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

Does Gold 22 Health cover dextroamphetamine?

1 · Your plan

Gold 22 Health

13887-13887FL0010001-0 · ACA · ACA Marketplace

2 · Your medication

dextroamphetamine

dextroamphetamineunder Gold 22 Health

Covered — some forms require step therapy

14 of 26 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.

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 (26)

9 HR dextroamphetamine 0.5 MG/HR Transdermal System [Xelstrym]Try another firstAmount limit
9 HR dextroamphetamine 1 MG/HR Transdermal System [Xelstrym]Try another firstAmount limit
9 HR dextroamphetamine 1.5 MG/HR Transdermal System [Xelstrym]Try another firstAmount limit
9 HR dextroamphetamine 2 MG/HR Transdermal System [Xelstrym]Try another firstAmount limit
dextroamphetamine sulfate 1 MG/ML Oral SolutionAmount limit
dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra]Amount limit
dextroamphetamine sulfate 10 MG Extended Release Oral CapsuleAmount limit
dextroamphetamine sulfate 10 MG Extended Release Oral Capsule [Dexedrine]Amount limit
dextroamphetamine sulfate 10 MG Oral TabletAmount limit
dextroamphetamine sulfate 10 MG Oral Tablet [Zenzedi]Amount limit
dextroamphetamine sulfate 15 MG Extended Release Oral CapsuleAmount limit
dextroamphetamine sulfate 15 MG Extended Release Oral Capsule [Dexedrine]Amount limit
dextroamphetamine sulfate 15 MG Oral TabletTry another firstAmount limit
dextroamphetamine sulfate 15 MG Oral Tablet [Zenzedi]Try another firstAmount limit
dextroamphetamine sulfate 2.5 MG Oral TabletTry another firstAmount limit
dextroamphetamine sulfate 2.5 MG Oral Tablet [Zenzedi]Try another firstAmount limit
dextroamphetamine sulfate 20 MG Oral TabletTry another firstAmount limit
dextroamphetamine sulfate 20 MG Oral Tablet [Zenzedi]Try another firstAmount limit
dextroamphetamine sulfate 30 MG Oral TabletTry another firstAmount limit
dextroamphetamine sulfate 30 MG Oral Tablet [Zenzedi]Try another firstAmount limit
dextroamphetamine sulfate 5 MG Extended Release Oral CapsuleAmount limit
dextroamphetamine sulfate 5 MG Extended Release Oral Capsule [Dexedrine]Amount limit
dextroamphetamine sulfate 5 MG Oral TabletAmount limit
dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi]Amount limit
dextroamphetamine sulfate 7.5 MG Oral TabletTry another firstAmount limit
dextroamphetamine sulfate 7.5 MG Oral Tablet [Zenzedi]Try another firstAmount limit

← All coverage for dextroamphetamine