What does my Part D plan mean when they mention different “tiers”?
To keep costs down, many plans place drugs into different tiers on their formularies. Tiers can be divided by various plans in different ways, and each tier costs a different amount. Here is a basic example of how it is generally laid out:
– Tier 1: lowest co-pay; most generic medications
– Tier 2: medium co-pay; preferred, brand-name medications
– Tier 3: higher co-pay; non-preferred, brand-name medications
– Tier 4 or Specialty Tier: highest co-pay; very high cost medications
In certain situations, if a higher-tier drug is deemed necessary by your physician, you may file for an exemption to get this medicine at the co-pay of a lower tier.
Disclaimer: Answers to inquiries concerning information about health conditions and/or medications are not for diagnostic or treatment purposes and can not be considered conclusive without consulting with a physician for diagnosis and treatment. Any information contained here is not a substitute for medical advice and may be outdated, invalid, or subject to debate. If you are in need or immediate medical attention, contact your physician or call 911. If you need to speak to a pharmacist, call Grand Bay Pharmacy at (251) 865-5555.
