FillMapSmart Silver 22 Health · 13887-13887FL0010004-0About this plan

Does Smart Silver 22 Health cover MoviPrep?

1 · Your plan

Smart Silver 22 Health

13887-13887FL0010004-0 · ACA · ACA Marketplace

2 · Your medication

MoviPrep

MoviPrepunder Smart Silver 22 Health

Covered — some forms require step therapy

1 of 3 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

$40per 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 (3)

{1 (ascorbic acid 7540 MG / polyethylene glycol 3350 40000 MG / potassium chloride 1200 MG / sodium ascorbate 48110 MG / sodium chloride 3200 MG Powder for Oral Solution) / 1 (polyethylene glycol 3350 100000 MG / potassium chloride 1000 MG / sodium chloride 2000 MG / sodium sulfate 9000 MG Powder for Oral Solution) } Pack [Plenvu]Try another firstAmount limit
ascorbic acid 4700 MG / polyethylene glycol 3350 100000 MG / potassium chloride 1015 MG / sodium ascorbate 5900 MG / sodium chloride 2690 MG / sodium sulfate 7500 MG Powder for Oral SolutionAmount limit
ascorbic acid 4700 MG / polyethylene glycol 3350 100000 MG / potassium chloride 1015 MG / sodium ascorbate 5900 MG / sodium chloride 2690 MG / sodium sulfate 7500 MG Powder for Oral Solution [MoviPrep]Amount limit

← All coverage for MoviPrep