InsureTC.com Insurance Blog
InsureTC.com Insurance Blog
How do you know you're getting the best price for your prescription drugs?
Last September my doctor gave me a new prescription. I have a High Deductible HSA plan which means I pay the insurance company's discounted price for my drugs until I meet my deductible. Shortly after my doctor appointment I got a text from the pharmacy that my prescription was ready and my cost was $186.00. I went to https://www.goodrx.com/ and looked up the drug, dosage and quantity. My cost on the website coupon would be $18.00.
When I went to the pharmacy I asked them if the price I was texted was my actual discounted price through my insurance. They said it was and I showed them the coupon on my phone and said I would rather do the coupon. I realize that if I pay cash I won't be able to apply that amount to my HSA health plan deductible - but it was worth it to me to not be out the cash since I never meet my deductible anyway. I could still pay for the prescription using money from my HSA bank account. The tech looked at my coupon and said "I can do better than that". She had a coupon on the case register which she scanned. My price $14.00!
I asked her where all the money would go if I had paid the $186.00 and she rolled her eyes and said "it's complicated". I suspect that everyone - the pharmacy, the vendor, the health plan and the pharmaceutical company would all get a piece of my action with the "special" price offered through my health plan.
In November I got an email from my health plan telling me about a new benefit. The Right Price Program automatically compares coupons, discount programs and my carrier negotiated price and gives me the lowest available without me having to shop and compare myself. I had a test of the program this week. The cost of my prescription was $14.62.
I went to goodRx and double checked - their best price for the same dosage, drug and quantity was $17.67. It looks like the new program is working - but I will continue to check the prices.
This drug is a generic and the cost is literally pennies a dose. Most available Medicare Advantage plans offer this drug for $0 copay. Even the plans with $0 premium have the $0 tier 1 drug copays at preferred pharmacies. When I get Medicare in 2023 I will continue to check the prices just to keep everyone honest.
The new Inflation Induction Act provides insulins for $35. Select plans have some insulins right now for $0 copay. We will have to see what happens to the free insulin since the law will obviously lower the cost of many of the high priced options - but will big pharma set the floor at $35 to help make up the difference? It will be another thing to watch going forward.