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HDHP question, Rx without insurance
Old 02-19-2013, 07:29 AM   #1
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HDHP question, Rx without insurance

Hello folks,

One more health insurance question.

I have a high deductible HSA-type health insurance plan, $4000 deductible/calendar year and coverage cycle is from Nov to Oct, so its actually more than $4000. Only 3 employees are covered under this insurance plan by the employer (among those 3, we are the only family, who really use it on regular basis.)

I use a few Rx medications for my health conditions. If I buy these medications through goodrx.com, they are cheaper than what my Rx card will offer me. For example, A 3-month supply of Medicine A from insurance company 'recommended' mail order pharmacy costs $310. If I buy same medicine using insurance information from goodrx.com will cost me $220. So I plan to buy all my medications through goodrx.com
Either way, the amount will be paid using HSA money.

Of course, this will NOT count towards the $4000 deductible. Even if I use Rx coverage on my insurance plan, I doubt I will make $4000 this year. In such case, if either one the family members ends up in the hospital, I will end up paying a lot more. In that case, I will just have to bite the bullet. (Such possibility is rather low but emergency can strike any time, nobody knows. If such situation arises, I am ready to bite the bullet.)

My question is, what implications I am looking at, should I go through goodrx.com instead of my health plan Rx coverage. The reason of going this route is, first save money and second, buffer next year's premiums a little bit. (I understand, even if I don't use health insurance at all, still the prices are going to shoot at certain percentage point.) Does this make sense? Would you do the same, should you end up in my shoe?

Thanks in advance.
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Old 02-19-2013, 09:58 AM   #2
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Quote:
Originally Posted by noelm View Post
I use a few Rx medications for my health conditions. If I buy these medications through goodrx.com, they are cheaper than what my Rx card will offer me. For example, A 3-month supply of Medicine A from insurance company 'recommended' mail order pharmacy costs $310. If I buy same medicine using insurance information from goodrx.com will cost me $220. So I plan to buy all my medications through goodrx.com
Either way, the amount will be paid using HSA money.
Does "using insurance information" mean goodrx.com is billing your insurer for the medicine? In that case there should be no impact other than you are saving some money. Unless your plan doesn't pay as much for out of network pharmacies, in which case you may not get as much credit towards your deductible, if Rx even counts towards that.

You might also consider using the HSA as a "retirement" account and pay your current costs from taxable funds. Just another opportunity for tax-advantaged savings if you would like.
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Old 02-19-2013, 12:25 PM   #3
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Does "using insurance information" mean goodrx.com is billing your insurer for the medicine? In that case there should be no impact other than you are saving some money. Unless your plan doesn't pay as much for out of network pharmacies, in which case you may not get as much credit towards your deductible, if Rx even counts towards that.
GoodRx.com is a drug pricing service - it is not insurance and collects no insurance information from those who use it to price and perhaps purchase drugs.

To the OP, if you choose to use a different pharmacy than the one in your plan's network you are not creating a problem for yourself. In some plans certain drug co-pays can be applied to the deductible (these are generally expensive and for chronic conditions). You would need to do the math to determine whether it is to your benefit to use your plan's pharmacy network, or someone else.

You have just discovered that your plan's ability to negotiate really great discounts for drugs is not that great.

-- Rita
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Old 02-19-2013, 12:26 PM   #4
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@Animorph,

Goodrx.com does not bill to my insurance. I am not quite clear of their business model but they offer their insurance 'like' information for the pharmacies to process the prescription and the user pays 'out of pocket'.

I did consider HSA as retirement account but for time being we decided to use it for medical expenses.
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Old 02-20-2013, 04:42 PM   #5
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mass has some plans under romneycare that the deductible goes to rx drugs also
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