Ask a pharmacist: Paying out of pocket for your prescriptions

Is it legal to pay cash for my prescriptions if I have insurance?

Paige Clark:

It’s not only legal, but also your right. Consumers have been misled by pharmacy benefits managers (PBMs) and insurance companies to believe they can’t purchase their prescriptions for a cash price. But you can. The best part — you could save money.

What are my options for the way I pay at the pharmacy?

Paige Clark:

Many people think reaching for their insurance card at the pharmacy counter is their only option, but there’s more than one way to purchase your prescriptions. Paying a cash price often allows you and the pharmacy to bypass additional fees and middlemen that can cause price hikes when you pay with insurance.
Always ask what your medication would cost out of pocket in comparison to the cost dictated by your insurance company’s PBM. That way you can find out if you’re getting the best value each time.
Technology gives patients and pharmacies more options than ever. With myPrescryptive, you can search for the best price on your prescriptions, choose your pharmacy, and schedule clinical services like tests and vaccines, all from your phone. The pharmacy experience has never been better.

What are the advantages of paying cash for prescriptions?

Paige Clark:

It’s no secret: the current pharmaceutical system is broken. An estimated 81 million prescriptions get left at the pharmacy due to cost. Paying a cash price means you can avoid additional fees and middlemen that can cause price hikes when you pay with insurance.
And with the popularity of high-deductible health plans, many customers don’t reach the dollar amount required to activate their pharmacy benefit. So, purchasing their prescriptions for cash can save them money, and frustration.
Not only does paying a cash price benefit the customer, but it also allows the pharmacist to avoid the ongoing reimbursement struggle with PBMs. One less thing to think about, so they can stay focused on serving their customers, helping their community, and growing their business.

How much money can I save by paying cash?

Paige Clark:

The savings that come with paying cash depend on the type of medication, your insurance benefit, and other factors such as quantity and brand versus generic drugs.
If you have a higher deductible, your insurance benefits might not cover the cost of your medications. Your pharmacist can help you project your expected pharmacy expenses for the year. If your costs don’t meet your pharmacy deductible, purchasing your prescriptions for cash can save you money.

What steps do I need to take to pay cash?

The savings that come with paying cash depend on the type of medication, your insurance benefit, and other factors such as quantity and brand versus generic drugs.
If you have a higher deductible, your insurance benefits might not cover the cost of your medications. Your pharmacist can help you project your expected pharmacy expenses for the year. If your costs don’t meet your pharmacy deductible, purchasing your prescriptions for cash can save you money.

Paige Clark:

It’s simple. The next time you’re at the pharmacy counter ready to pay for your prescription, just ask for a cash price. It might be a better deal to leave your insurance card in your pocket.
You can also use myPrescryptive to manage your prescriptions and search for the cash price before you get to the pharmacy. That way there are no surprises, and you’ll know if you’re getting the best value every time.