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Real members of myPHteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.
November 16, 2025
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Answer Summary

Members rallied around concerns about UHC Medicare Part D dropping coverage for Opsumit and Uptravi in 2026, with many sharing that they... Read more

Members rallied around concerns about UHC Medicare Part D dropping coverage for Opsumit and Uptravi in 2026, with many sharing that they received similar notices and that their doctors or nurse coordinators assured them they would advocate for coverage or find alternatives. Several members offered practical strategies, including switching to SilverScript through Aetna (which still covers Opsumit but costs an additional $104 monthly), applying for assistance through PAN Foundation for copayments or full medication costs, exploring Mark Cuban's Cost Plus Drugs for generic alternatives like sildenafil, and considering traditional Medicare with a supplement instead of Advantage plans to avoid frequent coverage changes. A recurring theme was trusting in faith and medical teams to navigate the uncertainty, with members emphasizing the importance of verifying formularies during open enrollment, pursuing patient assistance programs, and staying proactive about alternative medications within the same treatment pathways.

A myPHteam Member

I had heard the same here in Arizona. But my understanding is that it is only Aetna's D plan, NOT C (the Advantage plan) that has Opsumit in their formulary. I also know that Aetna's C plan is being dropped by all the HonorHealth Physician groups in Artizona.

Luckily I am not impacted. I no longer take Opsumit and I am on the Wellcare D plan.

You should verify all of this and then make any necessary changes that work better for you while it is still Open Enrollment.

November 16, 2025
A myPHteam Member

Hi Jean, my insurance agent callwd me a month ago and told me they would no longer be covered, but when I called my Dr the nurse coordinator told me not to worry that my Dr would take care of it. So I am praying he does! Gid bless you my friend! πŸ™β€οΈπŸ€—πŸ™Œ

November 16, 2025
A myPHteam Member

Good morning everyone 🌞 Hope everyone is doing well πŸ™πŸ™ my My Doctor changed my medication I know longer taking Opsumit and Adempas he put Me on a medication that has Both of the same ingredients in to one it called OPSYNVI Tablet 10-20 mg just one every morning then I will go up to OPSYNVI Tablet 10-40 in about another 6 weeks I've been taking it about a month feeling really good
I give All the glory to My lord Jesus Christ πŸ™πŸ™ and putting good Doctors in my path and my family is very good support team πŸ™β€οΈ and eat the right foods

November 19, 2025
A myPHteam Member

Don't despair. You may have to change medications within the same pathways but there are options. If you haven't done so already, contact your physician so they can look into which medications are covered by your plan in 2026.

November 17, 2025
A myPHteam Member

I was told by my person, due to my chronic conditions I should stay away from the Advantage programs, as they can change more often and also many doctors choose not to accept the advantage plans.

November 16, 2025

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