Each covered drug is in 1 of 5 drug tiers. A drugs tier listing is a function of three things.
Formulary Versus Non Formulary Prescription Drugs Bia
Prescription drug tier list. Why drugs are listed in tiers. Mostly brand name drugs as well as some generics. Its real cost the payers negotiated cost and whether there are cheaper options. Many tier 4 drugs have lower cost options in tiers 1 2 or 3. The next anticipated update will be july 1 2019. However there may be instances when only a tier 3 drug is appropriate which will require a higher copayment.
Your plans summary of benefits will have a section on prescription drug costs. For an up to date list of covered drugs or if you have questions please call unitedhealthcare. When you look up a drug the second column of the drug list will show you what tier its in. List of prescription drugs covered by your plan is current as of october 1 2019. Find your plans drug list. Each tier has a copay or coinsurance amount.
But tiers are also based on drug class. A prescription drug list is a list of drugs available to blue cross and blue shield of oklahoma bcbsok members. A mix of brand name and generic drugs. Use tier 2 or tier 3 drugs instead of tier 4 to help reduce your out of pocket costs. The prescription drug tier which consists of the lowest cost tier of prescriptions drugs most are generic. The more the drug costs the payer the higher the tier.
These costs are decided by your employer or health plan. A prescription drug list pdl also called a formulary is a list of commonly used medications organized into cost levels called tiers. Tier 3 brand drugs that dont have a generic available. Tier 2 prescription generic and some otc drugs. Also may include higher priced generics that have more costeffective options at lower tiers. Your physician may have the option to write you a prescription for a tier 1 tier 2 or tier 3 drug as defined below.
Where can i find out how much ill pay for drugs in each tier. Tier 4 highest cost medications that provide the lowest overall value. 1 2019 and is subject to change after this date. Your 2019 prescription drug list advantage three tier this prescription drug list pdl is accurate as of jan. These drugs are considered to be safe and cost effective. How much you may pay out of pocket for prescription drugs is determined by whether your medication is on the drug list.
The prescription drug tier which consists of medium cost prescription drugs most are generic and some brand name prescription drugs. You can find out more about how to read a drug list in our help center. All covered drugs are placed into one of three tiers. Tier 1 lowest cost prescription generic and some over the counter otc drugs. This pdl applies to members of our unitedhealthcare neighborhood health plan river valley all savers and oxford medical plans.
Gallery of Prescription Drug Tier List
