Medicare Advantage Drug Cost for Veltassa



There are 29 Medicare Advantage Plans with additional prescription drug coverage for Veltassa available to residents in Virginia. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $33.39 ($1,001.66). Veltassa is typically listed as a Tier 5 drug on the formulary and does not require prior authorization.

Below is the average retail cost and your co-pay for Veltassa in Virginia. You can also see if each plan requires prior authorization, step therapy or has drug quantity limits. Please check the formulary for different brand and generic drug names. Every Medicare Advantage Plan will vary in coverage, co-pays, costs and premiums. This chart can help you sort through different plan details to find a Medicare Advantage Plan in Fairfax with the best coverage and the cheapest prices for your medications in Virginia.



Proprietary Name:Veltassa
Generic Name:Patiromer
Drug Package:30 Packet In 1 Carton
Drug Strength:25.2g/1
Substance:Patiromer
Dosage Form:Powder, For Suspension
Route:Oral
Labeler:Vifor Pharma, Inc.
Pen Name:Human Prescription Drug
NDC#53436025230
RX#1716223
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Fairfax





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Medicare Advantage Coverage for Veltassa in Virginia


Click the Plan Name for More Details
Click the header to sort
Plan
Name ⇅
Tier
Level
Your
Cost
Preferred
Cost
Non
Preferred
Cost
Mail
Limit
Amt/
Days
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
AARP Medicare Advantage

5NA33%33%/NN$33.55
($1,006.45)
AARP Medicare Advantage Choice Plan 1

5NA30%30%/NN$33.55
($1,006.45)
Aetna Medicare Choice Plan

4$100$100$100/YN$35.34
($1,060.15)
Aetna Medicare Premier Plan

4$100$100$100/YN$35.34
($1,060.15)
Aetna Medicare Prime Plan

4$100$100$100/YN$35.34
($1,060.15)
Aetna Medicare Select Plan

4$100$100$100/YN$35.34
($1,060.15)
Anthem MediBlue Plus

4$95$100NA/NN$35.32
($1,059.70)
Erickson Advantage Freedom

5NA33%33%/NN$33.02
($990.74)
Erickson Advantage Liberty with Drugs

5NA33%33%/NN$33.02
($990.74)
Erickson Advantage Signature with Drugs

5NA33%33%/NN$33.02
($990.74)
Kaiser Permanente Medicare Advantage High VA

533%33%NA/NN$31.07
($931.99)
Kaiser Permanente Medicare Advantage Standard VA

533%33%NA/NN$31.07
($931.99)
Kaiser Permanente Medicare Advantage Value VA

533%33%NA/NN$31.07
($931.99)
Optima Medicare Value

3$42$47NA/NN$30.72
($921.63)


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SNP Prescription Drug Cost for Veltassa

Click the Plan Name for More Details about that Plan
Click the header to sort
Plan
Name ⇅
Tier
Level
Cost
Preferred
Cost
Non
Preferred
Cost
Amt
Mail
Limit
Days/
Amt
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
Aetna Better Health of Virginia

4NA$0NA/YN$35.12
($1,053.74)
Aetna Medicare Assure Premier

4NA$0NA/YN$35.12
($1,053.74)
Aetna Medicare Assure Value

4NA$0NA/YN$35.12
($1,053.74)
Anthem MediBlue Care To You

5NA33%NA/NN$30.16
($904.80)
Anthem MediBlue Dual Advantage

4$95$100NA/NN$35.32
($1,059.70)
Anthem MediBlue Full Dual Advantage

4$95$100NA/NN$35.32
($1,059.70)
Erickson Advantage Champion

5NA33%33%/NN$33.02
($990.74)
Erickson Advantage Guardian

5NA33%33%/NN$33.02
($990.74)
Molina Medicare Complete Care

1NA$0NA/NN$30.55
($916.58)
Optima Community Complete

3NA$0NA/NN$31.29
($938.59)
UnitedHealthcare Dual Complete

5NA$0NA/NN$33.49
($1,004.59)
UnitedHealthcare Dual Complete Balance

5NA$0NA/NN$33.49
($1,004.59)
UnitedHealthcare Dual Complete ONE

5NA$0NA/NN$33.49
($1,004.59)
UnitedHealthcare Dual Complete ONE Plus

5NA$0NA/NN$33.49
($1,004.59)
UnitedHealthcare Nursing Home Plan 2

5NA25%NA/NN$33.49
($1,004.58)


Do any Medicare Advantage Plans Cover Veltassa? Yes, 29 Medicare Advantage Plans cover this drug in Virginia.

How much does Veltassa Cost? $33.39, the average retail cost in Virginia is $33.39 per unit or $1,001.66 for a 30-day supply at in-area pharmacies.

What Tier is Veltassa? Tier 5, most Advantage Plans list Veltassa on Tier 5 on their formulary. Usually, the higher the tier, the more you have to pay for the medication.

Do I need Prior Authorization for Veltassa? No, the majority of Medicare Prescription Plans do not require prior authorization from your doctor for Veltassa.



Additional Notes by Medicare Help:

Most plans have 4 levels of coverage. The exception is the $0 Deductible Plans.
1.Pre-Deductable: Before you reach the plans deductible. Some plans offer select Pre-deductible drug Coverage
2.Initial Coverage: (ICL) After you reach the plans deductible but before the Initial Coverage limit.
3.Coverage Gap: (AKA Donut Hole) After you reach the plans ICL but before the Catastrophic of $7550 in 2022.
4.Catastrophic: Anything over $7550 you will receive a significant increase in coverage.

Formulary Definitions:

Tier Level: Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less.
Cost Preferred: Your Cost for the Drug at the Providers In Network Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Non Preferred: Your Cost for the Prescription Drug at a Non-Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Mail: Your Cost for Prescription Drugs through a Mail Order Pharmacy. As a Percent of the total drug cost or a flat rate.
Quantity Limit Amount/Days: Certain drugs have a Quantity Limit. That means the plan will only cover the drug up to a designated quantity or amount. If your prescribing doctor feels it is necessary to exceed the set limit, he or she must get prior approval before the higher quantity will be covered.
Prior Authorization: Certain Drugs require you or your doctor to get prior authorization in order to be covered. Usually just an additional form. If you dont get approval, the plan may not cover the drug.
Step Therapy: Means you must first try one drug to treat your medical condition before the plan will cover another drug for the same condition. If you have already tried other drugs or your doctor thinks they are not right for you, you and your doctor can ask the plan to cover this drug.
Avg Unit Cost: Average unit cost (e.g. per pill) for specified days supply at in-area retail pharmacies. A pharmacy is considered in-area when it is geographically located in the service area.




What if a drug I need is not listed?

Please check the formulary for different brand and generic names. If you still cannot locate your drugs, your plan may not offer coverage. Talk to your doctor first about changing your prescription to a drug on your plans formulary. If this is not an option, you can request an exception to have the plan review its coverage decision based on your individual circumstances.

Last updated on
Source:CMS Formulary Data Q4 2022
Source:NDC Directory by FDA.gov

**We make every attempt to keep our information accurate. But please check with the plan providers to verify all information.

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