Skip to main content

Frequently asked questions

1. When will I receive my ID Cards?

ID cards will be mailed directly to the address on file with your Plan Sponsor prior to the effective date of your plan.

2. How do I get started with ordering prescriptions?

Simply call 866.287.9885 toll free and speak to a Customer Service Representative.

3. How do I get prescriptions filled?

Simply present your ID card and prescription to a participating pharmacy. To check if your pharmacy is participating, utilize the Find In Network Pharmacies feature under the Resources tab or call the Help Desk at 1-877-635-9545.

4. My claim was rejected at the pharmacy. What do I do?

Please make sure your pharmacist is aware you have a ProAct prescription card, especially if this is a new benefit for you. If there are problems with your claim, your pharmacist should call ProAct at 1-877-635-9545. Also, certain medications require a Prior Authorization. In the event that your prescription is denied due to a Prior Authorization requirement, DO NOT LEAVE THE PHARMACY. Contact ProAct immediately for a resolution.

5. What is Prior Authorization?

Some medications must be authorized for coverage because they’re only approved or effective in treating specific illnesses, they cost more, or they may be prescribed for conditions for which safety and effectiveness have not been well established. Your physician can start the prior authorization review process by visiting www.ProActRx.com/paforms to obtain medication specific request forms. Forms should be faxed to ProAct’s Clinical Team at 1–844–712–8129. Once we receive a completed prior authorization form from your doctor, we conduct a clinical review within 48–72 hours. We then send you and your doctor a letter regarding the prior authorization decision.

6. I had to pay for my prescription. How do I get reimbursed?

Simply complete a Direct Member Reimbursement form. You can obtain a form by logging onto your member account at www.ProActRx.com or by contacting the Help Desk at 1-877-635-9545. Please make sure you sign the form and attach your receipts. Reimbursement is generally based on the maximum amount allowed for the prescription less your copayment and deductible, if applicable, and may not be the same amount you paid. To avoid paying more for your prescriptions, make sure to use your ProAct prescription card at any participating pharmacy.

7. What are “maintenance medications”?

Maintenance medications are prescription drugs that you take regularly on a long-term basis. These medications treat chronic conditions or needs such as: asthma, diabetes, birth control, high cholesterol, high blood pressure, and arthritis. A maintenance medication can also be a drug that you take for three to six months and then discontinue. For example, an allergy medication that you take throughout the spring and summer could be considered a maintenance medication.

8. How do I find out if a specific drug is considered a maintenance medication?

If your doctor has prescribed you a medication, but you are unsure of its status as a maintenance medication, call the Help Desk, 24 hours a day, 7 days a week, 365 days per year, and one of our representatives will inform you.

9. What is the Mail Order Program?

The Mail Order Program incentivizes members to obtain up to a 90-day supply of a maintenance medication through the mail at a lower copayment than at a retail pharmacy. Mail Order prescriptions get filled via ProAct Pharmacy Services. Please see the additional benefits below: a. Free home delivery of up to a 90-day supply of your medication to your doorstep. b. The option to sign up for automatic refills on eligible prescriptions. c. For any prescriptions enrolled in automatic refills, the ProAct system will automatically send a refill renewal request to your doctor when your prescription has no refills remaining.

10. How does Mail Order work?

ProAct advises first time users of the Mail Order Pharmacy to ask your doctor for two prescriptions: • The first prescription should be written for a one-month supply and filled at your local retail pharmacy. • The second prescription for up to a 90-day supply with the desired number of refills that is sent to ProAct. Your doctor can e-prescribe, call in, or fax your prescription to our pharmacy (NCPDP #3335468). Certain restrictions may apply based on the medication prescribed and pharmacy regulations.

11. How do I sign up for a Mail Order account?

After your physician has determined you will be using maintenance medications and the dosage is appropriate, you should contact the Help Desk at 1-877-635-9545 to create a Mail Order account. Once you have setup your profile, confirmed your mailing address, and provided a method of payment, your prescription will be shipped directly to your door. It is important that you provide a method of payment to complete the process. Remember you may use your Flexible Spending or Health Savings Account to pay for these expenses, if applicable. You also have the option of setting up automatic billing to your credit card on file with us or you can opt to be billed monthly via an invoice in the mail.

12. How long will it take to get my prescription order through the Mail Order Program?

You can expect your order to arrive within 5-7 business days after we receive your order. To make sure you receive your refills before your current supply runs out, re-order at least three weeks before you need your refill or enroll in our Automatic Refill Program. When initiating your first prescription request through Mail Order, it is recommended that you have approximately 30 days of medication on hand to prevent lapse in therapy due to any unforeseen circumstances with your initial order.

13. How do I request a refill?

Members may request refills over the phone, online, or through the mail. a. Online: Members can request refills on the ProAct website at: www.ProActRx.com. Log into your account, view your active Mail Order scripts, and select “refill”. b. Phone: Call our 24/7 Help Desk at 1-877-635-9545 to request a refill on any of your active Mail Order scripts. c. Mail: Upon receipt of your first Mail Order prescription, there will be an invoice along with a paper refill request form. Fill this form out and send back in the provided envelope.

14. When can I request a refill?

You may request a refill 21-days in advance of your current prescription running out. Members also have the option of utilizing the ProAct Automatic Refill program (see “How Do I Sign Up for Automatic Refills”). This will begin the process for applicable prescriptions with remaining fills 10 days before they are due to refill. If you have a prescription that is enrolled in the program, but there are no refills on the script, the ProAct system will automatically send a refill renewal request to your doctor. * *Some prescriptions, including controlled substances, are excluded from automatic renewal.

15. How do I sign up for automatic refills?

For eligible medications filled through Mail Order, you have the option of enrolling in our Automatic Refill Program. Please give us a call at 1-877-635-9545 to enroll. If at any time you wish to stop automatic refills for any of your prescriptions, please let us know. *Please note: Controlled substances are excluded from automatic refills.

16. How does Mail Order work with controlled substances?

Certain controlled substances may be eligible to be dispensed through the Mail Order pharmacy. State and federal regulations may impact the fulfillment of your medication. Please contact ProAct at 1-877-635-9545 for specific questions on the processing of controlled substances.

17. May I request expedited shipping for my prescription order?

Yes, expedited shipping may be requested for Mail Order prescriptions filled via ProAct Pharmacy Services. Applicable shipping and handling charges may apply. Prescriptions filled via Noble Health Services are shipped next day deliver at no extra cost.

18. After I place an order, how do I check on its delivery status?

To check on delivery status, log into your online account to view your active scripts and track your delivery. You may also give us a call at 1-877-635-9545 to request the status.

19. What if I am not home to receive my medication(s)?

Most medications do not require you to be home at the time of delivery as they will be shipped directly to your mailbox. If you are receiving a controlled substance, a signature will be required for the medication to be left at your home. Members may provide us with an alternate address in which to ship the medication, where someone is present to sign for it. If you are leaving your residence for an extended period, simply provide us with an alternate shipping address or a one-time use address in which to ship your medication(s). *Additional documentation or notifications may be required for medications with specific handling requirements.

20. What if my medication needs to be refrigerated?

If your medication requires refrigeration, our team will call you to schedule the delivery at a time when you will be home. All refrigerated medication will be delivered with temperature-sensitive packaging to ensure the integrity of the medication.

21. What is a specialty drug?

Specialty drugs are high-cost prescription medications used to treat complex, chronic conditions like cancer, rheumatoid arthritis, and multiple sclerosis. Specialty drugs sometimes require special handling and administration (typically injection or infusion), and patients using a specialty drug may need careful oversight from a health care provider who can watch for side effects and ensure that the medication is working as intended.

22. What is Noble Health Services?

Specialty pharmacies dispense medications used to treat complex and chronic conditions. ProAct’s specialty pharmacy is Noble Health Services. Our experts at Noble strive to support patients in all aspects of therapy and always provide the utmost care, from prescription needs and medication therapy management to financial guidance. Emergency on-call support is available via the toll-free number. Physicians may mail, fax, call, or e-scribe to “Noble Health Services” (NCPDPD # 5806457). Packages will ship next day delivery to the member’s home, physician, or any address designated by the member. It is important that someone is available to sign for the delivery, as many specialty medications are shipped with manufacturer required temperature controls, such as cold packs for refrigerated items.

23. Who should I contact if I have additional questions?

ProAct, Inc. Available 24-hours per day, 7 days a week. Toll-free telephone number: 1-877-635-9545 Email: Support@ProActRx.com