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