Drug tiers for 2019

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 $3,820 in total drug costs for the year (the combined total of what you have paid plus what Priority Health has paid for your prescriptions).

PriorityMedicareSM(HMO-POS)

This plan has no Part D deductible, so you'll only pay these amounts for your drugs. Tier 5 specialty drugs are limited to a 30-day supply per fill.

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)
40% coinsurance (preferred retail)
45% coinsurance (standard retail)
40% coinsurance (90-day mail order)
33% coinsurance

PriorityMedicare IdealSM

Costs shown for tiers 1 - 5  are what you'll pay after you meet the $125 Part D deductible.

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)
45% coinsurance (preferred retail)
50% coinsurance (standard retail)
45% coinsurance (90-day mail order)
30% 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
$5 (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)
30% coinsurance

PriorityMedicare MeritSM(PPO)

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)
45% coinsurance (preferred retail)
50% coinsurance (standard retail)
45% coinsurance (90-day mail order)
31% coinsurance

PriorityMedicare SelectSM(PPO)

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)
40% coinsurance (preferred retail)
45% coinsurance (standard retail)
40% coinsurance (90-day mail order)
33% coinsurance

PriorityMedicare ValueSM

Costs shown for tiers 1-5 are what you'll pay after you meet the $75 Part D deductible.

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)
45% coinsurance (preferred retail)
50% coinsurance (standard retail)
45% consurance (90-day mail order)
31% coinsurance