Medicare Part D Copays

Medicare Part D plans usually have 5 tiers for their medications in their formularies.
Tier 1 is usually a preferred generic medication. 

Tier 2 is usually a non-preferred generic. 

Tier 3 is usually a preferred brand.

Tier 4 is usually a non-preferred brand.

Tier 5 is usually a specialty medication.

The insurance company will set the copay for each tier. For example, one company might charge a $3 copay for Tier 1 medications, while another charges $5. This is why it’s important to review the plan’s formulary to make sure your medications are covered and to know what you can expect to pay for those medications.

Medicare offers a Drug Finder Tool which can be found at www.medicare.gov. You can use this tool to enter your zip code and medications. The Drug Finder Tool will show you which plans in your state will be most cost effective for you.

You must do your annual homework with Part D to ensure the lowest out of pocket drug spending for the next year.