What are the different levels of member cost-sharing for covered medications called?

The term that refers to the different levels of member cost-sharing for covered medications is "drug tiers." This concept is integral to understanding how health insurance plans, particularly those involving prescription drugs, manage costs for both the insurer and the member.

Drug tiers categorize medications based on their cost, with each tier representing a different level of financial responsibility for the member. Commonly, lower tiers include generic medications that typically have lower copayments, while higher tiers might include brand-name or specialty drugs that require higher out-of-pocket expenses. This tiered system helps to incentivize members to choose more cost-effective options while ensuring that they have access to necessary medications.

Understanding drug tiers is essential for members, as it directly impacts their prescription costs, influencing their decisions on which medications to choose based on their financial situation and healthcare needs.