Formularies are developed to meet the needs of most members based on the most commonly prescribed drugs including certain prescription drugs that medicare requires that we cover. 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.
Medicare Part D A First Look At Prescription Drug Plans In
Medicare prescription drug tier list. List of prescription drugs covered by your plan is current as of october 1 2019. Tier 4 non preferred drugs. These prescription drugs are lower in cost than tier 5 tier 5 specialty. These are the highest cost drugs including some injectables your plan may let you know when your prescription drug is moved to a higher cost sharing tier. This pdl applies to members of our. A prescription drug list pdl also called a formulary is a list of commonly used medications organized into cost levels called tiers.
It shows the drugs we cover the tier a drug is on any limits or requirements and mail order availability. The formulary includes at least 2 drugs in the most commonly prescribed categories and classes. The easiest way to find out what tier your drugs are in is by using your plans drug list. Its also called a formulary. All the drugs on our drug lists have been approved by the us. You can find out more about how to read a drug list in our help center.
Your summary of benefits tells you the drug costs for tiers. And we do research to make sure the drugs we choose are safe effective and lower in cost. In general the higher the tier the higher the members out of pocket cost for the covered drug. Each covered drug is in 1 of 5 drug tiers. Search our formulary for covered drugs and get the information you need. Your 2020 prescription drug list advantage 4 tier effective jan.
Plans include both brand name prescription drugs and generic drug coverage. Generally the lower the tier the less you pay. Silverscript plans use a system with five medicare formulary tiers. A drug list is a list of prescription drugs your health plan covers. A medicare part d drug list formulary is a list of drugs covered by a plan. 1 2020 this prescription drug list pdl is accurate as of jan.
When you look up a drug the second column of the drug list will show you what tier its in. Food and drug administration. Silverscript medicare part d formulary tiers indicate the level of cost sharing for a covered drug. Each tier has a copay or coinsurance amount. These costs are decided by your employer or health plan. 1 2020 and is subject to change after this date.
The next anticipated update will be july 1 2020. Outpatient health care or medicare part d prescription drugs.
Gallery of Medicare Prescription Drug Tier List
