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Drug tiers for 2012

The higher a drug's cost level or "tier," the higher the cost. In the chart below, you'll see what you'll pay for each drug tier for a 31-day supply at a network pharmacy and for a 90-day supply through mail order.
  • These copays apply before you reach $2,930 in total drug costs (total of what you pay plus what Priority Health pays).
  • Costs may vary when your plan is provided by an employer.

Drug tiers for 2012**

TierPriorityMedicare ValuePriorityMedicarePriorityMedicare SelectPriorityMedicare Rx
Tier 1
Generics		 $9 (31-day)
$22.50 (mail order 90-day) 		$8 (31-day)
$20 (mail order 90-day)		 $8 (31-day)
$20 (mail order 90-day)		 $9 (31-day)
$22.50 (mail order 90-day)
Tier 2
Preferred
brand name		 $40 (31-day)
$100 (mail order 90-day)		 $35 (31-day)
$87.50 (mail order 90-day)		 $40 (31-day)
$100 (mail order 90-day)		 $45 (31-day)
$112.50 (mail order 90-day)
Tier 3
Non-preferred brand name		 $81 (31-day)
$202.50 (mail order 90-day)		 $70 (31-day)
$175 (mail order 90-day)		 $80 (31-day)
$205 (mail order 90-day)		 $95 (31-day)
$237.50 (mail order 90-day)
Tier 4
Specialty		 33% of Priority Health's discounted cost (mail order 31-day) 33% of Priority Health's discounted cost (mail order 31-day) 33% of Priority Health's discounted cost (mail order 31-day) 27% of Priority Health's discounted cost (mail order 31-day)

**Copays shown are your cost for a 31-day supply at a retail pharmacy/90-day supply through mail order in the Priority Health network, before you reach $2,930 in total drug costs (total of what you pay plus what Priority Health pays). Costs may vary when your plan is provided by an employer.

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