selexipag 1.2 MG Oral Tablet [Uptravi]

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selexipag

RxCUI: 1729029

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
61.8%
Plan Coverage
3,132
Plans Covering
T4.1
Avg Tier
99%
Prior Auth Required

What the CMS Formulary Data Shows for selexipag 1.2 MG Oral Tablet [Uptravi]

Per the CMS 2026 Part D formulary file, selexipag 1.2 MG Oral Tablet [Uptravi] (RxNorm concept RXCUI 1729029, generic name selexipag) appears on 198 distinct formulary files spanning 3,132 Medicare Part D plan offerings - 61.8% 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 1.2 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 1.2 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 1.2 MG Oral Tablet [Uptravi] today.

Coverage Details

Formularies covering
198
Plans covering
3,132
Coverage rate
61.8%
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

78 plans
Tier 1, Preferred Generic
2 plans
Tier 2, Generic
17 plans
Tier 4, Non-Preferred
3 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering selexipag 1.2 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
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

Frequently Asked Questions

Is selexipag 1.2 MG Oral Tablet [Uptravi] covered by Medicare Part D?

Yes, selexipag 1.2 MG Oral Tablet [Uptravi] is covered by 3,132 Medicare Part D plans (61.8% of all Part D formularies).

What tier is selexipag 1.2 MG Oral Tablet [Uptravi] on Medicare Part D plans?

selexipag 1.2 MG Oral Tablet [Uptravi] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 6.

Does selexipag 1.2 MG Oral Tablet [Uptravi] require prior authorization?

99% of Part D formularies require prior authorization for selexipag 1.2 MG Oral Tablet [Uptravi]. Step therapy: 0%. Quantity limits: 88.9%.

How much does Medicare spend on selexipag 1.2 MG Oral Tablet [Uptravi]?

In 2023, total Medicare Part D spending on selexipag 1.2 MG Oral Tablet [Uptravi] was $758,070,464, covering 3,727 beneficiaries. The average spend per beneficiary was $203,399.64.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial