand. Then you will be on hold for a long while and finally be able to talk to an actual person. This is no assurance that anything will be accomplished on your behalf, but at least you will get through to something other than a computer.
    I have now made it my routine to ask the name of the person, mark the date, time, ?’s and responses of all contacts with MEDCO. What good this will do is unknown.
    I get the feeling that those employed by MEDCO to carry out their plan on the ground level most likely are overburdened, underpaid, and overwhelmed.
    I have read other complaints about MEDCO. There are people who have much worse circumstances and much less ability to either pay out-of-pocket or make numerous calls in all directions for their own sakes.
    Why not out-source this whole mess to China? This will be extremely cost-effective for all! Many patients will die from taking drugs laced with road paint, lead, antifreeze or wood chips!
    But our beloved insurance companies will be making great profits in the meanwhile…less people to care for, less cost for materials…less responsibilty for tainted things. Win-win! Maybe I should order a few shares of MERK, MetLife, or EVEN MEDCO!
    Does anyone out there dealing with MEDCO feel as frustrated as I? Does anyone give a care? Does anyone know of any way to try to resolve this trouble? Do we, as patients, have a voice?

  37. DUHHH! Ignorance is bliss, Dave.
    Yes, Medco is a pharmacy. But it is not just a pharmacy. It provides pharmacy benefit services (“PBM”) services through networks of retail pharmacies, its own pharmacies, and a specialty pharmacy. It is pushing the envelope to define a new industry–and the ONLY way that industry will succeed is to increase utilization of generic drugs.
    Is that evil? Of course not. But Medco has unprecedented power–and incentive–to determine what medications we can take, under what conditions, and at what cost.
    In the long run, this MAY turn out to lower costs for everybody. In the short-run, individuals are hurt not just by the occasional mistakes made by the mail-order pharmacy but also by the aggressive policies of the Pharmacy Benefit Management side of Medco to push us all into generics or formulary prescriptions even when the doctor and patient agree that another treatment is more appropriate.
    There are too many horror stories around the office since switching to Medco 8 months ago for them all to be coincidences! Medco simply does a TERRIBLE job of “managing” our pharmacy benefits by working with the insurance companies and the doctors to make sure we get the appropriate drugs at the appropriate prices. And every time the “benefit management” practices create a mistake that costs the patient money or worse, the “pharmacy” manages to charge additional fees. And it has the muscle to force the patient to pay even for inappropriate shipments.
    Never before have we had the fox guarding the henhouse to this extent.
    Dave, keep on reducing “dispensing errors.” Because Medco makes so many “policy errors” that you have to improve something else to make up for it.
    Medco is not just a pharmacy. It’s a pioneer pushing the envelope by inventing a new industry. But a lot of us consumers are paying for progress with unnecessary doctor visits, inappropriate fees, and unpleasant confrontations with poorly-trained Medco customer service agents–some of whom are as ignorant as Dave, who probably actually believes that Medco is “just a pharmacy”.
    Dave, you may be just an ignorant pharmacist. But Medco is a lot more than just the pharmacy.

  38. Ignorance is bliss! I am a Medco pharmacist, so hear this. We are not your insurance company! We are a pharmacy, a large one, which provides the benefits for your INSURANCE company. I hear, “Medco doesn’t allow this, or Medco won’t pay for that, or Medco doesn’t think this….” What you should be saying is, “My insurance company won’t pay…..” We follow the rules of your insurer, so if we have to send alternate meds or require prior authorizations, it’s because your INSURANCE company requires it, NOT Medco. We ARE a pharmacy, not much different that Walgreens, CVS, etc. We fill 90 day supplies and fill far more Rx’s than the other chains, but in essence, we are only a pharmacy. So when you say that Medco makes you do this or that, WRONG! It’s your Medical Insurer. And re: all of these stories about how we filled your Rx’s wrong, there are 2 sides to every story, and yours is just one of them. We never fill Rx’s to “screw the patient.” Most of the time, mistakes occur because your doctor ordered the wrong med, daw or refill. We make fewer dispensing errors than any other pharmacy in the country. So be appreciative that we do so well for our patients. If you want to complain to someone, call your insurance company.

  39. They substituted my DAW (Dispense as Written) drugs with Generic. When I complained they indicated too bad…no refund. If I had wanted substitution, I would have indicated it on my order form. I’m going out of my way to buy drugs elsewhere. Too bad they are giving their business as well as other mail-order pharmacies a bad name. They are definitely on my list not to buy and believe me I’m telling all the employees I work with. Since I worked with medical-pharmacy employee benefits my self…I have their names and addresses. thx. Kathy

  40. About a week into January of 2007, I received a letter from United Health Care that they would no longer cover long-term medicines that were bought at any pharmacy other than Medco by Mail. This letter included instructions on how to make purchases from that company. I gave the fax number of Medco, along with my relevant insurance information, to my doctor’s office and asked them to send my wife’s prescriptions.
    A week later we received the prescriptions, but there were problems. First and foremost, one of the medicines was incorrect. My wife needs Metformin Extended Release, but she received plain Metformin. Secondly, the amounts on two of the prescriptions was incorrect. Rather than a 90-day supply, we were sent 90 pills. On one of the drugs this would last 45 days, on another of them it would only last 15 days.
    The customer service representative of Medco was supremely unhelpful, claiming that they filled exactly what the prescriptions called for, and disavowed any responsibility to make things right. My doctor’s office has agreed to cover the cost of the incorrect prescription, but if they had not stepped foreward I would have been obliged to pay for medicines which we could not use.
    I have occasionally experienced similar situations with Walgreens, but have never had to accept the wrong medicines, nor incorrect amounts. They always corrected mistakes on the spot.
    To make matters worse, there seems to be no middle ground when it comes to daytime telephone calls from Medco. They will either call about every inconsequential step of filling the prescription, or they will not call at all. “Only call if I am needed to authorize something” does not seem to be an option. As a 3rd-shift worker, I find this completely unacceptable.
    The company I work for has taken away all choice of medical coverage with the exception of United Health Care (or “none,” which is of course not a viable option in today’s world). And UHC has taken away all choice of pharmacy other than Medco. When you add to this the fact that the pharmacy from which I am being forced to buy pills is costing more than I was paying before, this amounts to yet another effective pay cut for me, and very likely many other employees. This is certainly not what I expected after “upgrading” to a UHC policy with premiums more than twice the levels of the plan I previously had.
    Early in April I had to re-order medicines from Medco. When they arrived I learned that two of them had been replaced with generics without my permission. The accompanying letter stated that the change had been authorized by my wife’s doctor.
    The doctor’s office told a different story. They remembered the call from Medco. The office staff spoke to the Medco caller, and deferred the decision to the patient (my wife).
    No one from Medco ever spoke to my wife about this, nor to her doctor, nor to me. If they had, then they would have learned that my wife has had serious side-effects from past attempts to substitute another medicine for that which was prescribed.
    Once again resolution of the problem proved to be difficult. Medco claimed that they could only replace one prescription at a time. pending payment, blaming the cost of the pills for this decision. After much debate and negotiation, my wife decided, against my advice, to try the generic brands, on the condition that they would be replaced should any problems ensue.
    I remember when this company offered multiple choices for health care coverage. It was part of the cafeteria plan which was touted as an excellent employee benefit at the time. I also remember that each different plan carried a different level of employee contribution. When I was forced to choose between United Health Care or no group health coverage at all, my personal contribution to health insurance premiums increased dramatically as level of service decreased reciprocally, although the company claims that lower costs for employees was the reason for the change. Perhaps the company is saving money, but with my costs increasing fourfold, I hope to be forgiven if I am skeptical that this change in employee benefits was in the best interest of the employees.
    In any case, lower costs mean nothing if the level of service is worth nothing. If Medco cannot be trusted to gain proper authorization before making changes to prescriptions, then they cannot be trusted to fill prescriptions at all. Lack of competition – and regulation – has made these providers lax and uncaring. Because we cannot take our business elsewhere, Medco feels no pressure to improve customer service.

  41. Mail order drugs are bad for your health. In many states, the outside temperature exceeds the ambient storage temperature of the drug most of the year. This compromises the drugs efficacy. In other words, it may be cheaper but the government and mail-order pharmacies are compromising your health. Forced mail order should be banned.

  42. Not only is Medco the worst at switching prescriptions, their customer service department is horrible! Every time you call you get some over talking, non-professional know it all that refuses to listen to your problem. On a previous call to them, I was advised by a Supervisor, Evelyn Music that I would be credited for sending back some medication. Now I am told by Shawnee (like the Indian)in the RESOLUTION DEPARTMENT that whenever you send medication back, you will be billed and the medication destroyed (if you can believe that). I tried to explain that’s not what I was told. It is not posted any where on the website either. I asked for a Supervsior, I was told that it took 48 hours in order for a Supervisor to call me back. Then I was told that she could TRY to page a Supervisor which would take about 15 minutes. This is just another example of a company who CARES nothing about customer service, honoring their word or intergrity. So what did I spend 45 minutes on the phone talking to Shawnee in the RESOLUTION DEPARTMENT for? Nothing was been resolved and I still have been billed!!!

  43. I suspect that those who refill prescriptions at Medco do not have health problems. I take a pain medication for degenerative disk disease. On December 11, I used Medco’s automated service to order a refill and received a confirmation number and date for delivery of December 16. On December 12, they left an automated message that they could not refill the prescription and would send a letter – no callback number or anything. I have experienced their lousy customer service before and called them, busting through their automated “helpers” to identify the problem and get my prescription refilled. I received the letter today – December 18, a week after I called. If I had waited for the letter, I would have been without medication for over a week.

  44. Why do I get the distinct impression that Mary works for Medco…altho the church of scientology also comes to mind…

  45. Medco bites big time. I didn’t recieve my meds but they want to charge me for them anyway. I should get a 7 day refill from my Dr. and they say they will reimburse me. I they can’t get my original refill to me, why should I believe they will reimburse me. Scam and ripoff. Big business reaping the profits at the expense of the suckers that are forced to use them. They suck hard.

  46. Medco has repeatly ripped me off. They will refuse to fill your perscriptions until you give them money that you don’t owe then charge you more money for the next one…

  47. where to start well lets just start with the fact that we have all done this to ourselves. First Medco a pharmacy management company and a mail order pharmacy company. The first part means Medco does not make the rules they are managing the rules for you employer,union,insurance plan ect;;ect. So if you wish to blame anyone blame everyone. Lets start with Pre approval Pre is for Prior does everyone now what that means if not look it up. This means there are reasons for a pre-approval it is due to some medications are expensive and we all know the person who goes to the doctor and there doctor will write them anything and to try to keep the cost down for all its members most companys and insurances want to make sure that they are not abused. Next some medications are NOT APPROVED for long term use did the example of vioxx pass by you all the was a pre approval medication and that is why Prior approvals maybe need. And yes when a Prior approval is done it is strength specific and all of that is verified by the doctor’s office.
    Once again medco is not snooping in trash cans to steel buisness from retail pharmacy’s one medco already knows what you get from the retail pharmacy cause they manage you retail pharmacy’s most of the time. Once again medco makes the calls to members at there plan(ie employer,union or insurance) request due to they want to keep cost down for everyone and by controlling the cost of medications is one way. Since most retail pharmacy’s can charge you what every they want and there cost is higher then medco’s due to Medco deals in volumes.
    And lets get this one straight also medco does not make up your copays one again you plan(ie insurance,employer and Union) decide on a plan and what will be charged and how much they will pay and how much you will pay. They also want there members to us mail order to save them money and to save you money so they do not have to raise you cost. and yes plans have copays that say if you choose not to use mail order then you will pay a higher price for the medication (this is due to now they are paying a higher price for everything you fill locally) and yes plan do expect those of you who insist that they cannot or will not use a generic to pay for that option due to if not everyone else will be paying for it due to higher benefit cost with higher price for benifits or higher copays so get over yourselves why should I pay for your medication cause you want brand.
    Let me address the copay with United health care they have more than the 3 teirs they will tell you about they can on some plans have up to 7 tiers. An the over charge was from United health care not medco because as stated above the insurance set the copays.
    If you want to look at someone to blame then we must be also willing to blame ourselves we are a bunch of running to the doctors for medicine when our kids have a simple cold or cough and we insist they need it. To a generation that have overeaten an have such losy diets that we must pop a bill for everything. And the same with doctors all the specialist we have doctors for our feet,eyes,nose,heart. and our sex organs yes we are heathier and there is a cost to it. The best thing you can do for yourselves is be an informed consumer read everything if you don’t understand it call have some else explain it to you don’t assume. And for pete’s sake stop treating your doctors like Gods who make no mistakes make then accountable for there mistakes you would do no less if you went out to dinner and the waiter brought you the wrong meal but we let the doctors office of the hook.

  48. Medco is currently implementing a program to scoop up business from retail pharmacies. They look at peoples retail claims history, and then they call the people at home to suggest “cost saving” alternatives. Of course these cost saving alternatives are filled by Medco through mail service.
    Seems a little odd that they have the right to cull retail claims submitted by say Walgreens and scoop the customers away from retail.
    Just a thought

  49. Medco has refused to fill prescriptions written by my doctor because their pharmacist’s feel that there is not enough proof that I need it. Please advise me on when a pharmacist at a mail order company who does not know me or my medical conditions and only has a 4-5 yr college degree, is more qualified than my personal doctor who has been practicing as a specialist in field of medicine for 20years. In additional the staff is completely lacking in professionalism and education. I am a supervisor of customer care and have never been offended as much as I have been with the people that work for Medco. I am a relatively calm and patient individual as my job requires, but these people and this company has driven me to rage. They absolutely refuse to assist you and even when you call to try and ensure that everything is done right, it is still all wrong.
    The additional issue is that you can not fill a prescription for the same medication more than 3 times at a pharmacy. Anyone that takes adhd and other psychotropic drugs knows your maintenance medications can change on a monthly basis. Their resolution to this is to pay full price for 2weeks of the medication the have the doctor fax in the request for a 90 day supply. So not only do you have to pay to have the insurance you have to pay full retail value for 2 weeks of the medication, then pay for a 90 day supply (plus shipping)for a medication you might not take for even 30 days. This is fraud and a scam. They are forcing people to pay for 90 days worth of medication they do not need. This not only includes new drugs but different doses of the drugs. Medco’s policy does not take this into consideration.
    For 3 months now I have been trying to get Medco to fill my prescription for adderall. Prior to even trying to fill it I was able to confirm that it was a covered medication. No where did it tell me I needed to have my doctors actually call them before they would fill it. When I tried to fill it they refused to pay for it w/o the pre-authorization. When I called them from the store they told me that the prescription the doctor had already written would not be approved at all since there was no pre-approval. I ended having to pay almost $300 to get this vital medication. Before the next visit to the doctor I called Medco and requested information on how to get the pre-approval, what I needed the doctor to do and how I could ensure an easy transaction. While the person was polite the information he gave me was totally incorrect and once again I had to pay full retail value for the medication. Finally after months for arguing with Medco I received a letter stating I had approval for the medication. This Tuesday I tried to fill my prescription for Adderall and Medco refused to fill it because I was only approved for 10mg so they refused to fill it. I had already received pre-authorization and a letter confirming that I would be able to get the medication; however, when I went to get it filled MEDCO denied it. I called them and told them I received a letter and it was approved. Medco said no that the doctor prescribed only 10mg increments and since the prescription was for a 20mg I would not be able to fill it. I explained that I had talked to the doctor and he approved up to 30 mg a day and that the letter I was sent stated nothing about only 10mg increiment. The lad actually started yelling at me. Finally after having to pay a 35 new script charge from my doctor and making a forth trip to the pharmacy I was able to get the 20mg prescription but have to take 2 pills verse one.
    Medco needs to be shut down, they are putting my life in danger and I am sure many other people’s lives in danger as well.

  50. Medco is a bunch of crooks. They charged my credit card for $285 when my companies’ policy calls for a charge of $86 to me. Medco claims the charge is legitimate because I ordered brand Prilosec over the phone and not my doctor. Since when can a patient order drugs on the phone without a duly authorized doctors prescription. That is illegal. The FDA has been notified. My previous prescription had expired. They did this intentionally just to steal ~ $200 from me. My doctor did fax my prescription to Medco and erroneously listed generic Omeprazole which I cannot take and Medco knew this and had a record that I had used Prilosec, not Omeprazole. My phone call was to alert them a mistake had been made, not order drugs without a prescription.

  51. I FEEL MEDCO IS THE WORST. I AM LOBBYING WITH MY COMPAINES TO SWITCH BACK TO OUR OLD PRESCRIPTION PLAN. THE STAFF IS RUDE AND UNKNOWLEDGEABLE! EVERY TIME I SEND IN MY PRESCRIPTION MY CHECK IS CASHED BUT MY PRESCRIPTION IS NOT SENT! I AM NEVER NOTIFY ABOUT I ALAYS HAVE TO CALL TO QUESTION THIS. I WAS TOLD BY A RUDE STAFF MEMBER NAMED ROBIN THAT MY COMPANY DOES NOT PAY THEM ENOUGH TO DO WHAT MEDCO DOES. I WAS ALSO TOLD BY HER THAT TO GET MY PRESCRIPTION ACCURATLY FILLED I SHOULD GO TO A PHARMACY AND PAY FOR IT. IF I NEED TO GO TO A PHARMACY AND PAY FULLY FOR MY RX THAT WHAT AM I PAYING MY COMPAMY FOR MEDCO FOR? PLEASE BE CAREFUL WITH YOUR PRESCRIPTIONS WITH MEDCO. BE VERY CAUTIOUS CHECK EVERYTHING WITH THEM. I CALLED MY INSURANCE COMPANY AND TOLD THEM WHAT THEY SAID . MY INS WAS APPLALED ABOUT WAS SAID TO ME. THEY SAID THEY SEND A LOT OF BUSINESS THIER WAY AND WILL LOOK IN TO THAT.

  52. I have recently had a run in with Medco. They are our prescription insurance through United Healthcare. I’ve spoken with three different Medco representatives about their overcharges on my son’s prescription. The first rep told me to call back in 72 hours because they needed to research how I would get reimbursed. The second rep told me to submit a claim to United Healthcare, even though I told her United Healthcare said I needed to go through Medco. The third rep, a Supervisor gave me an address to write to Medco to see if I could get reimbursed. All three reps said Medco had the incorrect copay in the system, $50, which isn’t even an option for a retail or non-retail pharmacy. The highest tier is $30!! When I tried to register to see drug prices, United Healthcare points me to Medco, Medco gives me an error on my e-mail and tells me to register. When I try to reregister, I get an error that that e-mail has already registered! When I submit a complaint to their webmaster, I get a response to MY E_MAIL (the one they say is invalid) saying, “thanks for my interest in Medco.” MEDCO IS A BUNCH OF THIEVES WHO ARE RIPPING OFF CONSUMERS!!!!!!!!!!

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