If you’re staring at your 2025 Affordable Care Act premium renewal and feeling priced out, you’re far from alone. With enhanced ACA subsidies set to expire and premiums climbing in many states, countless Americans are facing an impossible choice: pay premiums that consume a significant chunk of their income, or go without coverage entirely.
The good news? A growing number of online healthcare platforms are offering a different approach that might actually cost you less than high premiums and copays, especially if you’re relatively healthy and primarily need access to routine medications and preventive care.
The Cash-Pay Alternative
While it might seem counterintuitive, paying cash through certain telehealth and online pharmacy services can sometimes cost less than using traditional insurance. These platforms have cut out much of the overhead associated with conventional healthcare—no waiting rooms, no insurance billing departments, no facility fees—and they’re passing those savings on to patients.
Here’s what makes these services worth considering:
Transparent, upfront pricing. You know exactly what you’ll pay before you commit, with no surprise bills arriving weeks later.
No insurance required. These platforms work on a direct-pay model, which means you don’t need active insurance coverage to access care.
Convenience that saves time and money. Skip the doctor’s office visit copay, the time off work, and the transportation costs. Consultations happen via video, phone, or even through chat messaging.
Competitive medication prices. Many of these services negotiate directly with manufacturers or offer generic options at prices that can beat your insurance copay—especially if you haven’t met your deductible yet.
Who Benefits Most?
These services are particularly valuable if you:
- Are being priced out of ACA marketplace plans due to reduced or eliminated subsidies
- Are self-employed or freelance and facing premium increases you simply can’t afford
- Are relatively healthy and mainly need access to routine prescriptions and basic care
- Fall into the “subsidy gap”—earning too much to qualify for help but not enough to comfortably afford premiums
- Have a high-deductible plan that you’re paying hundreds for monthly but rarely actually use
- Need ongoing prescriptions for manageable conditions like birth control, hair loss, mental health medications, or chronic conditions that don’t require specialist care
Let’s explore some of the most reputable options available…
Major telehealth + pharmacy services:
- Lemonaid Health – https://www.lemonaidhealth.com
Lemonaid charges around $25-$35 for most telehealth visits, has options for some lab testing if needed to prescribe medications, and provides medications at prices comparable or lower than retail pharmacy prices. - Nurx – https://www.nurx.com
Well known as a provider of birth control medications, Nurx also treats a wide variety of other health needs, such as mental health, skin care, weight management, and general health.
Telehealth visits range between $15 and $80, depending on the medical need, and medication prices are reasonable. If you do have insurance coverage, many medications can be a $0 copay.
Retail pharmacies with telehealth:
- Amazon Pharmacy/Amazon Clinic – https://pharmacy.amazon.com and https://clinic.amazon.com
Amazon’s pharmacy is already well known for having generics at low cost, and sometimes zero cost with insurance. They also rolled out a telehealth service, which, when combined with their online pharmacy, helps side-step costly in-person provider visits. Chat-based doctor visits start at $29, and video visits start at $49. Amazon also offers telehealth service discounts if you are a Prime member. - CVS MinuteClinic – https://www.cvs.com/minuteclinic (for in-person visits) https://www.cvs.com/minuteclinic/virtual-care (for telehealth visits)
CVS has in person clinics at some locations, typically in larger cities. They also offer virtual care appointments. They charge $69 to $129 for virtual visits and will bill your insurance if you have any, further reducing the price. Prescriptions can be sent to an affilated CVS pharmacy or sent to another pharmacy if needed. They cover a wide variety of medical issues. - Walgreens – https://www.walgreens.com/topic/healthcare-clinic/telehealth.jsp
Telehealth visits are available in most states for $29 to $79 for the visit. Walgreens notes that they can either call the prescription in to a store or deliver it to your home. The caveat is that you will be paying Walgreens prices for the prescription. In some cases, that can be cost-prohibitive, but if you need a lower-cost generic, it may still be a good value.
While these services may not cover every need, they can fill many coverage gaps and save you considerable time and money.
