Prescription Drug Savings

Floralscent

Floralscent

Dryer sheet wannabe
Joined
Dec 29, 2024
Messages
13
Location
MN/MO
Hello! Thank you all for this great forum...I have learned so much recently.

Early retirement is the plan for us mid to late 2025. We are currently on employer sponsored health plans and I find our coverage, premiums and MOOP to be reasonable, considering the high cost of everything these days. We will qualify for tax credit with ACA and are looking at plans right now.

Looking ahead to drug coverage in retirement- has anyone used the free prescription savings plans? Not sure I can say the names of them here (one starts with the word good) and they are appear to be free but maybe I am wrong. Does one just show the pharmacy a barcode or something for the drug that you are needing and then they discount the price? Do you use this only if the drug is not covered by insurance or does it help discount your drug cost even if covered by insurance?

Does anyone have experience with these savings and are these savings only good when you don't have ins coverage for a drug? Any info you can share is certainly welcome and thanks so much!
 
I use GoodRX for my cat's daily inhaler. It is easy to use. I have good drug coverage right now so I don't use it for me. I will compare prices when I'm on medicare later.
 
Floralscent said:
Looking ahead to drug coverage in retirement- has anyone used the free prescription savings plans? Not sure I can say the names of them here (one starts with the word good)
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Search for GoodRX here and you'll find many, many threads where it's discussed.
 
Nothing wrong with checking prices for all your prescriptions on GoodRx and using them if it makes sense. My Blue Cross/Blue Shield ACA plan has better pricing for my current needs, but not all plans are the same.
 
I was going to use Goodrx once for a med at $135 (vs. over $500 regular), but if I did, I couldn't use insurance, so it wouldn't even apply towards the deductible that you are required for the Tier 4 med or toward my out of pocket max. It was brand name only, no generic, and it ended up that I was able to use a manufacturer's savings card since I had commercial insurance, even though my insurance wouldn't cover any of it yet. So my cost was $0 for the first month and would be $25/mo afterwards, whether I've hit my deductible or not. Also, my insurance shows about $500 was spent toward the deductible and toward my out of pocket max, even though I spent $0.

perks.optum.com is another one.
 
GoodRx and Single Care are probably the two best known "Rx Coupon Savings" app. It's pretty simple...enter then name of the drug, the dosage and the number of pills, caps, etc. and get a list of participatimg pharmacies and the price. Show the electronic 'coupon' on your device to the pharmacist to get that price. You can use GoodRx whether you have a Part D plan or not. We use it for the oddball Rx that's not on our Part D plan.
 
Oh, I remembered, I did use a GoodRx coupon once because I had decided to start COBRA, but my insurance wasn't showing active yet when I went to pickup a prescription, so the pharmacist put in a GoodRx coupon for me to bring the prescription down from $24 to $12. It had been running about $4 with insurance. By my next refill, insurance was showing active.
 
I've used GoodRx but mostly use https://www.krogerhealthsavings.com/drug. If you have a Kroger chain Grocery Store (Ralphs, Frys, etc. etc.) near you, this works great. It used to be tied to GoodRx, but the current incarnation is independent. While I've always had prescription coverage through medical insurance, at times the Kroger coverage is cheaper. I pay $36 a year for my subscription. Some maintenance meds are free. I've already priced all of my and DW's current drugs once on Medicare, and we'll go with one of those freebie Part D's but buy all our prescriptions through the Kroger plan. I believe we have 9 prescriptions between the two of us, including two that can be a bit expensive. Best wishes!
 
We recently started using Amazon pharmacy. I gave them our Anthem insurance information and when I fill a prescription they compare my insurance price with their discount program. Quite often their discount program price is better than my Anthem insurance price. We also love the ease of using Amazon pharmacy when we travel.
 
Since this thread popped back up, I’ll pile on with a new question on a similar topic…

Is anyone aware of a new program for 2025 or perhaps a Walmart pharmacy benefit that could have caused this situation: This year I have a $1700 deductible with my ACA HDHP plan. In January, I had some claims for bloodwork, a doctor appt, and some CPAP supplies. The claims with BC/BS started to be processed and the deductible “tracker” showed that I had used about $513 toward my deductible. This seems accurate. Yesterday, I needed a refill of my Mounjaro diabetes prescription. The “full” price for this is about $1200. Given the current amount left for my deductible, I would owe almost all of that to fill up the deductible. There also is a manufacturer coupon that would cover $150 of it. So I’d still owe over $1000 for it. It’s not fun, but I get it. That’s my deductible. Last year, I had to pay a similar large amount for my first fill of the drug at CVS.

However, when I went to Walmart to pick it up, I was only charged $25. I told them that can’t be right. It should be a lot more. They verified my insurance info and said they get real-time pricing from E-Scripts, who handles prescription processing for BC/BS. So I paid my $25 and left with my prescription. $25 is what the drug normally costs me after my insurance and the manufacturer’s coupon. The Walmart receipt shows a “CASH” price of $1200 and “Patient Pays” $25.

When I got home, I signed into my E-Scripts account. The claim shows as “processed” and it shows that I would have to pay $1200. It also shows $1200 more has been paid toward my deductible. So E-Scripts appears to think I paid the full price.

So, unless Walmart has some added agreement with the manufacturer to further discount or there is some other change I’m not aware of, I have to think this is an error in my favor. I wonder if Walmart or Escripts will figure it out at some point. I wonder when the reconciliation between Walmart and E-Scripts occurs.

Thoughts?
 
2retireearly said:
I had no idea you could use any of these drug plans for non humans? That is good to know...
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Yeah my old vet used to hand out goodrx cards with the rx. . . back in the days of paper anyway. My cat had to take (human) heart meds.
 
I've used GoodRx, Rx Saver and Single Care for lower prices on prescriptions. It's easy and a great deal, you just have to understand that it is outside of your insurance so the cost won't be applied to your deductible.

Those sites are free but GoodRx also has a Gold Membership for a small monthly cost for even lower prices. DH did a free trial to get a better price for a one time prescription and then did not renew. You do not need a membership, just an account to use the coupons.

Our Part D plan has $0.00 cost for all of our Tier 1 drugs. I have one Tier 4 that would be $175 for 90 days. Instead of using my Part D plan I get it from Mark Cuban Cost Plus Drugs ( Homepage of Mark Cuban Cost Plus Drugs) for $25 including $5.00 shipping. They don't carry all prescriptions but they are adding new ones all the time and you can get an alert if one you are looking for becomes available. You can see the medications they carry and the prices without having an account.
 
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PaunchyPirate said:
When I got home, I signed into my E-Scripts account. The claim shows as “processed” and it shows that I would have to pay $1200. It also shows $1200 more has been paid toward my deductible. So E-Scripts appears to think I paid the full price.
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This sounds exactly what happened when I got Quviviq in my earlier post. Prescription Drug Savings They gave the discounted price even though I haven't met the deductible, which I wasn't expecting, either. And it shows I nearly met my $500 deductible from getting that medication despite not paying anything for it, because of what the manufacturer discounted was about $500.

I also confirmed there is a $25 Mounjaro Savings Card from the manufacturer, so it seems to add up and match my experience:

It will be interesting to see if it goes up next month.
 
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GenXguy said:
This sounds exactly what happened when I got Quviviq in my earlier post. Prescription Drug Savings They gave the discounted price even though I haven't met the deductible, which I wasn't expecting, either. And it shows I nearly met my $500 deductible from getting that medication despite not paying anything for it, because of what the manufacturer discounted was about $500.

I also confirmed there is a $25 Mounjaro Savings Card from the manufacturer, so it seems to add up and match my experience:

It will be interesting to see if it goes up next month.
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Yes, I've been taking Mounjaro for one year. And I've been using the Mounjaro Savings Card to save me a lot of money. It would be responsible for $150 of the discrepancy that I experienced yesterday. But I'm still over $800 ahead of the game for some reason. I figure some accounting process will catch it at some point and bill me somehow. But fingers crossed that doesn't happen. I'd love nothing more than to screw the medical system for once.

I do know that the insurance companies are not permitted to count manufacturer coupon benefits toward your deductible. They have been lobbying to get that changed. But as of now, it is "free" money to us consumers with respect to deductibles.
 
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PaunchyPirate said:
Yes, I've been taking Mounjaro for one year. And I've been using the Mounjaro Savings Card to save me a lot of money. It would be responsible for $150 of the discrepancy that I experienced yesterday. But I'm still over $800 ahead of the game for some reason. I figure some accounting process will catch it at some point and bill me somehow. But fingers crossed that doesn't happen. I'd love nothing more than to screw the medical system for once.

I do know that the insurance companies are not permitted to count manufacturer coupon benefits toward your deductible. They have been lobbying to get that changed. But as of now, it is "free" money to us consumers with respect to deductibles.
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One other thing to note. I first started using Quviviq the middle of last year after I had already met my deductible. The insurance co-pay for that tier is $60. With the manufacturer coupon, my cost was $0 for first fill and $25 for refills. But each time I filled it, I was credited $60 to my out of pocket maximum, which I ended up hitting, so it saved me there also. And this year, that ~$500 counted toward the deductible and out of pocket maximum, both, despite me spending $0 for that first fill of the year. So, that was nice. The second refill (which was this month), the amount credited to out of pocket was $60 despite my cost being $25.
 
I recently switched 3 medications to Cost Plus Drugs. They do take some insurances, but not mine. Even with no insurance, they are cheaper than mine was with insurance.
 
WOW... just paid for my 90 days Jardiance... $860!!

I think it was cheaper last year but have not looked.... it is supposed to be included in the 10 drugs they negotiate price on... even then almost $200 per month...
 
Texas Proud said:
WOW... just paid for my 90 days Jardiance... $860!!

I think it was cheaper last year but have not looked.... it is supposed to be included in the 10 drugs they negotiate price on... even then almost $200 per month...
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Mine was in that range. I suspect that DW and I will each pay the full $2,000 in 2025, but I haven't moved into it. Not sure if I want to know.
 
Texas Proud said:
WOW... just paid for my 90 days Jardiance... $860!!

I think it was cheaper last year but have not looked.... it is supposed to be included in the 10 drugs they negotiate price on... even then almost $200 per month...
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You will hit the max at some point, right?
 
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