Does Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx cover codeine / guaifenesin?
Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx
68445-68445AZ0600030-0 · ACA · ACA Marketplace
codeine / guaifenesin
codeine / guaifenesinunder Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$30per 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
- Preferred brand
- 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.
Covered forms and strengths (2)
- codeine phosphate 1.26 MG/ML / guaifenesin 20 MG/ML Oral Solution [M-Clear WC]Amount limit
- codeine phosphate 2 MG/ML / guaifenesin 20 MG/ML Oral SolutionAmount limit