Every Part D plan has something called a formulary, which is a list of drugs covered under the plan. Each formulary has a set of tiers, and in most cases, Part D plans have between three and six tiers. A lower-tier drug usually has lower copays or coinsurance than a drug in a higher tier. For example: Tier 1 – Lowest copay, usually generic drugs Tier 2 – Medium copay includes some low-cost brand-name drugs Tier 3 – Higher copay includes brand-name drugs that have generic versions also available Tier 4 – Higher-co-pay brand-name drugs, and some specialty drugs Tier 5 – Highest copay includes high-cost specialty prescription drugs Suppose you are prescribed a drug in a high tier, and a drug that is similar or therapeutically equivalent is also available in a lower tier at a lower price. In that case, you can ask your insurance company for an exception to get the lower coinsurance or copay. Call Kevin Leinum Medicare Agent – your local Medicare Expert about what Medicare covers or how enrolling in a Medicare Advantage or Medicare Supplement plan can improve your coverage and reduce your out-of-pocket costs.
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We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 75 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This is a proprietary website and is not associated, endorsed, or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program, please visit the Official U.S. Government Site for People with Medicare located at http://www.medicare.gov.