MedicarePartD.guide

A non-government resource built from CMS public data

YESINTEK 90 mg/mL Injection, Solution

Also known as Ustekinumab. Coverage in California (CMS PDP Region 32).

8 of 12 stand-alone Part D plans in California cover this drug on tier 5.

8 of 8 plans apply a prior authorization, step therapy or quantity limit.

283 Medicare Advantage plans in CA 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. CA: 283 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible5Specialty Tier25%—$3120.6627$3,120.661 unit
  • Prior authorization
  • Quantity limit 1 per 28 days
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible5Specialty Tier26%—$3010.5424$3,010.541 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible5Specialty Tier25%—$3121.1829$3,121.181 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible5Specialty Tier25%—$3010.5424$3,010.541 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible5Specialty Tier31%—$3121.1829$3,121.181 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible5Specialty Tier33%—$3010.5424$3,010.541 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible5Specialty Tier25%—$2916.0947$2,916.091 unit
  • Prior authorization
  • Quantity limit 1 per 28 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible5Specialty Tier33%—$2916.0947$2,916.091 unit
  • Prior authorization
  • Quantity limit 1 per 28 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 →