Employer-sponsored Medicare plan coverage level
The drug coverage level, or tier, is a classification for drugs listed in our approved drug list (or formulary). The tier determines your cost for a particular drug.
Tier 1, preferred generic drugs, includes some of the most commonly prescribed generic drugs. This is the lowest cost tier.
Tier 2, non-preferred generic drugs, includes some generic and some brand-name drugs, such as some self-administered insulin.
Tier 3, preferred brand drugs, includes brand drugs that have been available for awhile or are often prescribed due to their overall effectiveness and safety.
Tier 4, non-preferred brand drugs, includes higher-cost brand and some high-cost generic drugs. They are not preferred because there are equally effective alternative drugs which cost less.
Tier 5, specialty drugs, includes very high cost medications, both brand and generic. They are limited to a 30-day supply per prescription or refill. This is the highest cost tier.
Tier 6, infertility drugs, includes medicines that help bring about pregnancy.
Not covered: Drugs that your prescription plan will not pay for or that are not included on the formulary (Approved Drug List). Here's how to ask for an exception. For more information, contact Customer Service: 888.389.6648.