Why Are Medicare Beneficiaries Using Prescription Drug Discount Websites?

Health care costs continue to be a major concern for Americans. More than one-third (36%) of Americans say high out-of-pocket spending is the most important problem facing the U.S. health care system. Prescription drugs are among the top drivers of this spending. Between 2020 and 2023, spending on prescription drugs grew by an average of 8.6 percent annually, faster than spending on hospital services and physician and clinic visits. This issue is particularly acute for Medicare beneficiaries — 14 percent said they skipped filling a prescription due to cost in 2023.

Availability of prescription drug discount websites has increased in recent years. These sites, which include GoodRx, Cost Plus Drugs, BlinkRx, Amazon Pharmacy, and TrumpRx, suggest to consumers that they can use them to save money on prescription drugs. They encourage Americans — even those with insurance coverage — to purchase their prescriptions through them. If Medicare beneficiaries use them to purchase medications, then they cannot use their Medicare Part D prescription coverage for that prescription, and the cost of that prescription does not count toward their Part D out-of-pocket limit for the year.

For the second time, we surveyed Medicare beneficiaries about whether and why they have used the websites and examined their responses by type of Medicare coverage (i.e., traditional Medicare or Medicare Advantage), age, gender, income, and race and ethnicity. The data were collected as part of the Commonwealth Fund 2025 Medicare Open Enrollment Survey and included 4,018 Medicare beneficiaries who reside in their communities and excludes people who live in institutions, such as nursing homes.

How Do GoodRx, Cost Plus Drugs, and Other Drug Discount Websites Work for Medicare Beneficiaries?

The prescription drugs discount sites all work slightly differently. GoodRx and TrumpRx provide coupons that consumers bring to their pharmacies in person; Amazon Pharmacy and Cost Plus Drugs give patients the option of receiving their medications through the mail; and BlinkRx allows patients to choose either a coupon to use in-person or mail order.

In certain circumstances, a person with Medicare Part D prescription drug coverage may pay less using the discount sites than they would with their Part D plan. For example, a prescription could cost $400 out-of-pocket at the pharmacy and $200 with Part D insurance. If GoodRx offers a 55 percent discount on the prescription price, then the beneficiary would pay $180 with GoodRx, a $20 savings over their Part D coverage.

In 2026, Medicare beneficiaries have a $2,100 annual out-of-pocket spending maximum for Part D–covered drugs. To have their drug spending count toward this limit, beneficiaries must use their Part D coverage to purchase the prescription. Thus, the savings beneficiaries get using discount websites must be compared to long-term savings achieved by reaching the Part D out-of-pocket limit.

How Many Medicare Beneficiaries Are Using Drug Discount Websites and Why?

Seventeen percent of beneficiaries said in 2025 they had used one of the sites in the past 12 months, down from 19 percent in 2023. Beneficiaries in the lowest income category (i.e., less than $25,000 annually) were significantly less likely than people in every other income category to say they had used a prescription drug website in the past 12 months.

A significantly larger share of beneficiaries in traditional Medicare than those in Medicare Advantage (21% vs. 14%) said they used the sites. People in traditional Medicare without Part D coverage were as likely to use the discount websites as beneficiaries with Part D coverage.

Of those who said they used the sites in the past 12 months, more than half (57%) said they did so because costs were lower than their drug coverage. More than one in four beneficiaries (28%) said they used the websites to access drugs their health plan didn’t cover. One of ten (10%) said they used the sites because they were more convenient than their health plan, and 8 percent said they used the sites because they didn’t have any insurance coverage for prescription drugs.

A significantly larger share of Medicare beneficiaries age 65 and older, compared with those younger than 65 who have Medicare due to a qualifying disability, said they used the sites to access drugs at lower costs than their health plan (59% vs. 40%). A large share of beneficiaries younger than 65 qualify for the low-income subsidy for Part D, which helps to pay for the costs of their prescription drugs. Consequently, they have less exposure to drug costs and less financial incentive to use the discount sites. Among beneficiaries who used the sites, a larger share of beneficiaries younger than 65 than beneficiaries age 65 and older said their drug plan didn’t cover their prescribed drug (43% vs. 25%) or that the site was more convenient than their prescription drug coverage (21% vs. 8%). Beneficiaries younger than 65, on average, are prescribed more prescription drugs than beneficiaries age 65 and older and thus may be more likely to take prescriptions not covered by their Part D plan. One reason beneficiaries may view the discount sites as more convenient than their drug coverage is that the sites do not have prior authorization requirements, unlike Medicare Advantage and standalone Part D plans.

Implications for Consumers

More than half of Medicare beneficiaries who had used prescription drug discount sites reported that these websites provided their prescriptions at lower costs than their drug coverage. While their purchase costs using the discount sites may be lower in the short term, there could be higher financial costs over the long term. Beneficiaries may not be aware that spending on these sites does not count toward their annual out-of-pocket cap on prescription drug spending. Further, if beneficiaries use these sites in lieu of signing up for Part D drug coverage altogether and wish to enroll in Part D in the future, they will pay a late-enrollment penalty in the form of higher annual Part D premiums for the remainder of the time they are enrolled in Part D. Policymakers should ensure that beneficiaries have the information they need to weigh the benefits and trade-offs of using these sites so they can better manage their current and future prescription drug costs.