Tier (Drugs)
Drug tiers are how health insurance plans divide prescription drugs into different levels of cost.
Tier 1 thru Tier 5 is a common breakdown.
• Five levels of cost, with drugs in Tier 1 being the cheapest and drugs in Tier 5 the most expensive.
Your plan's Summary of Benefits and Coverage (SBC) document will list the number of tiers and associated costs.
♦ Insurance plans have recently begun listing pharmacies by tier also.
Their preferred pharmacy being Tier 1 and other network pharmacies Tier 2. Prescription costs being lower if Tier 1 pharmacies are used.
Related content
• How much do I have to pay for prescriptions?
Why do prescriptions cost so much?
• How are drug prices decided?
