Medicare Blog

why are goodrx prices better than medicare

by Dr. Barney Bartoletti III Published 2 years ago Updated 1 year ago
image

GoodRx makes it easy to compare your Medicare co-pays against GoodRx coupon prices to see which can save you more. Keep in mind that you cannot use GoodRx and Medicare at the same time. However, you can use GoodRx instead of government-funded programs, such as Medicare of Medicaid, to pay for your prescription medications.

But you can use GoodRx as an alternative to Medicare. You may want to use GoodRx instead of Medicare in certain situations, such as when Medicare doesn't cover your medication, the GoodRx price is cheaper than your Medicare copay, or you won't reach your annual deductible.Sep 27, 2021

Full Answer

Can I use GoodRx instead of Medicare?

But you can use GoodRx as an alternative to Medicare. You may want to use GoodRx instead of Medicare in certain situations, such as when Medicare doesn’t cover your medication, the GoodRx price is cheaper than your Medicare copay, or you won’t reach your annual deductible.

How much does GoodRx really save you on prescription drugs?

GoodRx says it can save consumers up to 80% off the price of prescription drugs. From my experience, the app does a great job of highlighting $4 generics and even medications that are 100% free! Take a look at the prices I found when I searched GoodRx for 30-day supplies of five popular generic medications: Lipitor (atorvastatin): $8.25

Is GoodRx cheaper than a co-pay?

If the GoodRx price is low enough, it can be cheaper than a co-pay and that lets the insurer off the hook to pay for the med (and this happens. Sometimes just cash pay is less as well. I used to do that for many of my dad’s prescriptions and he would freak when I said: Run it as cash, but it cost HIM less.

Should you use GoodRx to compare pet prescription drug prices?

You can use GoodRx to compare the discounted price with your insurance price and choose to use the lowest cost option. Put simply, it’s one or the other. The good in GoodRx. GoodRx is free! Everyone can use it to save on medications even those for your pets. It’s a great platform for price comparison shopping of your prescription medications.

image

Why are prescriptions so much cheaper with GoodRx?

GoodRx does not negotiate or set any medication prices. For GoodRx coupons, prices are negotiated between pharmacies or pharmacy purchasing groups and PBMs. GoodRx partners with PBMs to display the contracted price at each pharmacy.

Why can't Medicare patients use GoodRx?

GoodRx Coupons and Medicare Part D cannot be used in conjunction. This is due to a federal government statute, also known as “anti-kickback”, that prohibits Medicare beneficiaries from using manufacturers or discount drug coupons with their drug plan. However, you can use GoodRx in place of your prescription drug plan.

Is there a downside to using GoodRx?

GoodRx is rated a 4.6 out of 5 on TrustPilot with over 90% of users rating the popular discount card as excellent. Unfortunately, they also have about 10% of users that rate the service as poor or bad. The most common complaints seem to be related to customer service and changing or inaccurate discount prices.

What are the pros and cons of GoodRx?

The pros of GoodRx far outweigh the cons....GoodRx Pros and Cons Summary.ProsConsFree and no sign-up requiredGoodRx Gold required for best pricesBig savings on prescription drugs, especially genericsDiscount card pricing may be different from couponsAccepted by most U.S. pharmacies

Is Medicare GoodRx or Part D better?

GoodRx can also help you save on over-the-counter medications and vaccines. GoodRx prices are lower than your Medicare copay. In some cases — but not all — GoodRx may offer a cheaper price than what you'd pay under Medicare. You won't reach your annual deductible.

How does GoodRx make money on prescriptions?

GoodRX makes part of its revenue by collecting fees from the pharmacy benefits managers, or PBMs, it works with when consumers present their GoodRx coupon at the pharmacy.

What company owns GoodRx?

GoodRx Intermediate Holdings, LLCGoodRx / Parent organization

Does GoodRx work if you have insurance?

Keep in mind that you cannot use GoodRx and insurance at the same time. However, you can use GoodRx instead of insurance or government-funded programs, such as Medicare or Medicaid, to pay for your prescription medications. GoodRx is not insurance.

Is GoodRx good for seniors?

GoodRx is one of the most widely used and available prescription savings cards. The company is likely partnered with pharmacies near you, making it an excellent choice for seniors across the country.

Can seniors use GoodRx?

While you can't use GoodRx in conjunction with any federal or state-funded programs like Medicare or Medicaid, you can use GoodRx as an alternative to your insurance, especially in situations when our prices are better than what Medicare may charge. Here's how it works.

Does GoodRx cover brand name drugs?

In order to help people afford their brand-name drugs, last May, we launched the InsideRx program on GoodRx that offers an average of 34% off over 100 brand-name prescriptions. Today, we are excited to announce discounts on even more brand-name drugs.

How do I use GoodRx if I have Medicare?

If you choose to use a GoodRx coupon instead of your Medicare coverage, you must ask the pharmacist not to run your prescription through your Medicare. Instead, present your GoodRx coupon and ask that the pharmacist process the transaction as cash instead.

What should I do if my pharmacist has trouble using the GoodRx coupon?

Please ask your pharmacist to call 1-855-446-4051. A GoodRx Patient Advocacy representative will be able to help them process the discount correctly and answer any questions right away.

When should I use GoodRx instead of Medicare?

Even if you have Medicare, GoodRx can help you save money on your prescriptions, both in the short and long term. Because the amount you pay using GoodRx coupons will not count toward your Medicare plan, it’s important to think ahead and consider your medication expenses for the full year.

The bottom line

In a nutshell, Medicare works a lot like regular health insurance. You can’t use GoodRx with it, but you can use GoodRx in place of it. And, just like regular insurance, some Medicare plans may allow GoodRx to count toward your coverage limits. Check with your plan and save your pharmacy receipts in case you can submit them for Medicare credits.

When should you use GoodRx instead of Medicare?

There are some situations where you may want to consider using GoodRx instead of Medicare, such as when:

Are GoodRx cash prices always cheaper than Medicare copays?

Not always, but GoodRx can offer the most affordable price on many prescriptions. So check GoodRx before going to the pharmacy, especially if you have just been prescribed a new medication or your plan has changed its pricing.

Can you use GoodRx coupons to avoid Medicare coverage gaps or get out of them?

You can’t use GoodRx coupons to get out of the Medicare donut hole once you’re in it. But you can “avoid” it by using GoodRx instead of paying donut-hole prices.

Why is less prescription drug coverage available during Medicare coverage gaps?

In the coverage gap, or donut-hole stage, you’re responsible for paying a percentage of the full cost of your drug (e.g., coinsurance). In 2022, you’ll be responsible for paying 25% of the cost of brand-name drugs and generic drugs.

The bottom line

If you’re a Medicare enrollee, you may face certain scenarios where it makes sense to use GoodRx instead of your Medicare Part D plan. These cases include when Medicare doesn’t cover your medication, when GoodRx prices are lower than your Medicare copay, and when you won’t meet your annual deductible.

How much does GoodRx save?

GoodRx says it can save consumers up to 80% off the price of prescription drugs. From my experience, the app does a great job of highlighting $4 generics and even medications that are 100% free!

Which pharmacies accept Goodrx?

More than 70,000 pharmacies in the United States — including major chains like Costco, Kroger, Walmart, CVS, Rite Aid and Walgreens — will accept GoodRx. When you search GoodRx for your medication, you’ll see all of the pharmacies on the drug price page.

What is the number to call Goodrx?

Participating pharmacies are contractually obligated to accept GoodRx coupons. If your pharmacist refuses to accept them, you can call GoodRx at (855) 268-2822. There’s one big exception: GoodRx says Sam’s Club is no longer part of its network. 3.

How many PBMs does Goodrx use?

But here’s the secret sauce... with goodrx, they are using up to about Nine PBM’s to get you the best price, as well as telling you where the cheapest price is at. This means you will be getting the lowest or pretty much so for any drug if you are uninsured. And if insured, it will work for drugs they don’t cover.

Does GoodRx share data?

That’s something the company says it won’t do. However, GoodRx does share data in some cases. Here’s how the company puts it: “It’s common practice for companies to share data for advertising and analytics purposes, which is what GoodRx does.

Should I check GoodRx before leaving the house?

If you’ve been going to the same pharmacy for years , it’s important to check GoodRx before you leave the house because there may be better options nearby. You can even check prices while you’re at the doctor’s office to make sure that you can afford your new script.

Do I have to sign up for GoodRx?

The great thing about GoodRx is that you don’t have to sign up with your email, phone number, Facebook account or any other personal information to take advantage of the prescription drug discounts.

Why do pharmacies use GoodRx?

Another reason pharmacies want to play ball with GoodRx is because so many prescriptions ARE a lot of money, even with insurance, some patients will NOT take a filled prescription when they hear what it costs.

Does PBM get a discount?

The PBM gets a MASSIVE discount on the U&C price of the pharmacy—most likely well over 50%. (The pharmacy does NOT ever assume they’re going to get that U&C price.) This is done not med by med but as an average from my understanding.

How does GoodRx work?

GoodRx collects revenue from ads on it’s website and within the GoodRx mobile app. Like any website, when an ad is displayed using an ad broker service a portion of the proceeds are shared with the displaying website. The website owner gets an even larger share when the ad is clicked on by a user.

How many pharmacies does GoodRx have?

GoodRx, through its several PBM partnerships is contracted with practically every pharmacy in America, that’s over 70,000 pharmacies including the major chains like Walgreens, CVS, and Rite Aid in addition to grocery stores like Walmart, Publix, Albertson’s, and Kroger.

Where is GoodRx located?

GoodRx is a technology company based in Santa Monica, CA founded in 2011 by former Facebook and Yahoo employees to help people price shop prescription medications. Founder Doug Hirsch was alarmed at the cost of a medication he was prescribed in 2010 and started price shopping to find a lower price.

Does GoodRx have control over drug pricing?

GoodRx is only a technology company that displays the discounted drug pricing from multiple pharmacy benefit managers and therefore has no control over drug pricing. It relies on it’s partner PBMS to negotiate prices with pharmacies and is the crux of the inaccurate pricing concern.

Does Goodrx give discount cards?

GoodRx sends medical offices displays full of branded discount cards to place in the patient rooms or waiting areas. They have convinced many physicians and nurses to hand out their discount cards to patients with every prescription.

Does Goodrx have free medication lists?

Like any company GoodRx has it’s best interest in mind so it only displays the pricing of it’s partners or the paying advertisers. You won’t find the free medication lists from several pharmacies displayed on the GoodRx pricing page since those pharmacies haven’t paid to have them advertised on GoodRx.

Does Goodrx have a discount?

GoodRx has a discounted price for every FDA approved prescription medication in addition to certain vitamins and OTC medications. GoodRx even includes store memberships, pharmacy discount lists, and even some free medication programs in it’s price comparison tool.

How much does GoodRx Gold cost?

To access the steepest discounts, the company also offers a premium service called GoodRx Gold that costs around $6 per month for an individual and about $10 per month for a family up to six people.

How old do you have to be to get GoodRx?

GoodRx is a free program that offers multiple ways to save on your prescription drugs. Anyone is eligible to participate, so long as they are 18 years old and reside in the United States or its territories. Children can also be added to their parent or guardian's accounts.

How many pharmacies accept Optum Perks?

Over 18.6 million people have used the company's discount card, and more than 64,000 pharmacies in the U.S. accept Optum Perks (not just pharmacy chains, local pharmacies, too). You don't need to enroll in any program or sign up for a membership to receive your card.

How does PBM save money?

If you do not have insurance, the PBM can save you money directly by way of coupons and rebates when you use pharmacies in their network . One way they do this is by offering prescription drug discount cards.

How much discount do you get for pet medications?

All you need to do is present your discount card to the pharmacy of your choice. Discounts on prescriptions, including some pet medications, may be as high as 80%, but on average are in the 60% range. You can also text, print, or email your savings card, so you have it available when you need it.

What is RXSaver for?

RxSaver is a free program for residents of the United States ages 18 years and older. You can search via the website and mobile app for the best discounts on prescription medications, from a network of more than 60,000 pharmacies.

Do you have to pay deductibles for prescription drugs?

That means no deduct ibles. You will pay the retail price of the drug, minus the discount. In some cases, you may even get generic medications for free. Prescription drug discount cards are distributed by companies that also work as pharmacy benefit managers (PBMs).

image
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 1 2 3 4 5 6 7 8 9