Insurance and GoodRx
Sometimes, insurance isn’t the best deal — because of high deductibles or high co-pays, or because maybe your drug isn’t covered at all. In many cases, GoodRx prices actually beat insurance prices (a co-pay or co-insurance charge). The good news is you can use GoodRx instead of insurance. Here’s a guide to making the right call.
GoodRx beats insurance prices 40% of the time
For generic drugs, GoodRx saves people an average of $10-25 savings
70% of GoodRx customers have insurance
Can I use GoodRx instead of insurance?
If your find a better price on GoodRx than what your coverage offers, ask the pharmacist to use the coupon and process the transaction as a “cash” payment instead. They will use the codes on the GoodRx coupon to find your new price.
If the pharmacist has any trouble, please give us a call at 1-855-268-2822 (M-F 9am-6pm CST). Our advocates are there to help you, and can often resolve your issue while you’re still in the pharmacy.
10 drugs where GoodRx could be cheaper than your insurance
How to decide between GoodRx and my insurance?
You don't have to wait until you get to the pharmacy cash register – you can compare prices at home. Here's how:
Log on to your insurance company portal and find the "Price a Medication" link under your Pharmacy Benefits. Note any restrictions, such as prior authorization, step therapy, or quantity limits. Also, see if you’re under a deductible, which would have you pay full price for your prescription until you reach the out-of-pocket limit.
GoodRx lists free discount prices and provides coupons so you can receive a discounted price when you pick up your prescription. It’s all free!
Depending what your co-pay fee or co-insurance percentage charge is, GoodRx might be the better way to go to save more.
Why is GoodRx cheaper than my insurance?
Insurance companies use lists of drugs, called formularies, to price different drugs. If your medication is on a higher formulary tier or is a non-preferred drug, it can mean a higher co-pay or no coverage at all. What’s more, if your plan has a deductible for prescriptions, you may be expected to pay full price for your drug until you reach the out-of-pocket maximum.
In all these cases, GoodRx can offer a simpler and more affordable way to pay for your medication. If you find a cheaper discount with GoodRx than what your insurance is asking you to pay, then tell your pharmacist you want to pay cash with a GoodRx coupon instead of paying with insurance.
Can I get reimbursed by my insurance if I use GoodRx?
When you use GoodRx, you are choosing to pay without your insurance, but you can ask your insurer to reimburse you or to apply your purchase against your deductible.
Here’s the deal:
Paying with a GoodRx coupon is considered an “out-of-network” purchase, and it’s up to the insurance company to decide if they’ll pay you back — or whether they’ll count it toward your deductible. Frankly, it’s often tough to get a straight answer on the rules; when we called several insurance companies to ask about their policy, we got different answers, even from the same company, depending on who we talked to.
So, while we can’t promise you’ll get reimbursed, it can be worth trying. Here’s how:
If you don’t see your insurance, let us know! firstname.lastname@example.org