Cost Tiers

Cost Tiers are categories used by insurance plans to classify prescription medications based on their cost to the patient. Typically, medications are grouped into tiers with different copayment or coinsurance amounts assigned to each tier. Lower-cost generic drugs are often placed in lower tiers, while brand-name or specialty medications may be assigned to higher tiers with higher out-of-pocket costs for patients. Cost tiers help insurers manage medication costs and provide transparency for patients regarding their prescription expenses.