Does Complete Silver HMO $5950 $30 cover methotrexate?
Complete Silver HMO $5950 $30
70893-70893GA0010017-0 · ACA · ACA Marketplace
methotrexate
methotrexateunder Complete Silver HMO $5950 $30
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
$20per 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
- Generic
- 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