FillMap45495ga0050008

Does 45495ga0050008 cover methotrexate?

45495ga0050008
45495-45495GA0050008-0 · ACA · ACA Marketplace
methotrexate
methotrexateunder 45495ga0050008
Covered — some forms require prior authorization
20 of 24 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
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
Non preferred generic non preferred brand
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.

Covered forms and strengths (24)

  • 0.15 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 0.2 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 0.25 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 0.3 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 0.35 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 0.4 ML methotrexate 25 MG/ML Auto-Injector [Otrexup]Approval first
  • 0.4 ML methotrexate 31.3 MG/ML Auto-Injector [Otrexup]Approval first
  • 0.4 ML methotrexate 37.5 MG/ML Auto-Injector [Otrexup]Approval first
  • 0.4 ML methotrexate 43.8 MG/ML Auto-Injector [Otrexup]Approval first
  • 0.4 ML methotrexate 50 MG/ML Auto-Injector [Otrexup]Approval first
  • 0.4 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 0.4 ML methotrexate 56.3 MG/ML Auto-Injector [Otrexup]Approval first
  • 0.4 ML methotrexate 62.5 MG/ML Auto-Injector [Otrexup]Approval first
  • 0.45 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 0.5 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 0.6 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]Approval first
  • 2 ML methotrexate 25 MG/ML Injection
  • methotrexate 10 MG Oral Tablet [Trexall]Approval firstAmount limit
  • methotrexate 1000 MG InjectionAmount limit
  • methotrexate 15 MG Oral Tablet [Trexall]Approval firstAmount limit
  • methotrexate 2.5 MG Oral TabletAmount limit
  • methotrexate 25 MG/ML Injectable SolutionAmount limit
  • methotrexate 5 MG Oral Tablet [Trexall]Approval firstAmount limit
  • methotrexate 7.5 MG Oral Tablet [Trexall]Approval firstAmount limit

← All coverage for methotrexate