My Medication is What Tier?

When people begin using their Medicare prescription drug plan benefits, they don't realize the importance of their drug tier. They often don't realize there are different tiers of medications nor do they understand why there are different tiers of medication. The staggering differences between these levels mean a lot to those that have to pay for it.

What is a drug tier?

Thousands of medications are covered by a Medicare prescription drug plan. These medications are all very different when it comes how much they cost when they are made. The classification system they are sorted into helps people understand the difference in those manufacturing costs.

As medications are sorted, they are placed into like categories. Medications that share certain criteria and manufacturing costs are placed into one tier. Most insurance companies have 4 tiers of medications. Each tier is different from the others but share one thing in common; all medications that are on these tiers are Medicare approved medications.

Tier One Medications

Tier one medications are medications that are the most common generic medications. These medications have been on the market for some time and can be made by many different drug manufacturers. Because these are medications that can be made by different companies, they are often cheaper to make.

When a medication isn't expensive to make, the copays for these medications are relatively low. The costs of tier one medications are sometimes lower than the contracted copay of these medications. This is the most desired tier for medications because of their costs.

Tier Two Medications

Tier two drug medications are some of the most commonly prescribed medications on a formulary. The medications on this tier are also known as the preferred brand name medications. These medications are mainly made up of brand named medications. Although they are brand named medications, they have been on the market for quite some time but a generic form hasn’t been released yet.

These medications are still normally only made by one manufacture but they aren't as expensive to make as they were when their first were introduced to the market. With the lowered cost of making medications, the copay for tier two medications are a little more expensive than a generic. These copays are well within reason because of the cost to make them. Because of the copay for these medications, most beneficiaries want a tier two medication if it's not generic.

Tier Three Medications

The medications on tier three are the non-preferred brand named medications. These medications are normally the brand named medications newly released to the market. These medications are medications that aren't always commonly prescribed to treat illnesses. Because they aren't always prescribed, they aren't as easy to be made nor are they inexpensive to make.

When a person is prescribed a tier three medication, they find the costs of those medications are more than generic or even brand named medications. With these medications being new to the market or not being used as commonly as before, the cost to make them is a lot higher than most people expect. When a person is prescribed a tier three medication, they are charged more money than they were charged for the previous two tiers.

Tier Four Medications

The medications that are in tier four are medications that are considered specialty medications. These medications are only prescribed for certain illnesses that are very grave such as some cancer, severe cases of rheumatoid arthritis and many other illnesses. These are medications that aren't always prescribed because they are such specialized medications.

With the medications being so highly specialized, these medications are very expensive. Most Medicare part D insurance providers don't charge a copay for these particular medications. These prescription drug plans normally charge a co-insurance or a percentage of the negotiated price to be paid at the pharmacy by the patient. This is something that can be devastating for those that aren't expecting this news nor have the resources to pay for it.

As Medicare part D beneficiaries begin to look at their medications and what tiers they fall under, they begin to realize the true cost of having a Medicare part D plan. Although many people think their medications will fall into tier three and tier four classifications, most are surprised they don't. Those that find themselves being prescribed more expensive medications will go through the different stages of their part D prescription drug plan very quickly.

There are many parts to the machine called Medicare part D. These different parts may look as if they don't mean a lot but many times they are a major piece of the puzzle. As people begin to think about changing their Medicare part D plans, they should also look at where their medications fall within their new plan's formulary and tier.

Sep. 7 12'
First medication is Flexeril (Cyclobenzaprine HCl):Before tainkg cyclobenzaprine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, overactive thyroid (hyperthyroidism), heart problems (such as irregular heartbeat, heart block, heart failure, recent heart attack), difficulty urinating (such as due to an enlarged prostate), glaucoma.This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially drowsiness.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Consult your doctor before breast-feeding.Drowsiness, dizziness, dry mouth, or tiredness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fast/irregular heartbeat, mental/mood changes (such as confusion, hallucinations).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.Second medication is Perocet (Oxycodone and Acetaminophen):Before tainkg this medication, tell your doctor or pharmacist if you are allergic to it; or to other narcotics (such as morphine, codeine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: brain disorders (such as head injury, tumor, seizures), breathing problems (such as asthma, sleep apnea, chronic obstructive pulmonary disease-COPD), kidney disease, liver disease, mental/mood disorders (such as confusion, depression), personal or family history of regular use/abuse of drugs/alcohol, stomach/intestinal problems (such as blockage, constipation, diarrhea due to infection, paralytic ileus), difficulty urinating (such as due to enlarged prostate).This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.Liquid products may contain sugar, aspartame, and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, liver disease, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the effects of this drug, especially dizziness, drowsiness, urinary problems.Before using this medication, women of childbearing age should talk with their doctor(s) about the risks and benefits. Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It may slightly increase the risk of birth defects if used during the first two months of pregnancy. Also, using it for a long time or in high doses near the expected delivery date may harm the unborn baby. To lessen the risk, take the smallest effective dose for the shortest possible time. Tell the doctor right away if you notice any symptoms in your newborn baby such as slow/shallow breathing, irritability, abnormal/persistent crying, vomiting, or diarrhea.This medication passes into breast milk and may rarely have undesirable effects on a nursing infant. Tell the doctor immediately if your baby develops unusual sleepiness, difficulty feeding, or trouble breathing. Consult your doctor before breast-feeding.SIDE EFFECTS:See also Warning section.Nausea, vomiting, constipation, lightheadedness, dizziness, or drowsiness may occur. Some of these side effects may decrease after you have been using this medication for a while. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To prevent constipation, eat a diet adequate in fiber, drink plenty of water, and exercise. Consult your pharmacist for help in selecting a laxative (such as a stimulant type with stool softener).To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes, severe stomach/abdominal pain, difficulty urinating.Seek immediate medical attention if any of these rare but serious side effects occur: fainting, seizure, slow/shallow breathing, unusual drowsiness/difficulty waking up.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Jul. 7 15'

William

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