Medicare Part D coverage · sofosbuvir · RxCUI 1799212
sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet
Per the CMS 2026 Part D formulary file, sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet is covered by 2,016 Medicare Part D plans (39.9% of enrollable products), averaging Tier 3.9, with prior authorization required on 99.3% of covering formularies.
- 39.9%
- Plan coverage
- 2,016
- Plans covering
- T3.9
- Avg tier
- 99.3%
- Prior auth required
What the CMS Formulary Data Shows for sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet
Per the CMS 2026 Part D formulary file, sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet (RxNorm concept RXCUI 1799212, generic name sofosbuvir) appears on 140 distinct formulary files spanning 2,016 Medicare Part D plan offerings - 39.9% 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 3.9.
Real-world access to sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet depends on utilization management as much as tier placement: 99.3% of covering formularies require prior authorization. 0% require step therapy. 84.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 18 Part D beneficiaries filled sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $1,955,322 and an average per-beneficiary annual cost of $108,629.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 140
- Plans covering
- 2,016
- Coverage rate
- 39.9%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 99.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 84.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 18
- Total spending
- $1,955,322
- Avg per beneficiary
- $108,629.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet
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 |
| 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 |
| 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 |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | Yes | $0 | CA |
| 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 |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| 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 |
Show the next 30 plans
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | Yes | $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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | Yes | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | Yes | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | Yes | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | Yes | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| Senior Care (HMO I-SNP) | Align Senior Care MI, LLC | T1 | Yes | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $8.90 | AR |
| AgeRight Advantage Health Plan (HMO I-SNP) | Marquis Advantage, Inc. | T1 | Yes | $10.50 | OR, WA |
| Senior Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | Yes | $12.00 | CA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $13.10 | PA |
| Liberty Medicare Dual Plan (HMO D-SNP) | Liberty Advantage, LLC | T1 | Yes | $14.70 | NC |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | Yes | $15.20 | IL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet covered by Medicare Part D?
Yes, sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet is covered by 2,016 Medicare Part D plans (39.9% of all Part D formularies).
What tier is sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet on Medicare Part D plans?
sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet averages Tier 3.9 across Part D plans, ranging from Tier 1 to Tier 5.
Does sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet require prior authorization?
99.3% of Part D formularies require prior authorization for sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet. Step therapy: 0%. Quantity limits: 84.3%.
How much does Medicare spend on sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet?
In 2023, total Medicare Part D spending on sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet was $1,955,322, covering 18 beneficiaries. The average spend per beneficiary was $108,629.02.
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
- cysteamine 3.8 MG/ML Ophthalmic Solution [Cystadrops] T3.9
- brensocatib 10 MG Oral Tablet [Brinsupri] T3.9
- betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Suspension T3.9
- crinecerfont 25 MG Oral Capsule [Crenessity] T3.9
- {180 (danicopan 100 MG Oral Tablet [Voydeya]) } Pack [Voydeya 200 MG Dose Bottle] T3.9
- {90 (danicopan 100 MG Oral Tablet [Voydeya]) / 90 (danicopan 50 MG Oral Tablet [Voydeya]) } Pack [Voydeya 150 MG Dose Bottle] T3.9
Similar prior-authorization rate
- levalbuterol 0.21 MG/ML Inhalation Solution 99.3% PA
- nilotinib 71 MG Oral Tablet [Danziten] 99.3% PA
- {28 (letrozole 2.5 MG Oral Tablet [Femara]) / 42 (ribociclib 200 MG Oral Tablet [Kisqali]) } Pack [Kisqali Femara Co-Pack 400] 99.3% PA
- C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] 99.3% PA
- 0.9 ML tocilizumab-aazg 180 MG/ML Auto-Injector [Tyenne] 99.3% PA
- {56 (elexacaftor 50 MG / ivacaftor 37.5 MG / tezacaftor 25 MG Oral Tablet) / 28 (ivacaftor 75 MG Oral Tablet) } Pack [Trikafta (50 MG / 37.5 MG / 25 MG; 75 MG)] 99.3% PA