Formulary Tiers


To control costs, we group drugs into five formulary tiers. Each tier costs a different amount. A drug in a lower tier costs less than a drug in a higher tier. Our tiers provide a wide selection of brand-name drugs and higher cost generic drugs. Higher cost generic drugs cost less than their brand-name equivalents but they have the same active ingredients and are approved by the U.S. Food and Drug Administration (FDA). We suggest that you talk to your doctor to find out if a higher cost generic drug will work for you.

Cost-Sharing Tier 1 (Preferred Generic)

Certain generic drugs that are available at the lowest copayment for our members.

Cost-Sharing Tier 2 (Generic)

Higher cost generic drugs available at a higher copayment than Tier 1 Generic Drugs.

Cost-Sharing Tier 3 (Preferred Brand)

Value Plus: Common brand-name and some higher cost generic drugs, many of which may have lower cost options available on Tier 1 or Tier 2.
Premier: Common brand-name drugs, many of which may have lower cost options available on Tier 1 or Tier 2.

Cost-Sharing Tier 4 (Non-Preferred Drug)

Value Plus: Higher cost generic and non-preferred drugs, many of which may have lower cost options available on Tier 1, Tier 2, and Tier 3.
Premier: Non-preferred drugs, many of which may have lower cost options available on Tier 1, Tier 2 and Tier 3.

Cost-Sharing Tier 5 (Specialty Tier)

Unique and/or very high-cost drugs of which you pay a percentage of the total drug cost.



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