You've got prescription coverage. You pay your copays at the pharmacy. Everything's handled, right?
Not always.
Having insurance doesn't automatically mean you're getting the best price on your medications. Sometimes, paying out of pocket can actually cost less than using your coverage by utilizing some strategic Rx resources.
Your Insurance Works Hard (But You Can Help Work Smarter)
Many health plans include programs that work behind the scenes to identify savings on your prescriptions as part of your health benefits. At Reformed Benefits Association, we partner with RazorMetrics, a program that automatically finds lower-cost options for our members and notifies your doctor. If they approve, you get the savings without lifting a finger. No forms, no sign-up, no changes to your pharmacy routine.
If your plan offers something similar, that's already a huge advantage.
But you can take it even further by doing a little price comparison yourself. Think of it as being a smart shopper. Whether your plan has automatic savings programs or not, adding these two tools to your toolkit could save you even more money.
Two Tools Everyone with Health Insurance Should Know About
GoodRx is a free discount card service that works at retail pharmacies across the country. You simply look up your medication on their website or app. You will see discounted prices at nearby pharmacies that they’ve already negotiated. Then you use their discount code at checkout.
Remember, it's not insurance; it's a price comparison tool, but it can regularly beat your insurance price if you’re willing to go somewhere different and maybe even travel a bit. Learn more about how GoodRx works.
Cost Plus Drugs is Mark Cuban's (from Shark Tank) mail-order pharmacy that uses transparent pricing. As the name suggests, it’s the manufacturer’s cost plus 15%. They also add a $5 dispensing fee and $5 shipping. That's it. No insurance games, no hidden markups.
They carry over 2,000 generic medications and are regularly adding to their list. The catch? It's mail-order only, so you'll need to plan ahead. See how Cost Plus Drug Company works.
Neither replaces your current Rx coverage, because neither is guaranteed. These tools could vanish tomorrow, or change their prices. That’s different than your insurance plan rates, which are locked in for the full year, every year.
It’s best to think of these as additional options to check when you're filling a prescription to be a smart shopper.
When Your Insurance Coverage Makes the Most Sense
There are plenty of times when using your insurance is absolutely the way to go.
Brand-name medications almost always make more sense through your coverage. The discounts available through GoodRx or Cost Plus typically don't beat insurance rates for brand-name drugs.
IMPORTANT: If you're working toward your deductible — especially if you're on a high-deductible health plan — every dollar you spend through insurance (typically including your prescriptions) counts toward that deductible and your out-of-pocket maximum. That matters.
Also, when you need a medication immediately, your local pharmacy with same-day pickup beats waiting for mail delivery every time when you can’t risk skipping a day or more.
When to Pull Out Your Phone and Compare Prices
Generic medications are where things get interesting.
Even with typical Tier 1 copays (often around $10), some generics cost less through GoodRx or Cost Plus. You can get prices as low as $5, $6, sometimes $3 for a 30-day supply. If you're taking multiple maintenance medications, those savings add up fast.
If you're on a high-deductible plan and haven't met your deductible yet, you're paying full price anyway until you hit that threshold. In those situations, checking GoodRx or Cost Plus first could save you significant money on every prescription.
Maintenance medications (the ones you take every single month) are prime candidates for price comparison. A $15 difference per month is $180 a year on just one medication. Most people take more than one.
And if you're willing to wait a few days for mail delivery, Cost Plus Drugs can offer prices that seem almost too good to be true (but aren't).
Your 3-Step Price Comparison Process
Just keep it simple.
Step 1: Check your insurance copay tier for the medication. Most plans organize medications into tiers—Tier 1 (usually generics) might be $10, Tier 2 might be $40-90, and so on. If you're on a high-deductible plan and haven't met your deductible, you're paying full price.
Step 2: Look up the same medication on GoodRx and Cost Plus Drugs. It only takes a few minutes. GoodRx shows you prices at pharmacies near you. Cost Plus shows you its mail-order price.
Step 3: Choose the lowest price while considering your deductible needs.
If your insurance copay wins, use your coverage. If GoodRx or Cost Plus beats it, use them instead. You're not locked into one or the other; you're just making a smart decision on each prescription.
Take Control of Your Prescription Costs
You already have prescription coverage, and if you're with RBA, you have RazorMetrics working behind the scenes to find savings automatically. But adding a quick price comparison to your routine could save you hundreds of dollars every year, regardless of which plan you're on.
Check GoodRx at goodrx.com and Cost Plus Drugs at costplusdrugs.com next time you're filling a prescription. Your wallet will thank you. If you're an RBA member and want to discuss how this works with your specific plan, your advisor is here to help.
The information contained in this blog is for educational purposes only.