1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe
ustekinumab-aekn
RxCUI: 2705400
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.
17.2%
Plan Coverage
874
Plans Covering
T4.2
Avg Tier
100%
Prior Auth Required
What the CMS Formulary Data Shows for 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe
Per the CMS 2026 Part D formulary file, 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe (RxNorm concept RXCUI 2705400, generic name ustekinumab-aekn) appears on 93 distinct formulary files spanning 874 Medicare Part D plan offerings - 17.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.
Real-world access to 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 97.8% 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 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe today.
Coverage Details
- Formularies covering
- 93
- Plans covering
- 874
- Coverage rate
- 17.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 97.8% of formularies
Tier Distribution Across Plans
27 plans
Tier 1, Preferred Generic
12 plans
Tier 3, Preferred Brand
61 plans
Tier 5, Specialty
Standalone Drug Plans (PDP) Covering 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Wellcare Simple (HMO-POS) | WELLCARE OF CONNECTICUT, INC. | T5 | Yes | No | $0 | CT |
| Wellcare Giveback (HMO-POS) | WELLCARE OF CONNECTICUT, INC. | T5 | Yes | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| 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 |
| 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 |
| 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 |
| Troy Medicare (HMO) | TROY HEALTH, INC. | T3 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | TROY HEALTH, INC. | T3 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH | T3 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T3 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T3 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | SELECT HEALTH OF SOUTH CAROLINA, INC. | T3 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T3 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T3 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS FLORIDA INC | T3 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS LOUISIANA, INC. | T3 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS NORTH CAROLINA, INC. | T3 | Yes | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH MICHIGAN, INC. | T3 | Yes | $0 | MI |
| The Health Plan SecureCare - Option II (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T5 | Yes | $0 | OH |
| The Health Plan SecureCare - Option II (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T5 | Yes | $0 | OH, WV |
| The Health Plan SecureCare Capitol Plan (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T5 | Yes | $0 | WV |
| The Health Plan SecureChoice Optimum (PPO) | THP INSURANCE COMPANY | T5 | Yes | $0 | OH, WV |
| WellSense Signature (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T5 | Yes | $0 | NH |
| WellSense Signature Access (PPO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T5 | Yes | $0 | NH |
| Community Health Plan of WA Dual Complete (HMO D-SNP) | COMMUNITY HEALTH PLAN OF WASHINGTON | T5 | Yes | $0 | WA |
| Community Health Plan of WA Dual Select (HMO D-SNP) | COMMUNITY HEALTH PLAN OF WASHINGTON | T5 | Yes | $0 | WA |
| Providence Medicare Extra Part B Only + Rx (HMO) | PROVIDENCE HEALTH ASSURANCE | T5 | Yes | $0 | OR |
| Providence Medicare Prime + Rx (HMO) | PROVIDENCE HEALTH ASSURANCE | T5 | Yes | $0 | OR |
| Providence Medicare Dual Plus (HMO D-SNP) | PROVIDENCE HEALTH ASSURANCE | T5 | Yes | $0 | OR |
Frequently Asked Questions
Is 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe covered by Medicare Part D?
Yes, 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe is covered by 874 Medicare Part D plans (17.2% of all Part D formularies).
What tier is 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe on Medicare Part D plans?
1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe require prior authorization?
100% of Part D formularies require prior authorization for 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe. Step therapy: 0%. Quantity limits: 97.8%.
Read our methodology - how this data is sourced, computed, and verified.
Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial