Does Gold 22 Health cover eltrombopag?
Gold 22 Health
13887-13887FL0010001-0 · ACA · ACA Marketplace
eltrombopag
eltrombopagunder Gold 22 Health
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$250per 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.
- 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 (16)
- eltrombopag 12.5 MG Oral TabletApproval first
- eltrombopag 12.5 MG Oral Tablet [Promacta]Approval first
- eltrombopag 12.5 MG Powder for Oral SuspensionApproval first
- eltrombopag 12.5 MG Powder for Oral Suspension [Promacta]Approval first
- eltrombopag 18 MG Oral Tablet [Alvaiz]Approval first
- eltrombopag 25 MG Oral TabletApproval first
- eltrombopag 25 MG Oral Tablet [Promacta]Approval first
- eltrombopag 25 MG Powder for Oral SuspensionApproval first
- eltrombopag 25 MG Powder for Oral Suspension [Promacta]Approval first
- eltrombopag 36 MG Oral Tablet [Alvaiz]Approval first
- eltrombopag 50 MG Oral TabletApproval first
- eltrombopag 50 MG Oral Tablet [Promacta]Approval first
- eltrombopag 54 MG Oral Tablet [Alvaiz]Approval first
- eltrombopag 75 MG Oral TabletApproval first
- eltrombopag 75 MG Oral Tablet [Promacta]Approval first
- eltrombopag 9 MG Oral Tablet [Alvaiz]Approval first