“Can I use GoodRx with Medicare?” This is a question we get a lot, and for good reason – Medicare can be confusing. So let’s get right to it:
You can’t use GoodRx in conjunction with any federal or state-funded programs like Medicare or Medicaid. But you can use GoodRx, especially when our prices are better than what Medicare may charge. You just have to be sure you don’t use Medicare to pay at the same time.
How do I use GoodRx if I have Medicare?
If you choose to use a GoodRx coupon instead of your Medicare coverage, you must ask the pharmacist not to run your prescription through your Medicare. Ask that the pharmacist use the GoodRx coupon to process the transaction as cash instead.
This means that Medicare isn’t involved in the transaction, and that you’ll be paying the “cash” price (even if you use a credit card).
What should I do if my pharmacist has trouble using the GoodRx coupon?
Please ask your pharmacist to call +1 (855) 446-4051. A GoodRx Patient Advocacy rep will be able to help them process the discount correctly and answer any questions right away.
Why should I use GoodRx instead of Medicare?
Even if you have Medicare, GoodRx can help you save money on your prescriptions, both in the short and long term. Because the amount you pay using GoodRx coupons will not count towards your Medicare plan, it’s important to think ahead and consider your medication expenses for the year.
Here’s when you should consider using GoodRx:
- When your medication isn’t covered by Medicare. In these cases, always shop around. Chances are GoodRx can help you save on the cash price. GoodRx can also save you on over-the-counter meds and vaccines.
- When GoodRx prices are cheaper than your Medicare co-pay. For the top 20 Medicare plans in America, 66% of prescriptions are cheaper with GoodRx than your typical Medicare co-pay. You should especially consider this if you fall into one of the next three categories.
- When you won’t reach your annual deductible. If you don’t foresee a lot of medication expenses and know you won’t meet your deductible for the year, check GoodRx to see if you can save. If you won’t benefit from your plan’s “Initial Coverage” because you won’t qualify for it, there’s no point putting extra dollars towards it.
- When you’re in the donut hole. When you’re at that point where your Medicare plan provides less coverage, GoodRx is here to help. GoodRx cash prices are very likely to be cheaper than Medicare co-pays during this coverage gap. Note: What you pay with GoodRx will not go towards getting you out of the donut hole and onto your plan’s “Catastrophe Coverage”.
- To avoid the donut hole altogether. If you find yourself approaching the donut hole and can’t afford the expensive medication costs, you may be better off using GoodRx. As long as it makes sense for the rest of the year, you’ll be keeping future costs down.
In a nutshell, Medicare works a lot like regular health insurance. You can’t use GoodRx with it, but you can use GoodRx in place of it. And just like regular insurance, some Medicare plans may allow GoodRx to count towards your coverage limits. Check with your plan and save your pharmacy receipts in case you can submit them for Medicare credits.
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