Drug costs for 2021
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 30-day supply at a preferred retail pharmacy and at a standard pharmacy, and for a 90-day supply through mail order (with free shipping). Costs may vary when your plan is provided by an employer.
Your drug copays/coinsurance
This is what you'll pay until you reach $4,130 in total drug costs for the year (the combined total of what you have paid plus what Priority Health has paid for your prescriptions).
PriorityMedicare EdgeSM
This plan has no Part D deductible, so you'll pay these amounts for your drugs.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$2 (preferred retail) $6 (standard retail) $0 (90-day mail order) |
$8 (preferred retail) $13 (standard retail) $0 (90-day mail order) |
$38 (preferred retail) $43 (standard retail) $95 (90-day mail order) |
40% coinsurance preferred retail) 45% coinsurance (standard retail) 40% coinsurance (90-day mail order) |
33% coinsurance |
PriorityMedicare CompassSM
Costs shown for tiers 3, 4 and 5 are what you'll pay after you meet the $100 Part D deductible. There is no deductible for drugs in tiers 1 or 2.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$4 (preferred retail) $10 (standard retail) $0 (90-day mail order) |
$15 (preferred retail) $20 (standard retail) $0 (90-day mail order) |
$42 (preferred retail) $47 (standard retail) $105 (90-day mail order) |
45% coinsurance preferred retail) 50% coinsurance (standard retail) 45% coinsurance (90-day mail order) |
31% coinsurance |
PriorityMedicare KeySM
Costs shown for tiers 3, 4 and 5 are what you'll pay after you meet the $100 Part D deductible. There is no deductible for drugs in tiers 1 or 2.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$4 (preferred retail) $10 (standard retail) $0 (90-day mail order) |
$15 (preferred retail) $20 (standard retail) $0 (90-day mail order) |
$42 (preferred retail) $47 (standard retail) $105 (90-day mail order) |
45% coinsurance (preferred retail) 50% coinsurance (standard retail) 45% coinsurance (90-day mail order) |
31% coinsurance |
PriorityMedicare VitalSM
Costs shown for tiers 3, 4 and 5 are what you'll pay after you meet the $350 Part D deductible. There is no deductible for drugs in tiers 1 or 2.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$1 (preferred retail) $6 (standard retail) $0 (90-day mail order) |
$4 (preferred retail) $10 (standard retail) $0 (90-day mail order) |
$42 (preferred retail) $47 (standard retail) $105 (90-day mail order) |
45% coinsurance preferred retail) 50% coinsurance (standard retail) 45% coinsurance (90-day mail order) |
26% coinsurance |
PriorityMedicare IdealSM
Costs shown for tiers 3, 4 and 5 are what you'll pay after you meet the $125 Part D deductible. There is no deductible for drugs in tiers 1 or 2.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$4 (preferred retail) $9 (standard retail) $0 (90-day mail order) |
$13 (preferred retail) $18 (standard retail) $0 (90-day mail order) |
$42 (preferred retail) $47 (standard retail) $105 (90-day mail order) |
50% coinsurance preferred retail) 50% coinsurance (standard retail) 50% coinsurance (90-day mail order) |
30% coinsurance |
PriorityMedicare ValueSM
Costs shown for tiers 3, 4 and 5 are what you'll pay after you meet the $75 Part D deductible. There is no deductible for drugs in tiers 1 or 2.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$2 (preferred retail) $7 (standard retail) $0 (90-day mail order) |
$10 (preferred retail) $15 (standard retail) $0 (90-day mail order) |
$42 (preferred retail) $47 (standard retail) $105 (90-day mail order) |
50% coinsurance preferred retail) 50% coinsurance (standard retail) 50% coinsurance (90-day mail order) |
31% coinsurance |
PriorityMedicare MeritSM
This plan has no Part D deductible, so you'll pay these amounts for your drugs.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$2 (preferred retail) $7 (standard retail) $0 (90-day mail order) |
$10 (preferred retail) $15 (standard retail) $0 (90-day mail order) |
$42 (preferred retail) $47 (standard retail) $105 (90-day mail order) |
50% coinsurance preferred retail) 50% coinsurance (standard retail) 50% coinsurance (90-day mail order) |
33% coinsurance |
PriorityMedicareSM
This plan has no Part D deductible, so you'll only pay these amounts for your drugs.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$1 (preferred retail) $6 (standard retail) $0 (90-day mail order) |
$8 (preferred retail) $13 (standard retail) $0 (90-day mail order) |
$38 (preferred retail) $43 (standard retail) $95 (90-day mail order) |
45% coinsurance preferred retail) 45% coinsurance (standard retail) 45% coinsurance (90-day mail order) |
33% coinsurance |
PriorityMedicare SelectSM
This plan has no Part D deductible, so you'll only pay these amounts for your drugs.
Tier 1 Preferred generic |
Tier 2 Generic |
Tier 3 Preferred brand |
Tier 4 Non-preferred drug |
Tier 5 Specialty |
$1 (preferred retail) $6 (standard retail) $0 (90-day mail order) |
$7 (preferred retail) $12 (standard retail) $0 (90-day mail order) |
$37 (preferred retail) $42 (standard retail) $92.50 (90-day mail order) |
45% coinsurance preferred retail) 50% coinsurance (standard retail) 45% coinsurance (90-day mail order) |
33% coinsurance |
After you reach $4,130 in drug costs
Once you and Priority Health combined spend $4,130 for your drugs during the year, then you enter what's called a "coverage gap." During this gap, you'll pay:
- 25% of the cost of your generic drugs
- 25% of the cost of your brand drugs, plus dispensing fee
Then, once your out-of-pocket Part D drug costs reach $6,550, for the rest of the year you pay the greater of:
- 5% of the cost OR
- $3.70 for generic drugs
- $9.20 for all other drugs
Compare & save on your prescriptions
Log in to your member account to use the Cost Estimator tool to see the costs of drugs at pharmacies near you.