Could You Lower Your Prescription Costs on an ACA Marketplace Plan?

Cara Bradley
Nov 2, 2018 · 4 min read

We crunched the numbers to see what one family could pay for their medications on 2019 Marketplace plans — and how much they could save with Blink.

Nearly 12 million Americans signed up for 2018 health plans through the Marketplace, created by the Affordable Care Act (ACA, aka Obamacare). And for the nearly 55% of Americans who regularly take prescription medications, the reality of high drug prices is an important concern, even if they have prescription drug coverage.

So how much might a family pay for their prescription drugs with a 2019 Marketplace plan? And how much could they potentially save by paying for their medications with Blink Health?

To find out, we created a fictional patient: Jessica, a 50-year-old woman who lives in New Jersey with her husband, Joe, who is also 50 years old. Jessica is living with high blood pressure and anxiety, while Joe lives with type 2 diabetes. Together, they take eight different prescription medications each month to manage these health conditions.

The 2019 Marketplace plans available to Jessica and Joe on healthcare.gov include Bronze, Silver and Gold plans. Bronze plans typically have lower monthly payments but higher out-of-pocket costs before the plan begins to pay, while Gold plans usually have higher monthly payments but lower amounts paid out-of-pocket before the plan begins to pay. Silver plans are the most popular plans on the Marketplace.

We took a look at how much Jessica and Joe would pay out of pocket for their prescription medications under the plans’ coverage of generic drugs, plus how much they could save with Blink Health.

If Jessica and her husband paid pharmacy cash prices at CVS for each of their medications, they’d spend an estimated $470 per month. That adds up: over the course of the year, that’s an estimated $5,818 on a Bronze plan, $3,107 on a Silver plan and $2,208 on a Gold plan. This includes cost-sharing under each plan’s generic drug coverage offering which will vary by plan and coverage may not take effect until a patient reaches a certain amount of out-of-pocket spending.

Alternatively, if Jessica and her husband purchased their monthly prescriptions through Blink Health, they would only spend an estimated $772 for the year. Their savings would amount to an average of $5,045 on a Bronze plan and $2,335 on a Silver plan.

Saving money on prescription medications — even with a Marketplace plan — is that easy with Blink Health.

Even with health coverage, many patients are still overpaying on their prescription medications. That’s why Blink Health is on a mission to help all Americans, regardless of coverage status, afford the medications that keep them healthy. To see how much you could save on your prescriptions (whether or not you have a health plan) you can find the Blink Prices of your medications on blinkhealth.com or on the Blink app for Android or iOS. You can compare these Blink Prices to your current out-of-pocket costs to find the affordable medications that you and your family need.


Please note that the fictional patients in this article would not qualify for a discount (subsidy or premium tax credit) on these exchange plans and thus any prices listed are the full estimated costs. Estimated pharmacy retail prices are of October 2018 from a CVS pharmacy location in New Jersey. Annual out-of-pocket Blink Rx costs listed in this article are calculated under the assumption that the drug coverage administrators do not count Blink purchases towards prescription drug coverage out-of-pocket costs. Contact your drug coverage administrator to confirm whether Blink purchases count towards your out-of-pocket costs.

Blink Health is not insurance. Blink Health Administration, LLC, 233 Spring Street, 8th Floor East, New York, NY 10013, (844) 366–2211, www.blinkhealth.com. See website for state-by-state availability.

Unscripted

Healthcare and the prescription drug industry are complicated. That’s why Blink Unscripted is here. To help you understand it a little better so you can get and do what you need to be healthy.

Cara Bradley

Written by

Health Editor at Blink Health.

Unscripted

Healthcare and the prescription drug industry are complicated. That’s why Blink Unscripted is here. To help you understand it a little better so you can get and do what you need to be healthy.

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