MedicarePartD.guide

A non-government resource built from CMS public data

STELARA 90 mg/mL Injection, Solution

Also known as Ustekinumab. Coverage in Arizona (CMS PDP Region 28).

6 of 10 stand-alone Part D plans in Arizona cover this drug on tier 5.

6 of 6 plans apply a prior authorization, step therapy or quantity limit.

80 Medicare Advantage plans in AZ 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. AZ: 80 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$8980.1445$8,980.141 unit
  • Prior authorization
  • Quantity limit 1 per 28 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$8980.1446$8,980.141 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible5Specialty Tier26%—$8980.1446$8,980.141 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible5Specialty Tier25%—$8980.1445$8,980.141 unit
  • Prior authorization
  • Quantity limit 1 per 28 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible5Specialty Tier25%—$8980.1446$8,980.141 unit
  • Prior authorization
  • Quantity limit 1 per 28 days
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible5Specialty Tier33%—$8980.1446$8,980.141 unit
  • Prior authorization
  • Quantity limit 3 per 84 days

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.

See coverage in all 39 regions →