r/Zepbound•
TXRanger1837

Another eVoucher & Rx Cost Question - but with more actual numbers to figure out

Insurance/PA

June was my first month on Zep. I paid the $25 that everyone seems to the first month. This month I'm paying $200. I'm trying to figure out why.

In June, a $1304 claim was submitted to my insurance for Zep. My plan allowance for that drug is $1049. My claim shows insurance paid $188. I paid $25.

So is it safe to assume that the automatically applied eVoucher paid the difference of $836? (1049-188-25)

I called the pharmacy and asked about the Eli Lilly savings card. I was told that she could call to get the voucher removed and the EL card applied, but she can't undo that change once it's done. So I called my insurance.

Zep is a Tier 3 on my plan. That means I pay 40% (capped at $300). I met my deductible last month with that first dose. I'm nowhere near my OOP max.

If everything I have read about the eVoucher in 2026 is true, I'd have $1300, right? Let's say $836 was used in Month 1. That leaves $464 on the voucher.

$1049 - $464 = $585
40% of 585 = $234

So why am I being charged $200? That's a $100 off my $300 cap.

Makes me wonder what is actually happening. I thought I get to use up the entirety of the $1300 eVoucher. Is that not true? Since I met my deductible, is the remainder going to be credited to me in $100 increments?

I am asking because I don't know when to switch to my Eli Lilly card and ditch the eVoucher. I can't get a handle on what is actually happening with the numbers.

Posted Jul 13, 2026, 4:33 PM UTC

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