FillMapGold Value 1819 ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) · 36194-36194FL0410003-0About this plan

Does Gold Value 1819 ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) cover lidocaine?

1 · Your plan

Gold Value 1819 ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access)

36194-36194FL0410003-0 · ACA · ACA Marketplace

2 · Your medication

lidocaine

lidocaineunder Gold Value 1819 ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access)

Covered — just walk in

Nothing to clear first — take the prescription to an in-network pharmacy.

What you'd pay

$30per 30-day fill

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.

Tier: Preferred brand
Approval first: Not needed
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 (24)

10 ML lidocaine hydrochloride 10 MG/ML Injection
10 ML lidocaine hydrochloride 15 MG/ML Injection
10 ML lidocaine hydrochloride 20 MG/ML Injection
2 ML lidocaine hydrochloride 10 MG/ML Injection
2 ML lidocaine hydrochloride 20 MG/ML Injection
20 ML lidocaine hydrochloride 15 MG/ML Injection
250 ML lidocaine hydrochloride 4 MG/ML Injection
250 ML lidocaine hydrochloride 8 MG/ML Injection
30 ML lidocaine hydrochloride 10 MG/ML Injection
5 ML lidocaine hydrochloride 10 MG/ML Injection
5 ML lidocaine hydrochloride 10 MG/ML Prefilled Syringe
5 ML lidocaine hydrochloride 20 MG/ML Injection
5 ML lidocaine hydrochloride 20 MG/ML Prefilled Syringe
5 ML lidocaine hydrochloride 40 MG/ML Injection
50 ML lidocaine hydrochloride 5 MG/ML Injection
500 ML lidocaine hydrochloride 4 MG/ML Injection
lidocaine 0.05 MG/MG Medicated Patch
lidocaine hydrochloride 0.02 MG/MG Topical Gel
lidocaine hydrochloride 10 MG/ML Injectable Solution
lidocaine hydrochloride 20 MG/ML Injectable Solution
lidocaine hydrochloride 20 MG/ML Mucous Membrane Topical Solution
lidocaine hydrochloride 40 MG/ML Mucous Membrane Topical Solution
lidocaine hydrochloride 40 MG/ML Topical Solution
lidocaine hydrochloride 5 MG/ML Injectable Solution

← All coverage for lidocaine