Your insurance plan’s co-pay may not be the lowest price. Many insurance plans have high deductibles or limited formularies that don't cover the drugs you need.
You may be surprised to learn that there are many discounts available that will provide lower prices than your co-pay. Some pharmacies have special generic priced medications for $4 — or even free! — without insurance.
Here are three 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 $20 co-pay, Tier 2 may be $40 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 drug pricing, and then compare your co-pay to the price listed on GoodRx. You may be able to save money by using GoodRx and paying cash for drugs that are not “preferred.”
Have you satisfied your deductibles?
If you have a high deductible health plan (also known as an HDHP), you'll be paying out of pocket for most prescriptions and medical services until you hit your deductible.
For expensive brand-name drugs, your plan's price may not be as low as the prices GoodRx can find, especially if the drug isn't on your plan's formulary. 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), while many generic drugs can be found for less than that.
If you use GoodRx in place of your health insurance, just ask the pharmacist to process the transaction using the coupon or discount card instead of your insurance. You can also use your Health Savings Account (HSA) to pay for prescriptions when you use a GoodRx discount.
Remember that the cost of prescriptions purchased using GoodRx discounts will not automatically count toward your deductible. If you have other medical expenses, or if you have several expensive prescriptions, it may make more financial sense to use your insurance to satisfy your deductible.