which is the end of the coverage gap. Not everyone will enter the coverage gap. 
Under this plan,  you may pay even less for the following: 
Tier 1(Preferred Generic) - All Drugs 
Tier 2(Generic) - All Drugs 
Tier 3(Preferred Brand) - Select Insulin Drugs 
For more information on cost sharing in the coverage gap, please call us or access your Evidence of 
Coverage online. 14 Summary of Benefits H1036234000SB23 H1036234000 
Catastrophic Coverage