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I recently received, unsolicited, a set of "pharmacy discount cards" from the "Massachusetts Prescription Assistance Program". The cards offer to save me "up to 75%" on prescription medications at a list of participating pharmacies. A letter is attached encouraging me to use them, and pointing me to their website.

Fine print clarifies that the organization is not associated with the government, and since it's not clear what they are getting out of this, I assume it's a scam, or at least that they're not being forthright. But what is the angle here? What would happen if I used one of the cards and what are they trying to get out of me?

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Note that the "Massachusetts Prescription Assistance Program" appears to be a state-specific page for the "USA Medical Prescription Assistance Program". This is a "prescription discount card" business.

How this works:

If you have insurance, you pay less for prescriptions. This is because your insurance represents a lot of people, and are therefore able to negotiate lower prices. (Prescription drug pricing follows a software model, where there's a huge upfront development cost, but each individual pill doesn't really cost anything, so there's a lot of room to negotiate.)

If you're someone with no or inadequate health insurance, a prescription discount card does basically the same thing. Because a lot of people use their service, it's able to negotiate lower prices. It usually gets a small kickback from each purchased prescription, and as such does not need to charge you anything.

Is it worth it? Eh. The discounts are sometimes good, but other times aren't. If you have an expensive prescription, it can be worth checking, but if you have actual insurance you're probably better off going through it instead. Probably.

https://www.10tv.com/article/bbb-says-prescription-discount-cards-misleading-not-scam

EDIT: A more specific rundown of how this works.

  • Gotcha. So it looks like a scam, but really isn't. Thanks! – Eli Rose -- REINSTATE MONICA Aug 26 at 21:21
  • For what it means on my most expensive prescription (about $300 a fill) those discount cards save me about $100 more than insurance. Most decent pharmacies will try running both and use whatever is cheaper if you ask. – Vality Aug 26 at 21:50
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It's no revelation to state that our health care system in the US has many problems. One of them is the cost of prescription and disparate pricing.

If you have private insurance or Medicare D, the cost of a prescription depends on the Tier level that the provider puts the medication in. If in a higher Tier, in some cases it may actually cost you more for the Rx than the everyday cash price, particularly with Medicare D which unlike the Veterans Administration, is prohibited from negotiating with pharma companies for lower prices.

As an example, I use a common generic ointment. In Tier 1, a 30 gram tube of ointment cost me $1. Last year it was dropped from the insurance company's formulary and my cost became $71. Someone suggested that I check the item at GoodRx, a "pharmacy discount card" provider. Lo and behold, the cash price with the coupon printed from their web site was only $30.

I don't know what GoodRx gets out of this. Similarly, I don't know what your "pharmacy discount cards" from the "Massachusetts Prescription Assistance Program" offer or what they get out of it. And when push comes to shove, does it really matter? Obtaining your medicines for less is the only issue.

Contact the appropriate regulatory agency in Massachusetts to verify that the organization in question is legit. Then start comparison shopping.

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