Does Moda Select Alaska Standard Bronze cover somatropin?
Moda Select Alaska Standard Bronze
73836-73836AK0960001-0 · ACA · ACA Marketplace
somatropin
somatropinunder Moda Select Alaska Standard Bronze
Covered — some forms require prior authorization
19 of 34 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$500per 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.
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
- Specialty drugs
- Approval first
- Required
- Try another first
- No
- 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 (34)
- 0.25 ML somatropin 0.8 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 1.6 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 2.4 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 3.2 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 4 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 4.8 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 5.6 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 6.4 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 7.2 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 0.25 ML somatropin 8 MG/ML Prefilled Syringe [Genotropin]Amount limit
- 1 ML somatropin 12 MG/ML Cartridge [Genotropin]Amount limit
- 1 ML somatropin 5 MG/ML Cartridge [Genotropin]Amount limit
- 1.5 ML somatropin 10 MG/ML Pen Injector [Norditropin]Approval first
- 1.5 ML somatropin 3.3 MG/ML Cartridge [Omnitrope]Amount limit
- 1.5 ML somatropin 3.33 MG/ML Pen Injector [Norditropin]Approval first
- 1.5 ML somatropin 6.67 MG/ML Cartridge [Omnitrope]Amount limit
- 1.5 ML somatropin 6.67 MG/ML Pen Injector [Norditropin]Approval first
- 2 ML somatropin 10 MG/ML Pen Injector [Nutropin]Approval first
- 2 ML somatropin 2.5 MG/ML Pen Injector [Nutropin]Approval first
- 2 ML somatropin 5 MG/ML Pen Injector [Nutropin]Approval first
- 3 ML somatropin 10 MG/ML Pen Injector [Norditropin]Approval first
- somatropin 10 MG/ML Injectable Solution [Zomacton]Approval first
- somatropin 12 MG Cartridge [Humatrope]Approval first
- somatropin 24 MG Cartridge [Humatrope]Approval first
- somatropin 4.4 MG/ML Injectable Solution [Saizen]Approval first
- somatropin 5 MG Injection [Serostim]Approval first
- somatropin 5 MG/ML Injectable Solution [Omnitrope]Amount limit
- somatropin 5 MG/ML Injectable Solution [Saizen]Approval first
- somatropin 5 MG/ML Injectable Solution [Zomacton]Approval first
- somatropin 6 MG Cartridge [Humatrope]Approval first
- somatropin 6 MG Injection [Serostim]Approval first
- somatropin 8 MG/ML Injectable Solution [Serostim]Approval first
- somatropin 8.8 MG Cartridge [Saizen]Approval first
- somatropin 8.8 MG/ML Injectable Solution [Zorbtive]Approval first