Tier 4 definition
Examples of Tier 4 in a sentence
When purchased at a Specialty, Mail Order, or Retail Pharmacy Tier 1: 20% Not Covered Tier 2: 20% Not Covered Tier 3: 20% Not Covered Tier 4: 20% Not Covered When purchased at a Specialty Pharmacy (+) Tier 5: 20% Not Covered When purchased at a Retail Pharmacy (+): Specialty Prescription Drugs purchased at a retail pharmacy will require a significantly higher out of pocket expense than if purchased from a specialty pharmacy.
Tier 1 Preventive: $0 Tier 1 Non-preventive: $10 - After deductible Not Covered Tier 2 Preventive: $0 Tier 2 Non-preventive: $45 - After deductible Not Covered Tier 3: $70 - After deductible Not Covered Tier 4: $90 - After deductible Not Covered Tier 5: NRT and Smoking Cessation drugs are only placed in Tier 1, Tier 2, Tier 3, or Tier 4.
Tier 1: $25 Not Covered Tier 2: $87.50 Not Covered Tier 3: $210 Not Covered Tier 4 and Tier 5: See specialty prescription drug section below.
Tier 1: $10 Not Covered Tier 2: $35 Not Covered Tier 3: $70 Not Covered Tier 4 and Tier 5: See specialty prescription drug section below.
Tier 1: $10 - After deductible Not Covered Tier 2: $45 - After deductible Not Covered Tier 3: $70 - After deductible Not Covered Tier 4: $90 - After deductible Not Covered Tier 5: See specialty prescription drug section below.