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RX Deductable?

Discussion in 'After Hours Lounge (Off Topic)' started by Johnny Angell, Jan 17, 2020.

  1. Johnny Angell

    Johnny Angell Played With Dinosaurs Member

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    Under medicare, I have a supplemental policy and a medipac policy for prescriptions. There’s a deductible that starts over in the new year, $400 I think before the policy kicks In and starts paying. I was looking at GoodRx to see if I could save money on my Symbicort RX. My wife says don’t bother, it’ll just take longer to use up the deductible. I’m thinking anytime you pay less for something, I’m saving money. So, HTF’ers, who’s right?

    BTW, I’ve been getting the brand Symbicort up until this last refill, and it’s a generic. And it’s still very expensive, $340. I can’t remember what the full priced of Symbicort is because I haven’t paid it in a while. Good RX says I can get the generic for $300.

    I can only use GoodRx when I don’t use insurance, so if I were to call Walmart ask to change it to GoodRx, I suppose that wouldn’t go against my deductible. Aargh! My brain is starting to hurt.
     
  2. Todd Erwin

    Todd Erwin Producer
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    I'm kind of in the same boat, as my new policy is a high deductible plan, but I think their prescription portion is not working right, because so far all of my daily medications that I have refilled have come back with a $0 co-pay rather than full contracted price while other medications like antibiotics have been at the full contracted price (but within a dollar of what thew GoodRX price was).

    What I want to try the next time I have to pay for a prescription that is under $25 is to use GoodRx, then file a Rx claim with my insurance company and see if it gets applied to my deductible. I just wouldn't try it on something that expensive.
     
  3. Adam Lenhardt

    Adam Lenhardt Director

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    If GoodRx doesn't count toward your insurance, and you anticipate more than $400 in prescription costs for the year, do it through your insurance -- even if it costs more up front.

    If it does count toward your insurance, go for the cost savings. Even though you won't see it directly, the less prescription plans pay out, the slower the cost of them rises.
     
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  4. Todd Erwin

    Todd Erwin Producer
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    That's why I'm not willing to try filing a claim on something over $25 if I'm not sure it's going to count towards my deductible. Too many times I've been just a few hundred short of exceeding my deductible, and it's always better to hit that deductible as early in the year as possible than to nickle and dime it for 12 months.
     
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  5. Malcolm R

    Malcolm R Executive Producer

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    I agree with your wife and Adam and Todd. The only reason to do this would be if you expect to spend less than your deductible in this calendar year. If you fully expect to go over the deductible, as Todd says, it's better to reach that plateau as early in the year as possible so you get to maximize your benefit the rest of the year.
     
  6. Thomas Newton

    Thomas Newton Screenwriter

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    Which means that down the road, when you would have satisfied that deductible, you won't have. And then if you try to use your insurance to cover some prescription (not necessarily this one), you'll be paying all of your "savings" back and then some.
     
  7. Scott Merryfield

    Scott Merryfield Executive Producer

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    Insurance is always just a math problem. Since you should know your costs for each prescription using GoodRx or applying it to your deductible, it shouldn't be difficult. However, if you go the GoodRx route, you really shouldn't be paying for prescription coverage under your supplemental policy. That's actually what you should be trying to figure out - - whether it's cheaper to not have prescription coverage and just pay out of pocket with GoodRx, or have prescription coverage.

    Since retiring, we go through this exercise every fall before renewing our coverage for the next year. We are too young for Medicare, so we look at high deductible plans versus our anticipated medical expenses, and do the same for optical and dental coverage.
     
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  8. Todd Erwin

    Todd Erwin Producer
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    Just found out that my insurance will not apply any prescriptions purchased using GoodRx to my deductible, only those purchased and run through my insurance plan.
     
  9. Clinton McClure

    Clinton McClure Rocket Science Department
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    That’s how all insurance is supposed to work isn’t it?
     

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