FillMapStandard Silver 22 Health · 13887-13887FL0010002-0About this plan

Does Standard Silver 22 Health cover dabigatran etexilate?

1 · Your plan

Standard Silver 22 Health

13887-13887FL0010002-0 · ACA · ACA Marketplace

2 · Your medication

dabigatran etexilate

dabigatran etexilateunder Standard Silver 22 Health

Covered — the conditions depend on which form

Not the same for every form: 6 of 12 need your plan’s approval first, and 3 of 12 usually need a preferred medication tried first. Check your exact form in the list below — your doctor’s office handles either.

What you'd pay

$20per 30-day fillwith your plan

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: Required
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 (12)

dabigatran etexilate 110 MG Oral CapsuleAmount limit
dabigatran etexilate 110 MG Oral Capsule [Pradaxa]Try another firstAmount limit
dabigatran etexilate 110 MG Oral Pellet [Pradaxa]Approval first
dabigatran etexilate 150 MG Oral CapsuleAmount limit
dabigatran etexilate 150 MG Oral Capsule [Pradaxa]Try another firstAmount limit
dabigatran etexilate 150 MG Oral Pellet [Pradaxa]Approval first
dabigatran etexilate 20 MG Oral Pellet [Pradaxa]Approval first
dabigatran etexilate 30 MG Oral Pellet [Pradaxa]Approval first
dabigatran etexilate 40 MG Oral Pellet [Pradaxa]Approval first
dabigatran etexilate 50 MG Oral Pellet [Pradaxa]Approval first
dabigatran etexilate 75 MG Oral CapsuleAmount limit
dabigatran etexilate 75 MG Oral Capsule [Pradaxa]Try another firstAmount limit

← All coverage for dabigatran etexilate