STEQEYMA 45 mg/.5mL Injection, Solution

Also known as Ustekinumab-Stba. Coverage in New Jersey (CMS PDP Region 04).

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

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

28 Medicare Advantage plans in NJ 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. NJ: 28 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)$22.80/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)$28.20/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)$77.40/mo premium · $615.00 deductible	3Preferred Brand	17%	17%	$4345.1441	$4,345.141 unit	Prior authorization Quantity limit 3 per 84 days
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible	3Preferred Brand	15%	15%	$4345.1441	$4,345.141 unit	Prior authorization Quantity limit 3 per 84 days
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible	4Non-Preferred Drug	45%	45%	$4045.7543	$2,184.710.54 units	Prior authorization Quantity limit 1.5 per 84 days
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible	4Non-Preferred Drug	45%	45%	$4045.7543	$2,184.710.54 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 →