Does KP HI Gold 1000 Ded/250 Rx Ded cover polidocanol?
KP HI Gold 1000 Ded/250 Rx Ded
60612-60612HI0110011-0 · ACA · ACA Marketplace
polidocanol
polidocanolunder KP HI Gold 1000 Ded/250 Rx Ded
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]