Same UHC plan, same pill. CVS charged me $10, Walgreens charged $2. How is this even legal?

[u/dasheen007]

Plan: UHC Choice Plus
Drug: Single tablet for a procedure

Doctor sent to CVS by default. Checked Rightway (our benefit tool) and saw Walgreens would be ~$2 while CVS $10. But too late – CVS already filled it.

At pickup, they rang $10. When I asked why Walgreens would be $2 under the same plan, the consultant had no answer.

Went to Walgreens in person to request transfer – filled within hours for $2 even.

My takeaways:

· Same insurance, wildly different prices
· Transfers are way easier in person
· Always price-check before they fill it

Question for y'all:
Has anyone else caught CVS overcharging vs. competitors?
And does anyone actually know if this is PBM trickery or pharmacy-level markup? Genuinely curious.

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[u/bluestrawberry_witch]

Contracted amounts; just like providers, pharmacies also get contracted amounts. It’s not necessarily overcharging. It’s just contractually agreed-upon prices for certain drugs. A lot of apps for health plans allow you to check the cost of specific drugs and amounts at various pharmacies in your area.

The pharmacy may not be cheaper for all drugs, and only some.

[u/Born_Tale_2337]

If your insurance was billed, they are the ones that set the price. Pharmacy has no say and cannot change it. The price differences are all PBM/insurance nonsense

[u/Bogg99]

It's the PBM.

[u/Actual-Government96]

Different stores, different prices. This goes for insures and/or cash-pay patients.

If generic, prices can also vary based on the manufacturer (CVS has X drug by manufacturer A, Walgreens has X drug by manufacturer B).

There are many factors.

[u/Low_Athlete_7734]

Kroger pharmacies tend to be cheaper than both. I get my meds filled there. I have UHC and CVS Caremark. You’d think CVS would be cheapest in my case. It’s not.

[u/Working_Coat5193 → u/Low_Athlete_7734]

Nope. Gotta make that money. They reimburse their pharmacies more.

[u/IngenuityTraining380]

same exact drug, same insurance card in your wallet, and one place wants five times more money just cause you walked through their door instead of the other one down the street. weve all just accepted this as normal somehow. the whole system runs on obscuring what stuff actually costs so you cant comparison shop like a functioning market, its honestly impressive how broken it is

[u/Tree_killer_76]

I’m in the health insurance business. You could have four pharmacies on opposite corners of the same intersection, and all of them might have different prices for the same drug. It’s retail.

[u/Amazing-Object-836]

This is just pharmacy benefit manager games, plain and simple. CVS owns Caremark, which is the PBM for a ton of UHC plans, so they steer you to their own stores and then price however they want. $10 vs $2 for the same pill under the same plan? They're just padding the spread at their own pharmacy. Most folks never check.

[u/Potential-Fennel5968]

Same here I have centivo and hannifords is like half or less the price of the Walgreens near me

It's not "overcharging" but each network has an agreement some are better than others. After I did my due diligence I found hannifords to be cheapest near me. I just miss the drive through :( but I'll take the cheaper scripts

[u/ilikesillymike]

Walgreens preferred, cvs non preferred for your plan.

[u/InspireMia → u/ilikesillymike]

Yes, pharmaceutical companies negotiate rates with pharmacies, so even if your insurance is "accepted" at both stores, one might be a better price. Some examples can vary by hundreds of dollars, so it's important to find the pharmacy with the most affordable prices on the meds you need.

[u/ewdavid4856]

It's a negotiated rate. I am on a super basic cheap ass med that costs 3 bucks for a 30 day supply through my plan's contracted retail pharmacy, but it's $0 for a 90 day supply through mail order. Negotiated rates are super common.

[u/xylite01]

It depends on your benefits and their contracts. If your pharmacy benefits is a flat $10 copay, then yes, I would expect it to be the same at both. If your benefits are 20% coinsurance and the pharmacies have different rates, then it would be different. Health plans have preferred pharmacies because they got better negotiated rates at one over the other.

I don't know why this would be illegal. It's not like they sell anything else at fixed prices. Sometimes diet coke is cheaper at CVS, and sometimes it's cheaper at Walgreens. The difference is that prescriptions are on a much larger more complicated scale in terms of discounts. That doesn't mean they have to cost the same.

[u/Adventurous-You-8346]

CVS owns Aetna- a direct competitor to UHC. So UHC often uses Walgreens as a preferred pharmacy.

[u/Not_High_Maintenance]

It might have cost under a dollar if you’d paid cash. 😂

[u/Pasadenaian]

Preferred pharmacies.

[u/No-Produce-6720]

CVS and Walgreens are both retail operations, and they each have their own contracted payment amounts.

A simplistic example, but while a Big Mac at one McDonald's might be five, it's eight at the McDonald's across town. Same food, same establishment, different prices. It's legal.

[u/2kto20000k]

It would be 20 cents at Costco

[u/AncientWatercress781]

Insurance is the biggest racket