Outside the Plan: Discount Cards and Cash-Price Options Compared, 19 Side by Side
These are the options an employee uses outside the health plan: discount cards, cash-price pharmacies, a government portal, manufacturer programs and assistance programs. Each row links to the full page on how that option interacts with your plan. The plan-side vendors are very different products, so they have their own page: the inside-the-plan PBM comparison. Back to the main guide.
All 19 Options, One Table.
Type, who pays, how each option relates to the plan, and whether a purchase counts toward the deductible. Click any option for the full page.
| Option | Type | Who Pays | Plan Relationship | Counts Toward Deductible |
|---|---|---|---|---|
| GoodRx | Discount Card | Free to employee | Outside the plan | No. Cash purchase |
| Cost Plus Drugs | Cash-Price Pharmacy | Employee pays cash | Usually outside the plan | No, unless billed to the plan |
| Amazon Pharmacy | Cash-Price Pharmacy | Employee pays cash | Usually outside the plan | No, unless billed to the plan |
| TrumpRx | Government Portal | Employee pays cash | Outside the plan | No |
| SingleCare | Discount Card | Free to employee | Outside the plan | No. Cash purchase |
| Optum Perks | Discount Card | Free to employee | Outside the plan | No. Cash purchase |
| ScriptSave WellRx | Discount Card | Free to employee | Outside the plan | No. Cash purchase |
| RxSaver | Discount Card | Free to employee | Outside the plan | No. Cash purchase |
| Blink Health (BlinkRx) | Cash-Price Pharmacy | Employee pays cash | Usually outside the plan | No, unless billed to the plan |
| Walmart’s $4 List | Cash-Price Pharmacy | Employee pays cash | Usually outside the plan | No, unless billed to the plan |
| Costco Pharmacy | Cash-Price Pharmacy | Employee pays cash | Usually outside the plan | No, unless billed to the plan |
| Honeybee Health | Cash-Price Pharmacy | Employee pays cash | Usually outside the plan | No, unless billed to the plan |
| RxSaveCard | Employer-Funded Card | Employer | Beside the plan | Not through the PBM |
| LillyDirect | Manufacturer-Direct | Employee pays cash | Outside the plan | No |
| NovoCare Pharmacy | Manufacturer-Direct | Employee pays cash | Outside the plan | No |
| America’s Pharmacy | Discount Card | Free to employee | Outside the plan | No. Cash purchase |
| AARP Prescription Discounts | Discount Card | Free to employee | Outside the plan | No. Cash purchase |
| NeedyMeds | Discount Card | Free to employee | Outside the plan | No. Cash purchase |
| RxAssist | Directory | Free to look up | Outside the plan | No |
When Each Option Fits, and When to Skip It.
The same option can be right for one employee and wrong for the next. These are the fit notes from each option’s own page.
| Option | It Fits When | Skip It When |
|---|---|---|
| GoodRx | An employee without coverage; a cheap generic while still under a high deductible; a drug the plan excludes. | A $0 to $20 copay; a deductible waiver on that drug; an employee who will reach the out-of-pocket maximum anyway; anyone relying on care management that triggers on claims. |
| Cost Plus Drugs | An employee without coverage, such as part-time or waiting-period staff; a high-deductible member who accepts the spend will not count; a steady maintenance generic with a stable price. | A brand or specialty drug; a prescription needed today; a plan with $0 generics; anyone who needs the claim counted toward the deductible. |
| Amazon Pharmacy | An employee with Prime who takes one or more listed generics; an insured employee who wants mail delivery billed through the plan. | Someone without Prime; a Medicaid or CHIP member; an employee in California or Washington (for RxPass); a brand or specialty drug, which RxPass excludes. |
| TrumpRx | An uninsured employee; a drug the plan excludes, such as some weight-loss and fertility medications; a brand drug where the cash price beats the plan for someone in the deductible phase. | A generic, which is cheaper elsewhere; an employee with a low copay; anyone who needs the spend counted toward the deductible. |
| SingleCare | An employee without coverage; a generic where SingleCare beats both the plan and GoodRx that day; a drug the plan excludes. | A low copay; a $0 generic under a deductible waiver; any employee who needs the claim counted toward the deductible. |
| Optum Perks | An employee without coverage; a cheap generic while under a high deductible; a drug the plan excludes. | A low copay; a deductible waiver on the drug; an employee who will reach the out-of-pocket maximum anyway. |
| ScriptSave WellRx | An employee without coverage; a generic at an independent pharmacy; a drug the plan excludes. | A low copay; a deductible waiver; anyone whose care management program depends on claims data. |
| RxSaver | An employee without coverage; a cheap generic while under a high deductible; a drug the plan excludes. | A low copay; a deductible waiver on the drug; an employee who will reach the out-of-pocket maximum anyway. |
| Blink Health (BlinkRx) | An employee without coverage; a drug the plan excludes; someone who prefers a fixed price paid in advance. | A low copay; a deductible waiver on the drug; an employee who will reach the out-of-pocket maximum anyway. |
| Walmart $4 Prescription List | An employee without coverage; a common generic on the list while under a high deductible; a short course of a basic medication. | A drug not on the list; a low copay or $0 generic under a deductible waiver; an employee who needs the claim counted toward the deductible. |
| Costco Pharmacy | A steady maintenance generic; an uninsured employee; someone who already shops at Costco and prioritizes savings over speed. | An urgent prescription, because mail order is slow; a low copay; an employee who needs the claim credited to the deductible. |
| Honeybee Health | An uninsured employee; a maintenance generic with a stable price; someone who values mail delivery and published prices. | A prescription needed today; a plan with $0 generics; any employee who needs the spend counted toward the deductible. |
| RxSaveCard | You want to give employees a defined monthly amount for generics and low-cost drugs, and you accept that the spend sits outside plan reporting. | You need every dollar counted toward deductibles or visible in carrier data, or you have not seen the contract and reporting terms. |
| LillyDirect | Employees are already using it and you want to plan for the data gap, or covered alternatives cost more than the self-pay price. | You rely on plan data to manage a high-cost drug category, or you have not reviewed prescribing and safety questions with your carrier. |
| NovoCare Pharmacy | Your plan excludes weight-loss drugs and employees are paying out of pocket anyway, or your covered cost per member is above the self-pay price. | You cover GLP-1s and rely on claims data for utilization management, clinical programs or stop-loss reporting. |
| America’s Pharmacy | An employee wants a quick price check, or you want a fallback for people without coverage. | You need spend counted toward deductibles or visible in claims data. |
| AARP Prescription Discounts | You have older workers or retirees asking about price checks and want to give a clear answer. | You need plan-visible spend or a program that integrates with your coverage. |
| NeedyMeds | You want a nonprofit option to point lower-wage employees or families to, or you run a wellness or employee assistance program. | You need an integrated benefit with claims visibility. |
| RxAssist | You have employees on high-cost brand drugs and want a resource for them to research. | You expect it to lower plan costs. It is an employee referral, not a plan tool. |
What the Columns Mean.
Three columns decide most of what an HR leader needs to know.
Who Pays
Whether the employee pays cash at the counter, the option is free to the employee, or the employer funds it through the plan. This sets who carries the cost. Ask this first for any program you are considering, because the answer decides whether employees feel the benefit or the employer absorbs a new expense. Put the funding arrangement in writing so everyone understands who is responsible for what. For a quick estimate, use our free generic dispensing rate savings calculator.
Plan Relationship
Whether the purchase happens outside the plan, can be billed to the plan, or sits inside it. Outside the plan means the plan never sees the fill. This distinction affects reporting, plan records and how the program is described to employees. Ask whoever offers the program to explain in plain terms how it interacts with your plan, and have your adviser or counsel review anything that touches plan documents.
Counts Toward Deductible
Cash purchases made outside the plan generally do not count toward the deductible or out-of-pocket maximum. Confirm the rule in your own plan documents. Employees often assume every dollar they spend on prescriptions moves them toward their limits, and that is not always the case. Tell staff what applies, so they can weigh a cash price against running the claim through the plan.
Comparison Questions.
Quick answers before you read the individual pages.
Which option is best for our employees?
No single option wins. The right one depends on the drug, the employee’s coverage and where they stand against the deductible. The fit table above shows the situations each one suits and when to skip it.
Does paying cash count toward the deductible?
Usually not. A cash purchase made outside the plan generally does not count unless it is billed to the plan. The table shows the answer for each option, and your plan documents control.
Why are PBMs on a separate page?
Discount cards, pharmacies, portals and assistance programs are things an employee uses outside the plan. A PBM is the vendor an employer buys to run the benefit inside the plan. They answer different questions, so the PBM comparison has its own page.
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General information about a publicly available program, not medical, tax or legal advice. Prices, eligibility and terms change; confirm with the program and with your carrier or pharmacy benefit manager.
Related reading: Employees on Work Visas or Working Outside the United States
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