Medicare Part D coverage · icosapent ethyl · RxCUI 1811182
icosapent ethyl 500 MG Oral Capsule [Vascepa]
Per the CMS 2026 Part D formulary file, icosapent ethyl 500 MG Oral Capsule [Vascepa] is covered by 3,975 Medicare Part D plans (78.7% of enrollable products), averaging Tier 2.9, with prior authorization required on 0% of covering formularies.
- 78.7%
- Plan coverage
- 3,975
- Plans covering
- T2.9
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for icosapent ethyl 500 MG Oral Capsule [Vascepa]
Per the CMS 2026 Part D formulary file, icosapent ethyl 500 MG Oral Capsule [Vascepa] (RxNorm concept RXCUI 1811182, generic name icosapent ethyl) appears on 141 distinct formulary files spanning 3,975 Medicare Part D plan offerings - 78.7% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.9.
Real-world access to icosapent ethyl 500 MG Oral Capsule [Vascepa] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 38.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 279,946 Part D beneficiaries filled icosapent ethyl 500 MG Oral Capsule [Vascepa] in 2023, with total plan-and-beneficiary spending of $763,988,447 and an average per-beneficiary annual cost of $2,729.06. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry icosapent ethyl 500 MG Oral Capsule [Vascepa] today.
Coverage Details
- Formularies covering
- 141
- Plans covering
- 3,975
- Coverage rate
- 78.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 38.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 279,946
- Total spending
- $763,988,447
- Avg per beneficiary
- $2,729.06
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering icosapent ethyl 500 MG Oral Capsule [Vascepa]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T3 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering icosapent ethyl 500 MG Oral Capsule [Vascepa]
95 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 | No | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
Show the next 30 plans
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | Viva Health, Inc. | T1 | No | $27.70 | AL |
| VIVA Medicare Extra Care (HMO D-SNP) | Viva Health, Inc. | T1 | No | $27.70 | AL |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | Elderplan, Inc. | T1 | No | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | Metroplus Health Plan, Inc. | T1 | No | $58.80 | NY |
| BlueCare Plus (HMO D-SNP) | Volunteer State Health Plan | T2 | No | $0 | TN |
| BlueCare Plus Choice (HMO D-SNP) | Volunteer State Health Plan | T2 | No | $0 | TN |
| BlueCare Plus Select (HMO D-SNP) | Volunteer State Health Plan | T2 | No | $0 | TN |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T3 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T3 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T3 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T3 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T3 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T3 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T3 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T3 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T3 | No | $0 | TN |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is icosapent ethyl 500 MG Oral Capsule [Vascepa] covered by Medicare Part D?
Yes, icosapent ethyl 500 MG Oral Capsule [Vascepa] is covered by 3,975 Medicare Part D plans (78.7% of all Part D formularies).
What tier is icosapent ethyl 500 MG Oral Capsule [Vascepa] on Medicare Part D plans?
icosapent ethyl 500 MG Oral Capsule [Vascepa] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does icosapent ethyl 500 MG Oral Capsule [Vascepa] require prior authorization?
0% of Part D formularies require prior authorization for icosapent ethyl 500 MG Oral Capsule [Vascepa]. Step therapy: 0%. Quantity limits: 38.3%.
How much does Medicare spend on icosapent ethyl 500 MG Oral Capsule [Vascepa]?
In 2023, total Medicare Part D spending on icosapent ethyl 500 MG Oral Capsule [Vascepa] was $763,988,447, covering 279,946 beneficiaries. The average spend per beneficiary was $2,729.06.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- atazanavir 150 MG Oral Capsule T2.9
- efavirenz 600 MG / emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet T2.9
- lopinavir 100 MG / ritonavir 25 MG Oral Tablet T2.9
- lurasidone hydrochloride 120 MG Oral Tablet T2.9
- molindone hydrochloride 10 MG Oral Tablet T2.9
- mycophenolic acid 180 MG Delayed Release Oral Tablet T2.9
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA