Vumerity

Generic: diroximel fumarate

231 MG — Capsule

Multiple Sclerosis — Injectable

Also known as: diroximel fumarate

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: 20 hours, 34 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic 120 per 30 days PA | QL
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic 120 per 30 days PA | QL
Provider Partners North Carolina Community Plan (HMO I-SNP) Tier 1 - Preferred Generic 120 per 30 days PA | QL
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Tier 1 - Preferred Generic 120 per 30 days PA | QL
HealthSpring Preferred (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthSpring Preferred Select (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthSpring Preferred Savings (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthSpring Preferred Plus (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare PPO Enhanced (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare Essential Plus (HMO-POS) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare Enhanced (HMO-POS) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare Choice (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Blue Medicare Essential (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health Platinum (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health NC Duals (HMO-POS D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health smartHMO (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health Platinum Select (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Alignment Health AVA (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthTeam Advantage Plan I (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthTeam Advantage Plan II (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthTeam Advantage Vitality Plan (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Experience Health Medicare Advantage (HMO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthSpring True Choice (PPO) Tier 5 - Specialty 120 per 30 days PA | QL
HealthSpring TotalCare (HMO D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
HealthSpring TotalCare Plus (HMO D-SNP) Tier 5 - Specialty 120 per 30 days PA | QL
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 34 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 20 hours, 34 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via diroximel fumarate
Tier 3 - Non-Formulary PA
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