It’s no secret that the American health care system is complicated, and getting prescription medications can be particularly bewildering and costly. One option for consumers is GoodRx, a company that aims to make drug pricing more transparent while giving consumers access to discounts on prescription medications.
But what are the pros and cons of GoodRx, and how does it work with insurance plans, including Medicare?
[SEE: 11 Foods Not to Mix With Prescription Medications.]
What Is GoodRx and How Does It Offer Discounted Drug Prices?
GoodRx is a free-to-consumer website and mobile app that tracks prescription drug prices and provides coupons for discounts on medications. GoodRx is not an insurance program, and it operates outside of conventional health insurance programs like Medicare.
Doug Hirsch, cofounder of GoodRx, says the idea for the company came to him when he was prescribed a medication that was going to cost about $500 at his regular pharmacy. He tried another pharmacy up the road and was quoted $250. A third quoted him $400, for what he thought was a “cheap, generic drug.”
When he refused to pay and left the pharmacy without the medication he needed, the pharmacist chased him into the parking lot and said she wanted to help him get the medicine.
“I started by accident to find out there were these drug discounts that would enable someone who’s purchasing a drug to get it for much, much less,” he says.
How Does GoodRx Work?
With GoodRx, you can more easily access discounts to reduce the costs of prescription medications. GoodRx does this by working closely with pharmaceutical manufacturers and pharmacy benefit managers (PBMs).
PBMs, Hirsch says, are the “Ticketmaster of health care.” They negotiate with pharmacies on behalf of insurance companies and employers to set prices and copays for medications.
“We’re sort of Switzerland in the middle of trying to work on behalf of the consumer,” Hirsch explains, adding that GoodRx brings together all the various discount programs to find which is the best one for you. “There are tremendous savings, and often you’ll pay less than you would pay with a copay, or certainly if insurance doesn’t cover it.”
Hirsch says the company has saved Americans upward of $85 billion since launching in 2011. In 2024, 30 million Americans saved money by using GoodRx, with an average savings of 83% off retail prices for prescription medications, the company reports.
Using GoodRx
When you search for a specific medication in the app or on the website, you’ll be presented with a list of nearby pharmacies and exactly what they are charging for that prescription. GoodRx currently works at more than 70,000 pharmacies across the United States.
Hirsch also notes that GoodRx discounts medications that may be dispensed for your pet from a regular human pharmacy. Pets don’t qualify for Medicare or human health insurance plans, obviously, but their health care expenses can add up quickly.
[READ Senior Living Benefits: Finding Companionship in a Pet-Friendly Community]
Medicare Part D and GoodRX
There are several parts of Medicare, the federal health insurance program designed to cover people age 65 and older and some younger individuals with disabilities. Medicare Part D is an elective benefit offered by private insurance companies to cover some or all of the cost of certain prescription drugs.
Each Part D plan has its own list of what’s covered, called a formulary. That formulary can change from year to year. Depending on the specifics of your coverage, prices and benefits can also fluctuate. Therefore, it’s important to check the formulary of any Medicare Part D plan you’re looking to purchase during each annual enrollment period to ensure that the medications you need are included.
Whitney Stidom, vice president of consumer enablement with eHealth Inc., a health insurance broker and online resource provider headquartered in Austin, encourages all seniors to purchase Part D coverage.
“Everyone on Medicare needs prescription drug coverage,” she points out. “It’s no secret that prescription drugs can be costly, especially without insurance. As a Medicare beneficiary, enrolling in drug coverage is one of the best things you can do to shield yourself from medical expenses.”
[READ: How Medicare Beneficiaries Can Save Money on Prescription Drugs]
How to Use GoodRx Coupons to Lower Medicare Part D Costs
GoodRx is separate from Medicare and while it can’t be used in combination with Medicare in a single transaction, it can be used instead of it, as an alternative means of lowering drug costs.
“You use one or the other, but most pharmacists are happy to look at both prices and give you the cheaper one,” Hirsch notes.
Saving on prescriptions: When to use GoodRx instead of Medicare
If a medication you need isn’t covered by Part D, you’ll have to pay for it out of pocket, which can get expensive. GoodRx, however, can often reduce the cost if you’re prescribed a medication that’s not included in your coverage plan.
In some cases, the retail price offered via GoodRx could be lower than your copayment through Medicare. And if you know you’re not going to meet your deductible — the amount you pay out of pocket before your insurance starts to pay — it might be worthwhile to use GoodRx to get a cheaper price rather than running the prescription through your insurance.
GoodRx may reduce costs during the various phases but anything paid to the pharmacy while using GoodRx does not go towards your deductible or initial coverage phases of Medicare Part D.
For 2026, the Medicare Part D phases include:
— Deductible phase. You’ll pay the full cost of your prescription until you meet the annual deductible of $615.
— Initial coverage phase. Once you’ve met your deductible, you’ll be responsible for 25% of the cost of your drugs until your total out-of-pocket spending reaches $2,100.
— Catastrophic coverage phase. Once you’ve spent $2,100 out of pocket, your prescription drugs will be covered at 100% for the rest of the year.
During the deductible and initial coverage phases, you may be able to access a discounted rate for prescriptions via GoodRx.
However, if you’ve used GoodRx to get a cheaper retail price on a medication, that money spent doesn’t count toward your deductible or out-of-pocket limit with Medicare. Therefore, it’s important to consider whether that immediate cash savings will be worth it in the long run.
[READ: What Is the Medicare Part D Penalty?]
What Are the Downsides of Using GoodRx?
There aren’t many downsides of using GoodRx. However, relying on GoodRx as your sole source of prescription medication coverage is not what it was designed for, and it’s best to purchase prescription drug coverage as part of your health insurance selections.
“I’m not saying to ignore insurance,” Hirsch explains. “You really do need insurance, especially for name brand drugs to find your maximum savings.”
GoodRx can be used in place of health insurance prescription benefits to reduce cost and help you become a savvier consumer of health care.
“We’re in the information and education business primarily, and we’re offering discounts that hopefully can provide assistance,” Hirsch adds. “You can shop around and actually actively manage your health care budget.”
[READ: Health Saving Accounts and Medicare: Using an HSA to Pay for Medicare Premiums]
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GoodRx and Medicare Part D: How to Use GoodRx to Save Money on Prescriptions originally appeared on usnews.com
