A common feature of Part D benefit structures and formularies is cost sharing tiers.
•Tiered cost sharing means grouping Part D drugs into different cost-sharing levels within a Part D sponsor’s formulary. Many plans group drugs into 3 or 4 tiers with lower tiers costing less than higher tiers, for example:
•Thus, in evaluating whether a Part D plan should be recommended to a beneficiary, it is important to confirm not only that the beneficiary’s drugs are on the formulary, but to also evaluate which cost sharing tier the drugs fall into.
