Is it legal to pay cash for your prescriptions if you have insurance? It’s a question many pharmacy patients have either asked or thought about. The answer: It’s not only legal, but also your right. And the best part — paying cash for your prescriptions could save you money.

According to Avalere Health, a health care data analytics and consulting firm, 91% of prescriptions in the U.S. are filled through insurance. While reaching for your insurance card at the pharmacy is the default approach, it’s not the only way to pay.

In our recent Rewriting the Script Report, 31% of respondents said they primarily pay out of pocket for their medications and 61% of insured individuals have paid out of pocket despite having insurance. The biggest driver of this payment approach: High-deductible health plans (HDHPs).

A 2023 study from Kaiser Family Foundation found enrollment in HDHP plans has increased over the past decade, from 19% of covered workers in 2012 to 29% in 2022. With the rising co-pays of HDHPs, patients can sometimes overpay for their prescriptions when using insurance. This trend is forcing cost-conscious customers to find new ways to save.

Paying the cash price means you can bypass additional fees and middlemen that can cause price hikes when you pay with insurance. These added costs can run as high as $30 per prescription, according to a recent analysis by Kaiser Health News.

Millions of Americans leave their prescriptions at the pharmacy, skip doses, or stop taking their medications because of the cost — in fact, an estimated 81 million prescriptions never get picked up. When medications get left at the pharmacy because the price is too high, better health gets left behind, too. But when patients feel confident they’re getting the best value and know they have options for the way they pay, they’re more likely to leave with the medicine they need.

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The savings that come with paying cash depend on the type of medication and insurance benefits you may have. And while cash isn’t the answer every time, it’s always worth the ask. You never know, the savings could be substantial.

So, the next time you’re at the pharmacy counter ready to pay for your prescription, ask for the cash price. It might be a better deal to leave your insurance card in your pocket.