STARJEMZA 45 mg/.5mL Injection
Also known as Ustekinumab-Hmny. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).
2 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 4.
2 of 2 plans apply a prior authorization, step therapy or quantity limit.
32 Medicare Advantage plans in CT, MA, RI do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. CT: 7 plans · MA: 15 plans · RI: 10 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $915.5522 | $915.551 unit |
|
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 30% | — | $915.5522 | $915.551 unit |
|
Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.