The Carle Employee Health Plan provides coverage for prescriptions based on a tier system. Using lower tier or preferred medications can help you pay your lowest out of pocket cost; in addition to saving the plan money.
Below is guide to the different tiers; please note that if you have the high-deductible health plan, the tier cost levels will apply once you hit your deductible.
Drug Tier |
Drug Tier Description |
Helpful Hints |
Preventative |
Brands & generics used for preventative care |
No out-of-pocket cost |
Tier 1 |
Preferred generics |
Low out-of-pocket cost |
Tier 2 |
Non-preferred generics |
Most generic drugs |
Tier 3 |
Preferred brands |
Many brands have lower-cost generic options |
Tier 4 |
Non-preferred brands |
Many brands have lower-cost generic options |
Tier 5 |
Preferred Specialty |
May be limited to specialty pharmacy |
Tier 6 |
Non-preferred specialty |
May be limited to specialty pharmacy |
You may review the full Health Alliance formulary on the Plan & Benefits section on Hally. Click Pharmacy Benefits > Your Drug Benefits.