Formulary Matching
How we match your medications against plan formularies and compute tier-adjusted drug costs.
Formulary Matching
Each health plan has a formulary -- a list of covered drugs organized into tiers. Tier 1 (generic) drugs have the lowest copays, while Tier 4 (specialty) drugs can cost hundreds per fill. The same drug can be on different tiers across different plans.
Pelandri matches each of your medications against every plan's formulary using CMS Plan Finder data. We compute a coverage score (0-100) based on tier placement and a total annual drug cost by multiplying tier-specific copays by your fill frequency.