Does Capital Health Plan HMO Platinum 4000 cover treprostinil?
Capital Health Plan HMO Platinum 4000
66966-66966FL0050008-0 · ACA · ACA Marketplace
treprostinil
treprostinilunder Capital Health Plan HMO Platinum 4000
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$250per 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
- Specialty
- 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 (22)
- {112 (treprostinil 0.016 MG Inhalation Powder [Tyvaso]) / 112 (treprostinil 0.032 MG Inhalation Powder [Tyvaso]) / 28 (treprostinil 0.048 MG Inhalation Powder [Tyvaso]) } Pack [Tyvaso 16-32-48 MCG Titration Pack]Approval firstAmount limit
- {112 (treprostinil 0.032 MG Inhalation Powder [Tyvaso]) / 112 (treprostinil 0.064 MG Inhalation Powder [Tyvaso]) } Pack [Tyvaso 32-64 MCG Maintenance Pack]Approval firstAmount limit
- {112 (treprostinil 0.048 MG Inhalation Powder [Tyvaso]) / 112 (treprostinil 0.064 MG Inhalation Powder [Tyvaso]) } Pack [Tyvaso 48-64 MCG Maintenance Pack]Approval firstAmount limit
- {112 (treprostinil 0.048 MG Inhalation Powder [Tyvaso]) / 112 (treprostinil 0.08 MG Inhalation Powder [Tyvaso]) } Pack [Tyvaso 48-80 MCG Maintenance Pack]Approval firstAmount limit
- {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 210 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 2 Titration Kit]Approval firstAmount limit
- {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 1 Titration Kit]Approval firstAmount limit
- {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit]Approval firstAmount limit
- 12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]Approval first
- 12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]Approval first
- 12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]Approval first
- 12 HR treprostinil 2.5 MG Extended Release Oral Tablet [Orenitram]Approval first
- 12 HR treprostinil 5 MG Extended Release Oral Tablet [Orenitram]Approval first
- treprostinil 0.016 MG Inhalation Powder [Tyvaso]Approval firstAmount limit
- treprostinil 0.0265 MG Inhalation Powder [Yutrepia]Approval firstAmount limit
- treprostinil 0.032 MG Inhalation Powder [Tyvaso]Approval firstAmount limit
- treprostinil 0.048 MG Inhalation Powder [Tyvaso]Approval firstAmount limit
- treprostinil 0.053 MG Inhalation Powder [Yutrepia]Approval firstAmount limit
- treprostinil 0.064 MG Inhalation Powder [Tyvaso]Approval firstAmount limit
- treprostinil 0.0795 MG Inhalation Powder [Yutrepia]Approval firstAmount limit
- treprostinil 0.08 MG Inhalation Powder [Tyvaso]Approval firstAmount limit
- treprostinil 0.106 MG Inhalation Powder [Yutrepia]Approval firstAmount limit
- treprostinil 0.6 MG/ML Inhalation Solution [Tyvaso]Approval firstAmount limit