Medicare Part D coverage · selexipag · RxCUI 1729057
selexipag 0.4 MG Oral Tablet [Uptravi]
Per the CMS 2026 Part D formulary file, selexipag 0.4 MG Oral Tablet [Uptravi] is covered by 3,131 Medicare Part D plans (62% of enrollable products), averaging Tier 4.1, with prior authorization required on 99% of covering formularies.
- 62%
- Plan coverage
- 3,131
- Plans covering
- T4.1
- Avg tier
- 99%
- Prior auth required
What the CMS Formulary Data Shows for selexipag 0.4 MG Oral Tablet [Uptravi]
Per the CMS 2026 Part D formulary file, selexipag 0.4 MG Oral Tablet [Uptravi] (RxNorm concept RXCUI 1729057, generic name selexipag) appears on 198 distinct formulary files spanning 3,131 Medicare Part D plan offerings - 62% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.1.
Real-world access to selexipag 0.4 MG Oral Tablet [Uptravi] depends on utilization management as much as tier placement: 99% of covering formularies require prior authorization. 0% require step therapy. 88.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,727 Part D beneficiaries filled selexipag 0.4 MG Oral Tablet [Uptravi] in 2023, with total plan-and-beneficiary spending of $758,070,464 and an average per-beneficiary annual cost of $203,399.64. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry selexipag 0.4 MG Oral Tablet [Uptravi] today.
Coverage Details
- Formularies covering
- 198
- Plans covering
- 3,131
- Coverage rate
- 62%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 99% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 88.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,727
- Total spending
- $758,070,464
- Avg per beneficiary
- $203,399.64
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering selexipag 0.4 MG Oral Tablet [Uptravi]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| 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 |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| 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 |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| 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 |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| 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 |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is selexipag 0.4 MG Oral Tablet [Uptravi] covered by Medicare Part D?
Yes, selexipag 0.4 MG Oral Tablet [Uptravi] is covered by 3,131 Medicare Part D plans (62% of all Part D formularies).
What tier is selexipag 0.4 MG Oral Tablet [Uptravi] on Medicare Part D plans?
selexipag 0.4 MG Oral Tablet [Uptravi] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 6.
Does selexipag 0.4 MG Oral Tablet [Uptravi] require prior authorization?
99% of Part D formularies require prior authorization for selexipag 0.4 MG Oral Tablet [Uptravi]. Step therapy: 0%. Quantity limits: 88.9%.
How much does Medicare spend on selexipag 0.4 MG Oral Tablet [Uptravi]?
In 2023, total Medicare Part D spending on selexipag 0.4 MG Oral Tablet [Uptravi] was $758,070,464, covering 3,727 beneficiaries. The average spend per beneficiary was $203,399.64.
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
- brivaracetam 10 MG Oral Tablet [Briviact] T4.1
- rifaximin 550 MG Oral Tablet [XIFAXAN] T4.1
- tenofovir disoproxil fumarate 200 MG Oral Tablet [Viread] T4.1
- pomalidomide 1 MG Oral Capsule T4.1
- 1 ML benralizumab 30 MG/ML Prefilled Syringe [Fasenra] T4.1
- deferasirox 250 MG Tablet for Oral Suspension T4.1
Similar prior-authorization rate
- 3 ML liraglutide 6 MG/ML Pen Injector 99% PA
- 500 ML soybean oil 200 MG/ML Injection [Nutrilipid] 99% PA
- 3 ML icatibant 10 MG/ML Prefilled Syringe [Sajazir] 99% PA
- edaravone 21 MG/ML Oral Suspension [Radicava] 99% PA
- 0.5 ML ustekinumab 90 MG/ML Injection [Stelara] 99% PA
- {140 (selexipag 0.2 MG Oral Tablet [Uptravi]) / 60 (selexipag 0.8 MG Oral Tablet [Uptravi]) } Pack [Uptravi Titration Pack] 99% PA