Here’s a definition of the five drug tiers:
- Tier 1 – Preferred Generics: (This is the lowest cost tier): Includes generic drugs that are available at the lowest cost share for this plan.
- Tier 2 – Generics: Includes generic drugs that are available at a higher cost to you than drugs in Tier 1. Also includes some very low cost brand drugs.
- Tier 3 – Preferred Brands: Includes preferred brand name drugs that are available at a lower cost to you than drugs in Tiers 4 and 5. Also includes some high cost generic medications which are available at a higher cost to you than drugs in Tiers 1 and 2.
- Tier 4 – Non-Preferred Drugs: Includes brand and generic drugs that are available at a higher cost to you than drugs in Tier 3.
- Tier 5 – Specialty Drugs: (This is the highest-cost tier): Includes some injectables and other high-cost drugs.
You may be able to get extra help to pay for your prescription drug premiums and/or copays. To see if you qualify, call or contact:
- 1-800-Medicare (1-800-633-4227). (TTY: 1-877-486-2048) anytime
- The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m. (EST) Monday through Friday. TTY:1-800-325-0778
- The Texas Medicaid Office
For additional prescription drug benefit details, please refer to your Evidence of Coverage found in Plan Documents.