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

Does Gold 22 Health cover tolvaptan?

1 · Your plan

Gold 22 Health

13887-13887FL0010001-0 · ACA · ACA Marketplace

2 · Your medication

tolvaptan

tolvaptanunder Gold 22 Health

Covered — some forms require prior authorization

7 of 11 covered forms have a condition attached. 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.

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: Specialty drugs
Approval first: Required
Try another first: No
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 (11)

{28 (tolvaptan 15 MG Oral Tablet [Jynarque]) / 28 (tolvaptan 30 MG Oral Tablet [Jynarque]) } Pack [Jynarque 30/15 Carton]Approval first
{28 (tolvaptan 15 MG Oral Tablet [Jynarque]) / 28 (tolvaptan 45 MG Oral Tablet [Jynarque]) } Pack [Jynarque 45/15 Carton]Approval first
{28 (tolvaptan 30 MG Oral Tablet [Jynarque]) / 28 (tolvaptan 60 MG Oral Tablet [Jynarque]) } Pack [Jynarque 60/30 Carton]Approval first
{28 (tolvaptan 30 MG Oral Tablet [Jynarque]) / 28 (tolvaptan 90 MG Oral Tablet [Jynarque]) } Pack [Jynarque 90/30 Carton]Approval first
{56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]Approval first
Hyponatremia tolvaptan 15 MG Oral TabletAmount limit
Hyponatremia tolvaptan 15 MG Oral Tablet [Samsca]Amount limit
Hyponatremia tolvaptan 30 MG Oral TabletAmount limit
Hyponatremia tolvaptan 30 MG Oral Tablet [Samsca]Amount limit
tolvaptan 15 MG Oral Tablet [Jynarque]Approval first
tolvaptan 30 MG Oral Tablet [Jynarque]Approval first

← All coverage for tolvaptan