Does Anthem Gold Preferred Blue PPO 1000/20%/7500 cover doxycycline?
Anthem Gold Preferred Blue PPO 1000/20%/7500
57601-57601NH0350003-0 · ACA · ACA Marketplace
doxycycline
doxycyclineunder Anthem Gold Preferred Blue PPO 1000/20%/7500
Covered — the conditions depend on which form
Not the same for every form: 2 of 23 need your plan’s approval first, and 4 of 23 usually need a preferred medication tried first. Check your exact form in the list below — your doctor’s office handles either.
What you'd pay
This plan doesn't publish a price for this tier. Your pharmacy can quote it before you fill.
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
- Tier one
- Approval first
- Required
- 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 (23)
- {30 (doxycycline monohydrate 150 MG Oral Tablet) } PackAmount limit
- {31 (doxycycline monohydrate 100 MG Oral Tablet) } PackAmount limit
- {42 (doxycycline hyclate 100 MG Oral Tablet) } PackAmount limit
- {60 (doxycycline monohydrate 100 MG Oral Tablet) } PackAmount limit
- doxycycline hyclate 100 MG Delayed Release Oral TabletAmount limit
- doxycycline hyclate 100 MG Oral CapsuleAmount limit
- doxycycline hyclate 100 MG Oral TabletAmount limit
- doxycycline hyclate 150 MG Delayed Release Oral TabletApproval firstAmount limit
- doxycycline hyclate 20 MG Oral TabletAmount limit
- doxycycline hyclate 50 MG Oral CapsuleAmount limit
- doxycycline hyclate 50 MG Oral TabletTry another firstAmount limit
- doxycycline hyclate 50 MG Oral Tablet [Targadox]Try another firstAmount limit
- doxycycline hyclate 75 MG Delayed Release Oral TabletApproval firstAmount limit
- doxycycline monohydrate 100 MG Oral CapsuleAmount limit
- doxycycline monohydrate 100 MG Oral TabletAmount limit
- doxycycline monohydrate 100 MG Oral Tablet [Avidoxy]Amount limit
- doxycycline monohydrate 150 MG Oral CapsuleTry another firstAmount limit
- doxycycline monohydrate 150 MG Oral TabletAmount limit
- doxycycline monohydrate 5 MG/ML Oral SuspensionAmount limit
- doxycycline monohydrate 50 MG Oral CapsuleAmount limit
- doxycycline monohydrate 50 MG Oral TabletTry another firstAmount limit
- doxycycline monohydrate 75 MG Oral CapsuleAmount limit
- doxycycline monohydrate 75 MG Oral TabletAmount limit