FillMapPacificSource Oregon Standard Bronze HSA Plan Core

Does PacificSource Oregon Standard Bronze HSA Plan Core cover hydrocortisone?

PacificSource Oregon Standard Bronze HSA Plan Core
10091-10091OR0770003-0 · ACA · ACA Marketplace
hydrocortisone
hydrocortisoneunder PacificSource Oregon Standard Bronze HSA Plan Core
Covered — some forms require prior authorization
4 of 25 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$0per 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
Non preferred brand
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 (25)

  • hydrocortisone 0.01 MG/MG Topical Ointment
  • hydrocortisone 0.025 MG/MG Topical Ointment
  • hydrocortisone 0.5 MG Oral Granules [Alkindi]Approval firstAmount limit
  • hydrocortisone 1 MG Oral Granules [Alkindi]Approval firstAmount limit
  • hydrocortisone 1.67 MG/ML Enema
  • hydrocortisone 10 MG Oral Tablet
  • hydrocortisone 10 MG/ML Topical Cream
  • hydrocortisone 10 MG/ML Topical Cream [Ala-Cort]
  • hydrocortisone 100 MG Injection [Solu-Cortef]
  • hydrocortisone 1000 MG Injection [Solu-Cortef]
  • hydrocortisone 2 MG Oral Granules [Alkindi]Approval firstAmount limit
  • hydrocortisone 20 MG Oral Tablet
  • hydrocortisone 20 MG/ML Topical Lotion [Scalacort]
  • hydrocortisone 25 MG/ML Topical Cream
  • hydrocortisone 25 MG/ML Topical Lotion
  • hydrocortisone 25 MG/ML Topical Solution [Texacort]
  • hydrocortisone 250 MG Injection [Solu-Cortef]
  • hydrocortisone 5 MG Oral Granules [Alkindi]Approval firstAmount limit
  • hydrocortisone 5 MG Oral Tablet
  • hydrocortisone 500 MG Injection [Solu-Cortef]
  • hydrocortisone butyrate 0.001 MG/MG Topical Ointment
  • hydrocortisone butyrate 1 MG/ML Topical Cream
  • hydrocortisone butyrate 1 MG/ML Topical Solution
  • hydrocortisone valerate 0.002 MG/MG Topical Ointment
  • hydrocortisone valerate 2 MG/ML Topical Cream

← All coverage for hydrocortisone