Using GoodRx Discount Cards With Medicare Coverage

GoodRx works with Medicare, but not in the way you might expect

You can use a GoodRx discount card at the pharmacy while you have Medicare, but GoodRx and Medicare operate separately — they do not coordinate with each other. When you use GoodRx, you are paying out of pocket for a discount on the drug's price, not using your Medicare prescription benefit. This matters because using GoodRx can sometimes cost you more in the long run, and it may affect how your Medicare plan tracks your drug spending.

The key decision is whether to use your Medicare prescription coverage or the GoodRx discount on any given prescription. For some drugs and pharmacies, GoodRx will be cheaper. For others, your Medicare plan will be cheaper. You need to check both prices before you pay.

Key Takeaways

GoodRx is a discount program that works outside Medicare — when you use it, you pay cash and do not use your Medicare drug benefit.
You cannot use GoodRx and Medicare coverage for the same prescription at the same time; you choose one or the other at the pharmacy.
For some drugs, GoodRx will be cheaper than your Medicare copay; for others, your Medicare plan will be cheaper, so you must compare prices before filling.
Using GoodRx does not count toward your Medicare deductible or out-of-pocket maximum, which can cost you more money over the year.
If you are in the Medicare donut hole (coverage gap), using GoodRx may be cheaper than paying full price, but it still does not count toward closing the gap.

How GoodRx and Medicare interact at the pharmacy

When you go to the pharmacy with a prescription, you tell the pharmacist which benefit you want to use. If you say "use my Medicare," the pharmacy runs it through your Medicare Part D plan and you pay your copay (usually $5 to $15 for a generic, more for a brand name). If you say "use GoodRx," the pharmacy looks up the GoodRx discount price and you pay that price in cash — your Medicare plan never sees the transaction.

The pharmacist cannot use both at once. You must choose. This is why comparing prices matters: a GoodRx price of $8 for a 30-day supply might beat your Medicare copay of $15, but your Medicare copay might beat GoodRx's price of $45 for a different drug at the same pharmacy.

GoodRx prices vary by pharmacy and by quantity. The same drug at the same dose costs different amounts at CVS, Walgreens, Walmart, and independent pharmacies. You can see all the prices on the GoodRx website or app before you go to the pharmacy, and you can choose which pharmacy offers the best deal.

When GoodRx is cheaper than Medicare

GoodRx is often cheaper than your Medicare copay for common generic drugs. If your Medicare plan charges a $10 copay for a 30-day supply of lisinopril (a blood pressure drug), but GoodRx shows $6 at Walmart, you save $4 by using GoodRx. For drugs you take regularly, those small savings add up.

GoodRx can also be much cheaper than your Medicare copay for brand-name drugs that your plan does not cover well. If your plan puts a brand-name drug in a high copay tier ($50 or more), but GoodRx shows $20, using GoodRx makes sense for that prescription.

However, there is a catch: when you use GoodRx, that money does not count toward your Medicare deductible or your out-of-pocket maximum. If you have not met your deductible yet, using GoodRx means you are paying cash instead of moving closer to the point where Medicare starts paying. This can cost you more money over the whole year.

When Medicare is cheaper than GoodRx

For some drugs, your Medicare copay is lower than GoodRx's price. This is common for drugs that your plan covers well — drugs that the plan negotiated a good price for, or drugs that are on the plan's preferred list. You will not know unless you check.

Medicare is also cheaper when you factor in the deductible and out-of-pocket maximum. If you have not met your deductible, paying your Medicare copay counts toward it. Once you meet your deductible, Medicare starts paying a share of the cost. Once you hit your out-of-pocket maximum (usually $7,050 to $8,000 in 2024, but this varies by plan), Medicare covers the rest of your drugs for the year. Using GoodRx instead of Medicare means you never reach these thresholds, so you keep paying full price for every prescription.

The donut hole and GoodRx

The donut hole (or coverage gap) is a range of drug costs where you pay more out of pocket. In 2024, once you and your plan have spent $5,850 on covered drugs, you enter the donut hole and pay 25 percent of the cost of brand-name drugs and generic drugs until your out-of-pocket spending reaches $8,000. After that, catastrophic coverage kicks in and Medicare pays most of the cost.

If you are in the donut hole, GoodRx might be cheaper than paying 25 percent of the drug's cost. But using GoodRx does not count toward closing the gap — the $8,000 threshold only includes money you paid through your Medicare plan. This means you could spend a lot on GoodRx and still be in the donut hole for months longer.

The math depends on the specific drug and the specific price. For some drugs in the donut hole, GoodRx is clearly cheaper. For others, paying 25 percent through Medicare is cheaper. Again, you need to compare before you fill.

How to compare GoodRx and Medicare prices

Go to the GoodRx website or open the GoodRx app. Enter the drug name, dose, and quantity (for example, "lisinopril 10 mg, 30 tablets"). The site shows you prices at nearby pharmacies. Write down the lowest price.

Then check your Medicare plan's formulary (the list of covered drugs) and the copay for that drug. You can find this on your plan's website, in the member handbook, or by calling the plan's customer service number. Compare the GoodRx price to your Medicare copay.

If the GoodRx price is lower and you have not met your deductible yet, also think about whether you are close to meeting it. If you are, using Medicare might be worth paying a bit more now to reach the deductible sooner. If you have already met your deductible and out-of-pocket maximum, use whichever is cheaper for that prescription.

What to tell your doctor and pharmacist

You do not need your doctor's permission to use GoodRx. It is a discount program, not a different medication. However, if your doctor prescribed a brand-name drug and GoodRx is much cheaper for a generic version, you can ask your doctor if the generic is appropriate for you. Many doctors are happy to switch you if it saves you money.

Tell your pharmacist which benefit you want to use before they fill the prescription. Say "I want to use GoodRx" or "I want to use my Medicare." If you are unsure which is cheaper, ask the pharmacist to check both prices for you — most will do this without charging you.

Keep a record of which prescriptions you filled with GoodRx and which you filled with Medicare. This helps you track your out-of-pocket spending toward your Medicare maximum and makes it easier to compare costs over time.

Frequently Asked Questions

Does using GoodRx hurt my Medicare coverage?

No. Using GoodRx does not change your Medicare plan or your coverage. However, money you spend on GoodRx does not count toward your deductible or out-of-pocket maximum, so it may cost you more overall if you use it instead of Medicare for many prescriptions.

Can I use GoodRx if I have Medicaid as well as Medicare?

This depends on your state and your Medicaid plan. Some states do not allow Medicaid to pay for prescriptions if you have already used a discount card like GoodRx. Before using GoodRx, call your Medicaid plan and ask whether it affects your coverage.

What if GoodRx shows a price but the pharmacy charges me more?

GoodRx prices can change, and not all pharmacies honor all GoodRx prices. Call the pharmacy before you go, or ask the pharmacist to verify the price when you arrive. If the price is different, ask the pharmacist why — sometimes the pharmacy has a different discount or the drug is out of stock.

Does GoodRx work for all drugs?

GoodRx has prices for most common drugs, but not all. Specialty drugs (drugs for cancer, biologics, and other complex treatments) are often not on GoodRx. For those drugs, you will need to use your Medicare coverage or ask your doctor about other options.

Should I use GoodRx or Medicare for my regular medications?

Check the price for each drug at the beginning of the year, and check again if your Medicare plan changes. Prices and copays change, so what was cheaper last year might not be cheaper this year. Make the comparison for each prescription, every time you fill it, until you know your plan well enough to predict which will be cheaper.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.