The prescription drug tier which consists of medium cost prescription drugs most are generic and some brand name prescription drugs. Most medicare drug plans medicare prescription drug plans and medicare advantage plans with prescription drug coverage have their own list of what drugs are covered called a formulary.
Prescription Drug Formulary Legislation In Select States
Prescription drug tier list. However there may be instances when only a tier 3 drug is appropriate which will require a higher copayment. Mostly brand name drugs as well as some generics. Where can i find out how much ill pay for drugs in each tier. Use tier 2 or tier 3 drugs instead of tier 4 to help reduce your out of pocket costs. Each covered drug is in 1 of 5 drug tiers. You can find out more about how to read a drug list in our help center.
The formulary includes at least 2 drugs in the most commonly prescribed categories and classes. The next anticipated update will be july 1 2019. 1 2019 and is subject to change after this date. These costs are decided by your employer or health plan. This pdl applies to members of our unitedhealthcare neighborhood health plan river valley all savers and oxford medical plans. Your physician may have the option to write you a prescription for a tier 1 tier 2 or tier 3 drug as defined below.
A drugs tier listing is a function of three things. Its real cost the payers negotiated cost and whether there are cheaper options. A mix of brand name and generic drugs. Tier 2 prescription generic and some otc drugs. For an up to date list of covered drugs or if you have questions please call unitedhealthcare. But tiers are also based on drug class.
The prescription drug tier which consists of the lowest cost tier of prescriptions drugs most are generic. All covered drugs are placed into one of three tiers. Each tier has a copay or coinsurance amount. Find your plans drug list. The more the drug costs the payer the higher the tier. Your plans summary of benefits will have a section on prescription drug costs.
When you look up a drug the second column of the drug list will show you what tier its in. List of prescription drugs covered by your plan is current as of october 1 2019. Tier 3 brand drugs that dont have a generic available. Your 2019 prescription drug list advantage three tier this prescription drug list pdl is accurate as of jan. Tier 1 lowest cost prescription generic and some over the counter otc drugs. Plans include both brand name prescription drugs and generic drug coverage.
A prescription drug list pdl also called a formulary is a list of commonly used medications organized into cost levels called tiers. Tier 4 highest cost medications that provide the lowest overall value. Why drugs are listed in tiers. Also may include higher priced generics that have more costeffective options at lower tiers. Many tier 4 drugs have lower cost options in tiers 1 2 or 3.
Gallery of Prescription Drug Tier List
