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
Zeposia Oral Capsule
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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.
AmeriHealth Caritas NC
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Signature + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Gold Premier + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Signature + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Signature + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Essential + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Bronze Premier + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Premier + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
AmeriHealth Caritas Next Silver Essential + No Referrals
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
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 Basic Option 2026 | Tier 4 - Preferred Specialty | ✓ | — | — | PA |
| BCBS Federal Standard 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 Value 2026
via Zeposia Starter |
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 |
| 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 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 |
Cigna
40 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Connect Gold CMS Standard
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver CMS Standard
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect myDiabetesCare Silver | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Gold 1500 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect myDiabetesCare Bronze | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Bronze 5500 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Silver 3500 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Silver 4400 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Silver 3000 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Bronze 6500 Indiv Med Deductible | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze RD CMS Standard
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver RD CMS Standard
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect myDiabetesCare Silver
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver RD 2200 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Gold 1500 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect myDiabetesCare Bronze
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze 5500 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze RD 6000 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver 3500 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze RD 5000 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver RD 3500 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver 4400 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver RD 5000 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Silver 3000 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze 6500 Indiv Med Deductible
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Bronze RD CMS Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Gold CMS Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Silver RD CMS Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Silver CMS Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Bronze CMS Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Connect Gold RD CMS Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Bronze CMS Standard
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Connect Gold RD CMS Standard
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
Medicare Part D
8 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
Longevity Health Plan (HMO I-SNP)
via Zeposia Starter |
Tier 1 - Preferred Generic | ✓ | — | ✓ 28 per 180 days | PA | QL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | ✓ 30 per 30 days | PA | QL |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | ✓ 28 per 180 days | PA | QL |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
|
Troy Medicare (HMO)
via Zeposia Starter |
Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 5 - Specialty | ✓ | — | — | PA |
| Troy Medicare (HMO) | Tier 5 - Specialty | ✓ | — | — | PA |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ Preferred | PA | QL |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ Preferred | PA | QL |
| NC State Health Plan - HDHP 2026 | Tier 5 - Preferred Brand Specialty | ✓ | — | ✓ Preferred | PA | QL |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Gold Elite Saver Plus | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Simple PCP Saver | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Simple Diabetes | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Classic | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Bronze Classic 4700 | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Secure | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Bronze Classic Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Simple Diabetes | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Gold Elite Saver Plus | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Simple PCP Saver | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Bronze Classic 4700 | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Secure | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Classic | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Bronze Elite + PCP Saver Plus | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Gold Classic Standard | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Classic Standard | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Bronze Classic Standard | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Gold Classic Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Classic Standard | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| AIAN Cost Share | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| AIAN Cost Share | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Bronze Simple Diabetes | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |