Written and medically reviewed by Dorcas Morak, Pharm.D
Paying for prescriptions can get confusing—especially when you’re navigating insurance terms like copays, coinsurance, and prescription discounts. Each one affects how much you pay at the pharmacy counter. Depending on the medication and your coverage, one option may save you significantly more. Whether you’re on a daily generic like metformin, managing blood pressure with losartan, or using a specialty drug like Ozempic, here’s what you need to know to make smart choices and save money in 2025.
What Is a Copay?
A copay is a flat fee you pay for a medication or health service—usually determined by your insurance plan’s formulary. For example, you may be charged $10, $30, or $50 when filling a prescription, depending on whether it’s a generic, preferred brand, or specialty medication.
Here’s how it works:
- You pay a set price per fill, regardless of the drug’s retail cost.
- Copays are predictable and are not tied to your deductible.
- They are common for widely prescribed chronic condition medications like:
- Atorvastatin (Lipitor) – for cholesterol
- Glipizide (Glucotrol) – for diabetes
- Amlodipine (Norvasc) – for high blood pressure
- Levothyroxine (Synthroid) – for thyroid disorders
What Is Coinsurance?
Unlike copays, coinsurance is a percentage of a drug’s retail price that you pay after meeting your annual deductible. For example, if you're prescribed Ozempic, which retails around $900, and your plan has a 20% coinsurance rate, you would pay $180 out of pocket, while your insurer covers the remaining 80%. Key things to know:
- Coinsurance varies by drug tier and is often higher for new or specialty medications.
- Your cost is unpredictable because it depends on the retail price of the drug.
- Common for high-cost or complex-condition medications like:
What About Prescription Discounts?
Prescription discounts are offered through third-party savings programs, manufacturer coupons, or pharmacy networks such as the RxLess® Assurance Plan. These discounts reduce your out-of-pocket costs—even if you don’t have insurance—and can sometimes beat your copay or coinsurance.
Medications frequently eligible for discounts in 2025 include:
Generics:
Brand-name drugs:
Which Option Offers the Best Savings?
It depends on your insurance, medication, and financial situation:
- For generics like metformin or amoxicillin: Copays or discounts from the RxLess® Assurance Plan usually offer the best value.
- For expensive brand-name or specialty medications like Eliquis, Ozempic, or Humira: Compare your copay or coinsurance with any available manufacturer coupons.
- If you’re uninsured or have a high deductible: Discounts from the RxLess® Assurance Plan can offer major savings—sometimes even more than your insurance plan.
How Can You Compare Costs Effectively?
To get the best discount every time you fill a prescription:
- Review your insurer’s drug formulary to understand if you’re paying a copay or coinsurance.
- Check the retail price at your preferred pharmacy.
- Use the RxLess® Assurance Plan to find discounts that may beat your copay or coinsurance.
Note: You cannot combine a discount from the RxLess® Assurance Plan with your insurance. It’s either one or the other.
When Should You Use a Discount Instead of Insurance?
Consider using the RxLess® Assurance Plan if:
- Your medication isn’t covered or falls under a high-tier cost-sharing structure
- You’re in the deductible phase of your plan and paying full price
- You’re filling a prescription at a new pharmacy and want to compare prices ahead of time
- You’re prescribed an uncovered medication like:
Final Tip:
The RxLess® Assurance Plan lets you search real-time prices at over 70,000 pharmacies—including CVS, Walgreens, and Rite Aid—so you never overpay for medication again.
