Does Bronze 22 Health cover formoterol / mometasone?
Bronze 22 Health
13887-13887FL0010003-0 · ACA · ACA Marketplace
formoterol / mometasone
formoterol / mometasoneunder Bronze 22 Health
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
This plan doesn't publish a price for this tier. Your pharmacy can quote it before you fill.
Amount limit applies — you can still fill it, but your plan caps how much you get at a time. This plan's drug list records the cap without stating the amount — your pharmacy can tell you when they fill it.
- Tier
- Preferred brands
- Approval first
- Not needed
- Try another first
- No
- Amount limit
- Yes
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.
Covered forms and strengths (5)
- 120 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.05 MG/ACTUAT Metered Dose Inhaler [Dulera]Amount limit
- 120 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.1 MG/ACTUAT Metered Dose Inhaler [Dulera]Amount limit
- 120 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.2 MG/ACTUAT Metered Dose Inhaler [Dulera]Amount limit
- 60 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.1 MG/ACTUAT Metered Dose Inhaler [Dulera]Amount limit
- 60 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.2 MG/ACTUAT Metered Dose Inhaler [Dulera]Amount limit