Nobody pays rack rates. Most pharmacies keep their own PBM access cards (like GoodRx) to scan at the counter if customer doesn't bring their own. Some examples

Nobody pays rack rates. Most pharmacies keep their own PBM access cards (like GoodRx) to scan at the counter if customer doesn't bring their own. Some examples of self-pay prices: Insulin Lispro 10ml of 100 units/ml (1 vial) - $27.49 Amoxicillin 500mg (21 capsules) - $9.09 Lisinopril/HCTZ 20mg/12.5mg (90 tablets) - $12.15 This isn't very relevant to us though given none of us have any long-term issues (what actually got me to switch off health insurance was getting the EoB paperwork [every week, because the bills never seemed to stop for a long while after I stopped going to the burn clinic] for severely burning my hand in a grease fire; I would've been better off uninsured and shopping around). After a decade at the $20k/year assumption for family of 3's health insurance, we wind up with ~$200k saved up BEFORE investment gains (which, while I'll grant can be negative, we do have a pretty powerful, accessible, and long-term consistent engine in the US). Once I'm in my 40s, I should be able to afford having brain cancer; and if I don't get brain cancer, well, the biggest positive there is not having brain cancer.