No way to know cost of prescription prior to pharmacy filling it

[disneysteve]

This is nothing new but our healthcare system is so broken.

My daughter needed a medication refill. I stopped at CVS today to pick it up for her because we had to go there anyway. Her prescription was $48 which I thought was way high. I pulled out my phone and checked GoodRx and it was $35 so I had them reprocess it at that price which just took a couple minutes. Great, we saved $13. However, down the street at Walgreens, the exact same prescription through GoodRx would have only been $15. Now we know for next time, but what a messed up system.

I asked the pharmacy if there is a way for us to know the cost through insurance before the prescription is filled and she said there is not. They can't tell us the price until they process the prescription. So we have to call it in to the pharmacy, wait for them to fill it, then learn the cost, at which point we can then shop around and see if it's cheaper somewhere else. If it is, we can cancel it at the first place, which is a waste of everyone's time, and have it called in to the other place where it's cheaper.

Surely the technology exists to go to the insurance plan's website, type in the medicine, and find out the cost, the same way the pharmacy does.

[kork13]

Interesting .... Our insurance is pretty simple -- they have very clearly defined costs for prescriptions. Just depends on a few factors. Generic vs. name brand vs. formulary .... And if the pharmacy you fill the prescription at is in-network, not in-network, or mail service. Each combination of those have is own price, but at least it's clearly stated.

[disneysteve]

Interesting .... Our insurance is pretty simple -- they have very clearly defined costs for prescriptions. Just depends on a few factors. Generic vs. name brand vs. formulary .... And if the pharmacy you fill the prescription at is in-network, not in-network, or mail service. Each combination of those have is own price, but at least it's clearly stated.

I’ll have to have her look at her plan’s website and see if there’s a way for her to check prices in advance.

[LivingAlmostLarge]

It happens all the time. It's the people without insurance and the least money who get screwed the most. People with employer provided plans typically get $5 meds or some sort of copay without problems.

[disneysteve]

It happens all the time. It's the people without insurance and the least money who get screwed the most. People with employer provided plans typically get $5 meds or some sort of copay without problems.

She has coverage but for whatever reason this particular med had a high copay.