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Vascepa is a brand of icosapent ethyl. What agents check before quoting it: how many 2027 Part D plans cover it, on which tier, with what restrictions and copays, by plan type, carrier and state.
In 2027, 3,115 of 5,492 Medicare Part D and Medicare Advantage drug plans (56.7%) list Vascepa on their formulary, across 106 of 286 formularies. The most common placement is tier 3 (2,063 plans, 66.2% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 337 a quantity limit. Generic icosapent ethyl is on 5,492 of 5,492 plans (100%).
176 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $40, 35 of them $0; 2,939 charge coinsurance instead — median 25% of the drug's cost. Once a member's out-of-pocket drug spending reaches $2,400 in 2027, covered drugs cost $0 for the rest of the year.
2026: 4,171 of 5,496 plans covered it (75.9%); 2027: 3,115 of 5,492 (56.7%).
Of 4,367 plans offered in both years, 72 added it to the formulary and 1,093 dropped it.
Among plans covering it both years, 21 moved it to a higher tier and 1 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 19 |
| Tier 3 | 2,063 |
| Tier 4 | 1,033 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 108 of 323 | 33.4% | 0% |
| Medicare Advantage with drugs (MA-PD) | 1,780 of 3,200 | 55.6% | 0% |
| Special needs plans (SNP) | 1,227 of 1,969 | 62.3% | 0% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 830 of 830 | Tier 3 | 0 |
| Devoted Health | 728 of 728 | Tier 3 | 0 |
| Aetna Medicare | 631 of 631 | Tier 4 | 0 |
| Wellcare | 0 of 268 | No tier listed | 0 |
| HealthSpring | 0 of 226 | No tier listed | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 83 of 83 | Tier 4 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 0 of 80 | No tier listed | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 4 | 0 |
| Wellpoint | 63 of 63 | Tier 4 | 0 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 36 of 36 | Tier 3 | 0 |
| Capital Blue Cross | 35 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 0 of 29 | No tier listed | 0 |
| Medica | 0 of 27 | No tier listed | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 4 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 4 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 72 of 114 | 63.2% |
| Alaska | 3 of 9 | 33.3% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 92 of 147 | 62.6% |
| Arkansas | 45 of 85 | 52.9% |
| California | 228 of 397 | 57.4% |
| Colorado | 56 of 106 | 52.8% |
| Connecticut | 40 of 54 | 74.1% |
| Delaware | 22 of 43 | 51.2% |
| District of Columbia | 8 of 12 | 66.7% |
| Florida | 332 of 545 | 60.9% |
| Georgia | 63 of 149 | 42.3% |
| Guam | 1 of 1 | 100% |
| Hawaii | 32 of 50 | 64% |
| Idaho | 30 of 45 | 66.7% |
| Illinois | 76 of 132 | 57.6% |
| Indiana | 92 of 138 | 66.7% |
| Iowa | 35 of 64 | 54.7% |
| Kansas | 57 of 84 | 67.9% |
| Kentucky | 61 of 121 | 50.4% |
| Louisiana | 60 of 125 | 48% |
| Maine | 30 of 52 | 57.7% |
| Maryland | 24 of 49 | 49% |
| Massachusetts | 51 of 89 | 57.3% |
| Michigan | 94 of 182 | 51.6% |
| Minnesota | 23 of 63 | 36.5% |
| Mississippi | 52 of 104 | 50% |
| Missouri | 105 of 170 | 61.8% |
| Montana | 6 of 27 | 22.2% |
| Nebraska | 29 of 51 | 56.9% |
| Nevada | 52 of 100 | 52% |
| New Hampshire | 13 of 25 | 52% |
| New Jersey | 40 of 73 | 54.8% |
| New Mexico | 46 of 68 | 67.6% |
| New York | 142 of 215 | 66% |
| North Carolina | 94 of 176 | 53.4% |
| North Dakota | 9 of 26 | 34.6% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 97 of 171 | 56.7% |
| Oklahoma | 39 of 81 | 48.1% |
| Oregon | 48 of 92 | 52.2% |
| Pennsylvania | 141 of 323 | 43.7% |
| Puerto Rico | 1 of 64 | 1.6% |
| Rhode Island | 23 of 29 | 79.3% |
| South Carolina | 35 of 89 | 39.3% |
| South Dakota | 11 of 30 | 36.7% |
| Tennessee | 112 of 156 | 71.8% |
| Texas | 238 of 407 | 58.5% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 31 of 53 | 58.5% |
| Vermont | 4 of 14 | 28.6% |
| Virginia | 84 of 144 | 58.3% |
| Washington | 65 of 114 | 57% |
| West Virginia | 28 of 69 | 40.6% |
| Wisconsin | 39 of 96 | 40.6% |
| Wyoming | 4 of 13 | 30.8% |
Medicare Part D paid for 2,343,745 30-day fills of Vascepa in 2024 for about 300,961 enrollees, at an average total cost of $308.36 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Vascepa and the rest of a client's list on every plan in their county.
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Free tools for licensed insurance agents. Data from CMS public files; verify with plan documents before advising a client.
Counts are over every Medicare Advantage drug plan and stand-alone Part D plan in the CMS monthly formulary files, excluding employer plans. A plan counts as covering a drug when any strength or form of it is on the plan’s formulary; the tier, prior authorization, step therapy and quantity limit shown are the most favorable version on that formulary. Copays are for a 30-day supply at a preferred retail pharmacy after the deductible. This is a reference for licensed agents, not a plan recommendation; verify with the plan’s formulary before advising a client. Source: CMS Part D formulary files (release 10/08/2026). CMS formulary data.