FillMapModa Health Affinity Bronze 9000

Does Moda Health Affinity Bronze 9000 cover methylphenidate?

Moda Health Affinity Bronze 9000
39424-39424OR1660002-0 · ACA · ACA Marketplace
methylphenidate
methylphenidateunder Moda Health Affinity Bronze 9000
Covered — some forms require step therapy
17 of 36 covered forms have a condition attached. You may need to try a cheaper medication first — your doctor’s office handles it.
What you'd pay
$0per 30-day fill

From the first fill — no deductible on this drug.

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
Non preferred brand
Approval first
Not needed
Try another first
Required
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 (36)

  • 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral Tablet [Relexxii]Try another firstAmount limit
  • 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral Tablet [Relexxii]Try another firstAmount limit
  • 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral Tablet [Relexxii]Try another firstAmount limit
  • 24 HR methylphenidate hydrochloride 45 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 45 MG Extended Release Oral Tablet [Relexxii]Amount limit
  • 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral Tablet [Relexxii]Try another firstAmount limit
  • 24 HR methylphenidate hydrochloride 63 MG Extended Release Oral TabletAmount limit
  • 24 HR methylphenidate hydrochloride 63 MG Extended Release Oral Tablet [Relexxii]Amount limit
  • 24 HR methylphenidate hydrochloride 72 MG Extended Release Oral TabletTry another firstAmount limit
  • 24 HR methylphenidate hydrochloride 72 MG Extended Release Oral Tablet [Relexxii]Try another firstAmount limit
  • 40/60 Release 24 HR methylphenidate hydrochloride 10 MG Extended Release Oral CapsuleTry another firstAmount limit
  • 40/60 Release 24 HR methylphenidate hydrochloride 15 MG Extended Release Oral CapsuleTry another firstAmount limit
  • 40/60 Release 24 HR methylphenidate hydrochloride 20 MG Extended Release Oral CapsuleTry another firstAmount limit
  • 40/60 Release 24 HR methylphenidate hydrochloride 30 MG Extended Release Oral CapsuleTry another firstAmount limit
  • 40/60 Release 24 HR methylphenidate hydrochloride 40 MG Extended Release Oral CapsuleTry another firstAmount limit
  • 40/60 Release 24 HR methylphenidate hydrochloride 50 MG Extended Release Oral CapsuleTry another firstAmount limit
  • 40/60 Release 24 HR methylphenidate hydrochloride 60 MG Extended Release Oral CapsuleTry another firstAmount limit
  • 8 HR methylphenidate hydrochloride 10 MG Extended Release Oral TabletAmount limit
  • 8 HR methylphenidate hydrochloride 20 MG Extended Release Oral TabletAmount limit
  • 9 HR methylphenidate 1.11 MG/HR Transdermal SystemTry another firstAmount limit
  • 9 HR methylphenidate 1.67 MG/HR Transdermal SystemTry another firstAmount limit
  • 9 HR methylphenidate 2.22 MG/HR Transdermal SystemTry another firstAmount limit
  • 9 HR methylphenidate 3.33 MG/HR Transdermal SystemTry another firstAmount limit
  • BX Rating 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral TabletAmount limit
  • BX Rating 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral TabletAmount limit
  • BX Rating 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral TabletAmount limit
  • BX Rating 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral TabletAmount limit
  • methylphenidate hydrochloride 1 MG/ML Oral Solution
  • methylphenidate hydrochloride 10 MG Oral TabletAmount limit
  • methylphenidate hydrochloride 2 MG/ML Oral Solution
  • methylphenidate hydrochloride 20 MG Oral TabletAmount limit
  • methylphenidate hydrochloride 5 MG Oral TabletAmount limit

← All coverage for methylphenidate