Prescription Cost Calculator
Compare prescription drug payment options: evaluate retail cash prices, pharmacy discount card coupons (GoodRx), insurance copay tiers, and 90-day mail-order savings.
Prescription & Treatment Summary
Prescription Optimization Model
Best Price = Min(Insurance Copay / Coinsurance, Discount Card Coupon Price, Retail Cash Price)- Tier 1 Generic Copay: Standard low-cost preferred generic flat fee ($5–$15).
- Pharmacy Discount Coupon: Cash program pricing (GoodRx, SingleCare) that bypasses insurance.
- Mail Order Multiplier: 90-day mail order usually offers 3 months for the price of 2 or 2.5.
Step-by-Step Worked Example
Calculation Steps:
- Compare Options: Insurance ($15) vs Coupon ($28) vs Retail ($120).
- Optimal Channel = Insurance Copay ($15 per fill).
- Annual Out-of-Pocket Cost = $15 × 12 = $180/year.
- Annual Savings vs Full Retail = ($120 × 12) - $180 = $1,440 - $180 = $1,260 (87.5% savings).
How to Use This Calculator
- 1Enter the retail cash price of your prescription medication.
- 2Input your health plan’s formulary copayment or coinsurance percentage.
- 3Add any available discount card coupon prices (e.g. GoodRx, Cost Plus Drugs).
- 4Select 30-day retail pickup or 90-day mail order.
Assumptions & Limitations
- Purchasing through discount cards does not count toward your insurance deductible or OOPM.
Frequently Asked Questions
Can a prescription discount card be cheaper than insurance?
Yes. For many generic medications, discount coupons (like GoodRx) or cash pharmacies (like Mark Cuban Cost Plus Drugs) are cheaper than insurance copayments, especially under high-deductible plans.
What are the 4 prescription drug tiers?
Tier 1 includes low-cost generics; Tier 2 includes preferred brand-name drugs; Tier 3 includes non-preferred brand-name drugs; and Tier 4 comprises high-cost specialty biologics.
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