Does Medicare Part D cover Veltassa, and does it require prior authorization?

Does Medicare Part D cover Veltassa?

Veltassa appears on the Medicare Part D formularies of 174 payers in the corpus. 27 require prior authorization on every covering plan, 1 on some plans, and 146 on none.

Prior authorization is set per plan, not per payer. Pick a payer below for its full plan-by-plan breakdown, effective 2026-06-30.

Coverage by payer

Payer	Plans covering	Require prior auth	Status
UnitedHealthcare	697	0	No prior authorization
Cigna	171	0	No prior authorization
SCAN Health Plan	74	0	No prior authorization
Alignment Healthcare	67	0	No prior authorization
Medco Containment Life And Medco Containment Ny	60	0	No prior authorization
Simply Healthcare Plans, INC.	50	0	No prior authorization
Uhc Of California	40	0	No prior authorization
Bravo Health Pennsylvania, INC.	35	0	No prior authorization
Preferred Care Partners, INC.	35	0	No prior authorization
Physicians Health Choice Of Texas, LLC	22	0	No prior authorization
Medica Health Plans	17	0	No prior authorization
Ultimate Health Plans, INC.	16	0	No prior authorization
Excellus Health Plan, INC.	16	0	No prior authorization
Aetna (CVS Health)	15	5	Varies by plan
Selecthealth, INC.	14	14	Prior authorization required
Peoples Health, INC.	13	0	No prior authorization
Healthsun Health Plans, INC.	13	0	No prior authorization
Atrio Health Plans	12	0	No prior authorization
HMO Louisiana, INC.	12	0	No prior authorization
Quartz Health Plan Corporation	10	0	No prior authorization
Sanford Health Plan	9	0	No prior authorization
Healthpartners, INC.	8	0	No prior authorization
Keystone Health Plan East, INC.	8	0	No prior authorization
Network Health Insurance Corporation	8	0	No prior authorization
Fallon Community Health Plan	8	0	No prior authorization
Peak Health Insurance Corporation	8	8	Prior authorization required
Astiva Health, INC.	7	0	No prior authorization
Bravo Health Mid-Atlantic, INC.	7	0	No prior authorization
Health Alliance Plan Of Michigan	7	7	Prior authorization required
Medica Insurance Company	7	0	No prior authorization
Summacare INC.	7	0	No prior authorization
Champion Health Plan Of California INC	7	0	No prior authorization
Essence Healthcare PPO, INC.	7	0	No prior authorization
Champion Health Plan Of Nevada, INC.	7	0	No prior authorization
Bluecross And Blueshield Of South Carolina	7	0	No prior authorization
Providence Health Assurance	7	0	No prior authorization
Alterwood Advantage, INC.	7	0	No prior authorization
Mass General Brigham Health Plan, INC	6	0	No prior authorization
Gold Kidney Of Florida INC	6	0	No prior authorization
Essence Healthcare, INC.	6	0	No prior authorization
Hometown Health Plan, INC.	6	0	No prior authorization
Presbyterian Health Plan	6	6	Prior authorization required
Perennial Advantage Of Colorado, INC.	6	6	Prior authorization required
Globalhealth, INC.	6	0	No prior authorization
Preferred Care Network, INC.	6	0	No prior authorization
Chinese Community Health Plan	5	0	No prior authorization
Alliance Health And Life Insurance Company	5	5	Prior authorization required
Oh Chs Snp INC.	5	0	No prior authorization
Gold Kidney Of Arizona	5	0	No prior authorization
Care N' Care Insurance Company Of North Carolina	4	0	No prior authorization
Health New England, INC.	4	0	No prior authorization
The Health Plan Of West Virginia, INC.	4	0	No prior authorization
Communitycare Government Programs, INC.	4	4	Prior authorization required
Qcc Insurance Company	4	0	No prior authorization
Leon Health, INC.	4	0	No prior authorization
Verda Health Plan Of Texas INC	4	0	No prior authorization
Security Health Plan Of Wisconsin, INC.	4	0	No prior authorization
Gateway Health Plan, INC.	4	0	No prior authorization
Boston Medical Center Health Plan, INC.	4	0	No prior authorization
Thp Insurance Company	4	0	No prior authorization
Aspire Health Plan	4	0	No prior authorization
Dean Health Plan, INC.	4	4	Prior authorization required
Quartz Health Plan Mn Corporation	4	0	No prior authorization
Medisun, INC.	3	0	No prior authorization
Louisiana Health Service & Indemnity Company	3	0	No prior authorization
Eternalhealth, INC.	3	0	No prior authorization
Marquis Advantage, INC.	3	3	Prior authorization required
Village Senior Services Corporation	3	0	No prior authorization
Baycare Select Health Plans, INC.	3	0	No prior authorization
Cox Health Systems HMO INC	3	0	No prior authorization
Secur INC	3	3	Prior authorization required
Align Senior Care California INC.	3	3	Prior authorization required
Pruitthealth Premier, INC.	3	3	Prior authorization required
Capital District Physicians' Health Plan, INC.	3	0	No prior authorization
Procare Advantage, LLC	3	3	Prior authorization required
Eternalhealth Of Arizona INC	3	0	No prior authorization
Aultcare Health Insuring Corporation	3	0	No prior authorization
Simpra Advantage, INC.	3	3	Prior authorization required
Provider Partners Health Plan Of Pennsylvania, INC	3	0	No prior authorization
Provider Partners Health Plan Of North Carolina	3	0	No prior authorization
Provider Partners Health Plan Of Indiana	3	0	No prior authorization
Amerihealth Insurance Company Of New Jersey	3	0	No prior authorization
Vns Choice	3	0	No prior authorization
Blue Cross Blue Shield (affiliate)	3	0	No prior authorization
Mclaren Health Plan, INC.	3	0	No prior authorization
Liberty Advantage, LLC	3	3	Prior authorization required
Southeastern Indiana Health Organization, INC.	3	0	No prior authorization
Perennial Advantage Of Ohio, INC.	3	3	Prior authorization required
Provider Partners Health Plan Of Missouri, INC.	3	0	No prior authorization
Arizona Physicians Ipa, INC.	2	0	No prior authorization
Ks Plan Administrators, LLC	2	0	No prior authorization
Amerihealth Caritas Vip Next, INC.	2	0	No prior authorization
Beshp, INC.	2	0	No prior authorization
Arkansas Superior Select, INC.	2	0	No prior authorization
Lifeworks Advantage, LLC	2	2	Prior authorization required
Kansas Superior Select, INC.	2	0	No prior authorization
Signature Advantage, LLC	2	0	No prior authorization
Primewest Rural Mn Health Care Access Initiative	2	0	No prior authorization
South Country Health Alliance	2	0	No prior authorization
Verda Health Plan Of Arizona, INC.	2	0	No prior authorization
Sanford Health Plan Of Minnesota	2	0	No prior authorization
Nhc Advantage, LLC	2	2	Prior authorization required
Vista Health Plan, INC.	2	0	No prior authorization
American Health Plan Of Ut, INC.	2	0	No prior authorization
American Health Plan Of Missouri, INC.	2	0	No prior authorization
New Century Health Plan, INC.	2	0	No prior authorization
Troy Health, INC.	2	0	No prior authorization
Community Health Group	2	0	No prior authorization
Banner - University Care Advantage	2	0	No prior authorization
Texas Independence Health Plan, INC.	2	0	No prior authorization
Imperial Health Plan Of California, INC.	2	0	No prior authorization
Denver Health Medical Plan, INC.	2	0	No prior authorization
Healthpartners Insurance Company	2	0	No prior authorization
Pruitthealth Premier North Carolina, LLC	2	2	Prior authorization required
Elite Health Plan, INC.	2	0	No prior authorization
American Health Plan Of Iowa INC	2	0	No prior authorization
Elderserve Health, INC.	2	0	No prior authorization
Align Senior Care Mi, LLC	2	2	Prior authorization required
Isnp Ventures, LLC	2	2	Prior authorization required
Good Samaritan Insurance Plan Of Nebraska, INC.	2	0	No prior authorization
Group Health Cooperative Of Eau Claire	2	0	No prior authorization
Georgia Assurance, INC.	2	0	No prior authorization
Caresource Georgia CO.	2	0	No prior authorization
Visiting Nurse Association Of Central New York	2	0	No prior authorization
Community Health Choice Texas, INC.	2	2	Prior authorization required
Align Senior Care Florida, INC.	2	2	Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp	2	0	No prior authorization
Longevity Health Plan Of Colorado, INC.	1	0	No prior authorization
Tsg Guard, INC.	1	0	No prior authorization
Local Initiative Health Authority For La County	1	1	Prior authorization required
Longevity Health Plan Of Florida, INC.	1	0	No prior authorization
Imperial County Local Health Authority	1	0	No prior authorization
Community Care Health Plan, INC.	1	0	No prior authorization
Alameda Alliance For Health	1	0	No prior authorization
Amerihealth Caritas Louisiana, INC.	1	0	No prior authorization
Upper Peninsula Health Plan, LLC	1	0	No prior authorization
Oklahoma Superior Select, INC.	1	0	No prior authorization
Provider Partners Health Plan Of Illinois	1	0	No prior authorization
Allcare Health Plan, INC.	1	0	No prior authorization
Samaritan Health Plans, INC.	1	0	No prior authorization
Santa Clara County Health Authority	1	0	No prior authorization
Provider Partners Health Plan Of Texas, INC.	1	0	No prior authorization
Kern Health Systems	1	0	No prior authorization
Hap Caresource	1	0	No prior authorization
Select Health Of South Carolina, INC.	1	0	No prior authorization
Contra Costa County Medical Service Dba Contra Costa Health	1	0	No prior authorization
Longevity Health Plan Of North Carolina, INC.	1	0	No prior authorization
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic	1	0	No prior authorization
San Joaquin County Health Commission	1	0	No prior authorization
Banner Health Plan, INC.	1	0	No prior authorization
Aids Healthcare Foundation	1	0	No prior authorization
Health Plan Of Careoregon, INC.	1	1	Prior authorization required
Alohacare	1	0	No prior authorization
San Mateo Health Commission	1	0	No prior authorization
Amerihealth Michigan, INC.	1	0	No prior authorization
Amerihealth Caritas Florida, INC.	1	0	No prior authorization
Caresource Ohio, INC.	1	0	No prior authorization
Lagniappe Advantage Insurance Company	1	1	Prior authorization required
American Health Plan Of Fl, INC.	1	0	No prior authorization
Provider Partners Health Plan Of Kentucky	1	0	No prior authorization
Longevity Health Plan Of Michigan, INC.	1	0	No prior authorization
Santa Barbara San Luis Obispo Regional Health Authority Dba	1	0	No prior authorization
American Health Plan, INC.	1	0	No prior authorization
San Francisco Health Authority Dba San Francisco Health Plan	1	0	No prior authorization
Amerihealth Caritas North Carolina, INC.	1	0	No prior authorization
Longevity Health Plan Of New York, INC.	1	0	No prior authorization
Dignity Care Corporation	1	0	No prior authorization
Healthy Mississippi, INC.	1	1	Prior authorization required
Inland Empire Health Plan	1	0	No prior authorization
West Virginia Senior Advantage, INC.	1	0	No prior authorization
Longevity Health Plan Of Illinois, INC.	1	0	No prior authorization
American Health Plan Of Indiana INC	1	0	No prior authorization
American Health Plan Of Ms, INC.	1	0	No prior authorization
American Health Plan Of Pennsylvania INC	1	0	No prior authorization

“Require prior auth” counts a plan when any Veltassa product on its formulary needs authorization.

Source

Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File

Effective: 2026-06-30
Retrieved: 2026-07-19
SHA-256: e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.