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Veltassa Part D coverage 2027

Veltassa is a brand of patiromer. 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.

Coverage at a glance

In 2027, 626 of 5,492 Medicare Part D and Medicare Advantage drug plans (11.4%) list Veltassa on their formulary, across 102 of 286 formularies. The most common placement is tier 3 (388 plans, 62% of those covering it). 12 of the covering plans require prior authorization (1.9%), 0 step therapy and 299 a quantity limit.

What a 30-day fill costs

257 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 18 of them $0; 369 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.

What changed since 2026

2026: 1,840 of 5,496 plans covered it (33.5%); 2027: 626 of 5,492 (11.4%).

Of 4,367 plans offered in both years, 73 added it to the formulary and 968 dropped it.

Among plans covering it both years, 10 moved it to a higher tier and 33 to a lower one; 2 added prior authorization and 17 removed it.

Tier placement

By plan type

By carrier

By state

Medicare usage

Medicare Part D paid for 217,609 30-day fills of Veltassa in 2024 for about 52,110 enrollees, at an average total cost of $799.85 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).

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.