FillMapKP HI Bronze 6000/65 Plus CAM

Does KP HI Bronze 6000/65 Plus CAM cover polidocanol?

KP HI Bronze 6000/65 Plus CAM
60612-60612HI0110010-0 · ACA · ACA Marketplace
polidocanol
polidocanolunder KP HI Bronze 6000/65 Plus CAM
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay

This plan doesn't publish a price for this tier. Your pharmacy can quote it before you fill.

Tier
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.

Covered forms and strengths (2)

  • 2 ML polidocanol 10 MG/ML Injection [Asclera]
  • 2 ML polidocanol 5 MG/ML Injection [Asclera]

← All coverage for polidocanol