Are 90-Day Prescriptions Always Cheaper? A Cost Analysis

• Unbeatable Convenience: The most obvious benefit is saving time and energy. Instead of making twelve trips to the pharmacy each year, you only have to go four times. That’s eight fewer visits, which is a significant advantage if you have a busy schedule, transportation challenges, or mobility issues.
• Potential for Cost Savings: In the ideal scenario, a 90-day supply can lower your out-of-pocket costs. Many insurance plans are designed to incentivize these larger refills. For example, your plan might charge you two co-payments for a three-month supply instead of three, effectively giving you one month’s worth of medication at no extra cost.
• A Boost for Your Health: One of the most important benefits is improved medication adherence, the clinical term for sticking to your medication schedule. Studies consistently show that when people have more medication on hand, they are more likely to take it as prescribed. Better adherence leads to better health outcomes and can help prevent costly hospitalizations, which is why many health plans strongly encourage 90-day fills.

• Fewer Copays: If your insurance plan has a per-prescription copay, filling a 90-day supply means you pay that copay only once per quarter instead of every month. For example, instead of three $15 copays ($45), you might pay just one $30 copay, saving you $15 every three months.
• Reduced Dispensing Fees (a charge for each pharmacy fill): Every time a pharmacist fills a prescription, a “dispensing fee” is charged to cover their time and operational costs. This fee is built into the total price of the medication. Getting a 90-day supply means you only pay this fee once instead of three times.

The High-Deductible Trap: If you have a High-Deductible Health Plan (HDHP), you are responsible for paying 100% of your medical costs, often including prescriptions, until you meet your annual deductible. A deductible is a fixed amount (for example, $1,650) annually for a typical HDHP, and you must pay the full price of medications until you reach that amount. For someone with an HDHP, the full price of a 90-day supply of an expensive medication can be a huge upfront financial burden, making a 30-day supply a more manageable, albeit more expensive on a per-pill basis, option.

Preferred Pharmacy Networks: Many insurance plans have contracts with specific pharmacies to be their “preferred” 90-day supplier. This might be a large chain like CVS or Walgreens, or it could be the plan’s own mail-order service. Insurance plans may limit 90‑day supplies to preferred pharmacies, and these could be your insurer’s mail order or specific retail chains. If filled elsewhere, your plan may cover none or only part of the cost.

1. You’re Starting a New Medication

This is the most common and important exception. When you start a new drug, there’s always a chance of side effects or a need to adjust the dosage.

• The Savvy Patient Angle: If you fill a 90-day supply and have to stop the medication after two weeks, you’ve wasted over two months’ worth of medicine and money. Always ask for a 30-day supply of any new prescription until you and your doctor confirm it’s the right long-term fit.
  • Note: If your doctor adjusts your dosage or you experience side effects before the 90 days are up, you could end up wasting most of the medication.

2. You Have a High-Deductible Health Plan (HDHP)

A deductible is the amount you must pay out-of-pocket for healthcare services and prescriptions before your insurance starts to share the costs.

• The Savvy Patient Angle: With an HDHP, you pay the full, negotiated price of the drug until you meet your deductible. A 90-day supply means a much larger upfront cost. For example, paying $300 for a 90-day supply might be a bigger financial strain than paying $100 each month, even if the 90-day option is slightly cheaper per pill. Once your deductible is met, switching to a 90-day supply might make more sense.
• This is a critical moment to check LowerMyRx, as its discount price may be even lower than your plan’s negotiated price.

3. The Price Isn’t Actually Lower

It seems counterintuitive, but sometimes the math doesn’t work out. Due to complex pricing systems, three separate 30-day fills can occasionally be cheaper than one 90-day fill, especially for some generic drugs. The only way to know for sure is to compare prices.

Guidance for Your Doctor’s Office:

Guidance for Your Insurance Provider:

Call the member services number on the back of your insurance card and ask:

• “What is my copay for a 30-day supply versus a 90-day supply of my medication?”
• “Do I have to use a specific mail-order pharmacy or retail chain to get a discount on a 90-day supply?”

Guidance for the Pharmacy Counter:

When you’re at the pharmacy, remember that the pharmacist is a key resource. They can help you understand your options. Here are a few clear questions you can ask:

• “Can you please run the price for both a 30-day and a 90-day supply through my insurance so I can compare my out-of-pocket cost?”
• “What is the cash price for this medication if I don’t use my insurance?”
• “I have a LowerMyRx card/app. Can you check the price for both a 30-day and 90-day supply using this discount card? It might be lower than my copay.”

1. Can I get a 90-day supply for any medication?

No. This is typically reserved for “maintenance” medications used to manage chronic conditions. It is not used for short-term drugs like antibiotics or for controlled substances, which often have stricter regulations.

2. What if my doctor only wrote the prescription for a 30-day supply?

You can ask your doctor’s office if they would be willing to send a new 90-day prescription to the pharmacy. Alternatively, your pharmacist can often contact the doctor’s office on your behalf to request the change.

3. Is it possible to get a 90-day prescription without insurance?

Yes. You can always ask for a 90-day prescription and pay the pharmacy’s “cash price.”