etrasimod 2 MG Oral Tablet [Velsipity]
etrasimod
RxCUI: 2668057
What the CMS Formulary Data Shows for etrasimod 2 MG Oral Tablet [Velsipity]
Per the CMS 2026 Part D formulary file, etrasimod 2 MG Oral Tablet [Velsipity] (RxNorm concept RXCUI 2668057, generic name etrasimod) appears on 73 distinct formulary files spanning 1,434 Medicare Part D plan offerings - 28.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.
Real-world access to etrasimod 2 MG Oral Tablet [Velsipity] depends on utilization management as much as tier placement: 95.9% of covering formularies require prior authorization. 0% require step therapy. 86.3% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry etrasimod 2 MG Oral Tablet [Velsipity] today.
Coverage Details
- Formularies covering
- 73
- Plans covering
- 1,434
- Coverage rate
- 28.3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 95.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 86.3% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering etrasimod 2 MG Oral Tablet [Velsipity]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | ELDERPLAN, INC. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | HEALTH CHOICE ARIZONA, INC. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | HEALTHFIRST HEALTH PLAN, INC. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | ITASCA MEDICAL CARE | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | HOPKINS HEALTH ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | METROPLUS HEALTH PLAN, INC. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| CCA One Care (HMO D-SNP) | COMMONWEALTH CARE ALLIANCE, INC. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | COMMONWEALTH CARE ALLIANCE, INC. | T1 | Yes | $0 | MA |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $0 | DE |
| Florida Complete Care (HMO I-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $17.60 | PA |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | ELDERPLAN, INC. | T1 | Yes | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | VIVA HEALTH, INC. | T1 | Yes | $27.70 | AL |
| VIVA Medicare Extra Care (HMO D-SNP) | VIVA HEALTH, INC. | T1 | Yes | $27.70 | AL |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $31.20 | DE |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | ELDERPLAN, INC. | T1 | Yes | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | METROPLUS HEALTH PLAN, INC. | T1 | Yes | $58.80 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| Aetna Medicare Signature (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | Yes | $0 | KY |
Frequently Asked Questions
Is etrasimod 2 MG Oral Tablet [Velsipity] covered by Medicare Part D?
Yes, etrasimod 2 MG Oral Tablet [Velsipity] is covered by 1,434 Medicare Part D plans (28.3% of all Part D formularies).
What tier is etrasimod 2 MG Oral Tablet [Velsipity] on Medicare Part D plans?
etrasimod 2 MG Oral Tablet [Velsipity] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does etrasimod 2 MG Oral Tablet [Velsipity] require prior authorization?
95.9% of Part D formularies require prior authorization for etrasimod 2 MG Oral Tablet [Velsipity]. Step therapy: 0%. Quantity limits: 86.3%.
Read our methodology - how this data is sourced, computed, and verified.