Page 44 - APPENDICES for Diane Falten
P. 44

Initial coverage           Gap coverage             Catastrophic coverage
                               phase                      phase                    phase





                                                                                   Generic drugs:
                                                          Generic drugs:
                                                          25%                      $3.95 copay or 5% (whichever
                                                                                   costs more)
       Specialty Tier          33%
                                                          Brand-name               Brand-name drugs:
                                                          drugs:                   $9.85 copay or 5% (whichever
                                                          25%
                                                                                   costs more)
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