Mark Cuban Says This Common Prescription Mistake Could Cost You Hundreds

Having health insurance doesn't necessarily mean you're getting the lowest price on your prescriptions. Mark Cuban says some Americans could actually spend less by skipping insurance and paying cash instead.

That doesn't mean you should stop using your coverage. But comparing your insurance copay with the cash price could help you save money on bills, especially if you regularly fill prescriptions or live on a retirement budget.

Mark Cuban says paying cash could be cheaper

Cuban made the point while discussing health care costs on Bluesky in July. "Those billionaires and rich execs have no clue," he wrote. "They bitch about costs going up as much as you do."

His advice was straightforward: "You may be better off looking for cash prices," adding that cash "may be cheaper than your out of pocket."

Cuban himself has a financial interest in the issue. He co-founded Mark Cuban Cost Plus Drug Company, which sells generic medications using a pricing model based on acquisition costs, a 15% markup, pharmacy fees, and shipping.

Still, his point isn't limited to people without insurance. At a September Texas House hearing, Cuban said many Cost Plus customers are already insured. "They come to us because our cash price is often lower than what their insurance plan asks them to pay. That tells you something is wrong."

A $12 insurance copay could lose to a $4 cash price

KFF's October 2026 employer health benefits survey found that the average copayment for first-tier prescription drugs was $12 among covered workers in plans with three or more drug tiers.

Meanwhile, Walmart advertises select generic prescriptions starting at $4 for a 30-day supply. Eligible medications, dosages, and prices vary by location, so check with your pharmacy.

If your insurance charges a $12 copay for a prescription available for $4 in cash, you'd save $8 per refill. Fill it monthly, and that's $96 over a year.

Savings could add up further if you regularly take multiple medications. Money you don't spend at the pharmacy could go toward groceries, debt payments, or retirement savings.

Paying cash isn't always the cheaper option

Cash prices can vary dramatically between pharmacies. A prescription might cost less through Cost Plus Drugs, for example, but shipping fees could reduce your savings.

Your insurance plan may also offer negotiated prices that beat a pharmacy's advertised cash rate. And a discount card's price may differ from the pharmacy's regular cash price.

Rather than assuming one payment method is cheaper, compare both for the same medication, strength, formulation, and quantity. The cheapest choice can change when you switch pharmacies, refill a different amount, or move to another insurance plan.

Skipping insurance could affect your deductible

Comparing prices is especially worthwhile if you have a high-deductible health plan and haven't met your deductible. Depending on your plan, you might pay the insurer's negotiated price instead of a fixed copay.

However, prescriptions purchased outside your insurance generally won't count toward your plan's deductible or out-of-pocket maximum.

Suppose a prescription costs $20 through insurance but $8 in cash. Paying cash saves you $12 immediately. If you don't expect many medical expenses, that could be the better deal.

But if you expect substantial health care spending, paying through insurance may help you reach your deductible or out-of-pocket limit sooner. Consider your expected costs over the entire year, not just today's pharmacy bill.

Retirees should check their Medicare drug coverage

If you're retired and enrolled in Medicare Part D, comparing prescription prices could help stretch your retirement income. But paying outside your plan can affect which expenses count toward your deductible and annual out-of-pocket limit.

Medicare says purchases made using outside discount cards generally don't count toward those limits. Some qualifying cash purchases have different rules, so check with your Part D plan before deciding how to pay.

This matters if you take several medications each month. A small saving at the counter may be less valuable if it prevents other spending from counting toward your coverage limits.

Compare prices before filling your prescription

You don't need to cancel insurance or change medications to see whether Cuban's advice saves you money.

Ask your pharmacist what the prescription costs through insurance and what you'd pay in cash. Cuban has also encouraged patients to compare prices before leaving their doctor's office, pointing out that the same medication could cost $500 through insurance but just $100 in cash.

"If someone's insurance says a prescription costs $500, but they can buy the exact same drug for $100 at CostPlusDrugs.com, they should know that before they leave the doctor's office."

Bottom line

Mark Cuban says having health insurance doesn't guarantee the lowest prescription price. A $4 cash prescription could beat a $12 insurance copay, but it depends on the drug, pharmacy, and your coverage.

Before paying cash, consider whether the purchase will count toward your insurance deductible or Medicare drug costs. Comparing prices takes only a few minutes and could help you free up your retirement budget by reducing what you spend on prescriptions.

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