FillMapGold 22 Health · 13887-13887FL0010001-0About this plan

Does Gold 22 Health cover cyclosporine?

1 · Your plan

Gold 22 Health

13887-13887FL0010001-0 · ACA · ACA Marketplace

2 · Your medication

cyclosporine

cyclosporineunder Gold 22 Health

Covered — the conditions depend on which form

Not the same for every form: 2 of 21 need your plan’s approval first, and 1 of 21 usually need a preferred medication tried first. Check your exact form in the list below — your doctor’s office handles either.

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: Required
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.

Your cost-sharing levelMarketplace plans publish a different amount for each level. Your eligibility notice says which applies. Nothing here is saved.

Covered forms and strengths (21)

0.4 ML cyclosporine 0.5 MG/ML Ophthalmic SuspensionAmount limit
0.4 ML cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]Amount limit
cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]Amount limit
cyclosporine 0.9 MG/ML Ophthalmic Solution [Cequa]Try another firstAmount limit
cyclosporine 1 MG/ML Ophthalmic Solution [Vevye]Approval first
cyclosporine 1 MG/ML Ophthalmic Suspension [Verkazia]Approval first
cyclosporine 100 MG Oral Capsule
cyclosporine 100 MG Oral Capsule [Sandimmune]
cyclosporine 100 MG/ML Oral Solution [Sandimmune]
cyclosporine 25 MG Oral Capsule
cyclosporine 25 MG Oral Capsule [Sandimmune]
cyclosporine, modified 100 MG Oral Capsule
cyclosporine, modified 100 MG Oral Capsule [Gengraf]
cyclosporine, modified 100 MG Oral Capsule [Neoral]
cyclosporine, modified 100 MG/ML Oral Solution
cyclosporine, modified 100 MG/ML Oral Solution [Gengraf]
cyclosporine, modified 100 MG/ML Oral Solution [Neoral]
cyclosporine, modified 25 MG Oral Capsule
cyclosporine, modified 25 MG Oral Capsule [Gengraf]
cyclosporine, modified 25 MG Oral Capsule [Neoral]
cyclosporine, modified 50 MG Oral Capsule

← All coverage for cyclosporine