Drug costs for 2025

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
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order		 $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
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order		 $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
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order		 $0 $0 $105 45% coinsurance N/A

*Tier 5 Specialty drugs are limited to a 30-day supply per fill.

PriorityMedicare Thrive (PPO)

This plan has no part D deductible, so you'll only pay these amounts for your drugs.

  Tier 1
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order		 $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
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order		 $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
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order		 $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
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order		 $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
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order 		$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
Preferred generic		 Tier 2
Generic		 Tier 3
Preferred brand		 Tier 4
Non-preferred drug		 Tier 5
Specialty*
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
mail order		 $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.