FillMapPrestige Gold 50 + Dental + Vision+ 1 Free PCP Visit · 81413-81413WI0460016-0About this plan

Does Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit cover remestemcel-L?

1 · Your plan

Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit

81413-81413WI0460016-0 · ACA · ACA Marketplace

2 · Your medication

remestemcel-L

remestemcel-Lunder Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit

Covered — requires prior authorization

Your plan has to approve it first — your doctor’s office handles it.

What you'd pay

$50per 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.

Tier: Preferred brand
Approval first: Required
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.

Your cost-sharing levelMarketplace plans publish a different amount for each level. Your eligibility notice says which applies. Nothing here is saved.

Covered forms and strengths (12)

{1 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit < 12.5 kg]Approval first
{10 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 112.5 - < 125 kg]Approval first
{11 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 125 - < 137.5 kg]Approval first
{12 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 137.5 - < 150 kg]Approval first
{2 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 12.5 - < 25 kg]Approval first
{3 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 25 - < 37.5 kg]Approval first
{4 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 37.5 - < 50 kg]Approval first
{5 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 50 - < 62.5 kg]Approval first
{6 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 62.5 - < 75 kg]Approval first
{7 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 75 - < 87.5 kg]Approval first
{8 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 87.5 - < 100 kg]Approval first
{9 (3.8 ML remestemcel-L-rknd 6680000 CELLS/ML Injection [Ryoncil]) } Pack [Ryoncil Kit 100 - < 112.5 kg]Approval first

← All coverage for remestemcel-L