Ask the Cash Price on Your Medications

Did you know that your pharmacist can often lower your out of pocket expense for your medications if you ask? Just ask the cash price.

You read that right. All you have to do is ask, especially if your prescription is for a generic. It’s fairly common knowledge that there are many different prices for medical services and prescriptions, depending on your particular payment method. We all know that healthcare providers frequently charge higher prices to patients with insurance than cash-paying clients. Why this is legal remains a mystery to us, but that’s another topic for another day…

What you may not know is that insurance carriers often have “gag orders” in their contracts with pharmacists that prevent them from disclosing to their customers that a lower price exists on a medication. In many instances, the cash price for your medication may actually be less than your co-payment amount, and your insurance company may be pocketing the difference. Cash prices for generic drugs began dipping below co-pays many years ago when big-box retailers like Walmart, Walgreens, and Rite-Aid started offering $4 prescriptions for dozens of generic drugs. Although these programs are not as common as they were a few years ago, they have successfully driven down cash prices for generics to often “below co-pay” levels. The result is that your pharmacist can’t tell you there is a lower price, but you can ask and they have to tell you.

While no one really denies that these clauses exist, insurance carriers and drug manufacturers naturally deny that they are common, although a 2016 survey of 600 pharmacists found that 84% reported that patients had been overcharged 10 or more times in the previous month, and 35% reported that it had happened 50 or more times. A recent research letter published in the Journal of the American Medical Association reviewed 9.5 million Medicare Part D prescription claims and found that 25% of drugs purchased had a lower cash price than the co-payment that was actually paid by the customer. The overpayments were usually small, although some were as high as $30.

So the next time you visit your pharmacist, be sure and ask the cash price before you file it on your insurance. You might end up saving some money in the process.

Questions or comments? Post a comment below and let us know what you think! Also, don’t forget to contact us and get a FREE review of your drug plan to see if you are saving the most money possible.