Refilling a prescription without insurance is not as expensive as people think. For most stable chronic medications, the real cash-pay number is around $49 to $75 all-in — $45 for a licensed online visit plus roughly $4 to $30 for a 90-day generic fill at your pharmacy using GoodRx. That's less than one urgent-care visit and often less than two months of insurance copays on a high-deductible plan. Here's the full math.
TL;DR — Real cash-pay pricing
$45 flat — Bidwell Health online visit, no subscription, 15 minutes, 90-day prescription
$4–$30 — typical pharmacy cost for common generic meds with GoodRx
$49–$75 total for a 90-day supply of most chronic meds — cheaper than urgent care ($150–$300) and often cheaper than one round of insurance copays
FSA / HSA eligible — the $45 visit and the medication both qualify
Fast: prescription sent within 15 minutes to a few hours during business hours
Limit: stable, non-controlled chronic medications only — not for controlled substances or new diagnoses
Why cash-pay can cost less than using insurance
Most Americans assume insurance is always cheaper. For routine refills of common chronic generics, that's frequently untrue — and it's getting more untrue as deductibles rise. A few reasons:
High-deductible plans: if you haven't hit your deductible, you're paying the full negotiated rate for every visit and prescription. A $180 PCP visit plus a $40 prescription copay is $220 — compared to $45 cash-pay telehealth plus a $4 GoodRx fill.
Generic cash prices are brutally low: per GoodRx and Mark Cuban Cost Plus Drugs, most common generics are under $15 for 90 days at any major pharmacy.
Many insurance plans charge $15–$40 copay per fill — more than the cash price. Lisinopril is $4 cash; many plans charge a $15 copay. You'd literally lose money running it through insurance.
The telehealth visit is flat-priced. No negotiated rate, no deductible math, no copay surprise — $45 is the number.
This is especially true for the 15 or so most common chronic medications that make up the bulk of primary-care refills. It is not true for specialty medications, biologics, injectables, or anything still on-patent.
What the $45 Bidwell visit includes — and what it doesn't
Included in your $45:
Asynchronous intake reviewed by a licensed U.S. nurse practitioner (Bidwell Cranage or Ashley Cranage, APRN, FNP-C)
A 90-day prescription sent electronically to the pharmacy of your choice, if clinically appropriate
A detailed visit receipt suitable for FSA / HSA reimbursement
Secure follow-up messaging with the provider for clinical questions about your script
Not included:
The medication itself — you pay the pharmacy directly at pickup
Lab work (we don't order labs as part of a bridge refill visit)
Insurance billing — we're cash-pay only
Controlled substances — not refillable via cash-pay telehealth
New diagnoses or medication changes — you need a traditional primary-care visit for those
Your actual total cost: visit + pharmacy
Your out-of-pocket is the $45 visit plus whatever the medication costs cash at the pharmacy. For common chronic generics, the cash price with GoodRx or a pharmacy discount card is shockingly low.
Medication (90-day generic)
Typical cash price
With GoodRx
Lisinopril 10mg (blood pressure)
$12–$18
$4–$8
Amlodipine 5mg (blood pressure)
$15–$25
$6–$12
Losartan 50mg (blood pressure)
$18–$30
$10–$18
Metformin 500mg (diabetes)
$12–$20
$4–$10
Levothyroxine 50mcg (thyroid)
$15–$25
$8–$15
Sertraline 50mg (Zoloft, SSRI)
$20–$40
$10–$18
Escitalopram 10mg (Lexapro, SSRI)
$20–$40
$10–$20
Atorvastatin 20mg (statin)
$15–$25
$6–$12
Rosuvastatin 10mg (statin)
$18–$35
$10–$20
Albuterol HFA inhaler
$45–$75
$25–$40
Fluticasone (Flonase) nasal spray
$15–$25
OTC ~$12
Omeprazole 20mg (GERD)
$15–$25
OTC ~$10
Generic OCP birth control
$20–$40
$10–$25
Finasteride 1mg (hair loss)
$20–$40
$10–$20
Sildenafil 20mg (generic, off-label for ED)
$15–$40
$6–$20
Prices reflect publicly available GoodRx pricing at major U.S. pharmacies as of April 2026. Actual prices vary by pharmacy, ZIP, and pharmacy discount card. Costco Pharmacy and Mark Cuban Cost Plus Drugs typically run lower still on 90-day generics.
How we compare to the alternatives
Here's what a 90-day refill actually costs across the most common options, for a typical generic chronic medication like lisinopril or sertraline:
Option
Visit cost
Med cost
Total (90 days)
Urgent care
$150–$300
$4–$40 cash or copay
$154–$340
PCP visit (high-deductible plan)
$120–$220 before deductible met
$15–$40 copay or cash
$135–$260
PCP visit (good plan, low copay)
$20–$40 copay
$10–$30 copay
$30–$70
ER (don't)
$500–$3,000+
varies
$500+
Hims/Hers subscription
$0 consult (Hims) or $28–$80 (Hers)
$20–$60/mo plan
$60–$200+ (3 mo)
Bidwell Health cash-pay
$45 flat
$4–$30 via GoodRx
$49–$75
For a single stable refill of a common generic, Bidwell's $45 cash-pay visit is consistently the lowest option unless you have a very good insurance plan with a low copay and an already-met deductible.
Start a $45 refill visit now
90-day supply · No insurance needed · FSA/HSA eligible
You're currently in one of our 12 licensed states (Florida, New York, Virginia, Washington, Arizona, Colorado, Connecticut, Iowa, Maryland, Montana, New Mexico, Utah)
You're already taking the medication — this isn't a first prescription
Your dose has been stable for at least 3 months
You can send a photo of your current pill bottle with the label visible
The medication is on our covered list (the ~15 most common chronic non-controlled meds)
Birth control: most generic combined oral contraceptives
GERD: omeprazole, pantoprazole
ED: sildenafil, tadalafil (as a bridge or one-time Rx)
Hair loss: finasteride, topical minoxidil
Who doesn't qualify
Cash-pay telehealth bridge refills are not appropriate for:
Controlled substances — opioids, benzodiazepines (Xanax, Ativan, Klonopin), stimulants (Adderall, Vyvanse, Ritalin, Concerta), sleep meds (Ambien, Lunesta), gabapentin, pregabalin (Lyrica), tramadol, Fioricet with codeine. Federal DEA rules restrict these tightly.
New diagnoses — if you've never taken the medication before, you need a primary-care visit that can order labs, physical exam, and appropriate workup.
Recent dose changes — if your prescriber just changed your dose in the last 3 months, the follow-up belongs with them.
Complex or unstable conditions — uncontrolled diabetes with rising A1c, poorly controlled blood pressure, acute mental health concerns, etc.
Medications we don't cover — specialty drugs, biologics, injectables, chemo, controlled substance combinations, compounded formulations, etc.
One honest caveat: a bridge refill is a short-term solution so you don't run out while establishing or re-establishing ongoing primary care. It is not a substitute for a primary-care relationship. If you've been without a PCP for over a year, start one soon — bridge refills are a bridge, not a destination.
Step-by-step: how to get a cash-pay refill
Confirm you're in one of our 12 states. Florida, New York, Virginia, Washington, Arizona, Colorado, Connecticut, Iowa, Maryland, Montana, New Mexico, or Utah.
Take a photo of your current pill bottle. Label visible — drug name, dose, prescriber, last fill date. This is the single most important artifact for a fast approval.
Go to the intake form. Answer the short clinical questions — takes about 5 minutes.
Pay $45. Flat, one-time, no subscription.
Wait 15 minutes to a few hours. A licensed NP reviews your intake. You'll get an email when your prescription has been sent to your pharmacy.
Pick up at your pharmacy. Show your GoodRx coupon at the register for the lowest cash price, or use Costco / Walmart / Cost Plus Drugs for further savings.
Save your receipt if you're reimbursing through FSA / HSA.
Pro tips for the lowest possible cash price
Always check GoodRx before pickup. Same pharmacy, different price. Show the coupon or code at the register.
Costco and Sam's Club pharmacies don't require a membership for prescriptions (federal law) and routinely beat chain pharmacies on generics.
Mark Cuban Cost Plus Drugs sells 90-day supplies of many chronic generics for under $10 total, shipped. Works great as a mail-order option.
Skip "auto-refill" tied to insurance if you're paying cash — sometimes it triggers a higher price than the manual cash fill.
Ask the pharmacist — many pharmacies have in-house discount cards that beat GoodRx for specific drugs.
Frequently asked questions
Can I really skip insurance and still save money?
Yes, often. For common chronic generics, the $45 visit + $4–$30 pharmacy cost frequently comes in below what you'd pay using insurance on a high-deductible plan. If you have an excellent low-copay plan and your deductible is met, insurance may still win. Run the math for your specific medication.
Can I use FSA or HSA funds at Bidwell?
Yes. The $45 visit is an FSA/HSA-qualified medical expense. The medication fill at the pharmacy is also FSA/HSA eligible. We'll email you a detailed receipt with provider name, license number, date of service, and CPT-style visit description so your benefits administrator has everything they need.
What if I need a refill for a medication that's not on your list?
Message us before paying — we'll tell you honestly whether we can help. For medications outside our scope (specialty, controlled, compounded, or unstable conditions), we'll redirect you to a primary-care option or an online service that handles those conditions rather than take your $45 and refund it.
Does Bidwell accept any insurance?
No — we're cash-pay only. Your pharmacy insurance can still apply to the medication fill at pickup, if you have it. If you don't, a GoodRx coupon typically beats most insurance copays for generics anyway.
What if the medication I need is actually expensive?
For expensive brand-name or specialty medications, cash-pay is usually not the right path — a primary-care relationship with insurance billing matters. We focus on the common generics where cash-pay genuinely wins. If you tell us what you take, we'll be straight with you about whether we're the right fit.
How long does my Bidwell prescription last?
Typical bridge refills are written for a 90-day supply. That gives you roughly three months to re-establish primary care, hit your deductible, find a long-term prescriber, or come back for another bridge if needed.
Is this like Hims or GoodRx Care?
Similar but different. Hims uses a subscription model for specific conditions (hair, ED, weight loss). GoodRx Care is an on-demand telehealth service for a handful of common conditions. Bidwell is specifically built for cash-pay bridge refills of stable chronic meds at a $45 flat rate. For a full head-to-head, see our Hims vs Bidwell comparison.
What if I'm uninsured long-term?
You're in good company — millions of Americans are in the same spot. For chronic meds, cash-pay telehealth plus pharmacy discount cards is a reasonable long-term workflow, especially paired with community health centers for labs and annual exams. The AAFP and CDC both publish guidance for managing chronic conditions with limited resources — worth reading.
Ready to refill? $45 flat — no insurance required.
Clinically reviewed by Bidwell Cranage, APRN, FNP-C, AANP board-certified Family Nurse Practitioner, licensed in 12 states. Last reviewed: April 20, 2026 · Pricing reflects publicly available GoodRx and pharmacy data as of April 2026. Actual medication costs vary by pharmacy, ZIP, and discount card.