Quick facts
Tier 1 - Generic
Tier 1 (e.g. metformin, phentermine, atorvastatin, rosuvastatin)
Tier 2 - Preferred Brand
Tier 2, PA required for some (e.g. Ozempic, Jardiance, Basaglar, Entresto)
Tier 4 - Specialty
Tier 4, PA required (e.g. Wegovy with QL, Humira, Hadlima)
Carrier contact
1-800-555-0142 — member services
Your member ID card: check the carrier website or app, or ask HR for a copy.
Confirm details with your carrier for current plan information.