Can I use GoodRx if I have a Medicare Advantage plan?

Asked by: Prof. Everette Hand V  |  Last update: November 18, 2023
Score: 4.4/5 (52 votes)

While you can't use GoodRx in conjunction with any federal or state-funded programs like Medicare or Medicaid, you can use GoodRx as an alternative to your insurance, especially in situations when our prices are better than what Medicare may charge. Here's how it works.

Do I pay Part D if I have an advantage plan?

Most Medicare Advantage Plans include Medicare drug coverage (Part D). In certain types of plans that don't include Medicare drug coverage (like Medical Savings Account Plans and some Private Fee-for-Service Plans), you can join a separate Medicare drug plan.

Does GoodRx help even if you have insurance?

Yes, you can use a discount even if you have insurance

Prescription discounts, including those from GoodRx, can be a great option if you don't have health insurance. But if you do have insurance, you can always use a GoodRx discount instead of insurance if the cost is lower.

Do you pay Part D premium with Medicare Advantage?

Most Medicare Advantage Plans include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay one monthly premium for the plan's medical and prescription drug coverage. Plan benefits can change from year to year. Make sure you understand how a plan works before you join.

Is GoodRx better than Part D Medicare?

GoodRX is not a replacement for your Part D drug plan but it can be a useful tool to help save money on your medication costs. Although there is no guarantee you will save money there is simply no harm in trying since it is a free service!

Can I Use GoodRx on Medicare

28 related questions found

What is the max out-of-pocket for Medicare Part D?

adds a hard cap on out-of-pocket drug spending under Part D by eliminating the 5% coinsurance requirement for catastrophic coverage in 2024 and capping out-of-pocket spending at $2,000 in 2025. shifts more of the responsibility for catastrophic coverage costs to Part D plans and drug manufacturers, starting in 2025.

Is Medicare Part D and Medicare Rx the same?

Medicare Cost Plan

Medicare offers prescription drug coverage for everyone with Medicare. This coverage is called “Part D.” There are 2 ways to get Medicare prescription drug coverage: 1. Join a Medicare Prescription Drug Plan (PDP).

How do you qualify to get $144 back from Medicare?

To qualify for the giveback, you must:
  1. Be enrolled in Medicare Parts A and B.
  2. Pay your own premiums (if a state or local program is covering your premiums, you're not eligible).
  3. Live in a service area of a plan that offers a Part B giveback.

What is the premium for Medicare Advantage in 2023?

CMS announced that the average monthly plan premium among all Medicare Advantage enrollees in 2023, including those who pay no premium for their Medicare Advantage plan, is expected to be $18 a month.

When can you not use GoodRx?

Keep in mind that you cannot use GoodRx and insurance at the same time. However, you can use GoodRx instead of insurance or government-funded programs, such as Medicare or Medicaid, to pay for your prescription medications.

Who qualifies to use GoodRx?

Yes! Anyone can use GoodRx, regardless of whether they have commercial insurance, Medicare, Medicaid, or no insurance. Your patients should tell the pharmacist they will use a GoodRx discount instead of their insurance when they pay for their prescriptions.

Who pays the difference when using GoodRx?

When a patient redeems a GoodRx discount coupon, the pharmacy pays a fee to the PBM, who splits the fee with GoodRx. GoodRx also takes in membership fees from consumers and marketing revenue from pharmaceutical companies that use its platform.

Is Medicare going up in 2023?

For 2023, the Part A deductible will be $1,600 per stay, an increase of $44 from 2022. For those people who have not worked long enough to qualify for premium-free Part A, the monthly premium will also rise. The full Part A premium will be $506 a month in 2023, a $7 increase.

Is Medicare Part D deducted from Social Security?

You don't pay the extra amount to your plan. Most people have the extra amount taken from their Social Security check. If the amount isn't taken from your check, you'll get a bill from Medicare or the Railroad Retirement Board. You must pay this amount to keep your Part D coverage.

Can I switch from Medicare Advantage to Part D?

If you have prescription drug coverage through a Medicare Advantage plan, you have an extra opportunity to switch to another Medicare Advantage plan or change from Medicare Advantage to original Medicare and join a Part D plan during Medicare Advantage open enrollment each year.

How does Medicare Advantage add money to Social Security check?

Insurance companies that sell Medicare Advantage plans with a Give Back benefit work with the Social Security Administration to credit your Social Security benefits account each month. You will need to pay the difference between the Give Back benefit amount and your Medicare Part B premium.

Why do some zip codes get more Medicare benefits?

Why does my zip code matter for Medicare? Your zip code matters for Medicare because plan options change depending on your location. Also, Medicare Advantage plan networks depend on the private insurance company providing care to each client. Zip code is vital in terms of Medicare program eligibility.

What is the give back benefit on Medicare Advantage plans?

The Medicare give back benefit is just that: a benefit. Simply put, some plans offer to pay for some or all of your Part B premium. Think of the reduction like vision, dental or hearing benefits — Original Medicare does not cover these services, but some Medicare Advantage plans offer them to help attract customers.

Can you be dropped from a Medicare Advantage plan?

Medicare Advantage plans may discontinue your Medicare Advantage coverage if you don't pay your premium within the grace period allowed by the Medicare Advantage plan. If you can't make your premium payment, you should contact your Medicare Advantage plan's customer service.

Are Medicare Advantage patients healthier?

Historically, Medicare Advantage beneficiaries have been healthier than those in the traditional program, but this seems to be changing: beneficiaries now have similar characteristics and experiences regardless of coverage.

Do Medicare Advantage plans have limits?

Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you'll pay nothing for covered services. Each plan can have a different limit, and the limit can change each year. You should consider this when choosing a plan.

What is the penalty for not having Part D?

Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($32.74 in 2023) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.

What is the deductible for Medicare Part D in 2023?

This is the amount you must pay each year for your prescriptions before your Medicare drug plan pays its share. Deductibles vary between Medicare drug plans. No Medicare drug plan may have a deductible more than $505 in 2023.

How much is Medicare Part D 2023?

The estimated average monthly premium for Medicare Part D stand-alone drug plans is projected to be $43 in 2023, based on current enrollment, a 10% increase from $39 in 2022 – a rate of increase that outpaces both the current annual inflation rate and the Social Security cost-of-living adjustment for 2023.