Zeposia 7-Day Starter Pac

Generic: ozanimod

ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ ANOREXIANTS

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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: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 4 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026
via Zeposia 		Tier 2 - Preferred Brand ✓ — — PA
BCBS Federal Standard Option 2026
via Zeposia 		Tier 4 - Preferred Specialty ✓ — — PA
BCBS Federal Basic Option 2026
via Zeposia 		Tier 4 - Preferred Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 4 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Care 2026
via Zeposia 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Value 2026
via Zeposia 		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 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 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Home with UNC Health Alliance 2026
via Zeposia 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
BCBSNC Blue Local 2026
via Zeposia 		Tier 5 - Specialty ✓ — ✓ Restricted Access PA | QL
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 4 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026
via Zeposia 		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
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 4 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Longevity Health Plan (HMO I-SNP)
via Zeposia 		Tier 1 - Preferred Generic ✓ — ✓ 28 per 180 days PA | QL
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Zeposia 		Tier 5 - Specialty ✓ — ✓ 28 per 180 days PA | QL
Troy Medicare (HMO)
via Zeposia 		Tier 5 - Specialty ✓ — — PA
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Zeposia 		Tier 5 - Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 4 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Zeposia 		Tier 5 - Preferred Brand Specialty ✓ — ✓ Preferred PA | QL
NC State Health Plan - 70/30 Standard PPO 2026
via Zeposia 		Tier 5 - Preferred Brand Specialty ✓ — ✓ Preferred PA | QL
NC State Health Plan - HDHP 2026
via Zeposia 		Tier 5 - Preferred Brand Specialty ✓ — ✓ Preferred PA | QL
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