Sofosbuvir/Velpatasvir

Generic: sofosbuvir-velpatasvir

ANTIVIRALS

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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  ·  Checked: 12 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Signature + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Premier + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Signature + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Essential + No Referrals
via Epclusa 		Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Gold Premier + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Gold Signature + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Essential + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
AmeriHealth Caritas Next Silver Signature + No Referrals
via Sofosbuvir-Velpatasvir 		Brand-Preferred ✓ — — PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 12 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via Epclusa 		Tier 2 - Preferred Brand ✓ — — PA
BCBS Federal Standard Option 2026
via Epclusa 		Tier 4 - Preferred Specialty ✓ — — PA
BCBS Federal Basic Option 2026
via Epclusa 		Tier 4 - Preferred Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 12 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Local 2026
via Epclusa 		Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Care 2026
via Epclusa 		Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Value 2026
via Epclusa 		Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Advantage 2026 Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Local 2026 Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Care 2026 Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Value 2026 Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Advantage 2026
via Epclusa 		Tier 3 - High Cost Brand ✓ — — PA
BCBSNC Blue Home with UNC Health Alliance 2026
via Epclusa 		Tier 3 - High Cost Brand ✓ — — PA
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 12 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect Silver RD 3500 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 7000 HSA Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 4400 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD 5000 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 3000 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 6500 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver CMS Standard
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD CMS Standard
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Gold CMS Standard
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze RD CMS Standard
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Gold RD CMS Standard
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze CMS Standard
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect myDiabetesCare Silver
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver RD 2200 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Gold 1500 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect myDiabetesCare Bronze
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze 5500 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze RD 6000 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Silver 3500 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Connect Bronze RD 5000 Indiv Med Deductible
via Sofosbuvir-Velpatasvir 		Tier 5 - Specialty ✓ — ✓ PA | QL
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 12 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Humana Full Access H5525-034 (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HumanaChoice Giveback H5525-035 (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HumanaChoice SNP-DE H5525-036 (PPO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HumanaChoice H5525-049 (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HumanaChoice H5525-050 (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HumanaChoice H5525-070 (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Dual Select H5525-072 (PPO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HumanaChoice H5525-083 (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus H6622-025 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus H6622-026 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Dual Select H6622-027 (HMO-POS D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus H6622-057 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus H6622-060 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus H6622-061 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Choice H8145-004 (PFFS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Dual (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Value Plus (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Prime (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Care (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Full Dual Care (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Extra (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Giveback (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Chronic Care (HMO C-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Chronic Care Value (HMO C-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
HealthSpring True Choice (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring TotalCare (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring TotalCare Plus (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring Preferred (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring Preferred Select (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring Preferred Savings (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HealthSpring Preferred Plus (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Aetna Medicare Signature (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED DUAL 009 NC (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CORE 001 NC (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED GIVEBACK 002 NC (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED GIVEBACK 012 NC (HMO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CHOICE 001 NC (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CHOICE 003 NC (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CHOICE 005 NC (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CHOICE 008 NC (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — — PA
Humana Gold Plus H1036-137 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus H1036-233 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Dual Select H1036-307 (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus Giveback H1036-318 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Humana Gold Plus H1036-335 (HMO-POS)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HumanaChoice Giveback H5216-017 (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
HumanaChoice H5216-211 (PPO)
via Epclusa 		Tier 5 - Specialty ✓ — ✓ 28 per 28 days PA | QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 12 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via Sofosbuvir-Velpatasvir 		Preferred ✓ — — PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 12 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026
via Epclusa 		Tier 5 - Preferred Brand Specialty ✓ — ✓ For genotypes PA | QL
NC State Health Plan - 70/30 Standard PPO 2026
via Epclusa 		Tier 5 - Preferred Brand Specialty ✓ — ✓ For genotypes PA | QL
NC State Health Plan - 80/20 Plus PPO 2026
via Epclusa 		Tier 5 - Preferred Brand Specialty ✓ — ✓ For genotypes PA | QL
Source: CMS QHP JSON  ·  Checked: 12 hours, 42 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Classic Standard
via Epclusa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Classic Standard | with Atrium Health
via Epclusa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Classic Standard
via Epclusa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Classic Standard | with Atrium Health
via Epclusa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Bronze Classic Standard | with Atrium Health
via Epclusa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Gold Classic Standard
via Epclusa 		Tier 4 - Non-Preferred ✓ — ✓ PA | QL
Silver Simple Diabetes | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Classic | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Elite + PCP Saver Plus | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Classic 4700 | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Secure | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Diabetes
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
AIAN Cost Share | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple PCP Saver
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Classic 4700
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Secure
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Classic
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Elite + PCP Saver Plus
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Gold Elite Saver Plus
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
AIAN Cost Share
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Chronic Care CKM | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Simple Diabetes | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Simple Chronic Care CKM | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Gold Elite Saver Plus | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
Silver Simple PCP Saver | with Atrium Health
via Epclusa 		Tier 5 - Specialty ✓ — ✓ PA | QL
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