Medicare Part D Formulary Tiers

The Brand-Name and Generic drugs included in the SilverScript formulary are categorized into cost-sharing Tiers that are numbered from 1 - 5. SilverScript Medicare Part D formulary tiers indicate the level of cost-sharing for a covered drug. SilverScript plans use a system with five Medicare formulary tiers. The higher the tier, the higher the member’s out-of-pocket cost for the covered drug.

Cost-Sharing Tier 1: Preferred Generic

This is your lowest-cost tier. Low cost preferred generic drugs and some preferred brand drugs.

Cost-Sharing Tier 2: Generic

This is a lower cost tier, and includes preferred generic drugs and some preferred brand drugs.

Cost-Sharing Tier 3: Preferred Brand

This is your middle-cost tier, and includes preferred brand drugs and non-preferred generic drugs.

Cost-Sharing Tier 4: Non-Preferred Brand

This is your higher-cost tier and includes non-preferred brand drugs and non-preferred generic drugs.

Cost-Sharing Tier 5: Specialty Tier

The Specialty Tier is your highest-cost tier. A Specialty Tier drug is a very high cost or unique prescription drug which may require special handling and/or close monitoring. Tier 5 drugs may be brand or generic.

Helpful Links on Medicare Formulary Tiers: