When your doctor prescribes a medication, it’s important to know if it is covered. To do that, you’ll want to know how to access your plan’s Prescription Drug List (PDL), sometimes called a formulary. The PDL is a list of the most commonly prescribed medications. It includes both brand-name and generic prescription medications approved by the U.S. Food and Drug Administration (FDA). Medications are listed by common categories or classes and placed in tiers that represent the cost you pay out-of-pocket.
Prescription Drug Lists often have tiers, or groups of drugs categorized by cost. Your cost-share or copayment is based on which tier your drug is in. There are typically three or four tiers:
