I recently moved my G7 sensor prescription from Publix to CVS because Publix’s distributor wasn’t delivering. I was surprised when I picked them up that my copay was … zero. The last previous batch had a 20% copay, about $190.
I’m wondering why the change though I certainly don’t object. This was my first batch in 2025, so perhaps either Medicare coverage or my Advantage plan’s coverage changed for the new year. Or perhaps because I changed pharmacies, though I don’t think of CVS as a place to get free stuff.
It’s good to be curious but medical/insurance/Medicare can be a tangled mystery. I suspect your Advantage plan changed in 2025. Glad it changed in your favor!
I have to meet an annual deductible, then after that it’s no-copay. The thing is, the deductible applies to everything, so I can sometimes meet it in the “background” so to speak. This year I met it relatively early and didn’t need a Dexcom refill right away, so I didn’t have a co-pay on my first order. Other years I’ve had to pay on my first order but nothing thereafter. Dunno if your coverage works the same way but the explanation could be along those lines. Never look a gift horse… except you may have already paid for the “gift.”
ETA: the other thing to note is that if you’re still in deductible-land, you have to pay the full co-pay even if it exceeds the balance of the deductible. This ensures that you will almost always end up paying, in effect, a larger annual deductible than the one stated in your contract. This is what in business parlance is called “a neat idea.”
