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Iu17.org

Tier 0 (Zero)
What Is Tier 0?
Tier 0 is a fourth tier of drugs in our multi-tiered prescription drug program. We offer approximately 65
generic drugs with a cost of $0—that’s right, no copayment, no cost to you! Many of these generic drugs
are used to treat chronic, high-cost conditions like diabetes, high blood pressure and heart disease.
Tier 0 generic drugs, which are safe and effective, are often considered the best therapies—and the best buys—to treat common conditions.
What Are the Benefits of Tier 0?
• No copay, “free” drug therapies so you and your family can stay healthier
• You’re getting a “best buy”—tried and true therapies proven to be as safe and effective
Are There Any Out-of-Pocket Costs with Tier 0?
Some multi-tiered programs include a deductible. Check your outline of coverage to determine if you have
a deductible and the amount. If so, you are responsible for paying the pharmacy for your medications, but
at a discount, until you meet your deductible. After you meet your deductible, Tier 0 will then apply and
you can get these drugs at no cost.
Where Can I Find a List of Tier 0 Drugs?
The drugs are listed on Blue Cross of Northeastern Pennsylvania’s Prescription Drug Formulary on
www.bcnepa.com. Just click on “Rx Drug Benefits.”
How Can I Get Started?
Ask your doctor if a Tier 0 generic drug could work for you or your covered family members. If so, ask your
doctor to write you a new prescription for a Tier 0 generic drug.
Saving Money With Tier O Drugs
Tier 0 Drugs:
$420 a year
She currently takes Benicar, and pays a $35 per month
copayment each month. That’s $420 a year. $240 a year
The Tier 0 generic, lisinopril, is a different drug used to treat high blood pressure and per month
ramipril
costs $0 a month, saving her $420 a year! $120 a year
Why pay more?
per month
lisinopril
Tier 0 Drug List
Blue Cross of Northeastern Pennsylvania’s Prescription Drug Formulary Angiotensin Converting Enzyme Inhibitors
This list is subject to change at any time. For the most up-to-date listing, check the formulary on www.bcnepa.com under “Rx Drug Benefits.”
Cardiovascular Medications
Calcium Antagonists
cartia XTdiltiazem, diltiazem ER, diltiazem SR, diltiazem SA Other Antihypertensives
Diuretics
Hypolipoproteinemia Medications
fenofibrate
Beta-Adrenergic Antagonist Drugs
atenolol
Autonomic and CNS Medications
Selective Serotonin Reuptake Inhibitors
Endocrine Medications
Oral Hypoglycemic Drugs
glimepiride
Alpha Blockers
Blue Cross of Northeastern Pennsylvania administers health plans for Blue Cross of Northeastern Pennsylvania, Highmark Blue Shield, First Priority Health® and First Priority Life Insurance Company®. Independent licensee of the Blue Cross and Blue Shield Association. ® Registered Mark of the Blue Cross and Blue Shield Association.
Please note that self-funded group benefits may differ from benefits and services described herein. Consult your Summary Plan Description for complete details of your program.
Blue Cross of Northeastern Pennsylvania. 2012.

Source: http://www.iu17.org/wp-content/uploads/2013/07/Tier-Zero-EBG033-1-12.pdf

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