Why can't Medicare patients use GoodRx?

Asked by: Dr. Marcus Turcotte  |  Last update: August 22, 2022
Score: 4.7/5 (17 votes)

In a nutshell, Medicare works a lot like regular health insurance. You can't use GoodRx with it, but you can use GoodRx in place of it. And, just like regular insurance, some Medicare plans may allow GoodRx to count toward your coverage limits.

Why can't Medicare patients use GoodRx?

GoodRx Coupons and Medicare Part D cannot be used in conjunction. This is due to a federal government statute, also known as “anti-kickback”, that prohibits Medicare beneficiaries from using manufacturers or discount drug coupons with their drug plan. However, you can use GoodRx in place of your prescription drug plan.

Does everyone qualify for GoodRx?

GoodRx is free for consumers, and we do not require that you create an account to search for prices and receive discounts.

What's the catch in using GoodRx?

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. Wait, what?

Why can't Medicare patients use manufacturer coupons?

Medicare Patients Aren't Allowed To Use Drugmaker Discount Coupons : Shots - Health News U.S. law prohibits people on Medicare from using the discount coupons the makers of expensive medicines offer. The law aims to reduce federal drug spending and Medicare fraud, but can feel unfair.

GoodRx co-CEO explains how its new service helps patients access medical care for just $20

39 related questions found

Can seniors on Medicare use GoodRx?

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.

Can you use prescription discount cards with Medicare?

Prescription drug discount cards are free to use for Medicare beneficiaries who choose to pay out of pocket for their medications instead of using their drug plan.

What are the cons of GoodRx?

One of its special discount programs even offers select medications completely free of charge. The drawbacks of using GoodRX include the fact that many of its programs have membership fees and that it has received some significant negative press due to consumer data privacy concerns.

Do pharmacies lose money with GoodRx?

No, GoodRx does not make any money from direct and indirect remuneration (DIR) fees that are charged to pharmacies. Pharmacy benefit managers (PBMs) determine these DIR fees, and GoodRx does not receive any revenue from them.

Who pays for GoodRx prescriptions?

The PBM collects a per-prescription fee from the pharmacy whenever a consumer uses a discount program at a pharmacy. The PBM shares a portion of this fee with GoodRx, which directed the patient to the pharmacy. The GoodRx team has built and scaled a robust platform for monetizing the three steps above.

Which is better SingleCare or GoodRx?

Bottom Line. In terms of price, SingleCare beat out GoodRx with nearly every medication we searched for. Even if you were to pay for the GoodRx Gold subscription, SingleCare still often offers the lower price.

What does donut hole mean in Medicare?

Most Medicare drug plans have a coverage gap (also called the "donut hole"). This means there's a temporary limit on what the drug plan will cover for drugs. Not everyone will enter the coverage gap. The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs.

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.

How accurate is GoodRx?

GoodRx says the prices listed on the app are “generally very accurate.” However, you can call 1-855-268-2822 to speak with customer support if there's a price dispute at checkout. This is important: Do not pay for your prescription, go home and then contact GoodRx.

How do pharmacies make money with GoodRx?

The company currently makes the majority of its money from what it calls "prescription transactions." That means that when a consumer uses a GoodRx code to fill a prescription and saves money compared to the list price at that pharmacy, the company is paid by its pharmacy benefit manager partners, most of the time ...

Is AAA GoodRx better than regular GoodRx?

Even if you have health insurance to pay for your prescriptions, insurance co-pays are often higher than the discounts provided by GoodRx. AAA members can save up to 85% on prescriptions with GoodRx.

Can you use GoodRx 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. Thanks!

Why are my prescriptions so expensive with Medicare?

Another reason some prescriptions may cost more than others under Medicare Part D is that brand-name drugs typically cost more than generic drugs. And specialty drugs used to treat certain health conditions may be especially expensive.

Do you have to have a Medicare Part D plan?

Is Medicare Part D Mandatory? It is not mandatory to enroll into a Medicare Part D Prescription Drug Plan.

Will GoodRx prices go up in 2022?

The GoodRx research team has found that 2022 prices for 669 drugs have increased by an average of 5% so far this month.

Is GoodRx gold better than GoodRx?

The big difference between GoodRx and GoodRx Gold is that you have to pay a membership fee to use GoodRx Gold. However, the Gold membership offers even better prices and more convenience of using a single card.

Is GoodRx only for generic?

In order to help people afford their brand-name drugs, last May, we launched the InsideRx program on GoodRx that offers an average of 34% off over 100 brand-name prescriptions. Today, we are excited to announce discounts on even more brand-name drugs.

Does Walgreens use GoodRx?

Current Walgreens Pharmacy Prices and Discounts

Use GoodRx to look up prices and discount coupons at Walgreens Pharmacy and save up to 80% on your prescriptions.

Is the donut hole going away in 2021?

The Part D coverage gap (or "donut hole") officially closed in 2020, but that doesn't mean people won't pay anything once they pass the Initial Coverage Period spending threshold. See what your clients, the drug plans, and government will pay in each spending phase of Part D.