Review Plan Details > Part D

How a 4-Tier Drug Plan Works
For pricing, drugs are divided into the following four cost-share tiers:
Cost-share Tier 1 ($)	All Generic Drugs
Cost-share Tier 2 ($$)	Preferred Brand Drugs
Cost-share Tier 3 ($$$)	Non-Preferred Brand Drugs
Cost-share Tier 4 (25% coinsurance)	Non-Self Injectables

Brand and Generic Drugs

Blue Rx (PDP) plans cover both Brand and Generic drugs. Generic drugs:

• Usually cost less than Brand drugs
• Have the same active-ingredient formula as Brand drugs
• Are rated by the Food and Drug Administration (FDA) to be as safe and effective as Brand drugs

Changes to the Formulary (Drug List)

The formulary may change each month. There are many reasons why the formulary can change, such as:

• Generic drugs may become available
• New drugs could be developed
• A drug is no longer manufactured
• The Food and Drug Administration deems a drug to be unsafe

Requesting Exceptions to the Formulary

For information about requesting exceptions to our formulary, see our Appeals and Exceptions section. Members will be told 60 days ahead of time about changes in the formulary that affect them. You can also learn about changes:

• In the Drug Detail Section of the Drug Search results
• In the right-hand colum of this Web site's member section, under Formulary Changes
• And in the Explanation of Benefits (EOB) that is mailed to members monthly

Learn More

The full list of covered prescription drugs and their general cost is called a formulary. If you have more questions about the formulary and how it works, please visit our Frequently Asked Questions.

If you would like to have a copy of the formulary sent to you when it is available, please call Claims Customer Service at 1-800-693-1434 (TTY: 1-800-693-0765), 24 hours a day/seven days a week.

For more information about the requirements surrounding prior authorization, please see our prior authorization criteria.