Zeposia
Generic: ozanimod
0.92 Mg — Capsule
ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ ANOREXIANTS
Also known as:
ozanimod
Zeposia 0.92 Mg Capsule
ZEPOSIA CAPS .92MG
ZEPOSIA CAP STR KIT
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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.
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Focus 2026 | Tier 2 - Preferred Brand | ✓ | — | — | PA |
| BCBS Federal Standard Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
| BCBS Federal Basic Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
15 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Care 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Value 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Advantage 2026
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Advantage 2026
via Zeposia 7-Day Starter Pac |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Zeposia 7-Day Starter Pac |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Zeposia 7-Day Starter Pac |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Zeposia 7-Day Starter Pac |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Zeposia 7-Day Starter Pac |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Advantage 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
| BCBSNC Blue Local 2026 | Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
Cigna
2 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Cigna Plus NC 4-Tier Formulary 2026 | Tier 4 - Specialty | ✓ | — | ✓ Limited Distribution; Specialty Pharmacy Required | PA | QL |
|
Cigna Plus NC 4-Tier Formulary 2026
via Zeposia Starter |
Tier 4 - Specialty | ✓ | — | ✓ Limited Distribution; Specialty Pharmacy Required | PA | QL |
Medicare Part D
4 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 28 per 180 days | PA | QL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 28 per 180 days | PA | QL |
| Troy Medicare (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ Preferred | PA | QL |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ Preferred | PA | QL |
| NC State Health Plan - HDHP 2026 | Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ Preferred | PA | QL |