Tier 1 (Preferred Generic Medications)

• Generic drugs
• Lowest cost option

Tier 2 (Preferred Brand Medications)

• Preferred brand-name products based on safety, efficacy, and cost
• Second lowest cost option

Tier 3 (Non-Preferred Brand and Generic Medications)

• Brand name and generic drugs for which alternatives are available in Tier 1 or Tier 2
• Not used typically as a first-line of treatment
• Higher copayment or coinsurance option

Tier 4 (Specialty Medications)

• Medications which are more expensive than most medications and may be used to treat rare and complex conditions

Tier 5 (Zero Cost Share Preventive Drugs)

• Specific preventive medications with no patient cost-share