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Drug Tiers Explained
Individuals and Family Plans
All About Health Insurance
Drug Tiers Explained
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Drug Tier Plans
Drug Tier Definitions for Individual and Family PlansĀ
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