Are Prescription Co-Pays Ripping You Off?

Posted on September 6, 2007 by Melissa
Filed Under Insurance

I hear zinc is good for you… Have you ever looked into the actual cost of your medications? Could you be paying more in co-pays than your medicine actually costs without insurance?

A friend of mine told me about an issue she discovered when she changed health insurance plans recently. She had been paying her monthly co-pay of $15 for one of her long term medications for years. She never thought twice about it and naturally assumed the medication was more expensive than the co-pay. After all, prescriptions are notorious for being budget busters for people without insurance.

When she was switching to her new health insurance plan she ended up having to pay for this medication outright for a time. She found it cost only $6.45 to buy the same medication without the insurance plan. That’s a savings of $8.55 a month if she paid for it up front without insurance.

From that point on she has paid for that medication without her prescription plan and has saved money. She couldn’t believe that she had over paid all those years and now when she gets a new medication she asks the pharmacist what the cost would be without insurance. Most of the time the price is higher than the co-pay but you never know unless you ask.

She urged me to check with my pharmacist to make sure that none of my medications were actually cheaper than I was paying with my co-pay. I did and all my prescriptions cost more than my co-pay so it would be best for me to buy them on plan.

Non-generics are almost guaranteed to be more expensive than your co-pay. But common, widely used generics that have been around for a long time may actually be cheaper than the co-pay you are paying. You might also check Sam’s Club and Costco for deals. On many generics they offer very low prices.

I realize that not everyone will see any cost savings from this but I figure that if my friend was able to save money by avoiding her co-pay it could save others money, too. It is at least worth a shot if you are on any common generic prescriptions.

Make sure your prescription co-pay is helping rather than hurting your checkbook. Check with your pharmacist and make sure you aren’t paying more than you need to.

Comments

6 Responses to “Are Prescription Co-Pays Ripping You Off?”

Pinyo on September 6th, 2007 11:59 am

That is ridiculous. I am also dealing with my own medical insurance issue right now, but I cannot discuss it until resolved. Thanks for the post.
glblguy on September 6th, 2007 3:27 pm

I don’t think I’ve ever had this happen. If the medicine is less than my co-pay, I just charged the actual cost. Antibiotics typically fall into this category.

I use a Flexible Spending Account to cover my co-pays which works out great since it’s tax-free dollars. With our family of 8 (one child with Diabetes) we have a lot of medical expenses.
Melissa on September 7th, 2007 8:13 am

Pinyo-

It is ridiculous! You would think the pharmacist would have mentioned it at some point. It makes me wonder if I have ever unknowingly overpaid in the past.

I’m sorry that you are having trouble with health insurance right now. I hope you get it worked out soon.
Melissa on September 7th, 2007 8:27 am

glblguy -

Yes, flexible spending accounts are great but I would only recommend them for people who are organized enough to really use them.

Years ago, before we got on the right track with our finances, we decided to try this out. Of course, we forgot about it and the $100 in the account was lost. Tough lesson to learn.

We are planning on setting this up for next year now that we are actually organized enough to use it. Tax-free means a huge discount and since we have regular medical expenses it could really help out.

Thanks for the tip!
paidtwice on September 9th, 2007 11:37 pm

Those pharmacies don’t sound on the up and up. If the actual cost is less than the copay they should charge you the actual cost. I’m shocked (sort of) that a pharmacy would risk ripping someone off like that. It is kind of like insurance fraud in a way.

I am also a huge fan of flex spending accounts and hope it works for you in the future!!
Olivia on November 24th, 2007 11:36 pm

This is an old post of yours, but I’m just now reading up on your site. I’m in pharmacy school and I work at a pharmacy part time. The place your friend was going to doesn’t sound quite right if the cash price was less than her insurance co-pay; most places will default to the lowest price.

Anyway, I wanted to share a tip for possibly saving money on insurance co-pays. Ask your pharmacy how much money medications cost for a 90 day supply versus a 30 days supply. Some generic blood pressure meds, and other long-term meds, end up cheaper when you get 90 days worth (since you get somewhat of a bulk price) at cash price versus getting 30 days worth with insurance.