FillMapBlueExtend PPO HD Bronze 1

Does BlueExtend PPO HD Bronze 1 cover methylphenidate?

BlueExtend PPO HD Bronze 1
26065-26065SC0750005-0 · ACA · ACA Marketplace
methylphenidate
methylphenidateunder BlueExtend PPO HD Bronze 1
Covered — some forms require step therapy
4 of 33 covered forms have a condition attached. You may need to try a cheaper medication first — your doctor’s office handles it.
What you'd pay
$0per 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.

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
Not needed
Try another first
Required
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 (33)

  • 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral Tablet [Concerta]Try another firstAmount limit
  • 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral Tablet [Concerta]Try another firstAmount limit
  • 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral Tablet [Concerta]Try another firstAmount limit
  • 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral Tablet [Concerta]Try another firstAmount limit
  • 30/70 Release 24 HR methylphenidate hydrochloride 10 MG Extended Release Oral CapsuleAmount limit
  • 30/70 Release 24 HR methylphenidate hydrochloride 20 MG Extended Release Oral CapsuleAmount limit
  • 30/70 Release 24 HR methylphenidate hydrochloride 30 MG Extended Release Oral CapsuleAmount limit
  • 30/70 Release 24 HR methylphenidate hydrochloride 40 MG Extended Release Oral CapsuleAmount limit
  • 30/70 Release 24 HR methylphenidate hydrochloride 50 MG Extended Release Oral CapsuleAmount limit
  • 30/70 Release 24 HR methylphenidate hydrochloride 60 MG Extended Release Oral CapsuleAmount limit
  • 50/50 Release 24 HR methylphenidate hydrochloride 10 MG Extended Release Oral CapsuleAmount limit
  • 50/50 Release 24 HR methylphenidate hydrochloride 20 MG Extended Release Oral CapsuleAmount limit
  • 50/50 Release 24 HR methylphenidate hydrochloride 30 MG Extended Release Oral CapsuleAmount limit
  • 50/50 Release 24 HR methylphenidate hydrochloride 40 MG Extended Release Oral CapsuleAmount limit
  • 50/50 Release 24 HR methylphenidate hydrochloride 60 MG Extended Release Oral CapsuleAmount limit
  • 8 HR methylphenidate hydrochloride 10 MG Extended Release Oral TabletAmount limit
  • 8 HR methylphenidate hydrochloride 20 MG Extended Release Oral TabletAmount limit
  • BX Rating 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral TabletAmount limit
  • BX Rating 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral TabletAmount limit
  • BX Rating 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral TabletAmount limit
  • BX Rating 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral TabletAmount limit
  • methylphenidate hydrochloride 1 MG/ML Oral SolutionAmount limit
  • methylphenidate hydrochloride 10 MG Chewable TabletAmount limit
  • methylphenidate hydrochloride 10 MG Oral TabletAmount limit
  • methylphenidate hydrochloride 2 MG/ML Oral SolutionAmount limit
  • methylphenidate hydrochloride 2.5 MG Chewable TabletAmount limit
  • methylphenidate hydrochloride 20 MG Oral TabletAmount limit
  • methylphenidate hydrochloride 5 MG Chewable TabletAmount limit
  • methylphenidate hydrochloride 5 MG Oral TabletAmount limit

← All coverage for methylphenidate