What are the tiers of Medicaid coverage starting from the lowest cost?

The correct sequence of Medicaid coverage tiers from the lowest cost to the highest cost is Tier 1, Tier 2, Tier 3, and Tier 4. This organization reflects how the tiers are structured in many Medicaid programs, where the first tier typically covers services that are the least expensive or have the lowest copayments. As you move up the tiers, the costs generally increase, leading to either higher copayments or premiums, depending on the specific benefits covered under each tier.

Tier 1 usually includes preventive services and essential health benefits that are designed to be affordable for beneficiaries. Tiers increase in complexity and breadth of services provided as you progress to Tier 2, Tier 3, and Tier 4, which may involve more specialized services or higher-cost medications with increased financial responsibility for the Medicaid recipient. This tiered structure ensures that the most essential and cost-effective care is accessible to those who need it. Understanding these tiers can help pharmacy technicians guide patients regarding their expected costs and coverage.