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