Does Moda Health Oregon Standard Bronze Affinity cover doxycycline?
Moda Health Oregon Standard Bronze Affinity
39424-39424OR1670003-0 · ACA · ACA Marketplace
doxycycline
doxycyclineunder Moda Health Oregon Standard Bronze Affinity
Covered — some forms require step therapy
15 of 30 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 (30)
- {42 (doxycycline hyclate 100 MG Oral Tablet) } Pack [LymePak]Amount limit
- doxycycline anhydrous 40 MG Delayed Release Oral CapsuleTry another first
- doxycycline hyclate 100 MG Delayed Release Oral TabletTry another firstAmount limit
- doxycycline hyclate 100 MG Oral CapsuleAmount limit
- doxycycline hyclate 100 MG Oral TabletAmount limit
- doxycycline hyclate 120 MG Delayed Release Oral Tablet [Doryx]Try another firstAmount limit
- doxycycline hyclate 150 MG Delayed Release Oral TabletTry another firstAmount limit
- doxycycline hyclate 150 MG Oral TabletTry another firstAmount limit
- doxycycline hyclate 20 MG Oral TabletAmount limit
- doxycycline hyclate 200 MG Delayed Release Oral TabletTry another firstAmount limit
- doxycycline hyclate 50 MG Delayed Release Oral TabletTry another firstAmount limit
- doxycycline hyclate 50 MG Oral CapsuleAmount limit
- doxycycline hyclate 50 MG Oral TabletTry another first
- doxycycline hyclate 50 MG Oral Tablet [Targadox]Try another first
- doxycycline hyclate 60 MG Delayed Release Oral Tablet [Doryx]Try another firstAmount limit
- doxycycline hyclate 75 MG Delayed Release Oral TabletTry another firstAmount limit
- doxycycline hyclate 75 MG Oral TabletTry another firstAmount limit
- doxycycline hyclate 80 MG Delayed Release Oral TabletTry another firstAmount limit
- doxycycline hyclate 80 MG Delayed Release Oral Tablet [Doryx]Try another firstAmount limit
- doxycycline monohydrate 100 MG Oral CapsuleAmount limit
- doxycycline monohydrate 100 MG Oral Capsule [Mondoxyne]Amount limit
- doxycycline monohydrate 100 MG Oral TabletAmount limit
- doxycycline monohydrate 100 MG Oral Tablet [Avidoxy]Amount limit
- doxycycline monohydrate 150 MG Oral CapsuleAmount limit
- doxycycline monohydrate 150 MG Oral TabletTry another firstAmount limit
- doxycycline monohydrate 5 MG/ML Oral Suspension
- doxycycline monohydrate 50 MG Oral CapsuleAmount limit
- doxycycline monohydrate 50 MG Oral TabletAmount limit
- doxycycline monohydrate 75 MG Oral CapsuleAmount limit
- doxycycline monohydrate 75 MG Oral TabletAmount limit