RX Formulary.
Your prescription drug list. Understand how medications are covered and what you'll pay at the pharmacy.
Drug Tiers Explained
Medications are organized into tiers based on cost. Lower tiers mean lower costs for you.
Tier 1: Generic
$10
Lowest cost. FDA-approved generic equivalents of brand-name drugs.
Tier 2: Preferred Brand
$35
Moderate cost. Brand-name drugs on the preferred list.
Tier 3: Non-Preferred
$60
Highest cost. Brand-name drugs not on the preferred list.
Specialty Medications
Some medications used to treat complex conditions require special handling. These specialty drugs have different cost-sharing and may need prior authorization.
Specialty Drug Coinsurance
20% up to $250/fill
Save with Mail Order
Get a 90-day supply of maintenance medications for the cost of two copays.
Tier 1 (90-day)
$20
vs. $30 at retail
Tier 2 (90-day)
$70
vs. $105 at retail
Tier 3 (90-day)
$120
vs. $180 at retail
Frequently Asked Questions
You can search the formulary online through your insurance carrier's website, or ask your pharmacist at the time of pickup.
You may still be able to get coverage through an exception request. Your doctor can submit documentation explaining why you need that specific medication.
Yes, but you may pay more. If your doctor indicates "Dispense As Written," you'll typically pay the difference between generic and brand cost.