FillMapNH Local Choice HMO HSA Bronze 6000

Does NH Local Choice HMO HSA Bronze 6000 cover oxycodone?

NH Local Choice HMO HSA Bronze 6000
59025-59025NH0370102-0 · ACA · ACA Marketplace
oxycodone
oxycodoneunder NH Local Choice HMO HSA Bronze 6000
Covered — some forms require prior authorization
12 of 28 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
20%of the price your plan negotiates

Medicare hasn’t published this plan’s negotiated price for this drug yet — that file is updated every three months, and newly launched drugs appear in it late. Your pharmacy can quote the exact amount today. Your plan’s deductible comes first — you pay the full price until it is met.

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
Generic
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 (28)

  • 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 TabletAmount limit
  • Abuse-Deterrent oxycodone hydrochloride 10 MG Oral Tablet [Roxybond]Amount limit
  • Abuse-Deterrent oxycodone hydrochloride 15 MG Oral TabletAmount limit
  • Abuse-Deterrent oxycodone hydrochloride 15 MG Oral Tablet [Roxybond]Amount limit
  • Abuse-Deterrent oxycodone hydrochloride 30 MG Oral TabletAmount limit
  • Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet [Roxybond]Amount limit
  • Abuse-Deterrent oxycodone hydrochloride 5 MG Oral TabletAmount limit
  • Abuse-Deterrent oxycodone hydrochloride 5 MG Oral Tablet [Roxybond]Amount limit
  • oxycodone hydrochloride 1 MG/ML Oral Solution
  • oxycodone hydrochloride 10 MG Oral Tablet
  • oxycodone hydrochloride 15 MG Oral Tablet
  • oxycodone hydrochloride 20 MG Oral Tablet
  • oxycodone hydrochloride 20 MG/ML Oral Solution
  • oxycodone hydrochloride 30 MG Oral Tablet
  • oxycodone hydrochloride 5 MG Oral Capsule
  • oxycodone hydrochloride 5 MG Oral Tablet

← All coverage for oxycodone