ProAct Rx

They are probably the worst prescription insurance company we have ever dealt with. They have denied more medications than they have approved. My husband has been diabetic for 19 years, yet they continue denying the medications his doctor prescribes to help manage his condition. Ironically, they will approve his insulin — likely because it is the cheaper option — even though our out-of-pocket cost using their insurance is practically the same as using a GoodRx discount without insurance at all. Every other diabetes medication has been denied. The explanation we were given was that their “licensed physician” reviewed the information submitted by his treating physician and determined that he “does not have diabetes.” Yet somehow they still approve insulin. That makes absolutely no sense. It feels very clear that the denials are based on cost, not medical necessity. Over the last four months, his health has noticeably declined because he has not been able to access the medications his physician believes he needs. Diabetes runs heavily in his family, and he has already lost four family members to complications related to this disease. He takes his health seriously and actively tries to manage his condition, but the insurance company continues to stand in the way of the care he needs. They have also denied all of my more expensive medications that I have successfully taken for years. The entire experience has been terrible — frustrating customer service, underqualified representatives, little to no communication, and extremely long turnaround times. To put it into perspective, when I called regarding my own medication, I was told they needed a prior authorization from my healthcare provider. However, they specifically instructed me to tell my provider to submit it through their online portal because they were “at least 45 days behind” on reviewing faxed prior authorizations, while portal submissions could still take up to two weeks. People depend on these medications. For many individuals, access to treatment is literally life or death. Experiences like this make it feel like patient health is secondary to reducing costs, and that is deeply concerning.

Continual spiraling, won’t load most of the time, if does load, links don’t work. Terrible app! Don’t expect it to make prescriptions easier.