Does Gold 22 Health cover clozapine?
Gold 22 Health
13887-13887FL0010001-0 · ACA · ACA Marketplace
clozapine
clozapineunder Gold 22 Health
Covered — some forms require step therapy
1 of 12 covered forms have a condition attached. You may need to try a cheaper medication first — your doctor’s office handles it.
What you'd pay
$15per 30-day fill
From the first fill — no deductible on this drug.
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.
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
- Generics
- Approval first
- Not needed
- Try another first
- Required
- 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 (12)
- clozapine 100 MG Disintegrating Oral TabletAmount limit
- clozapine 100 MG Oral Tablet
- clozapine 100 MG Oral Tablet [Clozaril]
- clozapine 12.5 MG Disintegrating Oral TabletAmount limit
- clozapine 150 MG Disintegrating Oral TabletAmount limit
- clozapine 200 MG Disintegrating Oral TabletAmount limit
- clozapine 200 MG Oral Tablet
- clozapine 25 MG Disintegrating Oral TabletAmount limit
- clozapine 25 MG Oral Tablet
- clozapine 25 MG Oral Tablet [Clozaril]
- clozapine 50 MG Oral Tablet
- clozapine 50 MG/ML Oral Suspension [Versacloz]Try another firstAmount limit