As reported to the New York Times, Americans in most states are not aware that their pharmacists are barred from letting them know that they could save money on their prescription if they just paid the cash price instead of using their insurance. It seems counterintuitive, but it does happen. Asking your pharmacist what the cash price would be may end up saving you some money.
The New York Times reports that pharmacists frequently have what are called “gag clauses” in their agreements with Pharmacy Benefits Managers (PBM) that precludes that from giving you this information, but federal and state officials have expressed concerns over this practice. Already a handful of states have enacted various laws to help protect consumers. Connecticut has banned the gag clauses. North Carolina says that pharmacists have the right to tell their customers what the cost would be using their insurance and any more affordable alternative. Georgia’s law says a pharmacist can’t be penalized for letting their customers know. North Dakota passed a law that both banned gag clauses and said that a PBM or insurer may not charge a co-pay amount that exceeds the cost of the medication. This law is being challenged in the courts.
If you want your pharmacist to be able to tell you if you would save by paying cash, let your federal and state legislators know. Until the law is changed, don’t be afraid to ask or you can always used GoodRx.com to see what the cash price for any prescription would be at pharmacies near you.