[mtdjed]

We have Medicare Drug coverage for the very few drugs we are prescribed. Primarily Cholesterol and Blood Pressure. Periodically, or Physician changes our prescription. Most of our prescriptions have been zero. A couple of times the change has resulted in costs like $100 for 3 month's supply. Supposedly because a higher tier drug. Then we get exposed to services such as GOODRX which are free, and they offer a price like $10 for 3 months supply.

How do these companies make money when the company I buy my insurance from can't make money or so they indicate

[blueash]

Originally Posted by mtdjed

We have Medicare Drug coverage for the very few drugs we are prescribed. Primarily Cholesterol and Blood Pressure. Periodically, or Physician changes our prescription. Most of our prescriptions have been zero. A couple of times the change has resulted in costs like $100 for 3 month's supply. Supposedly because a higher tier drug. Then we get exposed to services such as GOODRX which are free, and they offer a price like $10 for 3 months supply.

How do these companies make money when the company I buy my insurance from can't make money or so they indicate

The company's formulary, the drugs they want you to take, are those with whose manufacturer's or importer's etc have negotiated a low price in exchange for higher volume sales, because you and other insured persons will use that pill.

For pills not on your formulary or on high cost tiers you are not getting much if any discount from the full retail price, which is very inflated. On the other hand goodRx and other online discount plans may have your medication and knows which pharmacy groups have bulk purchase discounts. You will notice that your GoodRx may have different prices at different pharmacies. Don't worry they are making money.

It is not unusual for your "copay" on a higher price med to be higher than the full cost to you to self pay using an online coupon. And this can change from month to month.

[Caymus]

Originally Posted by mtdjed

We have Medicare Drug coverage for the very few drugs we are prescribed. Primarily Cholesterol and Blood Pressure. Periodically, or Physician changes our prescription. Most of our prescriptions have been zero. A couple of times the change has resulted in costs like $100 for 3 month's supply. Supposedly because a higher tier drug. Then we get exposed to services such as GOODRX which are free, and they offer a price like $10 for 3 months supply.

How do these companies make money when the company I buy my insurance from can't make money or so they indicate

Doesn't the government pay for some of the costs under Part D?

[retiredguy123]

Originally Posted by Caymus

Doesn't the government pay for some of the costs under Part D?

Not directly. The Part D plan premium is subsidized by the Government, but the cost for individual drugs is set by the insurance company.

[bagboy]

Originally Posted by mtdjed

We have Medicare Drug coverage for the very few drugs we are prescribed. Primarily Cholesterol and Blood Pressure. Periodically, or Physician changes our prescription. Most of our prescriptions have been zero. A couple of times the change has resulted in costs like $100 for 3 month's supply. Supposedly because a higher tier drug.

Then we get exposed to services such as GOODRX which are free, and they offer a price like $10 for 3 months supply.

How do these companies make money when the company I buy my insurance from can't make money or so they indicate

Regarding GoodRx, you can Google how they make money, and what you will learn makes alot of sense. We both have drug insurance through WellCare/Caremark/CVS. Recently my generic Bystolic was $75 for 3 months thru insurance, Goodrx had it for $18 @Publix. Then a new script Zetia was $78 through insurance, GoodRx had it for $17 @Publix. My wife recently had a refill at CVS for $45, GoodRx was $21 at Walmart Neighborhood Market.
So my point is, gone are the days where we get our meds from one source, or one pharmacy. Shop around, always check GoodRx, and even consider Canadian Pharmacy, online not the local ones.
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