Prescription Drugs
Brand-Name Drug
Quick answer
A brand-name drug is a medication sold by the manufacturer that developed it, under a proprietary name. Brand drugs typically sit on higher Part D tiers with higher copays.
Plain-English definition
Preferred brand tiers cost less than non-preferred brand tiers.
Why it matters
Your out-of-pocket cost depends on the tier your plan assigns.
A simple example
Eliquis is a brand-name drug commonly on Tier 3.
Common mistakes & misconceptions
Related terms
Generic Drug
A generic drug has the same active ingredient, strength, and route as a brand-name drug but is sold under its chemical name at a lower cost.
Drug Tier
Drug tiers group medications by cost. Lower tiers (preferred generics, generics) have the lowest copays; higher tiers (preferred brand, non-preferred brand, specialty) cost more.
Formulary
A formulary is the official list of prescription drugs a Medicare Part D or Medicare Advantage plan covers, organized by tier. Every plan has its own formulary, and the same drug can be a different tier from one plan to another.
Specialty Drug
Specialty drugs are high-cost medications used to treat complex conditions like cancer, MS, or hepatitis C. They sit on the top Part D tier, often with coinsurance instead of a flat copay.
Frequently asked questions
Why is my brand drug so expensive?+
Higher tier plus possible coinsurance instead of copay.
Sources & references
📚 Where this information comes from
- Medicare.gov — official U.S. government site for people with Medicare ↗Primary source for benefits, enrollment periods, and plan comparison.
- CMS.gov — Centers for Medicare & Medicaid Services ↗Federal rulemaking, program updates, and official guidance.
- Social Security Administration — Medicare enrollment & premiums ↗Enrollment, premium withholding, and IRMAA determinations.
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Medicare Caddies is an independent insurance agency. We are not affiliated with, endorsed by, or connected to the U.S. government, the federal Medicare program, or the Centers for Medicare & Medicaid Services (CMS). We help compare Medicare Advantage plans from the insurance companies we represent, and we don't offer every plan available in your area.