Does Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard cover oxycodone?
Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard
44228-44228FL0040001-0 · ACA · ACA Marketplace
oxycodone
oxycodoneunder Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard
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.
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 three
- 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 (27)
- Abuse-Deterrent 12 HR oxycodone 13.5 MG Extended Release Oral Capsule [Xtampza]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone 18 MG Extended Release Oral Capsule [Xtampza]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone 27 MG Extended Release Oral Capsule [Xtampza]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone 36 MG Extended Release Oral Capsule [Xtampza]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone 9 MG Extended Release Oral Capsule [Xtampza]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone hydrochloride 10 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone hydrochloride 15 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone hydrochloride 20 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone hydrochloride 30 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone hydrochloride 40 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone hydrochloride 60 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
- Abuse-Deterrent 12 HR oxycodone hydrochloride 80 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
- Abuse-Deterrent oxycodone hydrochloride 10 MG Oral TabletApproval firstAmount limit
- Abuse-Deterrent oxycodone hydrochloride 10 MG Oral Tablet [Roxybond]Approval firstAmount limit
- Abuse-Deterrent oxycodone hydrochloride 15 MG Oral TabletApproval firstAmount limit
- Abuse-Deterrent oxycodone hydrochloride 15 MG Oral Tablet [Roxybond]Approval firstAmount limit
- Abuse-Deterrent oxycodone hydrochloride 30 MG Oral TabletApproval firstAmount limit
- Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet [Roxybond]Approval firstAmount limit
- Abuse-Deterrent oxycodone hydrochloride 5 MG Oral Tablet [Roxybond]Approval firstAmount limit
- oxycodone hydrochloride 1 MG/ML Oral SolutionApproval firstAmount limit
- oxycodone hydrochloride 10 MG Oral TabletApproval firstAmount limit
- oxycodone hydrochloride 15 MG Oral TabletApproval firstAmount limit
- oxycodone hydrochloride 20 MG Oral TabletApproval firstAmount limit
- oxycodone hydrochloride 20 MG/ML Oral SolutionApproval firstAmount limit
- oxycodone hydrochloride 30 MG Oral TabletApproval firstAmount limit
- oxycodone hydrochloride 5 MG Oral CapsuleApproval firstAmount limit
- oxycodone hydrochloride 5 MG Oral TabletApproval firstAmount limit