All Other Plans: Three-tier Prescription Drug Rider
Some employers offer a Three-Tier Prescription Drug Rider. This rider includes different copays for medications based on their category. To find out if you have a Three-Tier Prescription Drug Rider, look at your HAP identification (ID) card. On the right of your ID card is a copay box. In the copay box there are three copays that are associated with prescription coverage: Generic Rx copay (Tier 1), Pref. Rx copay (Tier 2) and Non Pref. Rx copay (Tier 3). Tier 3 medications include specialty drugs, lifestyle medications and brand name medications with lower cost alternatives. Next to each of these copay terms may be a numbered amount. If there is a number next to the term, then that number is your copay amount (010 is a copay).
For members with a three-tier drug benefit the copay tiers are as follows:
- Lowest tier- most generic prescription covered drugs
- Second tier- select brand prescription drugs
- Third tier- brand prescription drugs with lower cost alternatives, lifestyle prescription covered drugs (drugs for infertility, weight loss, impotence, erectile dysfunction), injectable drugs
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