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Will My Insurance Pay for GoodRx?

GoodRx
Written by GoodRx
Updated on June 16, 2021

When you use GoodRx to pay for a prescription, you are choosing to pay without insurance. But you can ask your insurer to reimburse you or to apply your purchase against your deductible. Here’s how to apply a payment made with a GoodRx coupon to your insurance deductible.

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Nearly half of Americans now have high-deductible health plans (HDHPs), which means many of us are exposed to high medication prices (at least until we reach our deductible). In many cases, paying for drugs with a GoodRx discount can be cheaper than paying with insurance.

So, if you use a GoodRx discount to get a lower price, can you get paid back for this purchase from your insurance? And even if you don’t get reimbursed, will your insurance count your payment against your deductible as an out-of-pocket expense?

The answer? It depends. Paying with a GoodRx coupon is considered an “out-of-network” purchase, and it’s up to the insurance company to decide if they’ll pay you back—or whether they’ll count it towards your deductible. Frankly, it’s tough to get a straight answer on the rules. When we called several insurance companies to ask about their policies, we got different answers even from the same company, depending on who we talked to.

So, while we can’t promise you’ll get reimbursed, it’s worth trying. Here’s how:

  1. Get your receipts together. Save everything!

  2. Fill out your insurer’s prescription reimbursement form (see list below).

  3. Mail (or fax) the form and your receipts (make copies for yourself!) to the address indicated.

Insurer & formAddress & fax
AetnaAetna Pharmacy Management
PO Box 52444
Phoenix, AZ 85072-2444
FAX: 1-888-472-1128
AnthemClaims Department
P.O. Box 52065
Phoenix, AZ 85072-2065
Fax: 401-404-6344
BCBS TexasPrime Therapeutics (Commercial) PO Box 25136
Lehigh Valley, PA 18002-5136
Blue Shield CAArgus Health Systems, Inc.
P.O. Box 419019,
Dept 191
Kansas City, MO 64141
CignaCigna Pharmacy Service Center
P.O. Box 188053 Chattanooga, TN 37422-8053
CVSCaremarkCVS/caremark
P.O. Box 52136
Phoenix, Arizona 85072-2136
Express ScriptsExpress Scripts
P.O. Box 14711 Lexington, KY 40512
HealthNetHealth Net of California
C/O Caremark
PO Box 52136
Phoenix, AZ 85072-2136
HumanaHumana Pharmacy Solutions
P.O. Box 14140
Lexington, KY 40512-4140
Fax: 866-754-5362
KaiserOptumRx Claims Department
P.O. Box 29044
Hot Springs, AR 71903
OptumOptumRx
ATTN: Claims Department
P.O. Box 29077
Hot Springs, AR 71903
OxfordOptumRx Claims Department
P.O. Box 29077
Hot Springs, AR 71903
United HealthcareOptumRx Claims Department
P.O. Box 29044
Hot Springs, AR 71903

Again, policies vary from insurer to insurer, but some may apply your payment against your deductible. They may also contact you for more information.

Let us know what happens, or if you need help. Reach us at help@goodrx.com or 1-855-446-4051.

FAQs about GoodRx and insurance

Can I get reimbursed when I use a GoodRx coupon?

When you use a GoodRx coupon or discount, you’re choosing to pay the cash price rather than the insurance price for your medication. Payments with GoodRx are considered “out-of-network” expenses. Some insurers may reimburse you for this cost or apply your payment against your deductible.

What is a deductible, anyway?

Many health insurance plans have a deductible, an amount of money you must pay out of pocket before your insurance coverage kicks in. Some plans have an overall deductible for all medical costs, while some have a separate deductible for prescription costs.

Once you meet your deductible, you may still have to pay a copay (a set cost per prescription) or a coinsurance fee (a set percentage of the overall cost) to get your prescription. Sometimes a price on GoodRx can be cheaper than your copay, so be sure to compare prices!

What if my insurer says they won’t reimburse me?

Every insurance company makes its own policy on how to handle out-of-network expenses, and some may decline to reimburse you or apply your payment against your deductible. We’ve found that these policies can vary depending on who you talk to. It’s worth following up.

What if my insurer asks why I didn’t pay with insurance?

Explain to your insurer that you chose to pay using GoodRx instead of your insurance because the price on GoodRx for your drug was cheaper than what you would have paid using your insurance.

Why should I use GoodRx if it doesn’t go towards my deductible?

For many people with high-deductible health plans (HDHPs), health insurance is only really helpful in case of a serious health issue. Filling the occasional prescription is often not enough to reach the deductible threshold with these plans, so you do have to do your homework to save. GoodRx also comes in handy if your insurer doesn’t cover your drug at all. In these cases, you’d be paying out of pocket anyway, and you can save money with GoodRx.

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