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

Does Smart Silver 22 Health cover levomilnacipran?

1 · Your plan

Smart Silver 22 Health

13887-13887FL0010004-0 · ACA · ACA Marketplace

2 · Your medication

levomilnacipran

levomilnacipranunder Smart Silver 22 Health

Covered — just walk in

Nothing to clear first — take the prescription to an in-network pharmacy.

What you'd pay

This plan doesn't publish a price for this tier. Your pharmacy can quote it before you fill.

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: Preferred brands
Approval first: Not needed
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 (5)

{2 (24 HR levomilnacipran 20 MG Extended Release Oral Capsule [Fetzima]) / 26 (24 HR levomilnacipran 40 MG Extended Release Oral Capsule [Fetzima]) } Pack [Fetzima Pack]Amount limit
24 HR levomilnacipran 120 MG Extended Release Oral Capsule [Fetzima]Amount limit
24 HR levomilnacipran 20 MG Extended Release Oral Capsule [Fetzima]Amount limit
24 HR levomilnacipran 40 MG Extended Release Oral Capsule [Fetzima]Amount limit
24 HR levomilnacipran 80 MG Extended Release Oral Capsule [Fetzima]Amount limit

← All coverage for levomilnacipran