Benefily
Sign inCreate account

Does Medicare Part D cover Veltassa?

Veltassa appears on the Medicare Part D formularies of 174 payers in the corpus, across 1,840 plans. 27 payers require prior authorization on every covering plan, 1 on some plans, and 146 on none.

Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 1,315 apply a quantity limit, on at least one Veltassa product.

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

PayerPlans coveringRequire prior authStep therapyQuantity limitStatus
UnitedHealthcare69700697No prior authorization
Cigna17100171No prior authorization
SCAN Health Plan74000No prior authorization
Alignment Healthcare67000No prior authorization
Medco Containment Life And Medco Containment Ny600060No prior authorization
Simply Healthcare Plans, INC.500050No prior authorization
Uhc Of California400040No prior authorization
Bravo Health Pennsylvania, INC.350035No prior authorization
Preferred Care Partners, INC.350035No prior authorization
Physicians Health Choice Of Texas, LLC220022No prior authorization
Medica Health Plans17000No prior authorization
Ultimate Health Plans, INC.16000No prior authorization
Excellus Health Plan, INC.160016No prior authorization
Aetna (CVS Health)15505Varies by plan
Selecthealth, INC.1414014Prior authorization required
Peoples Health, INC.130013No prior authorization
Healthsun Health Plans, INC.130013No prior authorization
Atrio Health Plans12000No prior authorization
HMO Louisiana, INC.12000No prior authorization
Quartz Health Plan Corporation10000No prior authorization
Sanford Health Plan9000No prior authorization
Healthpartners, INC.8000No prior authorization
Keystone Health Plan East, INC.8000No prior authorization
Network Health Insurance Corporation8008No prior authorization
Fallon Community Health Plan8000No prior authorization
Peak Health Insurance Corporation8808Prior authorization required
Astiva Health, INC.7000No prior authorization
Bravo Health Mid-Atlantic, INC.7007No prior authorization
Health Alliance Plan Of Michigan7700Prior authorization required
Medica Insurance Company7000No prior authorization
Summacare INC.7000No prior authorization
Champion Health Plan Of California INC7000No prior authorization
Essence Healthcare PPO, INC.7000No prior authorization
Champion Health Plan Of Nevada, INC.7000No prior authorization
Bluecross And Blueshield Of South Carolina7000No prior authorization
Providence Health Assurance7000No prior authorization
Alterwood Advantage, INC.7000No prior authorization
Mass General Brigham Health Plan, INC6000No prior authorization
Gold Kidney Of Florida INC6000No prior authorization
Essence Healthcare, INC.6000No prior authorization
Hometown Health Plan, INC.6000No prior authorization
Presbyterian Health Plan6606Prior authorization required
Perennial Advantage Of Colorado, INC.6606Prior authorization required
Globalhealth, INC.6000No prior authorization
Preferred Care Network, INC.6006No prior authorization
Chinese Community Health Plan5000No prior authorization
Alliance Health And Life Insurance Company5500Prior authorization required
Oh Chs Snp INC.5000No prior authorization
Gold Kidney Of Arizona5000No prior authorization
Care N' Care Insurance Company Of North Carolina4000No prior authorization
Health New England, INC.4000No prior authorization
The Health Plan Of West Virginia, INC.4000No prior authorization
Communitycare Government Programs, INC.4404Prior authorization required
Qcc Insurance Company4000No prior authorization
Leon Health, INC.4004No prior authorization
Verda Health Plan Of Texas INC4000No prior authorization
Security Health Plan Of Wisconsin, INC.4000No prior authorization
Gateway Health Plan, INC.4004No prior authorization
Boston Medical Center Health Plan, INC.4000No prior authorization
Thp Insurance Company4000No prior authorization
Aspire Health Plan4004No prior authorization
Dean Health Plan, INC.4404Prior authorization required
Quartz Health Plan Mn Corporation4000No prior authorization
Medisun, INC.3000No prior authorization
Louisiana Health Service & Indemnity Company3000No prior authorization
Eternalhealth, INC.3000No prior authorization
Marquis Advantage, INC.3303Prior authorization required
Village Senior Services Corporation3000No prior authorization
Baycare Select Health Plans, INC.3000No prior authorization
Cox Health Systems HMO INC3000No prior authorization
Secur INC3303Prior authorization required
Align Senior Care California INC.3303Prior authorization required
Pruitthealth Premier, INC.3303Prior authorization required
Capital District Physicians' Health Plan, INC.3003No prior authorization
Procare Advantage, LLC3303Prior authorization required
Eternalhealth Of Arizona INC3000No prior authorization
Aultcare Health Insuring Corporation3000No prior authorization
Simpra Advantage, INC.3303Prior authorization required
Provider Partners Health Plan Of Pennsylvania, INC3000No prior authorization
Provider Partners Health Plan Of North Carolina3000No prior authorization
Provider Partners Health Plan Of Indiana3000No prior authorization
Amerihealth Insurance Company Of New Jersey3000No prior authorization
Vns Choice3000No prior authorization
Blue Cross Blue Shield (affiliate)3003No prior authorization
Mclaren Health Plan, INC.3000No prior authorization
Liberty Advantage, LLC3303Prior authorization required
Southeastern Indiana Health Organization, INC.3000No prior authorization
Perennial Advantage Of Ohio, INC.3303Prior authorization required
Provider Partners Health Plan Of Missouri, INC.3000No prior authorization
Arizona Physicians Ipa, INC.2002No prior authorization
Ks Plan Administrators, LLC2000No prior authorization
Amerihealth Caritas Vip Next, INC.2002No prior authorization
Beshp, INC.2000No prior authorization
Arkansas Superior Select, INC.2000No prior authorization
Lifeworks Advantage, LLC2202Prior authorization required
Kansas Superior Select, INC.2002No prior authorization
Signature Advantage, LLC2000No prior authorization
Primewest Rural Mn Health Care Access Initiative2000No prior authorization
South Country Health Alliance2002No prior authorization
Verda Health Plan Of Arizona, INC.2000No prior authorization
Sanford Health Plan Of Minnesota2000No prior authorization
Nhc Advantage, LLC2202Prior authorization required
Vista Health Plan, INC.2002No prior authorization
American Health Plan Of Ut, INC.2002No prior authorization
American Health Plan Of Missouri, INC.2002No prior authorization
New Century Health Plan, INC.2000No prior authorization
Troy Health, INC.2002No prior authorization
Community Health Group2000No prior authorization
Banner - University Care Advantage2000No prior authorization
Texas Independence Health Plan, INC.2000No prior authorization
Imperial Health Plan Of California, INC.2000No prior authorization
Denver Health Medical Plan, INC.2000No prior authorization
Healthpartners Insurance Company2000No prior authorization
Pruitthealth Premier North Carolina, LLC2202Prior authorization required
Elite Health Plan, INC.2000No prior authorization
American Health Plan Of Iowa INC2002No prior authorization
Elderserve Health, INC.2000No prior authorization
Align Senior Care Mi, LLC2202Prior authorization required
Isnp Ventures, LLC2202Prior authorization required
Good Samaritan Insurance Plan Of Nebraska, INC.2000No prior authorization
Group Health Cooperative Of Eau Claire2000No prior authorization
Georgia Assurance, INC.2002No prior authorization
Caresource Georgia CO.2000No prior authorization
Visiting Nurse Association Of Central New York2000No prior authorization
Community Health Choice Texas, INC.2202Prior authorization required
Align Senior Care Florida, INC.2202Prior authorization required
Longevity Health Plan Of New Jersey Insurance Comp2000No prior authorization
Longevity Health Plan Of Colorado, INC.1000No prior authorization
Tsg Guard, INC.1000No prior authorization
Local Initiative Health Authority For La County1101Prior authorization required
Longevity Health Plan Of Florida, INC.1000No prior authorization
Imperial County Local Health Authority1000No prior authorization
Community Care Health Plan, INC.1000No prior authorization
Alameda Alliance For Health1001No prior authorization
Amerihealth Caritas Louisiana, INC.1001No prior authorization
Upper Peninsula Health Plan, LLC1000No prior authorization
Oklahoma Superior Select, INC.1001No prior authorization
Provider Partners Health Plan Of Illinois1000No prior authorization
Allcare Health Plan, INC.1000No prior authorization
Samaritan Health Plans, INC.1000No prior authorization
Santa Clara County Health Authority1000No prior authorization
Provider Partners Health Plan Of Texas, INC.1000No prior authorization
Kern Health Systems1000No prior authorization
Hap Caresource1000No prior authorization
Select Health Of South Carolina, INC.1001No prior authorization
Contra Costa County Medical Service Dba Contra Costa Health1001No prior authorization
Longevity Health Plan Of North Carolina, INC.1000No prior authorization
Santa Cruz Monterey Merced San Benito Mariposa Managed Medic1000No prior authorization
San Joaquin County Health Commission1000No prior authorization
Banner Health Plan, INC.1000No prior authorization
Aids Healthcare Foundation1000No prior authorization
Health Plan Of Careoregon, INC.1101Prior authorization required
Alohacare1000No prior authorization
San Mateo Health Commission1001No prior authorization
Amerihealth Michigan, INC.1001No prior authorization
Amerihealth Caritas Florida, INC.1001No prior authorization
Caresource Ohio, INC.1000No prior authorization
Lagniappe Advantage Insurance Company1101Prior authorization required
American Health Plan Of Fl, INC.1001No prior authorization
Provider Partners Health Plan Of Kentucky1000No prior authorization
Longevity Health Plan Of Michigan, INC.1000No prior authorization
Santa Barbara San Luis Obispo Regional Health Authority Dba1000No prior authorization
American Health Plan, INC.1001No prior authorization
San Francisco Health Authority Dba San Francisco Health Plan1000No prior authorization
Amerihealth Caritas North Carolina, INC.1001No prior authorization
Longevity Health Plan Of New York, INC.1000No prior authorization
Dignity Care Corporation1001No prior authorization
Healthy Mississippi, INC.1101Prior authorization required
Inland Empire Health Plan1000No prior authorization
West Virginia Senior Advantage, INC.1000No prior authorization
Longevity Health Plan Of Illinois, INC.1000No prior authorization
American Health Plan Of Indiana INC1001No prior authorization
American Health Plan Of Ms, INC.1001No prior authorization
American Health Plan Of Pennsylvania INC1001No prior authorization

“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Veltassa product on its formulary carries that condition.

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.