At my local grocer the pharm techs always seem somewhat baffled when I tell them to remove the insurance and they see my medication price is 50% cheaper. I usually raise my eyebrows as if to say “Really? You don’t see this kind of bullshit on a daily basis?”

Do you try this blindly, to test the cost, or do you somehow know which will be cheaper?

GoodRX app lets you look online for which pharmacies in your area offer discounts with them. So you already know going in that Randalls will charge X with GoodRX and Y with your insurance, Kroger will charge A and B, Walgreens C and D. So yeah you can discover the discrepancy online before you even walk into the store. You simply type your drug and dosage into GoodRx app with your location to get the list and prices. The real hack to get the best prices is to look at larger amounts. I have saved 50% or more on drugs by buying them in 90 day increments instead of 30 day increments (this of course only works with non controlled substances that can be purchased in more than 30 day increments at a time, but that is the vast majority of drugs). There is also no correlation to dosage and prices from what I’ve seen. I was taking 100mg of one drug for awhile, for instance, then I tried to fill 80mg of the same drug at the same place and it was inexplicably double the price

Once in the store you open the GoodRx app and in there is a discount code that they enter into their billing system that will give you the listed price in the app. Oftentimes I have discovered that the pharmacies keep a list of these types of codes (GoodRx is not the only one, just the one people know about the most due to advertising) and once I show them the app they will try a couple of other codes off their list and sometimes I will get a price that is even marginally cheaper (perhaps 5%) than the GoodRx price I showed them.

As to why I have to ask them to remove it, two reasons:

1: most people just assume insurance is always best, when it isn’t.

2: because lol USA healthcare, of course it only makes sense to do this with some of the meds I take and not others. My cholesterol meds are so cheap it doesn’t even matter whether they are insured, and some of my other meds are evergreened to hell and using insurance actually does help. It’s this third class of Expensive But With Actual Competition where this GoodRX stuff comes into play. So half my meds insurance pays for and the other half I pay out of pocket. lol USA healthcare

Goodrx makes money by exploiting the PBM system (which I'm in favor of them doing, to be clear.) If it becomes too popular then something will change in the pharmacy-PBM contracts or the goodrx coupon margin will naturally narrow as they become "the price" and their margins on the rebate sharing narrow as afforded by transaction volume.

Goodrx is great, but it doesn't save money for the majority of insured (for the half of the country on better-than-average plans) and it doesn't bring down costs nearly as much as you'd want for expensive medications. Cycling manufacturer's coupons for expensive medications can match or beat insurance copays when Goodrx won't. (And you'll increasingly find some insurance actually apply a manufacturer's coupon rather than cover directly. I had this happen recently with a 90-day supply of Freestyle Libre 3.)

It depends on the medication.

For generics the discount cards can often make the price lower than the prescription co-pay.