Ambetter upped my copay randomly??

Hi, I’m confused and hoping someone can tell me if I’m being scammed/ gaslit or if this is common practice. I recently chose Ambetter through the marketplace for this year. When I checked out the specs for this plan, the $3 copay for generic prescriptions caught my eye. I was excited about that cost and even though this plan has a higher premium, I felt the cheaper prescriptions would make it worth it.

Fast forward to last week, I got a refill notification and checked out the price of my generic, it said $10… which is weird because I KNOW my copay is $3. So today I called Ambetter to say hey what’s up with this and got a serious run around. The first agent I talked to said it’s showing $3 on her end so call my pharmacy and tell them. I called my pharmacy and they said “uh we don’t control that” (no shit). So I called Ambetter back only for the second person to say the same thing “it’s showing $3 on my end” and transfer me to their pharmacy department.

Here’s where it gets weird. The lady tells me it’s $10. I explain to her the whole situation and why it’s weird she’s saying that. She explains there’s a tier system and because my generic is a tier 1 generic it’s more… What’s really strange is the EOB portion of the app WAS saying $3 copay and now it’s saying $10.

So do copays shift based on prescription?? I’ve never heard of that but these companies invent new ways to screw us every day. Has anyone else dealt with this issue? Any (nice) feedback would be appreciated ty.

TLDR; My copay for generics went up randomly and now they’re saying the price is based on a tier system but it feels scammy.

submitted by /u/Shinetick
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