Understanding the Different Tiers

Scroll to the bottom of the page to figure out what tier your prescription falls on

What is a drug tier?

Prescription Drug Lists (formulary) often have tiers, or groups of drugs categorized by cost. Your cost-share or copayment is based on which tier your drug is in. There are typically three or four tiers (your plan’s tiers may be different):

  • Tier 1: Least expensive drug options, often generic drugs

  • Tier 2: Higher price generic and lower-price brand-name drugs

  • Tier 3: Mainly higher price brand-name drugs

  • Tier 4: Highest cost prescription drugs

Note: If you take insulin, you may be able to get Medicare drug coverage that offers savings on your insulin. You could pay no more than $35 for a month's supply. Contact us to find out if there is a plan available in your state and county.

What’s this donut hole thing all about?

Good question! Leave it to our government to create this convoluted concept!

 

Steps to finding your prescription’s tier

 

Step 1

Find your insurance company below.

Step 2

Please note all the insurance company websites are different. You may need to enter your zip code in order to get started. After entering your zip code, look for your plan and look for a link that says something along the lines of “enter drug information.”

Step 3

Please keep in mind you can always contact us if you have any questions.

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