Engine evidence · every 2026 Georgia marketplace plan · methodology below
Sometimes the cash price beats your copay. Sometimes it doesn't.
On 84 of Georgia's 203 marketplace plans, a ~$8 cash generic beats your copay on annual math; on 76, your copay beats cash; and on 43, nobody can tell you the insured price — because it is a negotiated rate published nowhere. Both directions are real, so we show both with equal billing.
203 plans. 55 of America's most-prescribed generics. Three honest answers.
Annual insured path (filed generic copay × 12 fills) versus annual cash path (4 × 90-day Cost Plus Drugs quote + shipping), plan by plan. The basket-median 90-day cash quote is $7.90 — $51.60 a year shipped.
84
plans where the ~$8 cash generic beats the filed copay
76
plans where the filed copay beats cash — including 8 plans with a $0 generic copay
43
plans where nobody can tell you the insured price from any published source
Filed generic copays across the 160 computable plans run $0–$30 per fill (median $5). Bucket counts by metal level are in the artifact; there is deliberately no issuer league table on this page.
Every plan lands in one of four buckets.
Cash wins — 84 plans
The plan files a pre-deductible generic copay, and copay × 12 costs more than four shipped 90-day cash fills at the basket median. 17 of these carry the multiple-tier flag below.
Copay wins — 76 plans
The filed copay is cheap enough that insurance beats cash on annual math — 8 of these plans file a $0 generic copay, which cash can never beat. 40 of these carry the multiple-tier flag below.
Flagged — 57 plans: Tier-1 filed value; plan has multiple in-network tiers
CMS marks these plans as having multiple in-network tiers, and the engine retains the Tier-1 filed value while flagging every benefit. Their verdicts are computed from that Tier-1 filed value and disclosed as flagged — counted inside the cash-wins and copay-wins totals above, never silently mixed in.
Nobody can tell you — 43 plans
22: Generic coinsurance — a percent of a negotiated price that is not published anywhere. 16: Filed generic value is “Not Applicable”. 5: Copay applies only after the deductible — the pre-deductible negotiated price is not published. No published source states the insured price of a generic on these plans.
The price nobody can tell you.
The cash price of a generic is public — every quote on this page traces to a public API response with a pinned hash. The price an insurer negotiated for that same generic while you are inside your deductible is published nowhere: not in the plan filing, not in the formulary, not on the card. On 43 of Georgia's 203 plans — every coinsurance design, every after-deductible copay, every “Not Applicable” filing — that unpublished number is the only insured price there is. A market where the cash price is knowable and the insured price is not is the transparency gap this page measures.
Read this before moving a fill to cash.
Cash typically does not count toward your deductible
A cash purchase made outside your plan typically does not count toward your deductible or out-of-pocket maximum, because the plan never sees the claim — unless your plan adjudicates it. Some plans and states allow member-submitted claims, and Cost Plus Drugs marks products it considers insurance-billable, so check your specific plan. If you expect to hit your out-of-pocket maximum this year, paying cash can cost you more overall even when the per-fill price is lower.
Shipping is in the math
Cost Plus Drugs charges roughly $5 shipping per order — per order, not per drug. The annual cash math here books it on every one of the four modeled 90-day orders, which overstates the cash cost for anyone who bundles several prescriptions into one order.
The annual math, both sides
Insured path: filed generic copay × 12 monthly fills — at the median filed copay of $5 that is $60/year. Cash path: 4 × (90-day quote + shipping) — at the basket median quote of $7.90 that is $51.60/year. The 90-day fill is the fair cash default because that is how mail-order pharmacies actually sell maintenance generics; a 30-day cash framing would triple the shipping and misstate the comparison.
This is a generics page
Every drug in the basket is a maintenance generic pinned to one RxCUI, strength, and quantity. Brand drugs, specialty drugs, insulins, inhalers, and controlled substances are excluded with stated reasons in the artifact — the cash-vs-copay arithmetic for those is a different and usually harsher story that this page does not model.
The 55-generic basket.
America's most-prescribed drugs (ClinCalc DrugStats), restricted to non-controlled oral-solid maintenance generics carried by Cost Plus Drugs — every top-130 drug is either quoted or excluded with a stated reason in the artifact. A sample, ranked by U.S. prescription volume:
#1 Atorvastatin 20 mg
$6.37 / 90 days
#2 Levothyroxine 50 mcg
$7.74 / 90 days
#3 Metformin 500 mg
$6.91 / 90 days
#4 Amlodipine 5 mg
$5.61 / 90 days
#5 Lisinopril 10 mg
$6.18 / 90 days
#7 Losartan 50 mg
$6.54 / 90 days
#8 Metoprolol tartrate 50 mg
$7.70 / 90 days
#9 Rosuvastatin 10 mg
$7.02 / 90 days
#12 Sertraline 50 mg
$7.07 / 90 days
#13 Escitalopram 10 mg
$8.74 / 90 days
#16 Pantoprazole 40 mg
$9.09 / 90 days
#17 Bupropion XL 300 mg
$10.03 / 90 days
…and 43 more in the committed artifact, each pinned to one RxCUI and one strength, each quote hash-pinned to its public API response.
The denominator, in full.
103
computable — verified pre-deductible generic copay
57
computable, flagged — Tier-1 filed value; plan has multiple in-network tiers
43
not computable — reasons enumerated above, never guessed
At the pair grain: 8,800 (drug, plan) pairs across the 160 computable plans; 7,620 verified on a generic-labeled formulary tier (3,692 cash-wins, 3,928 copay-wins), 581 on a non-generic tier, 88 on a tier label outside the published map, 511 not found in the issuer's file. Disclosed, never guessed.
How these numbers are computed.
Plan side — real filed data
Every 2026 Georgia marketplace plan from a statewide union over all 159 counties in the pinned market snapshot (snapshot_8827361338bd…, sources as of 2026-06-03): the filed generic-drug cost share, its quality flag, and whether it applies before or after the deductible.
Drug side — pinned, hashed cash quotes
Each basket generic is pinned to one RxCUI (re-verified against RxNorm at refresh), one strength, and a 30/90-day quantity. The cash quote is the Cost Plus Drugs public API's unit billing price (acquisition cost + the company's fixed 15% markup) × quantity + the flat $5 pharmacy labor fee — verified against the company's own published example — and every API response is sha256-pinned with its retrieval time in the artifact.
Formulary rung — verified tier placement
9 issuer formulary rails, 10 machine-readable drugs.json files fetched from the URLs in the snapshot's machine-readable index (two issuers' index rows are corrupt in the source PUF; the documented same-parent fallbacks are recorded and verified in the artifact), each sha256-pinned. Placement is matched per (drug, plan) with the engine's QHP formulary parser; a pair counts only when exactly one tier label maps to the generic tier in the published map below.
Deterministic, fail-closed, no issuer ranking
Rerunning the script from the pinned cache produces a byte-identical artifact. Plans and pairs that cannot be verified are counted and disclosed, never guessed. Bucket counts aggregate by metal level and cost-share shape only — this page publishes no issuer league table.
The tier-label map, verbatim
Every distinct drug_tier label observed across the 10 formulary files, and how it is mapped. Labels outside the map are a disclosed bucket (observed unmapped: GENERIC-BRAND — a mixed generic/brand tier cannot be honestly assigned to the filed generic value).
Formulary sources, hash-pinned
https://www.cigna.com/sites/json/drugs.json
issuer 15105 · sha256 c939079ae1625f28… · 263.7 MB · fetched 2026-08-29
https://legacy.providerlookuponline.com/mrf/optumrx/drugs/2877216/JSON_Drugs_UHCGAEX_HIX.json
issuer 43802 · sha256 adf375096ff037bf… · 21.7 MB · fetched 2026-08-29
https://fm.formularynavigator.com/jsonFiles/publish/143/32/drugs.json
issuer 45334 · sha256 68047745dc8ec4a3… · 85.1 MB · fetched 2026-08-29
https://fm.formularynavigator.com/jsonFiles/publish/143/32/drugs.json
issuer 49046 · sha256 68047745dc8ec4a3… · 85.1 MB · fetched 2026-08-29
https://d3ul0st9g52g6o.cloudfront.net/ffm/drugs.json
issuer 58081 · sha256 101053366cc09299… · 706.9 MB · fetched 2026-08-29
https://fm.formularynavigator.com/jsonFiles/publish/62/300/drugs.json
issuer 60224 · sha256 a5c68dd9da6f1d28… · 31.4 MB · fetched 2026-08-29
https://api.centene.com/ambetter/reference/drugs-AMB-GA.json
issuer 70893 · sha256 ac34e0dfc94d2a62… · 53.0 MB · fetched 2026-08-29
https://prime.adaptiverx.com/web/json?key=cnhmbGV4LnBsYW4uUGxhblBkZlR5cGUtOTIz
issuer 83761 · sha256 64325769603b2ea9… · 54.9 MB · fetched 2026-08-29
https://www.alliantplans.com/json/Formulary_GA_2026.json
issuer 83761 · sha256 ff38acbed62b2d22… · 29.9 MB · fetched 2026-08-29
https://healthy.kaiserpermanente.org/content/dam/kporg/data/ga/drugs.json
issuer 89942 · sha256 840dbeb929eac0ab… · 52.0 MB · fetched 2026-08-29
The full pricing methodology — sources, checksums, fail-closed rules — is public, alongside the plan-choice evidence this page extends.
Cash-or-copay questions, answered with the data.
Is paying cash for a generic cheaper than using my insurance copay?
It genuinely goes both ways — that is the finding. Across every 2026 Georgia marketplace plan, a ~$8 ninety-day cash generic (the median of 55 of America's most-prescribed generics at Cost Plus Drugs) beats the plan's filed generic copay on 84 of 203 plans on annual math — and the copay beats cash on 76, including 8 plans whose filed generic copay is $0. On the remaining 43, the insured price cannot be computed from any published source. Check your own plan's generic copay before assuming either way.
Do cash prescription purchases count toward my deductible or out-of-pocket maximum?
Typically no — that is the biggest caveat in this comparison. A cash purchase made outside your plan usually never reaches the plan, so it typically does not count toward your deductible or out-of-pocket maximum unless your plan adjudicates the claim. Some plans and states let members submit cash receipts, and Cost Plus Drugs itself marks products it considers insurance-billable, so the honest answer is: check your specific plan before moving a maintenance fill to cash.
What is the price nobody can tell you?
The insurer-negotiated price of a generic while you are still inside your deductible. The cash price is public — anyone can look it up. But on 22 Georgia plans the filed generic benefit is coinsurance (a percent of a negotiated price that is published nowhere), and on 5 more the copay only starts after the deductible — so before it, you pay a negotiated rate no public filing discloses. Plus 16 plans whose filed generic value is simply “Not Applicable.” That is 43 of 203 plans where no published source states what an insured generic costs.
How is the annual math computed on each side?
Both sides are stated. The insured path is the plan's filed generic copay × 12 monthly fills. The cash path is 4 × (the 90-day Cost Plus quote + ~$5 shipping per order) — the 90-day fill is the fair cash default because that is how the pharmacy actually sells maintenance generics, and booking shipping on all four orders overstates cash cost for anyone bundling prescriptions. At the basket median that is $51.60/year cash versus $60/year at the median filed copay of $5.
How do you know a drug is actually on a plan's generic tier?
By reading each issuer's CMS machine-readable formulary (drugs.json) — 10 files, sha256-pinned — and matching every pinned RxCUI to every plan with the repo's QHP formulary parser. 7,620 of 8,800 (drug, plan) pairs verified on a generic-labeled tier; the per-pair split was 3,692 cash-wins vs 3,928 copay-wins. Pairs on non-generic tiers, on tiers whose label is not in the published map, or missing from the file are disclosed buckets — never guessed.
Does Insurf make money if I buy from Cost Plus Drugs?
No. $0 relationship: Insurf receives nothing from Cost Plus Drugs — no affiliate fees, no referral fees, no data, no partnership. Insurf is not affiliated with or endorsed by Cost Plus Drugs, any carrier, Georgia Access, or any state. This page exists because the comparison is honest evidence for pricing whole plan-years, which is what Insurf's engine does.
The drug is one line item. Price the whole year.
$0 relationship: Insurf receives nothing from Cost Plus Drugs — no affiliate fees, no referral fees, no data, no partnership. Insurf is not affiliated with or endorsed by Cost Plus Drugs, any carrier, Georgia Access, or any state. Insurf, Inc. is not a licensed insurance agency; enrollment support is provided by an individually licensed insurance producer, who may be compensated by carrier commissions when an enrollment occurs — that compensation is disclosed on estimates, and the math on this page never varies with compensation. Figures on this page are modeled illustrations from filed public data and pinned public cash prices under the labeled assumptions above — informational only, not an offer of coverage, not a recommendation to buy, drop, or bypass any plan or pharmacy, and not financial, tax, legal, medical, coverage, or insurance advice. Cash prices change; the artifact records exactly when every price was retrieved.