FillMap70373mn0050037

Does 70373mn0050037 cover hydromorphone?

70373mn0050037
70373-70373MN0050037-0 · ACA · ACA Marketplace
hydromorphone
hydromorphoneunder 70373mn0050037
Covered — some forms require prior authorization
4 of 21 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
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 (21)

  • 0.5 ML hydromorphone hydrochloride 1 MG/ML Prefilled Syringe
  • 1 ML hydromorphone hydrochloride 1 MG/ML Cartridge
  • 1 ML hydromorphone hydrochloride 1 MG/ML Injection
  • 1 ML hydromorphone hydrochloride 1 MG/ML Prefilled Syringe
  • 1 ML hydromorphone hydrochloride 10 MG/ML Injection
  • 1 ML hydromorphone hydrochloride 2 MG/ML Cartridge
  • 1 ML hydromorphone hydrochloride 2 MG/ML Injection
  • 1 ML hydromorphone hydrochloride 2 MG/ML Prefilled Syringe
  • 1 ML hydromorphone hydrochloride 4 MG/ML Cartridge
  • 1 ML hydromorphone hydrochloride 4 MG/ML Injection
  • 24 HR hydromorphone hydrochloride 12 MG Extended Release Oral TabletApproval firstAmount limit
  • 24 HR hydromorphone hydrochloride 16 MG Extended Release Oral TabletApproval firstAmount limit
  • 24 HR hydromorphone hydrochloride 32 MG Extended Release Oral TabletApproval firstAmount limit
  • 24 HR hydromorphone hydrochloride 8 MG Extended Release Oral TabletApproval firstAmount limit
  • 5 ML hydromorphone hydrochloride 10 MG/ML Injection
  • 50 ML hydromorphone hydrochloride 10 MG/ML Injection
  • hydromorphone hydrochloride 1 MG/ML Oral SolutionAmount limit
  • hydromorphone hydrochloride 2 MG Oral TabletAmount limit
  • hydromorphone hydrochloride 2 MG/ML Injectable Solution
  • hydromorphone hydrochloride 4 MG Oral TabletAmount limit
  • hydromorphone hydrochloride 8 MG Oral TabletAmount limit

← All coverage for hydromorphone