Some prescription costs higher with insurance than cash

[By the River]

A local news station replayed an investigation into United Healthcare and Cigna prescription clawback charges.  For some medications, the cash cost was less than the patient's copayment.  Due to the pharmacists contracts, they had to bill the patient say $50, keep the pharmacist cost and fee of maybe $15 and send the other $35 back to the insurer.  The patient could have bought the medicine for $20 if they had asked.   

The series had some interesting examples.  It also led to Louisiana passing a law that allows the pharmacist to tell patients the cash price regardless of what the contract mandates.  United reported that they had eliminated this process.  Still goes to show that you should investigate prescription costs as much as you would anything else. 

http://www.fox8live.com/category/314285/medical-waste-a-lee-zurik-investigation

[Dee18]

And ask your doctor for coupons for any new or particularly expensive prescription.  Also, I go to a Walgreens because the pharmacy aide there always alerts customers to manufacturers' coupons.  For an Epipen this can be huge.

[EnjoyIt]

Always check Goodrx.com for the lowest price for your medication. 
Have your doctor look for alternative dosages for the same medication

For example a common antibiotic clindamycin is usually taken at 300mg.  Sometimes 300mg pills are more expensive than 2x150mg pills and visa versa.  Another example is purchasing a cream vs an ointment. One is usually cheaper than the other. When getting a script always try and have your doctor prescribe the least expensive one using goodrx. 
a list of all the variable cash prices.:
https://www.goodrx.com/zofran?form=orally%20disintegrating%20tab&dosage=4mg&quantity=10&label_override=ondansetron&hide_online_pharmacies=true&show_pet_friendly_pharmacies=false

What sucks is that you can't compare to your insurance.  My experience is that most medications can be bought for under $10. Especially if you work with your doctor and getting the least expensive alternative.


I needed an MRI recently.  Going through my insurance that MRI cost $750.  Paying Cash it was $500.  WTF.  My deductible is $6k so obviously the cash price is the correct way to go.  Why do I have insurance again?  I thought insurance companies could negotiate better pricing.