FillMapCapital Health Plan HMO Platinum 4000 · 66966-66966FL0050008-0About this plan

Does Capital Health Plan HMO Platinum 4000 cover diltiazem?

1 · Your plan

Capital Health Plan HMO Platinum 4000

66966-66966FL0050008-0 · ACA · ACA Marketplace

2 · Your medication

diltiazem

diltiazemunder Capital Health Plan HMO Platinum 4000

Covered — some forms require prior authorization

2 of 27 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.

What you'd pay

$5per 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.

Tier: Non preferred generic
Approval first: Required
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 (27)

12 HR diltiazem hydrochloride 120 MG Extended Release Oral CapsuleApproval first
12 HR diltiazem hydrochloride 60 MG Extended Release Oral CapsuleApproval first
12 HR diltiazem hydrochloride 90 MG Extended Release Oral Capsule
24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule
24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Cartia]
24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Dilt]
24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Tiadylt]
24 HR diltiazem hydrochloride 120 MG Extended Release Oral Tablet
24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule
24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule [Cartia]
24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule [Dilt]
24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule [Tiadylt]
24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule
24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule [Cartia]
24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule [Dilt]
24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule [Tiadylt]
24 HR diltiazem hydrochloride 300 MG Extended Release Oral Capsule
24 HR diltiazem hydrochloride 300 MG Extended Release Oral Capsule [Cartia]
24 HR diltiazem hydrochloride 300 MG Extended Release Oral Capsule [Tiadylt]
24 HR diltiazem hydrochloride 360 MG Extended Release Oral Capsule
24 HR diltiazem hydrochloride 360 MG Extended Release Oral Capsule [Tiadylt]
24 HR diltiazem hydrochloride 420 MG Extended Release Oral Capsule
24 HR diltiazem hydrochloride 420 MG Extended Release Oral Capsule [Tiadylt]
diltiazem hydrochloride 120 MG Oral Tablet
diltiazem hydrochloride 30 MG Oral Tablet
diltiazem hydrochloride 60 MG Oral Tablet
diltiazem hydrochloride 90 MG Oral Tablet

← All coverage for diltiazem