Cash prices for prescriptions are everywhere now. Here is what they do to your plan.
GoodRx, Cost Plus Drugs, Amazon Pharmacy and TrumpRx all promise a lower price than the pharmacy counter, and often they deliver. But a cash purchase happens outside your plan, so it can help one employee and quietly cost the group something else. This page compares the options and what each one means for an employer. It is part of our pharmacy benefit consulting work.
The names your employees are already searching.
Twelve cash-price pharmacy options, what each one is, and the catch. Terms are as published in October 2026 and change often, so confirm before you point anyone to one.
GoodRx
A free coupon and price-comparison app that works at local pharmacies. It is not insurance and it is not a pharmacy. It shows the coupon price near you, and the employee picks either the coupon or the plan for that fill. For a quick estimate, use our free generic dispensing rate savings calculator.
Cost model. Free to use, with an optional paid Gold tier that discounts some drugs further.
Watch for. Coupon fills are generally not billed to your plan, so they do not count toward the deductible.
Cost Plus Drugs
A mail-order pharmacy from Mark Cuban Cost Plus Drug Company that publishes its formula: the cost of the drug, plus a 15% markup, plus a $5 dispensing fee, with shipping added. For a quick estimate, use our free specialty drug exposure calculator.
Cost model. Cash and card, no coupon needed, transparent line items.
Watch for. Mostly generics, a limited formulary and little insurance billing. The prevailing view is to treat it as a supplement to the plan, not a replacement.
Amazon Pharmacy
An online pharmacy that ships by mail, or same day in some cities, and bills many insurance plans as well as taking cash. RxPass is a separate $5-a-month subscription for Prime members covering more than 50 common generics.
Cost model. Plan or cash at the pharmacy; flat monthly fee for RxPass.
Watch for. RxPass is not insurance, is not open to Medicaid or CHIP members, does not ship to California or Washington, and its fee cannot be paid with HSA or FSA funds.
TrumpRx
A federal website launched in February 2026 that lists discounted cash prices from drug manufacturers and, since May 2026, more than 600 generics, with GoodRx, Cost Plus Drugs and Amazon Pharmacy pricing shown alongside. It is not a pharmacy.
Cost model. Cash. You are sent to a coupon, a manufacturer’s site or a pharmacy to buy.
Watch for. At launch you attested you would not seek insurance reimbursement, and reporting says these purchases generally do not count toward deductibles.
SingleCare
A free coupon card accepted at more than 35,000 pharmacies, with signature cards for Walgreens, Walmart and CVS.
Watch for. Cannot be combined with insurance on the same fill, and prices differ by pharmacy.
Optum Perks
A free discount card from Optum Perks, LLC, an RVO Health company, advertising savings up to 80%.
Watch for. It says purchases will not contribute to a deductible or out-of-pocket maximum.
ScriptSave WellRx
A free discount card with a network of more than 54,000 pharmacies, marked discount only and not insurance.
Watch for. Cannot be used with insurance on the same fill.
RxSaver
A free coupon search with no sign-in or membership, accepted at thousands of pharmacies.
Watch for. Not usable with commercial plans, Medicare or Medicaid, and invisible to the employer.
Blink Health
Also known as BlinkRx: an online pharmacy where the patient pays online and the medicine is delivered or picked up.
Watch for. Earlier reporting says it cannot be stacked on insurance, so confirm current terms.
Walmart’s $4 List
Posted cash prices on select generics, starting as low as $4 for 30 days and $10 for 90 days, with no coupon.
Watch for. A short drug list, with some state price variation.
Costco Pharmacy
A membership-warehouse pharmacy that fills for non-members, with deeper discounts for members.
Watch for. Member-program purchases do not count toward the deductible, and mail order is slow.
Honeybee Health
A mail-order pharmacy with published prices that does not accept insurance.
Watch for. Every fill is cash and stays entirely outside the plan.
All Twenty-Three Options at a Glance.
The last four columns are category defaults, not vendor promises. Where a vendor can bill your plan or counts spend differently, its own page says so. Confirm with your carrier before telling employees anything about the deductible. See the outside-the-plan comparison and the inside-the-plan PBM comparison.
| 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 |
| SmithRx | PBM | Plan | Inside the plan | Yes |
| Capital Rx | PBM | Plan | Inside the plan | Yes |
| 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 |
| ProCare Rx | PBM | Plan | Inside the plan | Yes |
| ScriptGuideRX | PBM | Plan | Inside the plan | Yes |
Which Kind of Option Fits Which Goal.
Start with what you want the program to do, then pick the category. The vendor pages cover the details.
Give Employees a Price Check
Discount cards and cash-price pharmacies cost the employer nothing and need no enrollment. Expect no claims data and no deductible credit.
Fund a Defined Allowance
An employer-funded card puts a set dollar amount in employees’ hands for low-cost drugs. Ask for reporting and a written answer on the deductible.
Change the Cost Inside the Plan
A transparent PBM changes how plan claims are priced and reported. This is a contract decision, mostly for self-funded groups.
Address GLP-1 Cash Pricing
Manufacturer-direct and government portals now publish self-pay prices. Decide your coverage stance on purpose and plan for the data gap.
Help Employees Who Cannot Afford a Drug
Assistance directories point to manufacturer programs. They are a referral resource, not a plan tool.
Not Sure Where to Start
Send us your pharmacy spend and plan design. We will tell you which of these changes anything for your group.
Options the employer pays for or chooses.
These sit closer to the plan than a coupon does, so they carry contract terms and reporting questions. For the PBM side in depth, see our guide to employer-funded PBMs.
RxSaveCard
An employer-funded cash card. RxSaveCard says it works at more than 65,000 pharmacies and bypasses the PBM.
SmithRx
A transparent PBM that claims savings of 20% or more and passes through rebates, per a 2026 Transcarent release.
Capital Rx
A PBM founded in 2017 and now part of Judi Health, with a discount card option.
ScriptGuideRX and Other Employer-Funded PBMs
A guide to PBMs the employer contracts with directly, how they are paid and what to ask before switching.
ScriptGuideRX
SGRx Health, a PBM with a HealthChoice of Michigan program and a range of other services.
Buying straight from the drug maker.
Self-pay routes for specific medicines. They generally run outside the plan.
LillyDirect
Eli Lilly’s channel for telehealth, doctor search and home delivery of select Lilly medicines.
NovoCare Pharmacy
Novo Nordisk’s self-pay pharmacy, operated by CoAssist Pharmacy, with published Wegovy and Ozempic prices.
Three more free cards your employees may find.
Same basic model as the coupon services above. They lower a cash price and leave no claim behind.
America’s Pharmacy
A card with a network of more than 51,000 pharmacies, from the same operator as ScriptSave WellRx.
AARP Prescription Discounts
Provided by Optum Rx, with a network of more than 66,000 pharmacies.
NeedyMeds
A nonprofit card that says it works at more than 63,000 pharmacies, plus assistance information.
When no price is affordable.
Not a pharmacy and not a discount. A directory for employees who need manufacturer assistance.
TrumpRx is a catalog, not a pharmacy.
It sends the employee to someone else to buy, so the useful question is what it adds that GoodRx, Cost Plus Drugs and Amazon Pharmacy did not already offer.
What It Adds
Cash prices on brand-name drugs negotiated with manufacturers. Published examples include injectable Wegovy and Ozempic from $199 a month and Zepbound from $299, against list prices above $1,000.
What It Repeats
Generic prices that were already one search away. Post-launch reporting found that more than half of the listed brand drugs have, or soon will have, cheaper generics elsewhere, and the generic listings draw on the same three vendors.
Who It Helps
Uninsured people, and people whose plan excludes the drug, such as some weight-loss and fertility medications. Analysts describe its reach as narrow because it only applies to a person paying cash.
Who It Does Not
Employees with a $0 to $20 copay, whose plan price is usually lower. Plan-negotiated prices typically count toward the deductible and cash purchases do not, so a lower sticker price can raise total yearly spending.
What a cash purchase does to the plan.
Every item below comes from one fact: the claim never reaches your carrier or pharmacy benefit manager.
Deductible and Out-of-Pocket Maximum
Cash and coupon purchases are generally not credited to either one. Whether a plan will credit receipts a member submits is a plan-document question, and the carrier answers it. Employees who want credit should ask the carrier before assuming it applies, and keep receipts. Employers should avoid telling staff that outside purchases will count unless the plan says so.
Claims Data
The fill is invisible to your carrier or PBM. Adherence reports, utilization trends and renewal underwriting all run on claims, so drugs bought outside the plan can make a population look different than it is. Employers reviewing renewal data may want to ask how the carrier accounts for this gap.
Safety Checks
Interaction and duplicate-therapy checks run across the fills a pharmacy can see. An employee who splits prescriptions between the plan and a cash pharmacy can end up with no one seeing the whole list. Employees should tell their pharmacist and doctor about every source of medication.
Care Management Programs
Condition-management and disease-management programs that trigger on claims will not see drugs bought outside the plan, so outreach can be missed or misdirected. Employers whose programs seem to reach fewer people than expected should consider that outside fills are one possible reason, and ask the carrier how it identifies members for outreach.
HSA, FSA and HRA Funds
Prescription costs are generally qualified medical expenses, so these accounts can usually pay for them. Check subscription fees separately: Amazon says RxPass cannot be paid with HSA or FSA funds. Account rules differ by account type and plan, and tax treatment can vary, so employees should confirm with their account administrator or tax adviser.
Plan Design Already in Place
Deductible waivers, $0 generics and copay tiers on high-deductible plans often make the in-plan price lower than any cash price. Look for these before telling employees to go outside the plan. A quick check of the plan’s drug list and tier structure for a handful of common prescriptions usually answers the question.
When cash wins, and when the plan does.
The same program can be the right answer for one employee and the wrong one for the next. These are the patterns we see most.
Cash Wins: No Coverage
Part-time and waiting-period employees, or anyone not eligible for the plan, have no insured price to compare against. Benefits analysts list them among the best fits for Cost Plus Drugs. The comparison is different for them, since cash price is the only price available. They should still compare several sources, because cash prices vary widely by drug and pharmacy.
Cash Wins: Before the Deductible
On a high-deductible plan, a cheap generic can cost less in cash than at the plan’s negotiated rate. The trade is that the spend does not count toward the deductible. Employees who expect to reach the deductible anyway may do better using the plan, so the right choice depends on the drug, the plan and expected spending for the year.
Cash Wins: Excluded Drugs
Weight-loss, fertility and other drugs the plan does not cover have no plan price at all, which is where TrumpRx and manufacturer cash programs matter most. Because there is no plan comparison, employees should compare more than one cash source and confirm that the seller is a legitimate, licensed pharmacy.
Plan Wins: Low Copays
At a $0 to $20 copay the plan is usually cheaper than any cash price, and the claim counts toward the deductible and the out-of-pocket maximum. Copays vary by plan and by drug tier, so the cheapest route is whatever the plan’s own schedule shows, and it is easy to check before the employee pays.
Plan Wins: Maintenance Drugs
Plans with a deductible waiver or $0 cost share on chronic generics beat cash, and keep the data flowing to your care management programs. For anyone taking a drug every month, the saving from a lower plan price repeats, and the claims keep adherence and safety checks working. Employees should check their own copay first.
Plan Wins: High Spenders
An employee likely to reach the out-of-pocket maximum anyway gains from putting every claim through the plan, since cash spend never accrues toward that limit. Employees close to that limit, for example after a hospital stay or a costly specialty drug, should generally avoid pulling individual fills out of the plan.
What an employer should do about it.
You cannot stop employees from using these, and you should not try. You can make sure the plan, the message and the data are ready.
Decide What You Will Say
A short neutral message beats silence and beats an endorsement: these are options outside the plan, here is what they do to the deductible, and here is who to call before switching a maintenance drug. Review the wording with counsel or your adviser if you plan to put it in writing.
Ask Your PBM Three Questions
Does the plan credit member-submitted receipts? Is there a deductible waiver on common generics? Is there a lower-cost pathway that still shows the claim to the plan? Written answers from the PBM or carrier are worth keeping so employee guidance stays consistent from year to year.
Compare the Plan Price to the Cash Price
Run the top generics by volume. If cash is repeatedly lower than what your plan pays, that is a contract question for the PBM, not an employee-behavior problem. Include price, quantity and days supply in the comparison so the two numbers are measuring the same thing.
Treat Them as a Supplement
The general guidance is to weigh the cost and clinical implications before promoting a cash vendor and to use it alongside the plan, not instead of it. A cash price can be a useful option in specific situations, but it should not replace a conversation with the prescriber or the plan.
Watch Specialty and GLP-1 Cost Separately
The biggest dollars are in brand drugs, where TrumpRx pricing now sets a public reference point. Our GLP-1 coverage guide covers the plan side.
Do Not Rely on One Vendor’s Terms
Prices, fees, eligibility and partners on all of these change. Re-check the numbers before each open enrollment, and before any employee communication goes out. Keep a dated record of what was checked, so an employee question months later can be answered against what was true at the time.
Every cash-price option, in one place.
Each program below has its own section: what it is, what it costs, where it works, how it treats the deductible, and when it fits or does not. As published in October 2026; terms change, so confirm before pointing employees to one.
RxAssist · NeedyMeds · AARP Prescription Discounts · America’s Pharmacy · NovoCare Pharmacy · LillyDirect · Capital Rx · SmithRx · RxSaveCard · Honeybee Health · Costco Pharmacy · Walmart’s $4 list · Blink Health (BlinkRx) · RxSaver · ScriptSave WellRx · Optum Perks · SingleCare · TrumpRx · Amazon Pharmacy · Cost Plus Drugs · GoodRx
RxAssist and your health plan: a directory of manufacturer assistance programs.
RxAssist is not a pharmacy or a discount card. It is a database of patient assistance programs, credited to RxVantage. It matters because it is the route for people who cannot afford a drug at any price. It is one of several options on our cash-price pharmacy comparison.
What It Is
A patient assistance database that lists programs offered by drug manufacturers and others.
What It Costs
Looking up programs is free. Whether a program charges anything depends on the program.
Where It Works
It is a directory, not a pharmacy. Eligibility and applications are handled by each program.
Insurance
It is not insurance. Many programs have income or coverage requirements.
Deductible Treatment
Free drug from a manufacturer program is generally outside the plan, and does not accumulate toward the deductible.
Claims Data
Assistance programs usually leave no claim in your data.
It Fits When
You have employees on high-cost brand drugs and want a resource for them to research.
Skip It When
You expect it to lower plan costs. It is an employee referral, not a plan tool.
NeedyMeds and your health plan: a nonprofit discount card and assistance directory.
NeedyMeds is a nonprofit. It offers a free discount card that says it works at more than 63,000 pharmacies and offers savings of up to 80%. It also maintains information on assistance programs. It is one of several options on our cash-price pharmacy comparison.
What It Is
A nonprofit that provides a free discount card and information about assistance programs.
What It Costs
Free. NeedyMeds says the card can save up to 80% at more than 63,000 pharmacies. Actual savings vary by drug.
Where It Works
At participating pharmacies. The assistance information is separate and not tied to a pharmacy.
Insurance
It is not insurance. The card lowers cash prices.
Deductible Treatment
Card purchases may not count toward the deductible.
Claims Data
Nothing flows to your PBM.
It Fits When
You want a nonprofit option to point lower-wage employees or families to, or you run a wellness or employee assistance program.
Skip It When
You need an integrated benefit with claims visibility.
Does it count toward the deductible?
Generally no.
AARP Prescription Discounts and your health plan: an Optum Rx card for the 50-plus crowd.
AARP Prescription Discounts is provided by Optum Rx and works at more than 66,000 pharmacies, according to the program. It is closely related to Optum Perks. It is one of several options on our cash-price pharmacy comparison.
What It Is
A discount card provided by Optum Rx, with a published network of more than 66,000 pharmacies.
What It Costs
Free to use, as discount cards typically are. Prices vary by drug and pharmacy.
Where It Works
At participating pharmacies. It is a cash-price tool and does not replace Medicare Part D or employer coverage.
Insurance
It is not insurance and does not replace a plan.
Deductible Treatment
Purchases are cash purchases and may not count toward the deductible.
Claims Data
Nothing flows to your PBM or carrier.
It Fits When
You have older workers or retirees asking about price checks and want to give a clear answer.
Skip It When
You need plan-visible spend or a program that integrates with your coverage.
Does it count toward the deductible?
Generally no.
America’s Pharmacy and your health plan: another discount card from a familiar operator.
America’s Pharmacy is a free prescription discount card that says it works at more than 51,000 pharmacies. It is run by the same company as ScriptSave WellRx, so the plan effects are the same. It is one of several options on our cash-price pharmacy comparison.
What It Is
A prescription discount card with a published network of more than 51,000 pharmacies.
What It Costs
Free to the user, as discount cards typically are. Prices vary by drug and pharmacy.
Where It Works
Operated by Medical Security Card Company, LLC in Tucson, the same operator as ScriptSave WellRx. Employees do not need a sign-up.
Insurance
It is not insurance. It lowers a cash price at the counter.
Deductible Treatment
Purchases made with the card are cash purchases and may not count toward your deductible.
Claims Data
Nothing flows to your PBM. You will not see these fills.
It Fits When
An employee wants a quick price check, or you want a fallback for people without coverage.
Skip It When
You need spend counted toward deductibles or visible in claims data.
Does it count toward the deductible?
Generally no.
NovoCare Pharmacy and your health plan: Novo Nordisk’s self-pay route for Wegovy and Ozempic.
NovoCare Pharmacy is Novo Nordisk’s direct channel, operated by CoAssist Pharmacy. Self-pay prices are published and have been changing, which makes it relevant to employers who are weighing GLP-1 coverage. It is one of several options on our cash-price pharmacy comparison.
What It Is
A manufacturer-direct pharmacy for Novo Nordisk medicines, operated by CoAssist Pharmacy.
What It Costs
As published in October 2026: Wegovy pill $149, $199 or $299 by dose; Wegovy pen $199 for the first two fills through 12/31/2026, then $349; Wegovy HD $399. Ozempic pill $149; Ozempic pen $199, then $349 or $499. Confirm current prices before using them.
Where It Works
Novo Nordisk products only. A separate offer of $25 per month for insured patients has a stated $100 cap. Read the terms.
Insurance
Self-pay is an alternative to coverage, not a replacement. Some employees may be covered and still compare.
Deductible Treatment
Self-pay purchases do not run through the plan and generally do not count toward the deductible.
Claims Data
Direct purchases create no claim. You may see fewer GLP-1 claims than employees are actually using.
It Fits When
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.
Skip It When
You cover GLP-1s and rely on claims data for utilization management, clinical programs or stop-loss reporting.
Does it count toward the deductible?
Usually not. Ask your carrier.
LillyDirect and your health plan: manufacturer-direct access for select Lilly medicines.
LillyDirect is Eli Lilly’s own channel. It offers telehealth, doctor search and home delivery of select Lilly medicines. For employers, the question is the same as with any cash-price route: what does it do to your plan and your data? It is one of several options on our cash-price pharmacy comparison.
What It Is
A manufacturer-run service. Lilly describes it as offering telehealth, doctor search and home delivery of select Lilly medicines.
What It Costs
Prices are set by Lilly and vary by medicine. Check the site for current self-pay prices and any program terms before pointing employees to it.
Where It Works
Lilly medicines only. It is not a general pharmacy and does not cover other manufacturers’ products.
Insurance
It is a way to buy select medicines directly. It does not replace coverage, and some products may still be covered by your plan.
Deductible Treatment
Self-pay purchases generally do not run through the plan. Ask your carrier whether outside spend can be submitted for credit.
Claims Data
Direct purchases leave no claim in your PBM data, so utilization for these drugs may be understated.
It Fits When
Employees are already using it and you want to plan for the data gap, or covered alternatives cost more than the self-pay price.
Skip It When
You rely on plan data to manage a high-cost drug category, or you have not reviewed prescribing and safety questions with your carrier.
Does it count toward the deductible?
Usually not, because it runs outside the plan. Check with your carrier.
Capital Rx and your health plan: a PBM platform with a discount card on the side.
Capital Rx is a pharmacy benefit manager founded in 2017 and now part of Judi Health. It also offers a discount card. We cover both sides because they affect your plan differently. It is one of several options on our cash-price pharmacy comparison and our guide to employer-funded PBMs.
What It Is
A pharmacy benefit manager built on its Judi platform. Capital Rx is part of Judi Health and was founded in 2017.
What It Costs
As a PBM, priced under a contract with the plan. Its discount card has been described with a $0.99 white-label fee. Confirm current terms with the vendor.
Where It Works
Inside the plan for PBM services. The discount card works outside it, like other cash-price cards.
Insurance
As a PBM it administers your benefit. The discount card is separate and is not insurance.
Deductible Treatment
Plan claims count under your plan design. Discount card purchases are cash purchases and may not count. Confirm before telling employees.
Claims Data
PBM claims are visible to the plan. Card purchases may not be. Ask which reporting covers which.
It Fits When
You are evaluating PBMs for a self-funded plan, or you want a branded discount card as a supplement for people without coverage.
Skip It When
Your carrier controls the PBM and you only need a simple price lookup for employees.
SmithRx and your health plan: a transparent PBM, not a coupon.
SmithRx is a pharmacy benefit manager, so it sits inside the plan rather than beside it. It belongs in this comparison because it is the employer-side answer to the same price problem. Here is what it says about itself and what changes for your plan. It is one of several options on our cash-price pharmacy comparison and our guide to employer-funded PBMs.
What It Is
A transparent pharmacy benefit manager. SmithRx claims savings of 20% or more for employers.
What It Costs
Priced as a PBM contract. A 2026 Transcarent release said SmithRx passes through 100% of rebates and discounts. Confirm the pricing model in your own agreement.
Where It Works
Inside the plan. Claims run through the benefit and count as usual. Cost Plus Drugs is listed as a home-delivery option in Transcarent WayFinding alongside SmithRx and CapitalRx.
Insurance
This is the plan. Switching PBMs changes who processes your pharmacy claims and how they are priced, not whether employees have coverage.
Deductible Treatment
Claims adjudicated through the plan count the way your plan design says. That is the main difference from a coupon or cash card.
Claims Data
Full claims data flows to the plan. Ask about reporting detail, audit rights and how rebates are shown.
It Fits When
You are self-funded or have a say in PBM selection, and you want rebate and pricing transparency with full claims data.
Skip It When
You are fully insured in a small group where your carrier chooses the PBM, or you only want a quick price check tool for employees.
RxSaveCard and your health plan: an employer-funded cash card that sits beside the plan.
RxSaveCard says it lets employers fund a cash-price prescription card that works at more than 65,000 pharmacies and bypasses the PBM. That is a different model from a free coupon, because the employer pays. Here is what it says about itself and what we would ask before adopting it. It is one of several options on our cash-price pharmacy comparison.
What It Is
A prescription card sold to employers. RxSaveCard says it works at more than 65,000 pharmacies and bypasses the pharmacy benefit manager.
What It Costs
The employer funds the benefit. RxSaveCard has described an example of a $25 monthly allowance per employee. Ask for the actual fee schedule and how unused allowance is handled.
Where It Works
Pharmacies in its network, as the vendor describes it. Employees present the card at the counter for drugs they choose to buy at cash prices.
Insurance
The card sits outside your medical and pharmacy plan. It does not replace your carrier or PBM, and it is not insurance.
Deductible Treatment
Whether cash purchases count toward the deductible or out-of-pocket maximum is not stated in what we reviewed. Ask in writing and do not assume they do.
Claims Data
Purchases on the card do not flow through your PBM as claims, so your utilization reports will not show them unless the vendor provides its own reporting. Ask what exists.
It Fits When
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.
Skip It When
You need every dollar counted toward deductibles or visible in carrier data, or you have not seen the contract and reporting terms.
Does it count toward the deductible?
We could not confirm that from public material. Get the answer in writing, and check it against how your carrier treats outside purchases.
Honeybee Health and your health plan: a mail-order pharmacy that skips insurance.
Honeybee Health is a mail-order pharmacy that does not accept insurance at all. That makes the trade-off unusually clear: a flat cash price in exchange for staying entirely outside the plan. It is one of several options on our cash-price pharmacy comparison.
What It Is
A California-based mail-order pharmacy. Honeybee says it does not accept insurance and that most customers pay less because it sells generics without insurer fees. The employee needs an existing prescription.
What It Costs
Honeybee publishes prices per drug with no membership fee. Shipping is free on orders over $40. Honeybee does not offer a price comparison on its page, so check against your plan.
Where It Works
Mail order to all 50 states, Washington DC and Puerto Rico. Honeybee’s pharmacists obtain the prescription from the employee’s doctor or pharmacy, and carry most common generic medications.
Insurance
Honeybee does not accept insurance, so every fill is a cash purchase and cannot be billed to the plan.
Claims Data
The fill never reaches your carrier or PBM, so adherence and utilization reports will not include it.
It Fits When
An uninsured employee; a maintenance generic with a stable price; someone who values mail delivery and published prices.
Skip It When
A prescription needed today; a plan with $0 generics; any employee who needs the spend counted toward the deductible.
Costco Pharmacy and your health plan: a membership-warehouse price, open to non-members.
Costco’s pharmacy is often cited as one of the cheapest cash options in retail, and non-members can use it. Its member discount program is not insurance, so the employer questions are familiar. It is one of several options on our cash-price pharmacy comparison.
What It Is
A pharmacy inside a membership warehouse. Costco members can join the Member Prescription Program at no additional charge; Costco says it is not insurance and does not pay or reimburse anything. Reporting says membership-club pharmacies must serve non-members, but the program discounts are a member benefit.
What It Costs
Regular cash price for anyone, a program price for members, and the option to compare a coupon such as GoodRx at the counter. Costco says program savings range from 2% to 40% or more depending on the drug. Reported sample member prices on common generics ran from under $9 to under $12, and may have changed.
Where It Works
Costco pharmacy counters, Costco mail order, and many participating pharmacies such as Walgreens, Safeway and Vons. Reporting says standard mail shipping is free but takes 7 to 10 business days, so it suits maintenance drugs more than urgent needs.
Claims Data
Fills paid through the discount program do not reach your carrier or PBM.
Insurance Billing
Costco pharmacy counters may also bill insurance, depending on your plan’s network. Costco says the program cannot be combined with Medicare, Medicaid or state programs and cannot be used as a secondary billing source. Confirm that Costco is in network before telling employees to use it.
It Fits When
A steady maintenance generic; an uninsured employee; someone who already shops at Costco and prioritizes savings over speed.
Skip It When
An urgent prescription, because mail order is slow; a low copay; an employee who needs the claim credited to the deductible.
Walmart’s $4 list and your health plan: the oldest cash price in retail.
Walmart’s $4 list needs no card, no app and no coupon. It is simply a posted cash price on select generics. That simplicity is the appeal, and the employer questions are the same as for every cash option. It is one of several options on our cash-price pharmacy comparison.
What It Is
A Walmart program offering select generic drugs, at commonly prescribed dosages, at a flat low cash price. The full drug list is published by Walmart.
What It Costs
Walmart advertises a 30-day supply starting as low as $4 and a 90-day supply starting as low as $10. Some prices may vary by state, including California and Minnesota.
Where It Works
At Walmart pharmacies. Pricing may be limited to select manufacturers and is available while their supply is in stock at the dispensing pharmacy, and prepackaged drugs are covered only in the unit sizes on the list.
Claims Data
If the employee pays cash, your carrier or PBM does not see the fill.
It Fits When
An employee without coverage; a common generic on the list while under a high deductible; a short course of a basic medication.
Skip It When
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.
Does it count toward the deductible?
Walmart does not say. Treat a cash purchase as generally not counting, and ask your carrier.
Blink Health (BlinkRx) and your health plan: pay first, then delivered or picked up, outside the plan.
Blink Health works differently from a coupon card: the employee pays Blink online and then collects the drug. The employer effect is the same, because the plan is never billed. Blink Health is also known as BlinkRx. This summary combines BlinkRx’s current site with earlier reporting, so confirm current terms before telling employees about it. It is one of several options on our cash-price pharmacy comparison.
What It Is
An online pharmacy and prescription savings service, also known as BlinkRx. The doctor sends the prescription to BlinkRx, the patient gets a text showing the lowest price and pays online or by phone, and the medicine is delivered from a local network pharmacy at no charge. BlinkRx also works with drug manufacturers; its site does not describe an employer program.
What It Costs
BlinkRx advertises discounts of up to 80% that are applied automatically, and free home delivery in 50 states. Earlier reporting describes no sign-up fee, monthly fee or claim form. The price is paid up front and can differ by option.
Where It Works
Network pharmacies across the U.S., with auto-refills and prescription transfers. BlinkRx’s site does not explain how it interacts with insurance; earlier reporting says Blink savings cannot be stacked on insurance, so the employee chooses the cheaper of the two for each fill.
Insurance
Earlier reporting says Blink savings cannot be combined with insurance on the same fill, and BlinkRx’s site does not say otherwise. The employee picks BlinkRx or the plan.
Claims Data
The fill does not reach your carrier or PBM, so it is missing from utilization and adherence reports.
It Fits When
An employee without coverage; a drug the plan excludes; someone who prefers a fixed price paid in advance.
Skip It When
A low copay; a deductible waiver on the drug; an employee who will reach the out-of-pocket maximum anyway.
RxSaver and your health plan: a coupon search that never touches the plan.
RxSaver is a free coupon search that asks for no sign-in. That makes it easy for employees to use and invisible to you. Here is what it says about itself and what it means for the plan. It is one of several options on our cash-price pharmacy comparison.
What It Is
A free prescription discount service that offers coupons for medications. RxSaver says it is not insurance and that its coupons may offer a lower discount than your insurance copay.
What It Costs
Free, with no sign-in or membership required. RxSaver advertises savings of up to 80% off the pharmacy’s cash price, and says prices vary by location.
Where It Works
Thousands of pharmacies nationwide, including Walgreens, Walmart, CVS, Costco and Kroger. The employee searches a drug, gets a coupon and shows it to the pharmacist at checkout.
Insurance
RxSaver says its coupons cannot be used with commercial health plans, Medicare or Medicaid. The employee uses the coupon instead of the plan for that fill.
Claims Data
Your carrier or PBM does not see the fill, so adherence and utilization reports undercount that employee’s drugs.
It Fits When
An employee without coverage; a cheap generic while under a high deductible; a drug the plan excludes.
Skip It When
A low copay; a deductible waiver on the drug; an employee who will reach the out-of-pocket maximum anyway.
ScriptSave WellRx and your health plan: a discount card, not coverage.
ScriptSave WellRx is one of the older discount card programs and is marked clearly as discount only. It is worth knowing about because it is accepted at independent pharmacies the larger apps sometimes miss, and because employers still run into it. It is one of several options on our cash-price pharmacy comparison.
What It Is
A free prescription discount program, operated by Medical Security Card Company, LLC. It states it is discount only and not insurance.
What It Costs
Free. WellRx says savings average 75% and run up to 80% or more against cash retail prices. The member pays the full discounted price, and the program does not pay the pharmacy.
Where It Works
WellRx says more than 54,000 pharmacies nationwide, including chains such as Walmart, CVS, Albertsons and Kroger. The employee shows the card or the free app at the counter each time.
Insurance
WellRx says the discount cannot be used in conjunction with insurance. The employee picks card or plan for each fill.
It Fits When
An employee without coverage; a generic at an independent pharmacy; a drug the plan excludes.
Skip It When
A low copay; a deductible waiver; anyone whose care management program depends on claims data.
Does it count toward the deductible?
Generally no, because the plan is not billed. Confirm with your carrier.
Optum Perks and your health plan: a free card that stays outside the plan.
Optum Perks is a free discount card run by Optum Perks, LLC, an RVO Health company. Optum Perks states plainly what the card does to the deductible, which makes it useful for explaining the trade-off to employees. It is one of several options on our cash-price pharmacy comparison.
What It Is
A free prescription discount card and app that says it negotiates lower prices with pharmacies. The program is not insurance, and Optum Perks, LLC describes itself as an RVO Health company.
What It Costs
Free. The card advertises savings of up to 80% on prescriptions, and the employee shows a discount code at the pharmacy, which applies the discount immediately.
Where It Works
Pharmacies in the program’s network, so the employee should confirm that their pharmacy participates. The app helps find participating pharmacies.
Insurance
Optum Perks says you generally cannot use a discount card together with insurance, so the employee chooses card or plan for each fill.
Claims Data
A card fill is not billed to the plan, so your carrier or PBM does not see it.
It Fits When
An employee without coverage; a cheap generic while under a high deductible; a drug the plan excludes.
Skip It When
A low copay; a deductible waiver on the drug; an employee who will reach the out-of-pocket maximum anyway.
Does it count toward my deductible?
No. Optum Perks says a purchase made with the card instead of insurance will not contribute to a deductible or an out-of-pocket maximum.
SingleCare and your health plan: another coupon, same trade-off.
SingleCare works like GoodRx and sometimes beats it on price. The employer questions are the same: a coupon fill happens outside the plan. Here is what SingleCare says about itself and what that means for your plan. It is one of several options on our cash-price pharmacy comparison.
What It Is
A free prescription discount service that negotiates lower prices with pharmacies. SingleCare says it is not insurance.
What It Costs
Free. Membership is also free and adds bonus savings and $3 off a first eligible prescription. SingleCare advertises savings up to 80% off the cash price, and prices vary by pharmacy.
Where It Works
More than 35,000 pharmacies. Walgreens, Walmart and CVS have signature SingleCare cards. The employee shows the card and asks the pharmacist to process the fill with it. The card does not expire and anyone can use it.
Insurance and the Deductible
SingleCare says it can be used whether or not you have insurance, but cannot be combined with insurance on the same fill. It does not say whether the spend counts toward a deductible, so assume it does not and confirm with the carrier.
Claims Data
A coupon fill is not billed to the plan, so your carrier or PBM does not see it.
It Fits When
An employee without coverage; a generic where SingleCare beats both the plan and GoodRx that day; a drug the plan excludes.
Skip It When
A low copay; a $0 generic under a deductible waiver; any employee who needs the claim counted toward the deductible.
TrumpRx and your health plan: a price catalog, not a pharmacy.
TrumpRx is a federal website that lists discounted cash prices and sends you elsewhere to buy. It can help employees whose plan excludes a drug. It is much less useful for someone with a normal copay. Here is how to read it. It is one of several options on our cash-price pharmacy comparison.
What It Is
A federal site launched February 5, 2026, listing discounted cash prices from manufacturers that reached agreements with the administration. It is not a pharmacy: it does not sell, dispense or ship medicine.
What It Costs
The site is free and the drug is cash-pay. Published examples include injectable Wegovy and Ozempic as low as $199 a month and Zepbound from $299, against list prices above $1,000.
Where It Works
You search a drug and are sent to a coupon, a manufacturer’s site or a pharmacy to buy. In May 2026 it added more than 600 generics, with GoodRx, Cost Plus Drugs and Amazon Pharmacy pricing alongside.
Claims Data
A cash purchase through a manufacturer or coupon never reaches your carrier or PBM, so a GLP-1 or specialty brand bought this way is invisible to your plan.
It Fits When
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.
Skip It When
A generic, which is cheaper elsewhere; an employee with a low copay; anyone who needs the spend counted toward the deductible.
Amazon Pharmacy and your health plan: a pharmacy that can bill the plan, and a subscription that cannot.
Amazon is two different things here: a pharmacy that bills many insurance plans, and RxPass, a flat monthly subscription that sits outside insurance. Employees mix them up, and the difference decides what happens to the deductible. It is one of several options on our cash-price pharmacy comparison.
What It Is
An online pharmacy that fills prescriptions by mail, and same day in some cities. It bills many insurance plans as well as taking cash. RxPass is a separate subscription for Prime members covering more than 50 common generics.
What It Costs
At the pharmacy: the plan copay or the cash price. RxPass: a flat $5 a month, charged on the first of each month with a prorated first month. It requires Amazon Prime.
Where It Works
Mail order nationwide. RxPass does not ship to California or Washington, is not open to Medicaid or CHIP members, and only one person per account can enroll.
It Fits When
An employee with Prime who takes one or more listed generics; an insured employee who wants mail delivery billed through the plan.
Skip It When
Someone without Prime; a Medicaid or CHIP member; an employee in California or Washington (for RxPass); a brand or specialty drug, which RxPass excludes.
Cost Plus Drugs and your health plan: transparent pricing, outside the plan.
Cost Plus Drugs publishes exactly how it prices, which is why employers hear about it. It is also a mail-order pharmacy that mostly sits outside the plan. Here is how it works, what it means for the deductible and your data, and who it suits. It is one of several options on our cash-price pharmacy comparison.
What It Is
Mark Cuban Cost Plus Drug Company runs a mail-order pharmacy that publishes its formula: what it paid for the drug, plus a 15% markup, plus a $5 dispensing fee. Shipping is added.
What It Costs
No membership fee and no coupon. The price is the three-part formula above, so two employees see the same price for the same drug. Reported shipping starts around $5 and rises with larger orders; confirm current rates.
Where It Works
Mail order from its own site, and as a listed source on TrumpRx. The formulary is mostly generics; brand and specialty drugs are largely unavailable. It accepts few insurance plans, so most employees pay by card.
Claims Data and Care Management
Industry analysis notes the plan does not capture these fills, which creates gaps in claims data and adherence metrics and keeps the drugs out of disease-management programs that trigger on claims.
It Fits When
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.
Skip It When
A brand or specialty drug; a prescription needed today; a plan with $0 generics; anyone who needs the claim counted toward the deductible.
GoodRx and your health plan: a coupon, not a benefit.
GoodRx is the name employees search first, and its prices are often below a copay. It works by stepping outside the plan for that fill. Here is what it is, what it does to your deductible and your data, and where it makes sense. It is one of several options on our cash-price pharmacy comparison.
What It Is
A free app and website that shows coupon prices for a drug at nearby pharmacies. GoodRx says it is not insurance and that it does not set the prices itself: coupon prices are negotiated between pharmacies, or their purchasing groups, and pharmacy benefit managers.
What It Costs
Free to use. GoodRx advertises savings of up to 80% against the cash price. It also sells an optional paid Gold membership; confirm the current price and which pharmacies it covers before recommending it.
Where It Works
GoodRx says about 70,000 U.S. pharmacies accept its coupons. The employee shows the coupon at the counter and pays the coupon price, and the fill is not billed to the health plan.
Claims Data
Your carrier or PBM does not see a coupon fill, so adherence and utilization reports undercount that employee’s drugs.
It Fits When
An employee without coverage; a cheap generic while still under a high deductible; a drug the plan excludes.
Skip It When
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.
The ten questions that come up when an employee mentions a discount card.
Plain answers, as of October 2026.
Is GoodRx insurance?
No. GoodRx is a free price-comparison and coupon service, and it says so itself. An employee uses it in place of the plan for a single fill, not alongside it.
Can an employee use a discount card and the health plan on the same prescription?
Not for the same fill. The coupon price replaces billing the plan, which is why the purchase generally does not count toward the deductible. They can use the plan one month and a card the next.
Does a cash or coupon purchase count toward our deductible?
Generally no. Plan-negotiated prices count, and cash prices do not. Some plans will credit receipts a member submits; that is a plan-document question, so ask the carrier or PBM.
How does Cost Plus Drugs set its prices?
It publishes a formula: what the pharmacy paid for the drug, plus a 15% markup, plus a $5 dispensing fee, with shipping added. It is cash-based and weighted toward generics.
Is Amazon RxPass worth it for our employees?
It can be for an employee who already has Prime and takes one or more of the 50-plus covered generics. It is not insurance, it excludes Medicaid and CHIP members, it does not ship to California or Washington, and the fee cannot be paid with HSA or FSA funds.
Is TrumpRx a pharmacy?
No. It is a federal price catalog. It shows discounted cash prices and sends you to a coupon, a manufacturer or a partner pharmacy to buy. Since May 2026 it also lists more than 600 generics, using pricing from GoodRx, Cost Plus Drugs and Amazon Pharmacy.
Does TrumpRx replace our pharmacy benefit?
No. Its main value is for people paying cash, especially for brand drugs a plan excludes. For an employee with a low copay the plan is usually cheaper, and the plan claim counts toward the deductible.
Should we tell employees about these programs?
Yes, neutrally. Employees will find them anyway. A short note that explains what they do to the deductible and who to call first protects them more than silence or an endorsement does.
Do we need to change our plan design because of these?
Not automatically. Start by checking whether you already have deductible waivers or $0 generics, and whether the plan price on your top generics is higher than the best cash price. That comparison tells you whether there is a contract problem.
Can a cash-price vendor be connected to the plan so the claim counts?
Sometimes. Some pharmacy benefit managers have published employer materials on connecting Cost Plus Drugs to the benefit, and availability depends on your carrier or PBM. We evaluate that as part of a pharmacy benefit review.
Ready? Send us your renewal or pharmacy report, or talk it through with someone first. No cost, no obligation.
General information about publicly available programs, not medical, tax or legal advice. Prices, eligibility and terms change; confirm with each program and with your carrier or pharmacy benefit manager.
Related reading: Michigan Carrier Member Discount Programs
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