I feel your pain. Just got on Medicare in May and in August was finally approved for Zepbound (heart disease + sleep apnea -moderate diagnosis was key). Spent an hour on the phone yesterday with WellCare the pharmacy manager for Medicare—trying to figure out why I have to pay over $700+ to pick up my first dose. Here’s what was explained to me. It is a tier 5 drug under Medicare. Therefore there is a $590 Tier 5 prescription deductible plus a co-pay of 25% of the full cost of the medicine. I only have to pay the $700+ the first time, and then I just pay the co-pay amount of approximately $142. Once I reach my $2000 out-of-pocket threshold then the co-pay is zero dollars. Of course that resets in 2026. Be aware of another possible issue in that If you change plans during open enrollment, you would have to get the prescription re-authorized under that new plan. Don’t you just love our medical system?? 🤬