Tag: Pharmacy benefits

According to the Association for Accessible Medicines, the average copay for a generic drug is approximately $6.61, while a brand-name drug's is $55.82. This significant price difference helps explain **what does it mean if a drug is Tier 1**; it's the lowest-cost category on your insurance plan's drug list.

Effective July 1, 2025, CVS Caremark, one of the nation's largest pharmacy benefit managers (PBMs), removed Zepbound from its standard commercial formulary. This means that for many patients, the answer to 'Is Zepbound not available at CVS?' is tied directly to their insurance plan and requires exploring alternative pathways for coverage or access.

As of July 1, 2025, CVS Caremark, the pharmacy benefits manager (PBM), removed the obesity medication Zepbound from its standard formulary for many patients. This major insurance change has caused confusion, but patients can still physically fill their Zepbound prescription at a CVS retail pharmacy, provided they have a valid prescription and a way to pay for it.

Did you know that some lower-tier prescription drugs can have a copayment as low as $0 to $1, depending on your plan? Understanding **what is a tier 1 prescription drug** is the first step toward significant savings on your healthcare costs, helping you navigate your health insurance plan's formulary for maximum benefit.

In the United States, 1 out of 3 adults taking prescription drugs report being unable to take their medication as prescribed due to cost [1.6.1]. Understanding your insurance plan's drug tiers is a critical step in managing these expenses. So, **how do I know what tier my drug is in?**

Accounting for a disproportionately large share of total drug spending—often over 50% despite representing a small fraction of prescriptions—specialty drugs are a critical and growing area of modern medicine. This guide helps answer the complex question: **Which drugs are considered specialty drugs?**

Since its launch in 2020, Amazon Pharmacy has expanded to serve customers in all 50 U.S. states, making prescription delivery more accessible and affordable. This article provides a complete guide on **how does the pharmacy at Amazon work** and its various services.

Specialty medications can cost thousands of dollars a month, placing a heavy financial burden on patients. To address this, the PrudentRx program was developed as a strategy to manage the cost of these high-priced drugs for eligible health plan members. The program coordinates manufacturer copay assistance and other plan features to potentially reduce a patient's out-of-pocket costs to zero.

According to GoodRx, its coupon prices are better than insurance copays for 40% of the 100 most-prescribed drugs. This surprising statistic often leaves consumers wondering: why is it cheaper to use GoodRx than insurance for so many prescriptions?