Prescription Drug Coverage

Making Sense of Prescription Coverage

Formularies and tiers

Every plan keeps a formulary, its list of covered drugs sorted into tiers. Tier 1 generics might cost $10; a tier 4 specialty drug might cost hundreds. The same medication can sit in different tiers on different plans, which is why your prescriptions should help pick your plan, not the other way around.

Ways people overpay without knowing

• Filling a brand name when an identical generic exists
• Using a retail pharmacy when the plan's mail-order option is cheaper for maintenance drugs
• Not asking about 90-day fills, which often cost less per dose

Before you switch plans

Bring us your medication list. We check each drug against the formulary of any plan you are considering, so a plan switch never turns into a pharmacy surprise.