Drug tiers for 2017

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 network pharmacy and for up to a 90-day supply through mail order.

The copayments we show below apply:

  • After you pay your prescription deductible, if your plan has one
  • Before you reach $3,700 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.

New for 2017 - Members in most plans can take advantage of preferred pharmacy pricing. Review the preferred pharmacy list.

Drug tier cost sharing for 2017

PriorityMedicare KeySM

Tier 1
Preferred generic
Tier 2
Generic
Tier 3
Preferred brand
Tier 4
Non-preferred drug
Tier 5
Specialty
After you meet the $400 deductible: 25% coinsurance

PriorityMedicare IdealSM

Tier 1
Preferred generic
Tier 2
Generic
Tier 3
Preferred brand
Tier 4
Non-preferred drug
Tier 5
Specialty
After you meet the $400 deductible: 25% coinsurance

PriorityMedicare ValueSM

Tier 1
Preferred generic
Tier 2
Generic
Tier 3
Preferred brand
Tier 4
Non-preferred drug
Tier 5
Specialty
After you meet the $75 deductible:
$7 (standard retail)
$2 (preferred retail)
$0 (90-day mail order)
After you meet the $75 deductible: $15 (standard retail)
$10 (preferred retail)
$0 (90-day mail order)
After you meet the $75 deductible: $47 (standard retail)
$42 (preferred retail)
$105 (90-day mail order)
After you meet the $75 deductible: $100 (standard retail)
$95 (preferred retail)
$237.50 (90-day mail order)
After you meet the $75 deductible: 31% coinsurance (30-day supply only)

PriorityMedicare MeritSM

Tier 1
Preferred generic
Tier 2
Generic
Tier 3
Preferred brand
Tier 4
Non-preferred drug
Tier 5
Specialty
$7 (standard retail)
$2 (preferred retail)
$0 (90-day mail order)
$15 (standard retail)
$10 (preferred retail)
$0 (90-day mail order)
After you meet the $75 deductible: $47 (standard retail)
$42 (preferred retail)
$105 (90-day mail order)
After you meet the $75 deductible:
$100 (standard retail)
$95 (preferred retail)
$237.50 (90-day mail order)
After you meet the $75 deductible: 31% coinsurance (30-day supply only)

The $75 deductible does not apply to preferred generic or generic drugs. It applies to the first $75 of your costs for drugs from tiers 3, 4 and 5.

PriorityMedicareSM

Tier 1
Preferred generic
Tier 2
Generic
Tier 3
Preferred brand
Tier 4
Non-preferred drug
Tier 5
Specialty
$6 (standard retail)
$1 (preferred retail)
$0 (90-day mail order)
$13 (standard retail)
$8 (preferred retail)
$0 (90-day mail order)
$43 (standard retail)
$38 (preferred retail)
$95 (90-day mail order)
$88 (standard retail)
$83 (preferred retail)
$207.50 (90-day mail order)
33% coinsurance (30-day supply only)

PriorityMedicare SelectSM

Tier 1
Preferred generic
Tier 2
Generic
Tier 3
Preferred brand
Tier 4
Non-preferred drug
Tier 5
Specialty
$6 (standard retail)
$1 (preferred retail)
$0 (90-day mail order)
$12 (standard retail)
$7 (preferred retail)
$0 (90-day mail order)
$42 (standard retail)
$37 (preferred retail)
$92.50 (90-day mail order)
$85 (standard retail)
$80 (preferred retail)
$200 (90-day mail order)
33% coinsurance (30-day supply only)