3-Tier Pharmacy Copayment Program

Prescription drug prices vary tremendously - including drugs used to treat the same condition. We sort prescription drugs into three tiers to help you and your doctor choose the most cost-effective option for the medication you need. Each tier has a specific copay amount that you pay when you fill or order your prescription.

Tier Level Tier Copay Tier Description
Tier 1 Lowest copayment Medications on this tier have the lowest copayment. This tier includes many generic drugs.
Tier 2 Middle copayment Medications on this tier are subject to the middle copayment. This tier includes some generics and brand-name drugs.
Tier 3 Highest copayment This is the highest copayment tier and includes some generics and brand-name covered drugs not selected for Tier 2.

Look up Your Medication to Determine Tier Level and Special Coverage Considerations

For coverage dates starting 01/01/2015, please refer to the following links:

1This formulary also applies to Massachusetts Small Group and Individuals and Families up until the next enrollment renewal date in 2014. Thereafter, Massachusetts Individual and Small Group Drug List formulary applies.