FillMap11574il0020058 · 11574-11574IL0020058-0About this plan

Does 11574il0020058 cover testosterone?

1 · Your plan

11574il0020058

11574-11574IL0020058-0 · ACA · ACA Marketplace

2 · Your medication

testosterone

testosteroneunder 11574il0020058

Covered — requires prior authorization

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.

Tier: Preferred brand
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 (22)

0.5 ML testosterone enanthate 100 MG/ML Auto-Injector [Xyosted]Approval first
0.5 ML testosterone enanthate 150 MG/ML Auto-Injector [Xyosted]Approval first
0.5 ML testosterone enanthate 200 MG/ML Auto-Injector [Xyosted]Approval first
120 ACTUAT testosterone 10 MG/ACTUAT Topical GelApproval first
120 ACTUAT testosterone 10 MG/ACTUAT Topical Gel [Fortesta]Approval first
1250 MG testosterone 0.0162 MG/MG Topical GelApproval first
2500 MG testosterone 0.01 MG/MG Topical GelApproval first
2500 MG testosterone 0.0162 MG/MG Topical GelApproval first
5000 MG testosterone 0.01 MG/MG Topical GelApproval first
5000 MG testosterone 0.01 MG/MG Topical Gel [Testim]Approval first
5000 MG testosterone 0.01 MG/MG Topical Gel [Vogelxo]Approval first
60 ACTUAT testosterone 12.5 MG/ACTUAT Topical GelApproval first
60 ACTUAT testosterone 12.5 MG/ACTUAT Topical Gel [Vogelxo]Approval first
60 ACTUAT testosterone 20.25 MG/ACTUAT Topical GelApproval first
60 ACTUAT testosterone 20.25 MG/ACTUAT Topical Gel [Androgel]Approval first
60 ACTUAT testosterone 30 MG/ACTUAT Topical SolutionApproval first
60 ACTUAT testosterone 5.5 MG/ACTUAT Nasal Gel [Natesto]Approval first
testosterone 75 MG Drug Implant [Testopel]Approval first
testosterone cypionate 100 MG/ML Injectable SolutionApproval first
testosterone cypionate 200 MG/ML Injectable SolutionApproval first
testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone]Approval first
testosterone enanthate 200 MG/ML Injectable SolutionApproval first

← All coverage for testosterone