When you go to your pharmacy to fill a prescription, do you assume you are getting the lowest price because you have health insurance? In some cases, you may be able to get a greater prescription discount if you left your insurance card in your wallet and pulled out your phone instead.
I’ve been helping out at a medical practice and a couple of weeks ago, we had a patient with a Marketplace health plan that required her to meet the deductible first before the insurance kicked in to cover a specific drug. Her medication would have cost her almost $250. We told her to use GoodRx instead, which saved her over 53%.
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What is GoodRx?
GoodRx is a free website and mobile app that provides discount prices for prescription medications. It could save you up to 80% on brand name and generic drugs.
Founded in 2011 in Santa Monica, GoodRx has helped more than 18 million people save over $20 billion on their prescription drugs.
Using the service, consumers can compare the prices of medications at participating pharmacies to get the best deal. GoodRx is not insurance but can be used in place of insurance when you are paying for prescriptions out-of-pocket.
How Does GoodRx Work?
To find the lowest prices for your medication, you simply visit GoodRx.com or download the mobile app.
Next, you will enter the name of the drug, the dosage, and select the quantity.
The resulting page will be a list of pharmacies with the estimated price you would pay at the register.
For pharmacies where the GoodRx coupon will offer a discount, you can print out the coupon, email it to yourself, or text it to your phone. You can also write down the Member ID, Group number, BIN, and PCN to provide to your pharmacist.
And that’s it. There are no membership fees to pay, no accounts to sign up for, or other hoops to jump through.
You can even lookup the prices of drugs while at the doctor’s office to get an idea of what the cost may be so there won’t be any surprises.
Will My Pharmacy Accept GoodRx?
More than 70,000 pharmacies in the United States, including major chains such as Costco, CVS, Kroger, Publix, Walmart, Rite Aid, and Walgreens will accept GoodRx.
The best way to check whether your local pharmacy will give you the GoodRx prescription discount is to access the website or mobile app, search for your medication, and then enter your location on the results page.
You are likely to find more large chain pharmacies that accept GoodRx than small independent or mom-and-pop pharmacies.
If you are having trouble getting a participating pharmacy to give you the discounted price, you can call 1-855-268-2822, 7 days a week from 9 AM to 8 PM ET for a customer service representative to help you resolve most issues while you are still at the pharmacy.
GoodRx Prescription Discount Card or Coupon? What’s the Difference?
GoodRx had sent our office several savings kits with hundreds of Prescription Drug Savings Cards to leave out around the office for patients to take. You could also request a discount card be mailed to you through the GoodRx website.
These prescription discount cards may be helpful for people who prefer a physical card to keep in their wallets or aren’t too tech-savvy.
However, to get the most current up-to-date price shown on the website or mobile app, you need to access the site or app for the most current coupon before you go to the pharmacy.
The GoodRx discount cards never expire and will still get you a reduction in price if you decide to use one.
Can GoodRx Be Used With Insurance
GoodRx coupons cannot be used together with your health insurance, Medicare, or Medicaid plans. It is either one or the other.
If you look on a normal insurance card, you will notice a RxBIN, RxPCN, and RxGRP number. GoodRx has similar numbers on their coupons. When your pharmacist enters those codes into their computer to see what your drug prices are, they can only enter one group of numbers. You cannot stack multiple numbers to get a bigger prescription discount.
This doesn’t mean you can’t use GoodRx if you have insurance. If your insurance co-pay is more than the price listed on the GoodRx site, you can tell the pharmacist to run your prescription using the codes on the GoodRx coupon and process the transaction as cash instead.
When Should You Use GoodRx
You may be thinking since you are paying all this money for insurance, why would you use GoodRx instead of your insurance. Here are some situations when GoodRx can come in handy:
When the GoodRx Price Is Cheaper
This is mostly common sense. If the cost of a drug is more using your insurance than what you would have paid using GoodRx, you can save yourself some money using the discount code.
One thing to keep in mind: If you do not pay for medications using your insurance, it won’t be reflected in your out-of-pocket limit or deductible for the year. People with a lower deductible or out-of-pocket limit may want to stick with using their insurance if they see themselves hitting the amount.
Your Medication Isn’t Covered by Your Insurance
Insurance companies will have a list of all the drugs, called a formulary, that are covered under the pharmacy plan. If you do some digging, you will usually be able to find this list on your insurance provider’s website.
On this list, you will see the name of the drug, the dosage, the quantity that would be covered for each fill, and whether it is a preferred drug.
Situations we’ve run into where insurance didn’t cover a specific drug include:
- it is a brand name or non-preferred drug
- the patient wanted their medication ASAP rather than waiting for the doctor to put in a prior authorization (PA) because an exception was required
- the patient’s reason for being prescribed the drug was off-label or didn’t meet the conditions set by the insurance company or FDA when the PA was submitted
- their medication was lost or stolen
You Don’t Have Medical Insurance
Since the Affordable Care Act’s individual mandate was eliminated, there is no longer a penalty for not having health insurance. Even before the individual mandate was repealed, I had a friend who paid the tax penalty because it was still cheaper than paying for insurance.
Now with the pandemic, many people have also lost their jobs and in turn, their health insurance.
Without prescription drug coverage or insurance, people are stuck with paying the cash or retail pricing for a drug, which could be hundreds of dollars.
You have a Short-Term Health Plan
Many short-term health insurance plans also do not cover prescription drugs. These plans do not have to abide by the ACA guidelines. To keep premiums down and costs low, many of these providers don’t cover any prescription drugs, even cheaper generics.
If you are enrolled in one of these plans, you can benefit from using GoodRx and getting their discounted price.
How Does GoodRx Make Money
According to quarterly reports filed with the SEC under the “Components of our Results of Operations” section, GoodRx makes money through several ways.
The majority of their money comes from revenue generated from pharmacy benefit managers (PBMs) when a medication is filled using the GoodRx prescription discount code. For each prescription, the PBM gives a percentage of the fee the PBM charges the pharmacy to GoodRx.
GoodRx also has contracts with some pharmacies for a fixed transaction fee each time a GoodRx discount code is used. This transaction fee is reportedly $5 or more per claim. This is one of the reasons why many of the participating pharmacies are large chains rather than independent pharmacies. Most smaller pharmacies’ profit comes from filling a prescription. CVS or Walgreens is willing to earn less on each prescription but make it up by volume and people buying other products while in the store.
GoodRx has a membership program called GoodRx Gold that includes a monthly subscription fee of $5.99 for individuals and $9.99 for up to six family members. Gold members get access to more than 1,000 medications for under $10.
Finally, they also get paid by drug manufacturers for advertising on the site and direct mailers.
Is GoodRx Safe to Use
The free version of GoodRx does not require any personal information to get discount prices for drugs besides the medication info.
A Consumer Reports story found that GoodRx was at one time sharing some personal data such as drug names and pharmacies with third-party advertising and analytics companies.
In response, the company has appointed a new Vice President of Data Privacy, provided a way for users to delete their data, ability to opt-out of cookies and tracking, limited the amount of personal medical information being shared with third-parties, prevented any sharing of data with Facebook, and de-identified personal information in data they share with Google.
For more details, you can read more about steps they’ve taken for data privacy here.
Closing $ense
Kaiser Family Foundation found that 24% of people had difficulty affording their prescription drugs, and 29% of adults reported not taking their medication as prescribed because of the cost. Failure to take medicine to treat common health problems such as high blood pressure, diabetes, and high cholesterol could result in disastrous consequences.
Taking care of one’s health is important if you are trying to be financially responsible. Medical debt is the number one cause of personal bankruptcies. The best way to prevent a more serious health problem is prevention. This includes getting regular check-ups and taking your medication as prescribed by your physician.
GoodRx can help make costly prescription drugs more affordable for those with and without insurance. The next time you are in line at the pharmacy, open up the app or the website to see how much you could be saving.
Related: Ways to Save Money on Allergy Medications
Have you used GoodRx to save on prescription drugs? What other ways or services you have used to pay less for prescriptions?