Having Insurance Doesn’t Mean Lowest Drug Price


 Having Insurance Doesn't Mean Lowest Drug Price Extra Money Insurance Failed to Cover for Drug
Having insurance doesn’t always guarantee the lowest drug price. This post may help save you money for your prescription.


Being a consumer today might be compared to a gazelle in the sight of lions hiding in the tall grass because we don’t really see the whole picture. I always assumed that if you have health insurance with a prescription drug benefit that I didn’t have to worry about paying the lowest drug price. The insurance had my back? I was wrong about that one. What I found out is that you need to be a vigilant consumer when it comes to drug prices or suffer the consequences.

Recently I went to my local pharmacy and saw that prescription I was picking up was higher. This was routine stuff, nothing like some exotic new experimental drug. This was a generic drug that has been out for decades. So I asked the pharmacist, or actually the clerk, what suddenly made it so expensive. Apparently few of us actually do ask why the price is higher. She simply replied that she didn’t know.

The clerk told me they ran it through my insurance and she showed where on the receipt it said that. I assumed that the drug price went up like everything else lately. Then I remember the greedy executive hiking prices for that cancer drug a few years ago and I figured oh well this is the way I should expect to be treated.

So I asked, what would the price of that drug would be without my insurance. The clerk didn’t know and she looked it up. Surprise the drug turned out to be cheaper. Cheaper I asked? Are you sure? “Yes,” the clerk said. I told her that I’ll pay that!

No problem. I hadn’t left the pharmacy counter or even paid the higher price so she entered that prescription price. Now I only saved a few bucks.

This experience taught me an important lesson that I want to pass on. I learned from the clerk and from further research that stores can charge you the higher price because of a negotiated deal between pharmacies and insurance companies.

I was stunned. I guess they give them a slightly higher allowance on one prescription and, perhaps, get more off on some other drug. This is hardly to the consumer’s advantage, but on the contrary, it’s big business looking out for their bottom line.

Actually, they have a law which bans the gag rule that used to be on pharmacies preventing them from letting you know of a cheaper price. But under this law, the pharmacy isn’t required to tell consumers of the cheaper option. You have to ask if there is one.

Don’t assume insurance guarantees the cheapest price. I got one small prescription filled once using AAA! Also, there are free drug discount cards like GoodRx.com and there are many others. With this said, you mustn’t be afraid to use discount drug card sites to scan stores in your area for the pharmacies with the cheapest available price before you go. If you find your pharmacy is higher even for the cash price, then ask them to match the other retailer.

Something else we need to be concerned about is the power of drug companies. 60 Minutes did an interesting story on May 12, 2019 about the extent drug companies go to control prices through price fixing. Connecticut and 40 states joined forces with a 500-page lawsuit in this scheme that described in detail how far reaching corporate greed of these drug companies has become.

In the end, don’t be the gazelle being hunted for your hard earned dough. Be the lion and claw back as much of that cash as you can.



  1. gloria patterson
    May 14, 2019 / 2:18 pm

    the pharmacy isn’t required to tell consumers of the cheaper option. You have to ask if there is one………. this is like senior discount at stores they cannot ask but if you do they will tell you about the discount. I have to say that this has surprised me I will be more aware and asking questions now.

    • nuts4stuff
      May 15, 2019 / 5:21 am

      Believe it or not, I found out that it can be CHEAPER to pay for a drug like one I picked up WITHOUT insurance. I always ask now the price with insurance and without using insurance. How greedy can these companies get?

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