Does Healthy Premier Gold Copay Office Visits cover methotrexate?
Healthy Premier Gold Copay Office Visits
42261-42261UT0060001-0 · ACA · ACA Marketplace
methotrexate
methotrexateunder Healthy Premier Gold Copay Office Visits
Covered — some forms require prior authorization
11 of 26 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
50%of the price your plan negotiates
Medicare hasn’t published this plan’s negotiated price for this drug yet — that file is updated every three months, and newly launched drugs appear in it late. Your pharmacy can quote the exact amount today. 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.
- Tier
- Specialty
- 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 (26)
- 0.15 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.2 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.25 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.3 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.35 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.4 ML methotrexate 25 MG/ML Auto-Injector [Otrexup]Approval first
- 0.4 ML methotrexate 31.3 MG/ML Auto-Injector [Otrexup]Approval first
- 0.4 ML methotrexate 37.5 MG/ML Auto-Injector [Otrexup]Approval first
- 0.4 ML methotrexate 43.8 MG/ML Auto-Injector [Otrexup]Approval first
- 0.4 ML methotrexate 50 MG/ML Auto-Injector [Otrexup]Approval first
- 0.4 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.4 ML methotrexate 56.3 MG/ML Auto-Injector [Otrexup]Approval first
- 0.4 ML methotrexate 62.5 MG/ML Auto-Injector [Otrexup]Approval first
- 0.45 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.5 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 0.6 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo]
- 10 ML methotrexate 25 MG/ML Injection
- 2 ML methotrexate 25 MG/ML Injection
- 40 ML methotrexate 25 MG/ML Injection
- methotrexate 10 MG Oral Tablet [Trexall]Approval first
- methotrexate 1000 MG Injection
- methotrexate 15 MG Oral Tablet [Trexall]Approval first
- methotrexate 2.5 MG Oral Tablet
- methotrexate 25 MG/ML Injectable Solution
- methotrexate 5 MG Oral Tablet [Trexall]Approval first
- methotrexate 7.5 MG Oral Tablet [Trexall]Approval first