Does Focused Silver 22 Health cover ivacaftor / lumacaftor?
Focused Silver 22 Health
13887-13887FL0010005-0 · ACA · ACA Marketplace
ivacaftor / lumacaftor
ivacaftor / lumacaftorunder Focused Silver 22 Health
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
25%of the price your plan negotiates
Medicare hasn’t published this plan’s negotiated price for this drug yet — that file is updated every three months, and newly launched drugs appear in it late. Your pharmacy can quote the exact amount today. Your plan’s deductible comes first — you pay the full price until it is met.
This is the standard amount. If you qualified for a cost-sharing reduction when you enrolled, set your level above and this will follow it.
- Tier
- Specialty drugs
- Approval first
- Required
- Try another first
- No
- Amount limit
- None
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)
- ivacaftor 125 MG / lumacaftor 100 MG Oral Granules [ORKAMBI]Approval first
- ivacaftor 125 MG / lumacaftor 100 MG Oral Tablet [ORKAMBI]Approval first
- ivacaftor 125 MG / lumacaftor 200 MG Oral Tablet [ORKAMBI]Approval first
- ivacaftor 188 MG / lumacaftor 150 MG Oral Granules [ORKAMBI]Approval first
- ivacaftor 94 MG / lumacaftor 75 MG Oral Granules [ORKAMBI]Approval first