Does GoodRx take the place of Medicare Part D?

Asked by: Nicola O'Kon MD  |  Last update: February 11, 2022
Score: 4.4/5 (58 votes)

Key takeaways: GoodRx can't be used in combination with Medicare, but it can be used in place of Medicare.

Can I use GoodRx in place of Medicare Part D?

You can't use GoodRx and Medicare together. But you can use GoodRx as an alternative to Medicare. You may want to use GoodRx instead of Medicare in certain situations, such as when Medicare doesn't cover your medication, the GoodRx price is cheaper than your Medicare copay, or you won't reach your annual deductible.

Does GoodRx have a Part D plan?

Find savings on your Medicare prescriptionsJust enter your drug below to see if GoodRx can beat your Part D plan copay. Find savings on your Medicare prescriptionsJust enter your drug below to see if GoodRx can beat your Part D plan copay.

What is the catch with GoodRx?

GoodRx promotes itself as a company that allows you to compare drug prices and find coupons at over 60,000 pharmacies across the country. Sounds great right? Well, unfortunately there is a catch. GoodRx only works if you are paying without insurance, which is how less than 5% of prescriptions are paid for.

Is GoodRx creditable coverage for Medicare?

Let's go back to your initial question, “Why do I need insurance if I can use GoodRx?” GoodRx is NOT insurance. If you have Medicare you have a requirement to be enrolled in an approved (creditable) Prescription Drug Plan. ... During this time of no coverage you may be able to save money on your medications using GoodRx.

Goodrx vs. Medicare Part D | Which Should You Get?

19 related questions found

When did Part D become mandatory?

Medicare did not cover outpatient prescription drugs until January 1, 2006, when it implemented the Medicare Part D prescription drug benefit, authorized by Congress under the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003.”[1] This Act is generally known as the “MMA.”

Who is behind GoodRx?

The Santa Monica, California-based startup was founded in September 2011 by Trevor Bezdek and former Facebook executives Doug Hirsch and Scott Marlette. Marlette was one of the first 20 employees at Facebook and built Facebook's photo application.

How many times can you use a GoodRx coupon?

GoodRx coupons represent prices provided by PBMs. Unlike manufacturer copay cards, GoodRx coupons have no eligibility requirements, no activation step, and no restrictions on how many times the coupon can be used.

Does GoodRx work at Walmart?

GoodRx discounts are still accepted at Walmart and Sam's Club. If you have issues using a GoodRx discount at a Walmart or Sam's Club, please have the pharmacist call 1-866-921-7286. ... Get prescription saving tips and more from GoodRx Health.

How Does Medicare plan D work?

It is an optional prescription drug program for people on Medicare. Medicare Part D is simply insurance for your medication needs. ... Instead of paying full price, you will pay a copay or percentage of the drug's cost. The insurance company will pay the rest.

Do I have to get Medicare Part D?

En español | Part D drug coverage is a voluntary benefit; you are not obliged to sign up. You may not need it anyway if you have drug coverage from elsewhere that is “creditable” — meaning Medicare considers it to be the same or better value than Part D.

What medications are covered by Medicare Part D?

Medicare Part D plans must cover all or substantially all drugs in six categories: antidepressants, antipsychotics, anticonvulsants, antiretrovirals (AIDS treatment), immunosuppressants and anticancer.

Why is GoodRx cheaper than my insurance?

Why is GoodRx cheaper than my insurance? Your health insurance helps cover major medical expenses, but the cost of healthcare is rising, and many plans cover less than they used to. Insurance companies use lists of drugs, called formularies, to price different drugs.

What is the deductible for Medicare Part D in 2022?

The initial deductible will increase by $35 to $480 in 2022.

After you meet the deductible, you pay 25% of covered costs up to the initial coverage limit. Some plans may offer a $0 deductible for lower cost (Tier 1 and Tier 2) drugs.

Is SilverScript Part D good plan?

The SilverScript family includes several distinct plans. SilverScript was the only Medicare Part D prescription drug plan serving over half a million beneficiaries to earn a 4 out of 5 Star Rating from Medicare in 2020.

Does everyone accept GoodRx?

What are GoodRx coupons? GoodRx coupons will help you pay less than the cash price for your prescription. They're free to use and are accepted virtually every U.S. pharmacy. Your pharmacist will know how to enter the codes on the coupon to pull up the lowest discount available.

Does Costco take GoodRx?

Will My Pharmacy Accept GoodRx? More than 70,000 pharmacies in the United States — including major chains like Costco, Kroger, Walmart, CVS, Rite Aid and Walgreens — will accept GoodRx. ... If your pharmacist refuses to accept them, you can call GoodRx at (855) 268-2822.

How much does GoodRx cost per month?

GoodRx Gold is a monthly membership program that provides dramatic discounts on prescription drugs and healthcare services for you and your family. For $9.99/month, GoodRx Gold membership provides exclusive access to low drug prices for individuals.

Is GoodRx FDA approved?

GoodRx lists virtually all FDA-approved prescription medications, including brand-name and generic drugs; we even list vaccines! GoodRx cards and coupons never expire and can be used as often as necessary.

How does GoodRx make its profit?

GoodRX makes part of its revenue by collecting fees from the pharmacy benefits managers, or PBMs, it works with when consumers present their GoodRx coupon at the pharmacy.

Why can't Medicare patients use coupons?

Within the pharmaceutical industry, the Anti-Kickback Statute made it a crime for pharmaceutical manufacturers to offer drug coupons to Medicare beneficiaries. This is because it became illegal to influence the purchase of any prescription drugs that could later be reimbursed by Medicare.

What happens if I don't want Medicare Part D?

If you go for more than 63 days without creditable coverage, you'll have to pay a late-enrollment penalty for every month you delay. The penalty equals 1% of the “national base beneficiary premium” ($35.63 in 2017) times the number of months you didn't have Part D or creditable coverage.

What is the main benefit of Medicare Part D?

The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) ...

What happens if I refuse Medicare Part D?

If you don't sign up for a Part D plan when you are first eligible to do so, and you decide later you want to sign up, you will be required to pay a late enrollment penalty equal to 1% of the national average premium amount for every month you didn't have coverage as good as the standard Part D benefit.