STEQEYMA 45 mg/.5mL Injection, Solution

Also known as Ustekinumab-Stba. Coverage in North Carolina (CMS PDP Region 08).

6 of 12 stand-alone Part D plans in North Carolina cover this drug on tier 3–4.

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

77 Medicare Advantage plans in NC 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. NC: 77 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$3991.7744	$2,155.560.54 units	Prior authorization Quantity limit 0.5 per 28 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$3991.7744	$2,155.560.54 units	Prior authorization Quantity limit 0.5 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible	3Preferred Brand	18%	18%	$4345.1441	$4,345.141 unit	Prior authorization Quantity limit 3 per 84 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible	3Preferred Brand	17%	17%	$4345.1441	$4,345.141 unit	Prior authorization Quantity limit 3 per 84 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible	4Non-Preferred Drug	32%	32%	$4000.3828	$2,160.210.54 units	Prior authorization Quantity limit 1.5 per 84 days
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible	4Non-Preferred Drug	40%	40%	$4000.3828	$2,160.210.54 units	Prior authorization Quantity limit 1.5 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 →