FillMapModa Select Texas Standard Gold

Does Moda Select Texas Standard Gold cover doxycycline?

Moda Select Texas Standard Gold
17933-17933TX0010009-0 · ACA · ACA Marketplace
doxycycline
doxycyclineunder Moda Select Texas Standard Gold
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

← All coverage for doxycycline