System for navigating prescription pricing?

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michaeljc70
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Joined: Thu Oct 15, 2015 3:53 pm

System for navigating prescription pricing?

Post by michaeljc70 »

This probably doesn't apply to people with insurance with low prescription co-pays . I am wondering how others approach prescriptions since it can be cheaper to not use your insurance in some cases. There have been threads about GoodRx on here. There are also pharmacy (Kroger, Walmart) and non-pharmacy discount programs (GoodRx, WellRx) some of which require a membership fee. On top of that, I imagine the price with insurance will vary depending on where the prescription is filled if you don't have a fixed co-pay. You also often have different pricing for mail order service.

My question is, do you have a system to navigate all this?

I don't get a lot of prescriptions, so I keep it simple. I currently have the doctor send the prescription to a nearby Walgreens. They fill the prescription and I can login to my account online and see the price after insurance. I then compare that to GoodRx. If it is worthwhile, I will then transfer the prescription to the pharmacy that accepts GoodRx. I suppose if it was an expensive enough drug I might look for other discounts.

I was aggravated this week that for a prescription Walgreens with insurance was 3x+ what it was using GoodRx. It was only a $26 difference, but still.
njuser
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Re: System for navigating prescription pricing?

Post by njuser »

Only $26?? That's a lot.

I always check on GoodRx. I usually have our doctor call the prescription into our local supermarket drugstore that has decent prices. I will transfer it to big box discounter if it's 'worth it' to me. Sometimes Walmart has a specific thing a lot cheaper than others so I may transfer it there.

Since you have a prescription plan, you should be able to look up your drug on your plan's website and see what copay they would charge. Then look it up on GoodRx. If it's cheaper on GoodRx call your pharmacy before they fill it and get it transferred. It's more difficult if you pay different prices for the meds through your plan. Sometimes the pharmacist has to run it through the computer to see what it will cost.

I think it wastes the pharmacy's time to have to do this but that's how it is right now.
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Kenkat
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Re: System for navigating prescription pricing?

Post by Kenkat »

I’ve started to check GoodRx to see how it compares to my negotiated insurance rate. Since I am on a HDHP, I pay full freight on prescriptions until I hit my deductible and out of pocket limits. If GoodRx is cheaper, I have it run through there instead. Sometimes it can be a fair amount of money - $50 on one prescription, for example.
Theratking
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Re: System for navigating prescription pricing?

Post by Theratking »

I would also check for manufacturer rebates and copay cards. They especially make sense for HDHP.

I am not sure if goodrx is applied to your deductible with health plans. I am just unsure.

I would recommend looking at Sam’s club pharmacy. They have very low price points, and if you are a plus member you get discounts and it is part of your annual payback.
Topic Author
michaeljc70
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Re: System for navigating prescription pricing?

Post by michaeljc70 »

Kenkat wrote: Tue Dec 31, 2019 3:19 pm I’ve started to check GoodRx to see how it compares to my negotiated insurance rate. Since I am on a HDHP, I pay full freight on prescriptions until I hit my deductible and out of pocket limits. If GoodRx is cheaper, I have it run through there instead. Sometimes it can be a fair amount of money - $50 on one prescription, for example.
I pay full freight also until I hit the deductible. Since Walgreens always seems to be the highest on GoodRx in my area, I wonder if having the doctor send it to what is typically the cheapest pharmacy (on GoodRx) is a better plan. I know with Walgreens I can see the insurance price online after it is filled and I am not sure if every pharmacy does this. Can I then just tell them not to use my insurance if it is cheaper with GoodRX? I know they would have to re-run it, but since they created this "system" to benefit themselves that isn't my problem.

As an example, the prescription I got this week has 6 pharmacies on GoodRx ranging from $11.55 to $34.26 (Walgreens). It was $37 with my insurance at Walgreens. I got it for the $11.55 at Mariano's (Kroger).
BobTexas
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Re: System for navigating prescription pricing?

Post by BobTexas »

michaeljc70 wrote: Tue Dec 31, 2019 2:15 pm This probably doesn't apply to people with insurance with low prescription co-pays . I am wondering how others approach prescriptions since it can be cheaper to not use your insurance in some cases. There have been threads about GoodRx on here. There are also pharmacy (Kroger, Walmart) and non-pharmacy discount programs (GoodRx, WellRx) some of which require a membership fee. On top of that, I imagine the price with insurance will vary depending on where the prescription is filled if you don't have a fixed co-pay. You also often have different pricing for mail order service.

My question is, do you have a system to navigate all this?

I don't get a lot of prescriptions, so I keep it simple. I currently have the doctor send the prescription to a nearby Walgreens. They fill the prescription and I can login to my account online and see the price after insurance. I then compare that to GoodRx. If it is worthwhile, I will then transfer the prescription to the pharmacy that accepts GoodRx. I suppose if it was an expensive enough drug I might look for other discounts.

I was aggravated this week that for a prescription Walgreens with insurance was 3x+ what it was using GoodRx. It was only a $26 difference, but still.
This is basically what I do. Most of mine go to CVS which is the in-network pharmacy, but I have 1 I get from Costco since it is much cheaper. The only issue with that is if I don’t get it from CVS it doesn’t count towards my deductible or out-of-pocket max
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Kenkat
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Re: System for navigating prescription pricing?

Post by Kenkat »

I get prescriptions filled at Kroger and they have the GoodRx information on our account and usually will automatically pick the cheapest option, but if for some reason I see it cheaper on the app, they can switch it right as I pick up.

I have heard that you can sometimes get the GoodRx purchase applied to your HDHP deductible although I haven’t tried that yet as I just started using GoodRx fairly recently (this year) and it’s a moot point if you aren’t going to hit your deductible anyway.
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dual
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Re: System for navigating prescription pricing?

Post by dual »

Several posters have mentioned transferring their prescriptions to another pharmacy after a doctor sends it to a first pharmacy. I am very interested in this since my doctors only send a prescription electronically to a single pharmacy and I have been stuck with its price.

Please describe the transfer process in detail.

Some questions:
  • Do I need to establish an online account at the first pharmacy?
  • Do all pharmacies' online accounts allow transfers?
  • Does the doctor have to put my online account ID on the prescription to the first pharmacy? Otherwise how can the pharmacy link the prescription to my account if all they have is my name?
  • Do I need an online account at the transfer pharmacy?
  • Many pharmacies will not quote a price saying they "have to run it through insurance" to get the final price. Can you do more than one transfer?
edit: I realize that no one here is an expert on this topic. If you can tell me your experience with any of the questions it would be helpful.
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Kenkat
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Re: System for navigating prescription pricing?

Post by Kenkat »

You can usually take your prescription bottle and insurance information to the new pharmacy and they will contact the old pharmacy to get the prescription moved. I’d do this when there are refills remaining on the prescription if possible and with a little lead time so you don’t run out before the prescription is transferred.
Topic Author
michaeljc70
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Re: System for navigating prescription pricing?

Post by michaeljc70 »

dual wrote: Tue Dec 31, 2019 4:38 pm Several posters have mentioned transferring their prescriptions to another pharmacy after a doctor sends it to a first pharmacy. I am very interested in this since my doctors only send a prescription electronically to a single pharmacy and I have been stuck with its price.

Please describe the transfer process in detail.

Some questions:
  • Do I need to establish an online account at the first pharmacy?
Not if you do it over the phone.
  • Do all pharmacies' online accounts allow transfers?
No. But some do. Some require it not be your first prescription with them (Kroger is like that).
  • Does the doctor have to put my online account ID on the prescription to the first pharmacy? Otherwise how can the pharmacy link the prescription to my account if all they have is my name?
No. They use name and DOB I believe.
  • Do I need an online account at the transfer pharmacy?
No, not if you call.
  • Many pharmacies will not quote a price saying they "have to run it through insurance" to get the final price. Can you do more than one transfer?
Yes. They may not be happy with you, but I am pretty sure legally you can transfer the prescription at any time.

edit: I realize that no one here is an expert on this topic. If you can tell me your experience with any of the questions it would be helpful.
This is what I've seen. YMMV.

With Kroger I was not able to do it online because I was not an existing patient. I called. With Costco, I transferred from Walgreens to Costco mail order using the online portal. I don't have experience transferring to/from other pharmacies.

BTW....since this is Bogleheads...Kroger was offering $25 credit toward groceries for each transferred prescription.
sawhorse
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Re: System for navigating prescription pricing?

Post by sawhorse »

GoodRx and Canada. The Canadian pharmacy I use is Mark Marine's Pharmacy.
Quickblue02
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Re: System for navigating prescription pricing?

Post by Quickblue02 »

I use WalMart for my 30 day short term prescriptions and pay my inusrance CoPay. My insurance is through Caremark. I check Good Rx also to see if the other pharmacies have a better deal to beat my insurance CoPay.

For yearly drugs such as statin and blood pressure meds, I get a prescription for 365 days and use healthwarehouse.com. They have much better prices than my insurance CoPay for an entire year. healthwarehouse.com was rated highly on Consumers Reports magazine. My statin is $52/year. My blood pressure med is $50/year.
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