New scummy PBM tactic?

per Optum: “This drug is not covered by your plan, but we’ve discounted the price with Price Edge.” Then in the fine print… “The cost for this non-covered medication will not apply to your deductible or out-of-pocket maximum.”

It was not easy to spot this, looked like drug was covered/approved (especially on some plans).

It also appears like their system automatically cancels any prior auth attempts on any of these “not covered but discounted” medications. Making it impossible to get any PAs completed. Their system literally deletes the PA because they view the drug as “covered” under the “discount” 🙄. Calling of course all the idiots working there tell you it’s “covered” claim they apparently don’t have the same info I do so they can’t see the disclaimer about how it’s not actually covered, just made to look like it is.

Such a shitty, sneaky move by Optum highlighting once again while PBMs need to be obliterated.