0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza]
ustekinumab-hmny
RxCUI: 2725094
What the CMS Formulary Data Shows for 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza]
Per the CMS 2026 Part D formulary file, 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza] (RxNorm concept RXCUI 2725094, generic name ustekinumab-hmny) appears on 33 distinct formulary files spanning 104 Medicare Part D plan offerings - 2.1% 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 2.9.
Real-world access to 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 97% 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-hmny 90 MG/ML Prefilled Syringe [Starjemza] today.
Coverage Details
- Formularies covering
- 33
- Plans covering
- 104
- Coverage rate
- 2.1%
- 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
- 97% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | Yes | $0 | AL |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | PROCARE ADVANTAGE, LLC | T1 | Yes | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T1 | Yes | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | AMERICAN HEALTH PLAN OF FL, INC. | T1 | Yes | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | SECUR INC | T1 | Yes | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | SECUR INC | T1 | Yes | $4.80 | FL |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE MI, LLC | T1 | Yes | $8.80 | MI |
| AgeRight Advantage Health Plan (HMO I-SNP) | MARQUIS ADVANTAGE, INC. | T1 | Yes | $10.50 | OR, WA |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | Yes | $12.00 | CA |
| Liberty Medicare Dual Plan (HMO D-SNP) | LIBERTY ADVANTAGE, LLC | T1 | Yes | $14.70 | NC |
| KeyCare Advantage (HMO I-SNP) | ISNP VENTURES, LLC | T1 | Yes | $23.20 | MD |
| American Health Advantage of Mississippi (HMO I-SNP) | AMERICAN HEALTH PLAN OF MS, INC. | T1 | Yes | $23.80 | MS |
| Senior Care (HMO I-SNP) | LIFEWORKS ADVANTAGE, LLC | T1 | Yes | $24.60 | VA |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | Yes | $25.40 | GA |
| Georgia Health Advantage (HMO I-SNP) | GEORGIA ASSURANCE, INC. | T1 | Yes | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | GEORGIA ASSURANCE, INC. | T1 | Yes | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | AMERICAN HEALTH PLAN, INC. | T1 | Yes | $27.70 | TN |
| Simpra Advantage Nursing Home Plan (PPO I-SNP) | SIMPRA ADVANTAGE, INC. | T1 | Yes | $27.70 | AL |
| American Health Advantage of Oklahoma (HMO I-SNP) | OKLAHOMA SUPERIOR SELECT, INC. | T1 | Yes | $28.20 | OK |
| NHC Advantage (HMO I-SNP) | NHC ADVANTAGE, LLC | T1 | Yes | $31.00 | MO, NC, SC, TN |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF OHIO, INC. | T1 | Yes | $31.40 | OH |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | Yes | $32.70 | PA |
| American Health Advantage of Pennsylvania (HMO I-SNP) | AMERICAN HEALTH PLAN OF PENNSYLVANIA INC | T1 | Yes | $32.70 | PA |
| Lagniappe Advantage (PPO I-SNP) | LAGNIAPPE ADVANTAGE INSURANCE COMPANY | T1 | Yes | $32.90 | LA |
| American Health Advantage of Louisiana (HMO I-SNP) | DIGNITY CARE CORPORATION | T1 | Yes | $32.90 | LA |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | Yes | $35.20 | CO |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER NORTH CAROLINA, LLC | T1 | Yes | $35.70 | SC |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER NORTH CAROLINA, LLC | T1 | Yes | $36.20 | NC |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | LIBERTY ADVANTAGE, LLC | T1 | Yes | $36.20 | NC |
| American Health Advantage of Utah (HMO I-SNP) | AMERICAN HEALTH PLAN OF UT, INC. | T1 | Yes | $37.60 | UT |
| American Health Advantage of Idaho (HMO I-SNP) | AMERICAN HEALTH PLAN OF UT, INC. | T1 | Yes | $37.60 | ID |
| American Health Advantage of Indiana (HMO I-SNP) | AMERICAN HEALTH PLAN OF INDIANA INC | T1 | Yes | $38.40 | IN |
| Iowa Health Advantage (HMO I-SNP) | AMERICAN HEALTH PLAN OF IOWA INC | T1 | Yes | $41.50 | IA |
| Iowa Health Advantage Choice (HMO I-SNP) | AMERICAN HEALTH PLAN OF IOWA INC | T1 | Yes | $41.50 | IA |
| American Health Advantage of Missouri (HMO I-SNP) | AMERICAN HEALTH PLAN OF MISSOURI, INC. | T1 | Yes | $43.00 | MO |
| American Health Advantage of Missouri Choice (HMO I-SNP) | AMERICAN HEALTH PLAN OF MISSOURI, INC. | T1 | Yes | $43.00 | MO |
| Kansas Health Advantage (HMO I-SNP) | KANSAS SUPERIOR SELECT, INC. | T1 | Yes | $55.20 | KS |
| Kansas Health Advantage Choice (HMO I-SNP) | KANSAS SUPERIOR SELECT, INC. | T1 | Yes | $55.20 | KS |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | Yes | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | Yes | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | Yes | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | Yes | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T3 | Yes | $0 | WI |
| Geisinger Gold Preferred Complete Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T3 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | GEISINGER HEALTH PLAN | T3 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | GEISINGER HEALTH PLAN | T3 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | GEISINGER HEALTH PLAN | T3 | Yes | $0 | PA |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T3 | Yes | $21.10 | WI |
Frequently Asked Questions
Is 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza] covered by Medicare Part D?
Yes, 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza] is covered by 104 Medicare Part D plans (2.1% of all Part D formularies).
What tier is 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza] on Medicare Part D plans?
0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza] require prior authorization?
100% of Part D formularies require prior authorization for 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza]. Step therapy: 0%. Quantity limits: 97%.
Read our methodology - how this data is sourced, computed, and verified.