Methylphenidate Er(La)

10 Mg — Capsule

Central Nervous System Stimulant

Also known as: Methylphenidate Er(La) 10 Mg Capsule Methylphenidate Er(La) 20 Mg Capsule Methylphenidate Er(La) 30 Mg Capsule Methylphenidate Er(La) 40 Mg Capsule Methylphenidate Er(La) 60 Mg Capsule
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 8 hours, 50 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Gold RD CMS Standard Tier 3 - Preferred Brand — — ✓ QL
Connect myDiabetesCare Silver Tier 3 - Preferred Brand — — ✓ QL
Connect Silver RD 2200 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze RD CMS Standard Tier 3 - Preferred Brand — — ✓ QL
Connect Gold CMS Standard Tier 3 - Preferred Brand — — ✓ QL
Connect Silver RD CMS Standard Tier 3 - Preferred Brand — — ✓ QL
Connect Silver CMS Standard Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze 6500 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Silver 3000 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Silver RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Silver 4400 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze 7000 HSA Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Silver RD 3500 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Silver 3500 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze RD 6000 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze 5500 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect myDiabetesCare Bronze Tier 3 - Preferred Brand — — ✓ QL
Connect Gold 1500 Indiv Med Deductible Tier 3 - Preferred Brand — — ✓ QL
Connect Bronze CMS Standard Tier 3 - Preferred Brand — — ✓ QL
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 8 hours, 50 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic — — — None
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 2 - Generic — — ✓ 30 per 30 days QL
Troy Medicare (HMO) Tier 2 - Generic — — ✓ 30 per 30 days QL
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 2 - Generic — — ✓ 30 per 30 days QL
Aetna Medicare Signature (HMO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Chronic Care (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Signature Giveback (PPO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Signature Extra (PPO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Enhanced (PPO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Enhanced (PPO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Enhanced (HMO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Signature Care (HMO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Prime (HMO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Value Plus (HMO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Signature (HMO) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
Aetna Medicare Dual (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 60 per 30 days QL
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