Tiered Drug Benefits
With a multiple-tier drug benefit, your prescription medications fall into categories or “tiers.” Each tier has a different copay or coinsurance.
How Your Drug Benefits Work
Your LifeWise Assurance health plan includes coverage for prescription drugs. You’ll pay a part of the full cost of the drug based on what tier it is assigned in your plan.
Find out more about your pharmacy benefits:
- Sign in to your account and check your benefits booklet.
- Call us at 800-971-1491 so we can personally help you.
Check your ID card to see your copay or coinsurance for each drug tier.
B3 Drug Tier List
Drug Tier
Includes
Generic (1)
Tier 1 is the lowest tier and includes generic drugs. Generic drugs are as effective, safe, and high quality as their brand-name counterparts, yet less expensive.
Brand (2)
Tier 2 includes preferred brand drugs. Considered “preferred” when there is no generic, and/or because of their value and effectiveness.
Non-Preferred Brand (3)
Tier 3 includes non-preferred brand drugs. These drugs may be more expensive than their alternatives tiers 1 and 2.
M4 Drug Tier List
Drug Tier
Includes
Preferred Generic (1)
Tier 1 is the lowest tier and includes preferred generic drugs.
Preferred Brand (2)
Tier 2 includes preferred brand drugs.
Non-Preferred Brand (3)
Tier 3 includes non-preferred generic and brand drugs.
Specialty Drug (4)
Tier 4 includes specialty drugs. Specialty drugs are generally biologics and other targeted drugs usually used for complex medical conditions and often requiring special handling.
MB (Medical Benefit)
The MB tier includes medical benefit drugs normally administered in a clinic, infusion center or provided by a home infusion service. These drugs and their services are covered under the medical benefit, not under the pharmacy benefit. This drug may require prior authorization.