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    Medication

    Tiers

    Tiers are the cost-sharing levels a Part D or other drug plan assigns to medications, with preferred generics typically on lower tiers and brand or specialty drugs on higher tiers. A drug's tier determines the copayment or coinsurance the member pays.

    Definition

    Tiers are the cost-sharing levels a Part D or other drug plan assigns to medications, with preferred generics typically on lower tiers and brand or specialty drugs on higher tiers. A drug's tier determines the copayment or coinsurance the member pays.

    Why it matters

    Tier placement drives a patient's out-of-pocket drug cost and can prompt tier-exception requests, which matters for adherence and teaching.

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    Conversations on medication

    Episodes from Inside Home Health that put Tiers in operational context.

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