@daisylou, I just went through that the other night regarding a new Tymlos prescription. I dealt with someone from CVS specialty that was completely clueless, but tried again in the evening and was connected to a woman who was very knowledgable and explained the $2000 cap to me in terms I could understand.
On the other hand, a pharmacist from there called me yesterday afternoon because I had a thousand questions about Tymlos and I found her pretty ignorant. I was glad I had thoroughly read the literature beforehand on the Tymlos site because she was obviously not familiar with the drug.
She told me I could insert the needle into my stomach or my thigh, (I think just the stomach!), she told me there was NO warning about osteosarcoma on the Tymlos literature, she told me if I have any dizziness, drop in blood pressure, headache, etc. to call my doctor immediately (which scared me, since I thought that was pretty typical), she said I absolutely could not take less than 8 full clicks, and she had no idea or suggestions as to whether I should take it in the evening or morning for best benefit.
In the end, these are just people, like us, trying to learn the ins and outs of all these drugs, but they certainly need to get up to date on the latest Medigap info for 2025.
Ultimately, as I said, the pharmacy is simply going to bill your prescription plan. I don't expect CVS Specialty or Optum or anyone else to know much about $2000 cap, at least not anyone I'd speak to over the phone. It's your Part D plan that is going to pay the benefits. As long as the pharmacy has my insurance information, and the medication is covered, that's all they really need to know.
And, of course, you have to keep on top of it every month to make sure they're doing what they're supposed to do, i.e. not bill you after $2000 !