• John Bozer, MBA

Medicare vs. GoodRx for Prescription Drugs



We get it! Drug costs can shatter your monthly budget. That's why it is important to find the best price for your prescription drugs.


So, is it possible to use GoodRx if you have Medicare?


The answer is, YES, but you cannot use both Medicare and GoodRx for the same prescription. You need to select one or the other. The easiest way we have found to make this work is as follows:


  1. Load the GoodRx app on your smart phone (and you may want to order a GoodRx card to keep in your wallet as a backup).

  2. Look up your drug on GoodRx before going to the pharmacy. This will provide you with a comparison price.

  3. If your pharmacy already has your Medicare information on file, they will tell you the Medicare rate when you are ready to pay for your drug.

  4. For drugs that are higher than the GoodRx price (which you looked up beforehand), ask the pharmacist to rebill you with the GoodRx price instead.

  5. The pharmacist will ask to see the GoodRx discount coupon on the app on your smart phone.

Is it worth the hassle? Maybe not. If the drugs your doctor has prescribed are on Tier 1 or Tier 2 of your Medicare formulary, the Medicare prices may be lower than GoodRx prices. However, when your drugs hit the higher tiers, GoodRx prices can be lower. One recent example was when a client went to purchase a Tier 3 drug. She was told it would cost $101.48 for a 90 day supply through her Medicare plan. The GoodRx cost was only $13.26 for the same script. For her, it was worth the hassle.


After you have refilled your prescriptions, you will want to make a note of which ones have better prices through Medicare and which ones cost less through GoodRx. This will help you let your pharmacist know upfront how you intend to pay for the drug and will eliminate having to wait for them to re-bill the correct plan at the time of purchase.


It would be great if the pharmacist would keep this information on file for you but we have not found that to work for us, yet. At this point, we have to keep our own records and remind the pharmacist which drugs will be purchased through which plan--Medicare or GoodRx.


You may also want to consider using GoodRx instead of Medicare in the following scenarios:

  • When you won't reach your annual deductible, or

  • When you are in the coverage gap phase ("donut hole") of your Medicare plan, or

  • When Medicare does not cover your medication. (NOTE: Your first step for drugs that Medicare does not cover should be to ask your doctor if there is a comparable drug that is on your Medicare formulary which might be prescribed instead.)

One word of caution is that when you use your GoodRx discount instead of Medicare, the amount you pay will not automatically be applied toward your deductible. Some Medicare plans may allow GoodRx to count toward your coverage limits. Check with your plan and save your pharmacy receipts in case you can submit them for Medicare credit.


We encourage you to take charge of your healthcare and shop for the best prescription drug rates. Remember that your Medicare plan has a preferred pharmacy. Always check the rates you would pay from GoodRx against the Medicare rates at your plan's preferred pharmacy.



 


We are happy to answer your Medicare questions. Call John at (941) 315-5801 or click here to schedule your FREE Medicare Review. For existing Medicare clients, an annual review is recommended in the fall of each year near the Annual Enrollment Period. If you are turning 65 and new to Medicare, we can help you with your plan selection during your Initial Enrollment Period. We are here for you.


Your Licensed Medicare Specialist

John Bozer, MBA

Independent Medicare Insurance Representative


PHONE: 941.315.5801 • EMAIL: John@Bozer.biz WEBSITE: www.Bozer.biz/Medicare

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