GoodRx in Action: The Problem With High Deductible Health Insurance Plans

Elizabeth Davis
Posted on

We get lots of questions from folks who don’t understand how GoodRx works. Over the next few months, we’ll provide a few true stories of Americans who are fighting to afford their health care, and some of the ways that GoodRx is being used to help.

Lauren counts herself lucky—she has a steady job at a large company, and her employer provides health insurance. There’s just one catch: the only plan offered by her company has a very high deductible of $3,500.

In insurance-speak, this is called a High Deductible Health Plan, or HDHP. In 2015, more than 25% of insured Americans will have HDHPs, which require you to spend at least $1,250 (or potentially much more) annually before your plan contributes. Employers like HDHPs as they save money for both the company and the employee. In 2015, many companies will offer an HDHP as the only plan option for their employees.

As a young, healthy woman, this means Lauren will pay all of her medical and prescription expenses out of her own pocket unless she has a major medical issue.

Lauren is aware of some ways to cut her prescription costs, and her doctor always prescribes generic medications when possible. Until recently, she was taking fluoxetine (generic Prozac), which she found at $4 from some pharmacies—lower than many insurance co-pays—and generic Adderall. Her total was around $50 – $60 per month; not cheap, but manageable.

However, when the fluoxetine recently stopped working for her, Lauren’s doctor switched her to Wellbutrin (bupropion). Now filling her two generic prescriptions cost her $120 per month.

Her doctor recommended GoodRx to help Lauren save when she made the switch, but for too long, Lauren paid the full $120, thinking GoodRx must be too good to be true.

Finally, fed up with paying so much for the generic medications that she needed on top of her insurance premium, she decided to give GoodRx a shot. She was shocked when a GoodRx coupon reduced her total to $60 for both prescriptions—a 50% savings.

Lauren will save $720 over the course of the year and continue to be able to afford the medication she needs.

If you’re on an HDHP, it’s always worth comparing GoodRx prices to your insurance co-pay. You’d be surprised how often GoodRx can find lower prices. Keep in mind that when you pay with a GoodRx discount, it will not count towards your deductible. It’s up to you to decide whether it makes more sense to pay less for your prescriptions now or try to get through your deductible phase to get your full co-pay benefits.

Drugs featured in this story

Filed under