Does 58081ga0010073 cover methotrexate?
58081ga0010073
58081-58081GA0010073-0 · ACA · ACA Marketplace
methotrexate
methotrexateunder 58081ga0010073
Covered — some forms require prior authorization
5 of 22 covered forms have a condition attached. 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
- 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.
Covered forms and strengths (22)
- 0.15 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.2 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.25 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.3 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.35 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.4 ML methotrexate 25 MG/ML Auto-Injector [Otrexup]
- 0.4 ML methotrexate 31.3 MG/ML Auto-Injector [Otrexup]
- 0.4 ML methotrexate 37.5 MG/ML Auto-Injector [Otrexup]
- 0.4 ML methotrexate 43.8 MG/ML Auto-Injector [Otrexup]
- 0.4 ML methotrexate 50 MG/ML Auto-Injector [Otrexup]
- 0.4 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.4 ML methotrexate 56.3 MG/ML Auto-Injector [Otrexup]
- 0.4 ML methotrexate 62.5 MG/ML Auto-Injector [Otrexup]
- 0.45 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.5 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.6 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 10 ML methotrexate 25 MG/ML InjectionApproval first
- 2 ML methotrexate 25 MG/ML InjectionApproval first
- 40 ML methotrexate 25 MG/ML InjectionApproval first
- methotrexate 1000 MG InjectionApproval first
- methotrexate 2.5 MG Oral Tablet
- methotrexate 25 MG/ML Injectable SolutionApproval first