Using health insurance to fill a prescription for a generic drug could dramatically increase your out-of-pocket costs, particularly if you have not yet reached your policy’s annual deductible. That’s because people who use health insurance have to pay the price that the insurance company has set for the drug, and with generic drugs, these prices often are much higher than the prices you might pay when no insurance is used—sometimes hundreds of dollars higher for a 90-day supply.
Here’s what happens behind the scenes: Many generic drugs cost pharmacies 10 cents a pill or less. A value-oriented pharmacy, such as those at Costco, Walmart and Kroger, or a reputable online pharmacy, such as GoodRx.com and HealthWarehouse.com, might charge as little as $4 for a 30-day supply or $10 for a 90-day supply—if you don’t use insurance. What’s more, even after you reach your deductible, many insurance policies require a co-pay that is higher than what these types of pharmacies charge for generic drugs.
Among the many widely used drugs that can be purchased without insurance as generics for as little as $10 for a 90-day supply are the blood pressure medications atenolol, carvedilol, clonidine and furosemide…blood-clot-prevention drug warfarin…diabetes drugs glimepiride, glipizide, glyburide and metformin…cholesterol medication lovastatin…antibiotic amoxicillin…and pain medication naproxen.
What to do: When filling a prescription for a generic drug, check whether it’s cheaper to fill the prescription without using your coverage. Also, ask pharmacies whether they have a membership or rewards program that can further reduce the cost.
On the other hand, if you expect to spend a lot more than your deductible for medical costs in a given year, it might make sense to pay the higher prices so that you get past the deductible period more quickly. In some -cases, depending on the specifics of your coverage, that might result in greater overall savings.
