FillMapHMO Bronze 7500 · 86584-86584WI0010011-0About this plan

Does HMO Bronze 7500 cover palivizumab?

1 · Your plan

HMO Bronze 7500

86584-86584WI0010011-0 · ACA · ACA Marketplace

2 · Your medication

palivizumab

palivizumabunder HMO Bronze 7500

Covered — just walk in

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

What you'd pay

$500per 30-day fill

Your plan’s deductible comes first — you pay the full price until it is met.

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.

Tier: Specialty
Approval first: Not needed
Try another first: No
Amount limit: None

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 palivizumab 100 MG/ML Injection [Synagis]
1 ML palivizumab 100 MG/ML Injection [Synagis]

← All coverage for palivizumab