0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva]

Verify with CMS →

ustekinumab-ttwe

RxCUI: 2713887

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
33.4%
Plan Coverage
1,691
Plans Covering
T3
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva]

Per the CMS 2026 Part D formulary file, 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva] (RxNorm concept RXCUI 2713887, generic name ustekinumab-ttwe) appears on 129 distinct formulary files spanning 1,691 Medicare Part D plan offerings - 33.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.

Real-world access to 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva] today.

Coverage Details

Formularies covering
129
Plans covering
1,691
Coverage rate
33.4%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
100% of formularies

Tier Distribution Across Plans

46 plans
Tier 1, Preferred Generic
54 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 Yes $0 FL
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 Yes $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 Yes $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $0 NJ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 Yes $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 Yes $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 Yes $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 Yes $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 Yes $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 Yes $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 Yes $0 GA
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 Yes $0 MI
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Horizon NJ TotalCare (HMO D-SNP) HORIZON HEALTHCARE OF NEW JERSEY, INC. T1 Yes $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 Yes $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 Yes $0 MA
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 Yes $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 Yes $4.80 FL
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 Yes $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 Yes $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 Yes $5.00 OK
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF MICHIGAN, INC. T1 Yes $8.80 MI
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF ILLINOIS, INC. T1 Yes $15.20 IL
WellSense Added Value (HMO) BOSTON MEDICAL CENTER HEALTH PLAN, INC. T1 Yes $21.70 NH
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) VIVA HEALTH, INC. T1 Yes $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) VIVA HEALTH, INC. T1 Yes $27.70 AL
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF COLORADO, INC. T1 Yes $35.20 CO
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. T1 Yes $36.20 NC
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $40.00 NJ
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) ELDERPLAN, INC. T1 Yes $44.80 NY
ElderServe Star (HMO I-SNP) ELDERSERVE HEALTH, INC. T1 Yes $58.80 NY
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF NEW YORK, INC. T1 Yes $58.80 NY
MetroPlus Platinum Plan (HMO) METROPLUS HEALTH PLAN, INC. T1 Yes $58.80 NY
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T3 Yes $0 CA
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T3 Yes $0 CA
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T3 Yes $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T3 Yes $0 CA

Frequently Asked Questions

Is 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva] covered by Medicare Part D?

Yes, 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva] is covered by 1,691 Medicare Part D plans (33.4% of all Part D formularies).

What tier is 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva] on Medicare Part D plans?

0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.

Does 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva] require prior authorization?

100% of Part D formularies require prior authorization for 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva]. Step therapy: 0%. Quantity limits: 100%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial