Which tier generally requires the highest copayment in Medicare Part D plans?

In Medicare Part D plans, the tier structure is designed to categorize medications based on their cost and other factors. Generally, medications are organized into tiers, each associated with a different copayment level.

Tier 5 usually includes the most expensive medications, such as specialty drugs used to treat complex or chronic conditions. Because these drugs often involve higher costs for both the insurer and the patient, they typically carry the highest copayment amounts. As a result, beneficiaries can expect to pay significantly more out-of-pocket for medications classified under this tier, reflecting their enhanced cost and the need for specialized treatment.

Other tiers like Tier 1 often include generic medications with lower copayments, while Tiers 2 and 3 generally contain preferred and non-preferred brand-name drugs, respectively, which are less expensive than the specialty drugs found in Tier 5. Therefore, Tier 5 stands out as requiring the highest copayment due to the nature and expense of the medications included.