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