FillMapPremera Blue Cross Standard Gold

Does Premera Blue Cross Standard Gold cover epoetin alfa?

Premera Blue Cross Standard Gold
38344-38344AK1100001-0 · ACA · ACA Marketplace
epoetin alfa
epoetin alfaunder Premera Blue Cross Standard Gold
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$250per 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
Specialty drugs
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.

Covered forms and strengths (20)

  • 1 ML epoetin alfa 10000 UNT/ML Injection [Epogen]Approval first
  • 1 ML epoetin alfa 10000 UNT/ML Injection [Procrit]Approval first
  • 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen]Approval first
  • 1 ML epoetin alfa 2000 UNT/ML Injection [Procrit]Approval first
  • 1 ML epoetin alfa 3000 UNT/ML Injection [Epogen]Approval first
  • 1 ML epoetin alfa 3000 UNT/ML Injection [Procrit]Approval first
  • 1 ML epoetin alfa 4000 UNT/ML Injection [Epogen]Approval first
  • 1 ML epoetin alfa 4000 UNT/ML Injection [Procrit]Approval first
  • 1 ML epoetin alfa 40000 UNT/ML Injection [Procrit]Approval first
  • 1 ML epoetin alfa-epbx 10000 UNT/ML Injection [Retacrit]Approval first
  • 1 ML epoetin alfa-epbx 2000 UNT/ML Injection [Retacrit]Approval first
  • 1 ML epoetin alfa-epbx 3000 UNT/ML Injection [Retacrit]Approval first
  • 1 ML epoetin alfa-epbx 4000 UNT/ML Injection [Retacrit]Approval first
  • 1 ML epoetin alfa-epbx 40000 UNT/ML Injection [Retacrit]Approval first
  • epoetin alfa 10000 UNT/ML Injectable Solution [Epogen]Approval first
  • epoetin alfa 10000 UNT/ML Injectable Solution [Procrit]Approval first
  • epoetin alfa 20000 UNT/ML Injectable Solution [Epogen]Approval first
  • epoetin alfa 20000 UNT/ML Injectable Solution [Procrit]Approval first
  • epoetin alfa-epbx 10000 UNT/ML Injectable Solution [Retacrit]Approval first
  • epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit]Approval first

← All coverage for epoetin alfa