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A typical plan uses four or five tiers: Tier 1 — Preferred Generics: Lowest copay, often $0–$15 Tier 2 — Non-Preferred Generics: Slightly higher copay Tier 3 — Preferred Brand-Name Drugs: Moderate copay or coinsurance Tier 4 — Non-Preferred Brand-Name Drugs: Higher copay or coinsurance Tier 5 — Specialty Drugs: Highest cost tier, typically a percentage of the drug's price Starting in 2025, the Inflation Reduction Act introduced a $2,000 annual cap on out-of-pocket drug spending for all Part D enrollees, including those in Massachusetts