Pricing a prescription?

[dsneprincess]

I use a locally owned pharmacy and what they do is they give you your rx for whichever way is cheaper, the copay or the cash price. Case in point my generic copay is 10 but one of my meds is so cheap I get 90 days worth for 6 bucks! It pays to shop local!

This is great advice with most things, however, it REALLY applies to pharmacies. Most independent pharmacy owners/ pharmacists will bend over backwards to give you the best price and superior service. Unfortunately, it is sometimes not allowed by the insurers. The owners know what the cost of the drug is and what they can sell it for, especially when insurance is not involved. The drug store chains usually just have the same price schedule coast to coast set corporately and it usually involves a set minimum price that a local owner might not have. I think some of the chains are at a minimum of almost $12 now, so that your copay would almost 100% of the time be less and they get the maximum dollars allowed.

 

[SandrA9810]

If you opt for the cash price, even if it's the same cost, it won't go against your insurance. Some insurance policy have caps on the payout of medication. If you reach that cap before the end of the year, then you have to pay full price until the new year starts.

http://www.consumerreports.org/cro/...prescription-drugs-consumer-reports/index.htm

And don't forget to ask your doctor for samples. Most companies that still have patents on their products give doctor offices plenty of samples for patients to try versus some of the older generics.

Nuvaring can also be used for 28 days and skip the period. There is enough medication in the ring to last and still be effective.

 

[LJSquishy]

This is true, IF you are paying for it out of pocket. If your insurance is paying any part or it is going towards deductibles or out of pocket expenses, then your insurance is dictating the price and it will be the same wherever you go. If you presented any sort of card for prescription billing, even a discount card, the pharmacy is NOT setting the price, the insurance company is, even if they ay little or none of the cost.

This isn't necessarily true. I have typical health insurance and prescriptions are not the same price at every pharmacy. Most of the time they are in the same ballpark at different pharmacies, but sometimes there is a considerable difference.

 

[Marionnette]

Funny you say that.. My prescription was $10-11 a month, then a few months ago I went in and mine was free. I was surprised and questioned it, and the tech said "it's because of "Obamacare" that birth control is now free." And the next month I went in and it was $50. I don't get it.

The insurance companies only have to provide free birth control pills. They do not have to cover all brands. If you check your prescription drug formulary, there will be some brands that are covered and others which have copays.

My daughter asked her gynecologist to switch her RX to one of the free, generic versions. Even under Obamacare, the doctor's first choice of medicine was almost $50 a month.

Just another half-truth we have been told about Obsmacare. If you like your RX, you can keep it but you're still going to have to pay thru the nose for it.

 

[nyrebecca]

I use the depo shot and pick it up at the pharmacy. It had been $45 for the generic, it is now free. BUT, if I wanted the non generic I would be back to paying.

 

[luvmy3]

That is what I was switched too. I wonder if I switch to the generic my $225 copay will end up being free.

Well not free for me. I just called the pharmacy and it turns out I was prescribed the generic and cash price is $3 more than my copay.

I did a search online and found a coupon at GoodRx for less than half so I'm going to print that out and take it to the pharmacy.
I wasn't sure if it was legit but I found this. Hope it helps someone.

http://abcnews.go.com/blogs/health/...heaper-prescription-drugs-at-your-fingertips/

 

[orlandonewstarts]

Is there a list online showing which are available for free? I have insurance but work for a catholic based hospital - they refuse to cover birth control under their health insurance. Still very thankful for the insurance just wish it would cover this.

 

[pryncess527]

Plans that were "grandfathered" are exempt from the free preventative care requirement. I was quite disappointed to learn that my plan is grandfathered -- as long as they don't make any substantial negative changes to my policy or premium, they don't have to cover BC for free.

The list of BC that is covered, if your plan isn't grandfathered, is a pretty long list -- so if you aren't getting it for free it's more likely your plan is exempt

https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/

 

[ariel71]

Well not free for me. I just called the pharmacy and it turns out I was prescribed the generic and cash price is $3 more than my copay.

I did a search online and found a coupon at GoodRx for less than half so I'm going to print that out and take it to the pharmacy.
I wasn't sure if it was legit but I found this. Hope it helps someone.

http://abcnews.go.com/blogs/health/...heaper-prescription-drugs-at-your-fingertips/

I second Goodrx.com. I researched the site before I used it and found the Consumer Reports article below, so I wasn't worried about it being a scam. It shows comparative prices in your area and provides negotiated coupons for cash payers at most of the chains. Paying cash with that coupon saved almost $200 per fill on one of my prescriptions vs going through my insurance, and it was accepted at both CVS and Target. Granted, that's the only prescription I've ever had a problem with through insurance so it's the only one I've priced out.

http://www.consumerreports.org/cro/2012/05/can-a-phone-app-help-you-find-cheaper-drugs/index.htm

 

[kajs22]

The answer is definitely yes on prices at different pharmacies. Typically the chains - CVS, Rite Aid, Walgreens are going to be the most expensive as they are allowed to set their prices. The big stores such as Walmart, Target and typically your grocery store prices are less. Mail away is sometimes even less depending on the prescription.

The formulary issue is a completely different topic - that has more to do with your insurance and the price of a typical prescription will depend on which tier the drug itself is on. Here you must ask your PCP if there is a tier 1 medication they can prescribe in place of the more expensive one - usually there is.

 

[Pooh2]

Check what the cash price would be. I've actually seen a prescription cost MORE with insurance than the cash price.

This happened to us. For months, I was paying the insurance copay of $10 per month at Osco. I happened to be at Walmart and asked them what the cash price is: $10/90 days..

Walmart has done that to me as well, run it through insurance when the cash price was cheaper!

 

[CJMickeyMouse]

If you have an independent pharmacy in your area, it is DEFINITELY worth stopping in to check prices if you are paying out of pocket.

 

[Egdisney]

This is great advice with most things, however, it REALLY applies to pharmacies. Most independent pharmacy owners/ pharmacists will bend over backwards to give you the best price and superior service. Unfortunately, it is sometimes not allowed by the insurers. The owners know what the cost of the drug is and what they can sell it for, especially when insurance is not involved. The drug store chains usually just have the same price schedule coast to coast set corporately and it usually involves a set minimum price that a local owner might not have. I think some of the chains are at a minimum of almost $12 now, so that your copay would almost 100% of the time be less and they get the maximum dollars allowed.

Actually I just read an article where they went to 6 Different walgreens in the same town and they all charged differently! My small chain in town is meow expensive, though not outrageously so. I would try the discount clubs. I for example am on generic adderall. The savings at Sams is nearly $20 a month. You do not have to be a member, and if costco is cheaper, they will match it, at least according to my doc. I haven't checked with costco on the price of this drug, the one I was on before was the extended release, much more expensive but costco was $50 lower than the next lowest price!

 

[CloveLeaf]

WOW. Thanks to this thread. I just checked out GoodRx.com. The ointment I have been getting my DD cost $47.70 a tube with my insurance (high deductible) at both Costco and a grocery store. GoodRx shows $13.49 at Walmart... I hate my insurance now.

 

[runsandjumps]

Amazing to find out the difference between generics and insurance prices. My dd has asthma and takes two inhalers. One is $4, the other is $184 (the one she takes daily of course) Her other meds cost about $4 each. I had no idea! I really liked the goodrx website. Seems like it would save a lot of work.

Ana

 

[Colleen27]

With any prescription checking the cash price is a good idea. We've had several occasions where we were better off paying cash than using our insurance. We've also found Meijer to be cheaper than CVS on just about everything we've been prescribed (which admittedly isn't a lot - no maintenance meds or BC, just the occasional antibiotic and such). Since the prescription costs are barely a drop in the bucket towards our deductible we just take the cash price to save a few bucks.

 

[BelleBeautyandtheBeast]

I use goodrx and love it. It is crazy how much prices can vary!