Why did my prescription price go up?

The causes are a short list: the plan-year deductible reset (January's full-price fills), a formulary reshuffle moving your drug to a worse tier or off the list, the pharmacy's wholesaler or manufacturer change, a manufacturer list-price increase, or a patent event. The moves: ask the pharmacy to check and re-run - errors happen; compare the discount-card cash price, which sometimes beats the new insurance price; ask the prescriber for a same-class alternative in a better tier; and ask the plan about a tier exception if the jump is formulary-driven.

Price jumped

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What to do

• Ask the pharmacy why and re-run it. Coding errors are real.
• Check the discount-card price. Sometimes cash beats the new copay.
• Ask for a better-tier alternative. Same class, lower cost.
• Request a formulary exception. Especially with documented intolerance to alternatives.

Related questions

• Can I use a discount card with insurance?
• What is a therapeutic substitution?
• What is a prompt-pay discount?
• Why do two hospitals charge different prices?

Sources

• Healthcare.gov: Prescription Medication Coverage
• FDA: Generic Drug Facts