FillMapSilver Simple Diabetes | Cleveland Clinic · 45845-45845OH0100045-0About this plan

Does Silver Simple Diabetes | Cleveland Clinic cover oxycodone?

1 · Your plan

Silver Simple Diabetes | Cleveland Clinic

45845-45845OH0100045-0 · ACA · ACA Marketplace

2 · Your medication

oxycodone

oxycodoneunder Silver Simple Diabetes | Cleveland Clinic

Covered — requires prior authorization

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

What you'd pay

$3per 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: Generic
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.

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 (19)

Abuse-Deterrent 12 HR oxycodone hydrochloride 10 MG Extended Release Oral TabletApproval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 10 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 15 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 20 MG Extended Release Oral TabletApproval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 20 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 30 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 40 MG Extended Release Oral TabletApproval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 40 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 60 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 80 MG Extended Release Oral TabletApproval firstAmount limit
Abuse-Deterrent 12 HR oxycodone hydrochloride 80 MG Extended Release Oral Tablet [Oxycontin]Approval firstAmount limit
oxycodone hydrochloride 1 MG/ML Oral SolutionApproval firstAmount limit
oxycodone hydrochloride 10 MG Oral TabletApproval firstAmount limit
oxycodone hydrochloride 15 MG Oral TabletApproval firstAmount limit
oxycodone hydrochloride 20 MG Oral TabletApproval firstAmount limit
oxycodone hydrochloride 20 MG/ML Oral SolutionApproval firstAmount limit
oxycodone hydrochloride 30 MG Oral TabletApproval firstAmount limit
oxycodone hydrochloride 5 MG Oral CapsuleApproval firstAmount limit
oxycodone hydrochloride 5 MG Oral TabletApproval firstAmount limit

← All coverage for oxycodone