A tier system usually differentiates between how many tiers?

A tier system usually differentiates between how many tiers?

• A. 2-4 tiers
• B. 4-6 tiers
• C. 3-5 tiers
• D. 1-3 tiers

Answer: (C)

Formulary tier systems in health plans differentiate medication costs by levels of cost sharing. In practice, plans commonly use three to five tiers: a generic tier, a preferred brand tier, and a non-preferred brand tier. Some plans add a fourth tier for specialty drugs or non-formulary items, and others expand to five tiers by further separating categories like mail-order options or high-cost generics. Because three to five tiers cover the typical range used in real-world formularies, that three-to-five tier structure is the common, expected design.

Formulary tier systems in health plans differentiate medication costs by levels of cost sharing. In practice, plans commonly use three to five tiers: a generic tier, a preferred brand tier, and a non-preferred brand tier. Some plans add a fourth tier for specialty drugs or non-formulary items, and others expand to five tiers by further separating categories like mail-order options or high-cost generics. Because three to five tiers cover the typical range used in real-world formularies, that three-to-five tier structure is the common, expected design.