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