Your copay may not be the lowest price. Many insurance plans have high deductibles or limited formularies that don't cover the drugs you need. You'll be surprised to learn that there are many discounts available that will provide lower prices than your copay, and some pharmacies have special generic priced medications for $4 or even free without insurance.
Typically, health insurance provides you with 2 benefits:
- A discounted price for your medications
- A set co-pay (often $10) for your medications
Here are 3 things to consider when deciding whether to fill your prescription with your insurance or GoodRx:
Is this drug covered by your plan? If so, how much will it cost?
Insurance companies use “formularies” which list how much they will pay for a specific prescription. Formularies divide drugs into “tiers.” Tier 1 drugs may have a $10 co-pay, Tier 2 may be $20, and so on. For many brand name drugs, your plan may cover just a percentage of a negotiated price. Check your insurance company's website to see if they provide pricing, then compare your copay to the price GoodRx lists. You may be able to save money by using GoodRx and paying cash for drugs that are not “preferred.”
Have you satisfied your deductibles?
Many insurance plans have a separate prescription deductible you must hit before they'll pay for your medications, and other plans just have a high deductible for all of your care before they pay anything. In these cases, you'll usually still get a discounted rate, but it may not be as low as the prices GoodRx can find. Check your insurance company's website for more information.
Can GoodRx beat your co-pay?
Don't be surprised if local and mail order prices are well under your co-pay. The typical insurance plan in America offers a $10 co-pay for preferred drugs (and it goes up from there). Many, many generic drugs can be bought for less than $10. Why pay $10 when you could pay $4?