Skip to main content
Drug Info

Does United Healthcare cover Vyvanse?

Factors that affect whether UHC will cover this ADHD medication
SingleCare logo
By | Jul. 2, 2025 Medically reviewed by Chad Shaffer, MD
A health insurance card, medication, and stethoscope: Does United Healthcare cover Vyvanse?

Key takeaways

  • Vyvanse is a central nervous system stimulant that’s approved to treat ADHD and binge eating disorder.

  • Some United Healthcare plans may cover Vyvanse, but others might not. It often depends on the formulary’s drug tier, prior authorization, and the reason it’s prescribed.

  • Without insurance coverage, Vyvanse can cost over $550 per month. However, there are many other ways to save.

In this article:

Vyvanse (lisdexamfetamine dimesylate) is a brand-name medication that increases norepinephrine and dopamine levels in the brain and is approved by the Food and Drug Administration (FDA) to treat binge eating disorder and attention-deficit hyperactivity disorder (ADHD). Because it costs over $550 per month on average for 30, 30 mg capsules of Vyvanse, insurance coverage is often relied upon to make it more affordable. However, coverage varies by plan and may depend on various factors. Here’s what to know about United Healthcare’s coverage of Vyvanse. 

Does United Healthcare cover Vyvanse?

Some United Healthcare (UHC) prescription drug plans cover brand-name Vyvanse, but some may not. The details of each plan’s coverage depend on several different factors, including formulary details, prior authorization requirements, and reasons for the prescription. 

Formularies

One UHC drug formulary may cover Vyvanse but place it on a higher tier of its drug formulary. Generic drugs often occupy the lowest tier, followed by preferred brands, then non-preferred brands, and specialty drugs. Out-of-pocket costs typically escalate as the tiers go up.

“Vyvanse is sometimes placed on higher tiers, leading to higher copays,” says Zishan Khan, MD, a psychiatrist at Mindpath Health. Many formularies from United Healthcare classify brand-name Vyvanse as a non-preferred drug, so they might not cover it. However, many of the same plans will cover generic Vyvanse (lisdexamfetamine dimesylate).

Plan guidelines may also impose quantity limits, which are restrictions on the amount you can get per month. That’s because, like Adderall, Vyvanse is a controlled substance.

Prior authorization

Since many plans place brand-name Vyvanse in a higher tier, they may have prior authorization requirements before they issue coverage. Sometimes, prior authorization might require a healthcare provider’s explanation of its medical necessity. “Some reasons I use include the fact that it is once daily dosing, has a smoother delivery, and there is a lower abuse potential,” Dr. Khan says. 

The insurance company may also need to see that the patient had a history of treatment trials with other stimulants that were ineffective or poorly tolerated, according to Dr. Khan. This requirement is called step therapy, meaning that other prescription alternatives must be tried first.

Reason for the prescription

Vyvanse is approved by the FDA to treat ADHD and binge eating disorder, but some doctors may prescribe it for treatment-resistant depression or narcolepsy. These are “off-label” uses, for which some plans won’t cover Vyvanse. 

Does United Healthcare cover generic Vyvanse?

If you look at your UHC prescription drug formulary and see Vyvanse in a high tier, don’t be discouraged. Chances are, it will cover generic lisdexamfetamine dimesylate, since generic drugs are often significantly less expensive than their brand-name counterparts but equally effective.

For example, this UHC 2025 drug formulary lists Vyvanse as a drug that may be excluded from coverage or subject to prior authorization in Connecticut, New Jersey, and New York. However, it lists generic Vyvanse, lisdexamfetamine dimesylate, as a tier 3 drug, which means it will be covered but will cost more than drugs on tiers 1 and 2. Remember, formularies vary by plan, so check yours to verify coverage.

“I absolutely recommend generic lisdexamfetamine as a cost-effective alternative,” Dr. Khan says. “In fact, the vast majority of patients are given this by their pharmacies when I order Vyvanse.” Most prescriptions include the phrase “Substitution Permitted” as a way of allowing pharmacists to dispense the generic alternative.

How much does Vyvanse cost?

For anyone paying completely out of pocket for their Vyvanse prescription, it can cost around $553 for 30, 30 mg capsules. That’s a one-month supply, so paying out of pocket for an entire year can cost over $6,600.

As we’ve mentioned, generic Vyvanse is usually cheaper, but it still costs about $443 for 30, 30 mg capsules, which adds up to over $5,300 per year.

How much does Vyvanse cost with United Healthcare?

If your UHC plan covers either brand-name or generic Vyvanse, you most likely will pay less than the prices listed above. How much you’ll pay will depend on which tier they’re on and how much your copay or coinsurance is per tier. Some people might pay nothing for generic Vyvanse, while others might have much higher copays. The only way to know for sure is to check your prescription drug list.

How to check whether your United Healthcare plan covers Vyvanse 

United Healthcare makes it fairly easy to check your prescription drug list online. Its website has a page with links to the formularies for each plan, even organizing them by state. On this page, find your plan, then click the link. Scroll until you find Vyvanse, and you’ll also find its drug tier, plus any other requirements—like prior authorization or quantity limits. To get there from the homepage, click “Member Resources,” then “Pharmacy Benefits,” then “View a General PDL.”

You can also sign in to your member account, which will take you to a portal displaying all the important information about your plan, your claims, your prescriptions, and more. Once you log in, you’ll also have access to a chat function, so you can chat with a representative who can answer questions about drug coverage.

How to save on Vyvanse

If you don’t have health insurance, or if your insurance doesn’t cover Vyvanse, that doesn’t mean you have to pay full price. There are a few other reliable ways to save on Vyvanse, which can significantly reduce out-of-pocket costs.

One of those ways is with SingleCare coupons. These free discounts can take the price from $553 for brand-name Vyvanse down to $65 for the generic version. Signing up for a SingleCare discount card is free and provides access to discounts on thousands of medications at over 35,000 pharmacies nationwide. You can use them even if you have insurance, but you can’t use SingleCare and insurance coverage together. You have to choose one or the other.

Bottom line

Don’t let cost get in the way of treatment for ADHD or binge eating disorder. Talk to your healthcare provider about your options. They may be able to recommend a Vyvanse alternative that is more likely to be covered by UHC.