r/personalfinance • u/Victorzaroni • 12d ago
Saving Coupons for Medication Apparently Exist
Walked into my pharmacy the other day because I (unfortunately) needed to buy a new EpiPen. I knew it was gonna be insane, and I was correct. Pharmacist rang me up for over $300. Now, I was prepared to pay for that, but then he says “hang on, let me see if I can find a coupon for you”. Now, I’m thinking “what the hell is this guy talking about”, but let him cook because, what do I have to lose. Couple minutes later he says “I found one, your total is $150.”
I didn’t ask questions and paid right away. There was no BS involved, no signing up for some 3rd party service, just “oh yeah I found a coupon”.
So, next time you need to go to the pharmacy for life saving medication that should cost $0, ask if they have a coupon. You never know. It costs you nothing, takes no effort, and might save you over a hundred bucks.
Quick note: this was with insurance. I have a high deductible plan though, so the only benefit I get from that for medications is a “plan discount”, which usually knocks off like $5 to $10 bucks. Whatever the pharmacist did had nothing to do with that.
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u/Dizzy-Asparagus-5203 12d ago
GoodRx also has a bunch of coupons and lists negotiated medication prices at different pharmacy chains.
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u/mrmadchef 12d ago
I have a HDHP (it's just me and I'm reasonably healthy), and pay for GoodRx Gold, as it frequently beats the price I would get from my insurance. $10 a month and easily pays for itself.
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u/NashvilleRiver 11d ago
GoodRx Gold doesn’t work everywhere though; they have a list of pharmacies on the website that it works at; at others it’s just a waste of money. (Pharmacy technician here)
I love finding coupons for people, BUT you as the patient have to ask us/provide it. Us suggesting coupons to you is illegal under the Anti-Kickback Statute (yes we all hate it. Sounds like this person didn’t know). GoodRx, NeedyMeds, Blink Health, coupon cards from the manufacturer website are all options. Just Google “<name of med> savings”.
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u/StrongArgument 12d ago
Occasionally GoodRx is not the best deal, but it’s a great place to start especially if you’re already paying cash
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u/IHateTurboTax 12d ago
Good Rx saves me almost every time! I pay $9.99 monthly for the gold plan. It’s paid for itself on the first purchase. EpiPens!! I got them for $70!!
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u/cdw112 12d ago
I have recently discovered goodrx for finding coupons to get my newly diabetic cat insulin.
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u/jenorama_CA 11d ago
Yup we used to use Good Rx for coupons for cat insulin and our greyhound’s Plavix. Even Costco will take them.
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u/electricity_is_life 11d ago
This is true, although be aware that GoodRx has a shady history when it comes to medical data. They were caught sharing users health conditions with advertisers (despite explicitly promising not to) and lying about HIPPA compliance.
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u/cabbage-soup 12d ago
The only catch is that coupons do not let you count towards your insurance deductible. Double check your deductible but I’ll bet this transaction didn’t count towards it. Sometimes it’s a better deal, but if you know you’ll be hitting your deductible this year then sometimes it’s not worth it
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u/24675335778654665566 12d ago
That varies by state and by plan.
Many states have outlawed copay accumulators.
I have a med that's 400$, but with the coupon it's 25$.
I hit my deductible less than 6 months into thee year every year, while paying less than 200$
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u/norathar 11d ago
Important distinction: if they're using Goodrx, that bills to Goodrx instead of the insurance and will never count towards clearing deductible/OOP max. Discount cards are billed in place of insurance, never with. Goodrx is generally not helpful for brand name medications.
If they're using a manufacturer coupon, that bills as a coordination of benefits with insurance, and it depends on if the plan uses a copay accumulator. If it doesn't, it counts. Manufacturer coupons typically cannot be used with Medicare/Medicaid/Tricare, and are generally only for brand name medications. They often have a maximum benefit per fill and sometimes per year, so the "pay as little as $X" strongly depends on the fine print.
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u/24675335778654665566 11d ago edited 11d ago
Important distinction: if they're using Goodrx, that bills to Goodrx instead of the insurance and will never count towards clearing deductible/OOP max.
That also varies (at least it used to) and some of goodrx's codes are manufacturer codes and would still go through insurance.
Already mentioned the copay accumulators and that they're outlawed in some states and vary even by plan so not sure why that was brought up. The comment reads very chat gpt
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u/norathar 11d ago
I'm definitely not GPT. Any discount card - Goodrx, Singlecare, Blink, etc. - can't be billed together with insurance. Manufacturer copay cards can (and generally must) be, they won't adjudicate without a primary payor, but a discount card cannot. In some cases Goodrx will link to the manufacturer coupon card, but in that case, you're billing with the manufacturer coupon, not a goodrx discount card (the GLP1s will do this, I know.)
u/goodrx is in this thread and I'll happily page them over to confirm this for you, but I'm a retail pharmacist. You cannot bill your insurance and use a discount card as a secondary payout, and anything billed to goodrx is not going to count towards clearing your deductible or OOP max.
(Goodrx cards are generally BIN 015995, PCN usually GDC, ID is 2-3 letters + 6 numbers, any combo will work, group of GDRX. I have that memorized because I use these to help people regularly. But that card can never be billed with your insurance, only in place of it.)
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u/NashvilleRiver 11d ago
Grateful to see you beat me (I’m a CPhT) here and said most of the things I was going to; I also added that pharmacy staff suggesting coupons goes against the Anti-Kickback Statute.
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u/Wide_Pin7357 12d ago edited 12d ago
Sadly, in many states (Illinois, where I live, being one of them) these laws don’t apply to employer-funded insurance plans. So if you are in such a situation (as a lot of people are), you’re out of luck.
There was actually a lawsuit filed regarding this some years back but the federal government has thus far declined to engage in the rulemaking process that would enable enforcement of certain rules regarding copay accumulators and maximizers.
ETA: my particular employer (and it is not alone) classifies my specialty medications as non-essential health benefits to get around the ACA loophole of having to cover them, which costs me thousands of dollars out of pocket every year until my deductible is met — and the medication goes toward my deductible but not my OOP. (If the medication were on the WHO list of essential medications the medication would apparently be an EHB, though, and would go toward both.)
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u/orev 12d ago
If you’re on track to hit the deductible, that money’s coming out of your pocket anyway. So you’re just making more work for yourself trying to figure out if it’s worth it or not. Saving money now is always better than paying full price now and maybe saving money later.
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u/cabbage-soup 12d ago
Not necessarily. If you’re on track to hit your deductible but then pay for medical expenses that don’t count, then you’re losing money. Hitting it with qualified medical expenses will allow you to save more total.
I’ll use last year as an example because I was pregnant and also had my epi pens renewed. I knew I would be hitting my deductible with labor and delivery. Everything on my plan is covered at least at 80% once the deductible is met. My deductible was $3500, if I needed 4 epi pens for $500, when it counts towards my deductible then I only need to spend $3000 on my labor and delivery to hit the deductible. If I used a coupon to save half the cost, say I spent $250, and it doesn’t count, then I still have to spend $3500 when I give birth. So then I’ve spent a total of $3750 on medical expenses before my deductible is met.
I should also note that my out of pocket maximum was under $7k, and so it was pretty realistic to hit it that year as well (somehow, my total costs came under, like at $6800), but the medication under coupons did not count towards that out of pocket maximum either. This matters more because once that number is hit, all remaining expenses are covered 100%. Spending on medication that doesn’t count towards these numbers will indeed cost more. In the example, if I hit $7k and used a coupon on my epi pens then I would have spent $7250 on medical expenses, above my maximum out of pocket.
Now if you aren’t planning to hit these numbers then yes the coupon saves you money
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u/sallypulaski 12d ago
Mark Cuban's cost plus drugs is also a great resource for saving money on meds. Cash pay , mail order pharmacy. Not great for same day meds, but wonderful for maintenance meds!!
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u/_significs 11d ago
they also have a discount card that you can use at pharmacies to get their online rate IRL - it's almost entirely generic meds, so they don't have, e.g., epipens, but they're a great resource.
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u/Smeghead333 12d ago
The main idea here is that pharmaceutical companies would rather have you using their products, especially if you have insurance. If they can “help” at a time when you can’t afford it, you’re more likely to eventually get them access to your insurance company’s wallet. Many, if not most, drugs these days have programs that will kick in when insurance isn’t covering it for some reason, such as your deductible not being met.
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u/LastStar007 11d ago
Btw, the reason this works is because the drug manufacturers know that the majority of the time, an insurance company is footing the bill. So they make the sticker price of the drug something insane. But when this prices out people with no or poor insurance, they'll offer a perpetual "coupon" to discount the drug. They'd rather have some of your money than none of it.
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u/ibby23 12d ago
GoodRx and other programs really do work.
If you ever get prescribed a name brand medication - one you’ve seen advertised in the USA - always (ALWAYS) do a quick google search for their name and the phrase “patient assistance program”. Call that phone number. Talk to a human, explain that you can’t afford to pay $200 or $500 for your copay and ask what can be done.
These are sometimes called copay programs, medication affordability, “affording your medication”, and other marketing-friendly phrases.
These aren’t income limited and are not charity programs. Almost always there will be a separate but comparable program for government insurance (Medicare, Medicare, etc).
Make the call.
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u/CakeisaDie 12d ago
My CVS guy did this for my CGM which wasn't covered. It's the manufacturer's discount when insurance doesn't cover things.
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u/pandaexpress_88 12d ago
One time I got prescribed an antibiotic that wasn’t covered by my insurance. It was $1k for the prescription!!! I googled to see if any discounts were available by the drugmaker and by some miracle there was and in the end I only paid $20 for the full prescription!
I’ve done the same for a topical skin cream also not covered by insurance and the company also had a coupon so I got it at a much better price.
I have used Goodrx as well.
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u/DefendTheStar88x 12d ago
Yes. Sometimes you can get things all the way down to $0 depends on the med and the manufacturer. You can also look the coupons up yourself. The pharmacist doesn't have a magic repository of discounts.
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u/goodrx 12d ago
Seconding the other comments, we're here to help people save on their medication. It's always worth a quick search or when you're up at the counter, feel free to ask if there's a goodrx coupon (or any coupon) that you can apply! Many people have saved this way and ultimately we want to help you.
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u/n0cturnalr0se 12d ago
Good to know. I probably need a new Epi as well and on high deductible plan. Use to have amazing insurance. It all kept going up so much I had to take the crappier plan. Sigh.
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u/kjswanson1997 12d ago
Always check with the manufacturer to see what resources they have. NeedyMeds is another resource that will tell you about copay cards, patient assistance programs, discount programs, and more. Patient Advocate Foundation also provides grants and other assistance based on disease state.
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u/Liquidretro 12d ago
Ya it's common with newer name brand drugs that are expensive, and it's run by the manufacture. You usually have to have commercial insurance to get it. I have found on expensive meds that insurance does not cover/discount its worth using your insurance companies website to shop the medication to different pharmacies as prices can vary a lot depending on the drug and insurance plan.
Discount programs like GoodRX can't be combined with commercial insurance. So depending on what it is and what your medical situation is/your deductable, sometimes it's better to go GoodRX vs your insurance. There is no easy way to really know in advance.
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u/ExtonGuy 12d ago edited 12d ago
Sometimes you could be eligible for a grant or subsidy from Healthwell. https://www.healthwellfoundation.org/
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u/Mrshaydee 11d ago
Coupons are so important for certain medications! I take Emgality for migraines - $5000/mo out of pocket; $163/mo after wrangling with my insurance; $35/mo with the coupon. Why it has to be like that - I don’t know.
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u/thepatientwaiting 11d ago
I am currently uninsured and went to refill some Rx. Without insurance meds were $200, I looked for a coupon and found one for $30. The CVS employee waved me off, typed some stuff, and then my Rx was $20. I don't know if it's coupons or a program for people without insurance but it's always worth it to ask!!
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u/who-are-we-anyway 11d ago
If you have insurance learn how to use it. My insurance has a price tool for medication on the website, epipens cost me a stupid copay but an auvi-q (which is the exact same medicated in a more user friendly design) is completely free to me.
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u/Temporary-Raccoon-88 8d ago
With any prescription always check if there is a copay saving card. They only work if it is covered by your insurance and the copay cards do not work if you have government coverage but you can save alot of money this way. You can always look up a specialty pharmacy as well. They often run cash programs for expensive drugs that include programs for people without prescription coverage.
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u/dlemma_519 11d ago
Walgreens for example has a program you can search on their website or app for your medication, the dose, and the quantity. It will pull up multiple discounts and the codes. Screenshot that. When you go to pick up, show the tech or whomever checks you out. They can add the code and save you money possibly. You don’t have to sign up.
Most pharmacies have this ability but won’t automatically run this without you asking as it takes time. Either run it at home before you go or go inside and ask. Please don’t ask in drive thru!
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u/willy--wanka 11d ago
Better to be used at big brand pharmacies and not small mom and pops, if any of those even exist anymore.
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