Yes, You Can Use GoodRx If You Have Medicare
Key takeaways:
GoodRx can’t be used in combination with Medicare, but it can be used in place of Medicare.
You may want to consider using GoodRx instead of Medicare when Medicare doesn’t cover your medication, when you won’t reach your annual deductible, or when you’re in the coverage gap phase (“donut hole”) of your Medicare plan.
GoodRx’s prescription drug prices are frequently cheaper than Medicare copays.
“Can I use GoodRx with Medicare?” is a question we get a lot — and for good reason. Medicare can be confusing. So let’s get right to it.
While you can’t use GoodRx in conjunction with any federal or state-funded programs like Medicare or Medicaid, you can use GoodRx as an alternative to your insurance, especially in situations when our prices are better than what Medicare may charge. Here’s how it works.
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. Instead, present your GoodRx coupon and ask that the pharmacist 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 representative will be able to help them process the discount correctly and answer any questions right away.
When 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 toward your Medicare plan, it’s important to think ahead and consider your medication expenses for the full year.
Here’s when to consider using GoodRx:
When your medication isn’t covered by Medicare. In these cases, always shop around and compare prices. Chances are GoodRx can help you save on the cash price. GoodRx can also help you save on over-the-counter meds and vaccines.
When GoodRx prices are cheaper than your Medicare copay. While GoodRx prices won’t always beat Medicare copays, there are many prescriptions where we can offer the most affordable price. That’s why it is always worthwhile to check GoodRx before going to the pharmacy, especially if you are starting a new prescription or pricing under your plan has changed.
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 prices to see if you can save. If you won’t benefit from your plan’s “initial coverage” because you won’t ever pay enough toward your deductible to qualify for it, there’s no point in putting any extra dollars toward it.
When you’re in the donut hole. When you’re in the “coverage gap” phase and your Medicare plan is providing less coverage, GoodRx is here to help. GoodRx cash prices are very likely to be cheaper than Medicare copays during this coverage gap.
To avoid the donut hole altogether. If you find yourself approaching the donut hole and know that you won’t be able to 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 could be keeping future costs down.
Ready to see if we can beat your Medicare copays?
Check GoodRx to see how much you could save.
The bottom line
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 toward your coverage limits. Check with your plan and save your pharmacy receipts in case you can submit them for Medicare credits.
