Does Gold 22 Health cover pegfilgrastim?
Gold 22 Health
13887-13887FL0010001-0 · ACA · ACA Marketplace
pegfilgrastim
pegfilgrastimunder 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 (10)
- 0.6 ML pegfilgrastim 10 MG/ML Injection [Neulasta]Approval first
- 0.6 ML pegfilgrastim 10 MG/ML Prefilled Syringe [Neulasta]Approval first
- 0.6 ML pegfilgrastim-apgf 10 MG/ML Prefilled Syringe [Nyvepria]Approval first
- 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo]Approval first
- 0.6 ML pegfilgrastim-cbqv 10 MG/ML Auto-Injector [Udenyca]Approval first
- 0.6 ML pegfilgrastim-cbqv 10 MG/ML Injection [Udenyca]Approval first
- 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca]Approval first
- 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]Approval first
- 0.6 ML pegfilgrastim-jmdb 10 MG/ML Prefilled Syringe [Fulphila]Approval first
- 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]Approval first