diroximel fumarate

Generic: Vumerity

231 mg — Delayed Release Capsule

MULTIPLE SCLEROSIS AGENTS

Also known as: VUMERITY
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 10 hours, 58 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Vumerity 		Tier 1 - Preferred Generic ✓ — ✓ 120 per 30 days PA | QL
Longevity Health Plan (HMO I-SNP)
via Vumerity 		Tier 1 - Preferred Generic ✓ — ✓ 120 per 30 days PA | QL
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Vumerity 		Tier 1 - Preferred Generic ✓ — ✓ 120 per 30 days PA | QL
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Vumerity 		Tier 1 - Preferred Generic ✓ — ✓ 120 per 30 days PA | QL
HealthSpring Preferred (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthSpring Preferred Select (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthSpring Preferred Savings (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthSpring Preferred Plus (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Blue Medicare PPO Enhanced (PPO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Blue Medicare Essential Plus (HMO-POS)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Blue Medicare Enhanced (HMO-POS)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Blue Medicare Choice (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Blue Medicare Essential (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Healthy Blue + Medicare (HMO-POS D-SNP)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Alignment Health Platinum (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Alignment Health NC Duals (HMO-POS D-SNP)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Alignment Health smartHMO (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Alignment Health Platinum Select (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Alignment Health AVA (PPO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthTeam Advantage Plan I (PPO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthTeam Advantage Plan II (PPO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthTeam Advantage Vitality Plan (PPO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Experience Health Medicare Advantage (HMO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthSpring True Choice (PPO)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthSpring TotalCare (HMO D-SNP)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
HealthSpring TotalCare Plus (HMO D-SNP)
via Vumerity 		Tier 5 - Specialty ✓ — ✓ 120 per 30 days PA | QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 10 hours, 58 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Vumerity 		Non-Preferred — — — None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 10 hours, 58 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
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