ConnectiCare pays prescription drug benefits using drug tiers. Drug tiers are a way to group drugs according to their cost to you. Generally, you pay less for lower tier drugs and more for higher tier drugs. Your plan states how much you'll pay for drugs in each tier (known as your "copay" or "copayment"), after your deductible.
What's in each tier?
Tier 1 drugs are generics.
- For most members Tier 1 generics will cost you $5 or less. (Check your plan documents for your costs).
- Generic drugs are equally effective as brand name drugs, as they contain the same ingredients.
Tiers 2 and 3 contain brand name drugs.
- ConnectiCare covers brand name drugs listed on Tiers 2 and 3.
- Tier 2 drugs are ConnectiCare's preferred brands and tier 3 drugs are non-preferred brands. Tier 2 drugs will cost you less than Tier 3 drugs.
- If your doctor determines that you require the brand name drug when there is a generic version available, you will pay the generic (Tier 1) drug copay PLUS the difference between the full cost of the generic and the brand drug, instead of the brand copay. For example:
Tier 4 covers specialty drugs.
- These drugs are the highest cost drugs and require special authorization and handling. Learn more about specialty drugs.
For complete information about drug coverage, view your plan document.