The higher a drug's cost level or "tier," the higher the cost. In the chart below, you'll see what you'll pay for each drug tier for:
- A 30-day supply at a preferred retail pharmacy
- A 30-day supply at a standard pharmacy, and
- A 90-day supply through our preferred mail order pharmacy, Express Scripts (with free shipping)
Costs may vary when your plan is provided by an employer.
Your drug copays/coinsurance
This is what you'll pay until you reach $2,000 in out-of-pocket Part D drug costs for the year.
Important Message About What You Pay for Vaccines – Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible (if your plan has a deductible). Call Customer Service for more information.
Important Message About What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible (if your plan has a deductible).
PriorityMedicare EdgeSM (PPO)
This plan has no Part D deductible, so you'll pay these amounts for your drugs.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $2 ($0 for 90-day) | $8 | 25% coinsurance | 40% coinsurance | 33% coinsurance |
Standard retail | $7 | $15 | 25% coinsurance | 45% coinsurance | 33% coinsurance |
90-day preferred | $0 | $0 | 25% coinsurance | 40% coinsurance | N/A |
*Tier 5 Specialty drugs are limited to a 30-day supply per fill.
PriorityMedicare KeySM (HMO-POS)
This plan has no Part D deductible, so you'll pay these amounts for your drugs.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $4 ($0 for 90-day) | $15 | 25% coinsurance | 45% coinsurance | 33% coinsurance |
Standard retail | $10 | $20 | 25% coinsurance | 50% coinsurance | 33% coinsurance |
90-day preferred | $0 | $0 | 25% coinsurance | 45% coinsurance | N/A |
*Tier 5 Specialty drugs are limited to a 30-day supply per fill.
PriorityMedicare VitalSM (PPO)
Costs shown for tiers 3, 4 and 5 are what you'll pay after you meet the $350 Part D deductible. There is no deductible for drugs in tiers 1 or 2.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $1 ($0 for 90-day) | $10 | $42 | 45% coinsurance | 28% coinsurance |
Standard retail | $6 | $15 | $47 | 50% coinsurance | 28% coinsurance |
90-day preferred | $0 | $0 | $105 | 45% coinsurance | N/A |
*Tier 5 Specialty drugs are limited to a 30-day supply per fill.
PriorityMedicare ThriveSM (PPO)
This plan has no part D deductible, so you'll only pay these amounts for your drugs.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $3 ($0 for 90-day) | $10 | 25% coinsurance | 45% coinsurance | 33% coinsurance |
Standard retail | $11 | $18 | 25% coinsurance | 50% coinsurance | 33% coinsurance |
90-day preferred | $0 | $0 | 25% coinsurance | 45% coinsurance | N/A |
*Tier 5 Specialty drugs are limited to a 30-day supply per fill.
PriorityMedicare Thrive PlusSM (PPO)
This plan has no part D deductible, so you'll only pay these amounts for your drugs.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $4 ($0 for 90-day) | $13 | 25% coinsurance | 40% coinsurance | 33% coinsurance |
Standard retail | $9 | $18 | 25% coinsurance | 45% coinsurance | 33% coinsurance |
90-day preferred | $0 | $0 | 25% coinsurance | 40% coinsurance | N/A |
*Tier 5 Specialty drugs are limited to a 30-day supply per fill.
PriorityMedicare ValueSM (HMO-POS)
This plan has no part D deductible, so you'll only pay these amounts for your drugs.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $2 ($0 for 90-day) | $10 | 25% coinsurance | 50% coinsurance | 33% coinsurance |
Standard retail | $7 | $15 | 25% coinsurance | 50% coinsurance | 33% coinsurance |
90-day preferred | $0 | $0 | 25% coinsurance | 50% coinsurance | N/A |
*Tier 5 Specialty drugs are limited to a 30-day supply per fill.
PriorityMedicare MeritSM (PPO)
This plan has no Part D deductible, so you'll pay these amounts for your drugs.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $2 ($0 for 90-day) | $10 | 25% coinsurance | 50% coinsurance | 33% coinsurance |
Standard retail | $7 | $15 | 25% coinsurance | 50% coinsurance | 33% coinsurance |
90-day preferred | $0 | $0 | 25% coinsurance | 50% coinsurance | N/A |
*Tier 5 Specialty drugs are limited to a 30-day supply per fill.
PriorityMedicareSM (HMO-POS)
This plan has no Part D deductible, so you'll only pay these amounts for your drugs.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $1 ($0 for 90-day) | $8 | 25% coinsurance | 45% coinsurance | 33% coinsurance |
Standard retail | $6 | $13 | 25% coinsurance | 45% coinsurance | 33% coinsurance |
90-day preferred | $0 | $0 | 25% coinsurance | 45% coinsurance | N/A |
PriorityMedicare VintageSM (HMO-POS)
This plan has no Part D deductible, so you'll only pay these amounts for your drugs.
Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 | |
Preferred retail | $4 ($0 for 90-day) | $15 | 25% coinsurance | 40% coinsurance | 33% coinsurance |
Standard retail | $10 | $20 | 25% coinsurance | 45% coinsurance | 33% coinsurance |
90-day preferred | $0 | $0 | 25% coinsurance | 40% coinsurance | N/A |
*Tier 5 Specialty drugs are limited to a 30-day supply per fill.
After you reach $2,000 in drug costs
Once you spend $2,000 out-of-pocket for your Part D drugs during the year, then you enter what's called the " catastrophic stage," and, you'll pay $0 for your Part D prescription drugs for the remainder of the plan year.