oxymorphone hcl er

7.5 MG

Opioid Analgesics, Long-acting

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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: 23 hours, 19 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Bronze CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 3000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 6500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Gold CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect Gold RD CMS Standard Tier 3 - Preferred Brand ✓ — — PA
Connect myDiabetesCare Silver Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 2200 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Gold 1500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect myDiabetesCare Bronze Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 5500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD 6000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 3500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 3500 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Bronze 7000 HSA Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver 4400 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Connect Silver RD 5000 Indiv Med Deductible Tier 3 - Preferred Brand ✓ — — PA
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 23 hours, 19 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
HealthSpring TotalCare (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 90 per 30 days QL
HealthSpring TotalCare Plus (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 90 per 30 days QL
HealthSpring Preferred (HMO) Tier 4 - Non-Preferred — — ✓ 90 per 30 days QL
HealthSpring Preferred Select (HMO) Tier 4 - Non-Preferred — — ✓ 90 per 30 days QL
HealthSpring Preferred Savings (HMO) Tier 4 - Non-Preferred — — ✓ 90 per 30 days QL
HealthSpring Preferred Plus (HMO) Tier 4 - Non-Preferred — — ✓ 90 per 30 days QL
HealthSpring True Choice (PPO) Tier 4 - Non-Preferred — — ✓ 90 per 30 days QL
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