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Thread: Why do discount prescription cards work?

  1. #1
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    Why do discount prescription cards work?

    Yes, it is an odd place to post this question, but I don't know of a better place. Hey, someone might understand this.

    I got a prescription that was $85 retail and $58 on my Medicare Advantage plan. I tried three discount plans and the came up $12, $18, and $20. I used the $12 and got it for that price. I filled a 2nd prescription at the same time; it was $11 on my plan and $50 on the discount card.

    This seems bizarre to me. How can a discount card get it for me at 85% off (presumably make a couple bucks for themselves also) while my insurance was so much more. And just the opposite on the other drug.

    Anyone understand why this works?

  2. #2
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    Beats me, I don't even know what a prescription discount card is..........Rod.

  3. #3
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    People are frequently confused by the insurance company’s business model. It is advertised as providing you a service. The business model actually consists of collecting premiums; as large and as often as possible.
    "The Danish government believes that if we train 5,000 designers, and produce
    one Hans Wegner, the money is very well spent." - Ole Gjerlov-Knudsen

  4. #4
    It is providing a service. They don't say "free service". Anyone who bought it and later had a lightning caused house fire
    has been glad they bought it.

  5. #5
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    The prescription cards, discount coupons and free offers I've looked at almost always don't apply to people on Medicare or a Medicare Advantage program. They often don't apply if you have any relevant insurance. You might have gotten away with something when you used it. As to how they make money - Drug prices are so artificially inflated in most cases that making money isn't hard. There's enough for everybody and the only question is how it gets split up and of course how much you end up on the hook for.

  6. #6
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    I'm on Medicare and have Plan D prescription coverage. A month ago I used "Good Rx" to pay for a one-time prescription (i.e., not a daily maintenance drug) and it saved me about 75% over the Plan D costs and could be determined over the internet. Purchase was done at Costco for this particular script but CVS - using the Good Rx coupon - would still have been a 60% savings over Plan D.

    I have not received any further solicitations from Good Rx so I don't what's in it for them.

    Reminder - Coverages and costs for Medicare plans vary from state to state.
    "Don't worry. They couldn't possibly hit us from that dist...."

  7. #7
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    Cash rates are, IME, almost always lower than insurance rates anyway. Most insurers require a pretty stiff discount, so the prices reflect that (they're raised, so that they can discount and not lose money).
    ~mike

    scope creep

  8. #8
    Had some crazy discounts from Good RX compared to my old plan. Never made sense. New plan always beats Good RX. The whole system is purposely opaque IMO.

    I was told Phamacists are not allowed to tell you it is cheaper on a discount card. Never varified that though.

  9. #9
    Years back, was on a "brand name" prescription. Co- pay was $72. Pharmacist told me I should pay cash instead of insurance, so I asked cash price. It was fifty four dollars, a savings of eighteen dollars. Pharmacist explained that insurance didn't pay retail price either. They had to send difference back to insurance company. I was being charged for using insurance which I had already paid for. In any other business this would be called fraud. Same thing for lab work. Insurance paid total bill, but I needed to pay a forty dollar co-pay beyond total of bill. Wife recently got a new antibiotic. Co-pay at CVS was $47. With Good Rx, it was $12 out right at local grocery store. Many insurance companies require a "Gag order" on prescription prices, so you don't know you are being ripped off.

  10. #10
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    Quote Originally Posted by Ron Citerone View Post
    >....I was told Phamacists are not allowed to tell you it is cheaper on a discount card. Never varified that though.
    I believe that is true in many states. I had a prescription that insurance would not cover. The retail cost was quoted at $79. I asked the pharmacist if there was any discount available and she told me she could not say. I got it for <$20 with a GoodRX card which the doctor recommended.

  11. #11
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    I am on two medications with 90 day refills. My employer switched insurance companies this year and my out of pocket cost for the medications doubled or tripled. I just checked my pharmacy claims for the year and it looks like insurance didn't actually pay anything because the costs are less than my pharmacy co-pay. At $14 a month I haven't worried too much about the cost going up. These are common generics so I should see if could get them cheaper paying cash.

  12. #12
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    Ohio recently passed regulations to revoke PBM gag orders that pharmacists were forced to obey about providing cost info to patients.
    Brian

    "Any intelligent fool can make things bigger or more complicated...it takes a touch of genius and a lot of courage to move in the opposite direction." - E.F. Schumacher

  13. #13
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    I might have a partial answer to my question! My plan has $300 deductible on class 3 drugs. So probably paid nothing for the transaction in question because I have never had a class 3 drug. But it doesn't explain why GoodRX negotiated such a better price than UHC did.

  14. #14
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    One of my employers was notorious for being slow in paying their bills. One day on the way to work to purchase some tools the clerk noticed my uniform with my employer's emblems. He was going to give me the business discount even though this was a purchase for personal use. He then informed me the over the counter price was better than what they would charge my employer.

    Some discounts are better than others.

    jtk
    "A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty."
    - Sir Winston Churchill (1874-1965)

  15. #15
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    Quote Originally Posted by Jim Koepke View Post
    One of my employers was notorious for being slow in paying their bills. One day on the way to work to purchase some tools the clerk noticed my uniform with my employer's emblems. He was going to give me the business discount even though this was a purchase for personal use. He then informed me the over the counter price was better than what they would charge my employer.
    I called a place from my work phone a few years ago to ask if they had an item in stock. They assumed I was calling to buy for my employer based on the caller ID. They said they would extend me my employer's discount which resulted in a 50% savings on my next order. Not everything is discounted that much, but some things are.

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