Question about applying for health insurance?

High deductible health insurance plan question, Rx without insurance

• Purchasing meds without insurance coverage, what could be the implications? I have a high deductible HSA-type health insurance plan, $4000 deductible/calendar year and coverage cycle is from Nov to Oct, so its actually more than $4000. Only 3 employees are covered under this insurance plan by my employer (among those 3, we are the only family, who really use it on regular basis.) I use a few Rx medications for my health conditions. If I buy these medications through goodrx.com, they are cheaper than what my Rx card will offer me. For example, A 3-month supply of Medicine A from insurance company 'recommended' mail order pharmacy costs $310. If I buy same medicine using insurance information from goodrx.com will cost me $220. So I plan to buy all my medications through goodrx.com Of course, this will not count towards the $4000 deductible. Even if I use Rx coverage on my insurance plan, I doubt I will make $4000 this year. In such case, if either one the family members ends up in the hospital, I will end up paying a lot more. In that case, I will just have to bite the bullet. (Such possibility is rather low but emergency can strike any time, nobody knows.) My question is, what implications I am looking at, should I go through goodrx.com instead of my health plan Rx coverage. The reason of going this route is, first save money and second, buffer next year's premiums a little bit. Does this make sense? Would you do the same, should you end up in my shoe? Thanks in advance.

• Answer:

  First, do you know for certain that your costs through goodrx.com don't count toward your deductible? It is certainly worth a call to the insurance company to see if you can submit receipts for your expenses there so they count toward your deductible (if they allow it, you would basically be filing a claim even though you know the insurance company isn't going to reimburse you anything on it). If you can't do that, I think there are two factors that would steer me toward using the approved mail order pharmacy: (1) as you note, it would count toward your deductible and you will wind up paying less out of pocket should anything beyond routine care come up; (b) the fact that you are paying for the prescription with pre-tax dollars if you use HSA money vs. (presumably) post-tax dollars if you use goodrx.com alters the true cost significantly. If you have a marginal fed tax rate of 25%, plus state and FICA tax advantages, you are easily talking about a 35% "penalty" for using aftertax dollars. This would actually make it more expensive to pay $220 for medication using aftertax dollars than to pay $310 for medication using pretax dollars.