December 11, 2021

Cash or Copay: know your options

Insurance and prescriptions: Copay or not to copay?

Chalk it up to one of life’s great mysteries. Why is it sometimes better to pay cash for your medications than use your insurance? 

The fact is, there’s no clear answer for every prescription purchase. But we’ve got a few tips on what to do to get the lowest price possible every time you need to fill a ‘script.

But first things first.

What’s a copay?

Nope, there’s no dumb questions here. Copays are short for copayment. It’s your part of the cost of a medication set by your insurance company.

A copay could be a fixed amount, such as $10 for a generic medication, $80 for a brand-name drug or a percentage of the medication’s total price. 

Typically, you pay the full amount of a prescription until you’ve hit your deductible. Once you’ve hit the deductible, then you begin to “share” the cost in the form of your copay.

What’s a deductible?

It’s the fixed amount you have to pay each year before your insurance begins covering costs. Like copays, deductibles vary depending on your plan. You may have to cover the first $1,500 in a year before your insurance kicks in, or it could be a much higher amount (hence, a high-deductible plan). 

One caveat: Some plans don’t count prescription costs toward your deductible at all. 

So you’ve hit your deductible. Now what?

Sounds like great news. Your insurance is going to finally start chipping in on those prescriptions you need. 

As stated above, maybe, maybe not. And even if they do, it could be cheaper to pay cash anyway. The factors that determine this could baffle a rocket scientist, so unless you’re planning a trip to Mars, we’ll just skip to the tips-for-getting-the-lowest-price part.

Get an Rx discount card

They are offered by nearly every pharmacy on the planet. They’re free–and they can work better than your insurance card at saving you money in some instances. Figuring out those instances can require a little extra work on your part, or you could get the Gifthealth Savings Card, but more on that in just a bit.  

The low-tech option: Ask your pharmacist

Your prescription has been filled, you’re at checkout and you hand over your insurance card. Once you have your copay amount, ask the pharmacist what the price is using your prescription savings card. Lowest price wins. 

The high-tech/low-tech combo option: Use your Gifthealth Savings Card

The Gifthealth Savings Card is actually two cards in one. You can use it like the traditional savings card we talked about above at just about any pharmacy anywhere in the country. Or you can use it as an all-access pass to Gifthealth’s prescription pricing technology platform. 

It works like this:

  1. Present your card to your doctor and say you want to get your prescription filled at Gifthealth.
  2. Gifthealth receives your prescription and 
    -Checks your benefits to determine whether you should pay cash or use insurance
    -Applies all available benefits, discounts, vouchers, etc., to your purchase
    -Matches your location to the nearest pharmacy with the best price and service
    -Delivers your meds to your door FREE

This high-tech option does all the work for you, automatically. You get the lowest possible price every time and FREE delivery. Don’t lift a finger. Really.

The last word 

Confused? Don’t be. Prescription medications are complicated business in this country. We’ve made it our business to simplify it for you at every step. 

Get your Gifthealth Savings Card here.

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