Key takeaways:
Zeposia (ozanimod) is an oral capsule that treats ulcerative colitis as well as relapsing forms of multiple sclerosis in adults. Without insurance, it can cost more than $9,700 per month. A manufacturer copay savings card or patient assistance programs may help lower your cost.
Most Medicaid, ACA marketplace, and commercial insurance plans cover Zeposia. However, prior authorization and step therapy are often required before coverage is approved.
Zeposia is usually filled through a specialty pharmacy. Your specialty pharmacy team can help you understand your insurance coverage and find savings options.
Save on related medications
Zeposia (ozanimod) is an oral capsule that treats ulcerative colitis (UC) as well as relapsing forms of multiple sclerosis (MS) in adults. It’s a specialty medication, which means that in most cases you’ll need to receive it from a specialty pharmacy instead of your local drugstore. One reason for this is that Zeposia costs more than a typical prescription medication.
Here’s what you should know about how much Zeposia costs without insurance. We’ll also review how likely it is that your insurance plan will cover it, along with ways to save on the cost of your prescription.
How much does Zeposia cost without insurance?
The recommended Zeposia dosage is 0.92 mg once daily. But you’ll begin treatment with a 28-day starter kit that raises your dose from 0.23 mg to 0.92 mg.
The manufacturer list price for Zeposia is about $9,000 for the starter kit and about $9,700 for a 30-day supply of the regular daily dosage. The average retail price is typically even higher due to wholesaler and pharmacy markups. Currently, Zeposia is available only as a brand-name medication.
What factors affect the cost of Zeposia?
Several factors can affect the cost of Zeposia, including:
Location: Where you live can affect the cost of your medication. For example, according to GoodRx research, medications are typically more affordable in Denver than in New Orleans.
Pharmacy: Zeposia is typically filled by a specialty pharmacy. But prices can vary depending on the pharmacy you choose. Your prescriber and insurance plan can help you find the most affordable location to fill your prescription.
Insurance coverage: You’ll typically pay less for Zeposia if your prescription insurance covers it. But your copay may vary based on your plan’s formulary (more on that next).
Does insurance cover Zeposia?
Almost all enrollees in commercial and Medicaid insurance plans have coverage for Zeposia. It’s also covered for most people enrolled in an Affordable Care Act (ACA) marketplace plan. Medicare only covers Zeposia for about 11% of enrollees.
A prior authorization is required for almost all commercial and ACA insurance plans and about 77% of Medicaid plans. This means your prescriber needs to submit information explaining why Zeposia is medically necessary for you before your plan will cover it.
Step therapy is also required for most commercial and ACA plans, as well as about 67% of Medicaid plans. This means you’re required to try other treatments (or explain why you aren’t able to take them) before they’ll cover Zeposia.
If Zeposia is covered by your insurance, the amount you’ll pay depends on where it falls within your plan’s formulary (list of covered medications). Medications are often classified into different tiers — a lower tier typically means a lower copay. You can access your plan’s formulary online or by calling the customer service number on your prescription insurance card.
How different insurance plans cover Zeposia
The table below breaks down the percentage of enrollees who have coverage for Zeposia by insurance type. It also shows the likelihood of having prior authorization and step therapy requirements.
Insurance type | Enrollees covered for Zeposia | Enrollees required to get prior authorization | Enrollees required to do step therapy |
88.5% | 88% | 76.7% | |
Commercial plans (excluding ACA plans) | 98.8% | 90.6% | 81.7% |
Medicare (Medicare Advantage and Part D plans) | 10.8% | 10.5% | 5.4% |
Medicaid, including state-run and managed care plans | 99.9% | 76.7% | 66.8% |
Source: Managed Markets Insight & Technology, LLC™, as of January 10, 2026 (See methodology below.)
If your insurance doesn’t cover Zeposia, try these options:
Lower your cost with a patient assistance program (more on this below).
Ask your insurance plan to cover Zeposia by submitting a formulary exception request. Your prescriber may need to provide documentation and a letter of medical necessity explaining why this medication is required for your condition.
If the formulary exception request is denied, file an appeal.
Ask your prescriber about switching to a Zeposia alternative, such as Gilenya (fingolimod), that your insurance may cover. Many insurance plans prefer medications with a lower-cost generic.
Compare insurance plans during the next open enrollment period to find one that offers coverage for Zeposia.
Ways to save on Zeposia
Here are some ways to save on Zeposia.
1. See if you qualify for a copay savings card
If you have commercial insurance, you may be able to pay as little as $0 per month for Zeposia using a copay savings card from the manufacturer.
For people taking Zeposia for MS, this program can also cover medical costs related to lab testing that’s required before starting Zeposia, up to a $2,000 maximum. It will also cover the cost of Zeposia while you’re waiting for your insurance provider to respond to a prior authorization request for up to 24 months. These benefits aren’t currently available for those taking Zeposia for UC.
To qualify for the Zeposia copay savings card:
You must have private or commercial insurance.
You must not be enrolled in a government health insurance program, such as Medicare, Medicaid, or Tricare.
You must be a U.S. resident (including Puerto Rico).
You can enroll in the Zeposia copay savings program online or call 1-833-ZEPOSIA (937-6742) for assistance.
2. Check if you’re eligible for a patient assistance program
Zeposia’s manufacturer doesn’t offer a patient assistance program. But you can apply for financial support through other independent programs, such as the PAN Foundation. The Patient Advocate Foundation is also a helpful resource for financial support opportunities.
If you have Medicare insurance and a limited income, you may be eligible for the “Extra Help” program. This low-income subsidy assists with deductible and copay costs related to your medications.
3. Ask about a 90-day supply
In some cases, your insurance plan may offer a lower copay overall if you fill a 90-day supply of your medication instead of a 30-day supply. This option may also save you time and shipping costs.
4. Tap into your HSA, FSA, or HRA
If you have a health savings account (HSA), flexible spending account (FSA), or health reimbursement arrangement (HRA), you can use it to help cover your out-of-pocket costs for Zeposia. These tax-advantaged health accounts let you pay for eligible expenses with tax-free dollars.
Pay directly with your HSA or FSA card at the pharmacy, or cover the cost yourself and submit a request for reimbursement. The funds in an HSA or HRA typically roll over annually, but you have to use your FSA dollars before the deadline or they’ll expire.
The bottom line
Zeposia (ozanimod) is an oral capsule that treats ulcerative colitis as well as relapsing forms of multiple sclerosis in adults. Without insurance, it can cost more than $9,700 per month. A manufacturer copay savings card or patient assistance program can help make your Zeposia prescription more affordable.
Almost all commercial and Medicaid insurance plans cover Zeposia, as do most Affordable Care Act (ACA) marketplace plans. But prior authorization and step therapy are often required. Zeposia is typically filled by a specialty pharmacy. Don’t hesitate to reach out to your specialty pharmacy team for help with insurance coverage and savings opportunities.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of January 2026.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Celgene. (2024). Zeposia- ozanimod hydrochloride capsule [package insert].
Healthcare.gov. (n.d.). Appealing a health plan decision: Internal appeals. U.S. Centers for Medicare & Medicaid Services.
Medicaid.gov. (n.d.). Managed care. U.S. Centers for Medicare & Medicaid Services.
Patient Advocate Foundation. (n.d.). Multiple sclerosis (MS): Copay grant.
Patient Advocate Foundation. (n.d.). National Financial Resource Directory.
SSA.gov. (2026). Understanding the Extra Help With Your Medicare Prescription Drug Plan. Social Security Administration.
Zeposia.com. (n.d.). Co-pay savings and other financial support. Bristol Myers Squibb.
Zeposia.com. (n.d.). Sign up for co-pay. Bristol Myers Squibb.
Zeposia.com. (2025). What does it cost to take Zeposia? Bristol Myers Squibb.
