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

Does Standard Silver 22 Health cover Pneumovax 23?

1 · Your plan

Standard Silver 22 Health

13887-13887FL0010002-0 · ACA · ACA Marketplace

2 · Your medication

Pneumovax 23

Pneumovax 23under Standard Silver 22 Health

Covered — just walk in

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

What you'd pay

$0per 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: Zero cost share preventive drugs
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 (2)

0.5 ML Streptococcus pneumoniae type 1 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 10A capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 11A capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 12F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 14 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 15B capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 17F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 18C capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 19A capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 19F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 2 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 20 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 22F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 23F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 3 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 33F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 4 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 5 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 6B capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 7F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 8 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 9N capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 9V capsular polysaccharide antigen 0.05 MG/ML Injection [Pneumovax 23]Amount limit
0.5 ML Streptococcus pneumoniae type 1 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 10A capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 11A capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 12F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 14 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 15B capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 17F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 18C capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 19A capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 19F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 2 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 20 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 22F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 23F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 3 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 33F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 4 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 5 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 6B capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 7F capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 8 capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 9N capsular polysaccharide antigen 0.05 MG/ML / Streptococcus pneumoniae type 9V capsular polysaccharide antigen 0.05 MG/ML Prefilled Syringe [Pneumovax 23]Amount limit

← All coverage for Pneumovax 23