Prescription drug lists (PDL) often have tiers, or groups of drugs categorized by cost. Generally, a drug in a lower tier will cost less than a drug in a higher tier. Your cost-share or copay is based on which tier your drug is in.
The High Option pharmacy plan has six drug tiers:
A 30-day supply of non-specialty retail prescription drugs and a 90-day supply of non-specialty mail-order prescription drugs have three tiers:
Tier 1: Includes generic drugs
Tier 2: Includes preferred brand-name drugs
Tier 3: Includes non-preferred brand-name drugs
A 30-day supply of specialty retail prescription drugs and a 90-day supply of specialty mail-order prescription drugs have three tiers:
Tier 4: Includes generic specialty drugs
Tier 5: Includes preferred brand-name specialty drugs
Tier 6: Includes non-preferred brand-name specialty
The Consumer Driven Option pharmacy plan has three drug tiers:
Tier 1: Mostly generic drugs, but some brand-name drugs may be included
Tier 2: A mix of brand-name and generic drugs
Tier 3: Mostly brand-name drugs and some generics
The Medicare PDP for Postal Service retirees and the Medicare PDP for federal retirees both have four drug tiers instead of the standard six tiers under Medicare Part D.
Plans can change the PDL at any time. Your plan must notify you of any changes to a list that affects the medications you take.