Insurance says I hit OOP @ $2500 but definitely did not pay that much this year?

I'm a T2 diabetic in NJ with Amerihealth insurance and multiple prescriptions with have Jardiance and Mounjaro being the most expensive ones. I paid about $10 for 3 months of Jardiance with a coupon and $120 for 3 months of the Mounjaro at the pharmacy without a coupon.

My Jardiance claims say: Billed by Pharmacy $1,686.27 | ~Health Plan Paid~ $1,285.42 | Your Estimated Cost $400.85. My Mounjaro claim says: Billed by Pharmacy $2,950.03 | ~Health Plan Paid~ $2,362.15 | Your Estimated Cost $587.88.

This is what a claim for my endo looks like and I've had 2 visits + a derm visit: Total Provider Charges $430.00 | ~Health Plan Discount~ $289.68 | Your Estimated Cost $140.32

So it seems my insurance thinks I hit my OOP costs with prescriptions when I have not. Do they not consider coupons when calculating this?

I'm just trying to figure out if I should go to an UC for this persistent, aggressive cough I've developed or wait a week to see my PCP (which may be cheaper if my insurance has indeed effed up on the OOP costs).

submitted by /u/Oshiet
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