Medicare Part D coverage · 1 · RxCUI 2705575
1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe
Per the CMS 2026 Part D formulary file, 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe is covered by 341 Medicare Part D plans (6.7% of enrollable products), averaging Tier 5, with prior authorization required on 87.5% of covering formularies.
- 6.7%
- Plan coverage
- 341
- Plans covering
- T5
- Avg tier
- 87.5%
- Prior auth required
What the CMS Formulary Data Shows for 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe
Per the CMS 2026 Part D formulary file, 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe (RxNorm concept RXCUI 2705575, generic name 1) appears on 8 distinct formulary files spanning 341 Medicare Part D plan offerings - 6.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 5 to Tier 5, with a cross-plan average of Tier 5.
Real-world access to 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe depends on utilization management as much as tier placement: 87.5% of covering formularies require prior authorization. 0% require step therapy. 87.5% 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-ttwe 90 MG/ML Prefilled Syringe today.
Coverage Details
- Formularies covering
- 8
- Plans covering
- 341
- Coverage rate
- 6.7%
- Tier range
- Tier 5, Specialty
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 87.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 87.5% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Wellcare Simple (HMO-POS) | Coordinated Care OF Washington, Inc. | T5 | Yes | $0 | WA |
| Wellcare Simple Open (PPO) | Wellcare OF Mississippi, Inc. | T5 | Yes | $0 | MS |
| Wellcare Simple Open (PPO) | Wellcare OF Georgia, Inc. | T5 | Yes | $0 | GA |
| Wellcare Simple (HMO) | Wellcare OF Texas, Inc. | T5 | Yes | $0 | TX |
| Wellcare Simple (HMO) | Wellcare OF Texas, Inc. | T5 | Yes | $0 | TX |
| Wellcare Simple (HMO) | Wellcare OF Texas, Inc. | T5 | Yes | $0 | TX |
| Wellcare Simple (HMO) | Wellcare OF Texas, Inc. | T5 | Yes | $0 | TX |
| Wellcare Simple Open (PPO) | Wellcare Health Insurance Company OF America | T5 | Yes | $0 | AR |
| Wellcare Simple (HMO) | Health NET OF Arizona, Inc. | T5 | Yes | $0 | AZ |
| Wellcare Simple (HMO) | Health NET OF Arizona, Inc. | T5 | Yes | $0 | AZ |
| Wellcare Simple Value (HMO) | Health NET OF Arizona, Inc. | T5 | Yes | $0 | AZ |
| Wellcare Simple (HMO-POS) | Health NET OF Arizona, Inc. | T5 | Yes | $0 | NV |
| Wellcare Simple (HMO-POS) | Health NET OF Arizona, Inc. | T5 | Yes | $0 | NV |
| Wellcare Low Premium (HMO) | Health NET OF California, Inc. | T5 | Yes | $0 | CA |
| Wellcare Simple Focus (HMO) | Health NET OF California, Inc. | T5 | Yes | $0 | CA |
| Wellcare Simple Focus (HMO) | Health NET OF California, Inc. | T5 | Yes | $0 | CA |
| Wellcare Low Premium (HMO) | Health NET OF California, Inc. | T5 | Yes | $0 | CA |
| Wellcare Low Premium (HMO) | Health NET OF California, Inc. | T5 | Yes | $0 | CA |
| Wellcare Simple (HMO-POS) | Wellcare OF Connecticut, Inc. | T5 | Yes | $0 | CT |
| Wellcare Giveback (HMO-POS) | Wellcare OF Connecticut, Inc. | T5 | Yes | $0 | CT |
Show the next 30 plans
| Wellcare Simple (HMO-POS) | Buckeye Community Health Plan, Inc. | T5 | Yes | $0 | OH |
| Wellcare Low Premium (HMO-POS) | Wellcare Health Plans OF NEW Jersey, Inc. | T5 | Yes | $0 | NJ |
| Wellcare Giveback (HMO-POS) | Wellcare Health Plans OF NEW Jersey, Inc. | T5 | Yes | $0 | NJ |
| Wellcare Simple (HMO-POS) | Wellcare Health Plans OF NEW Jersey, Inc. | T5 | Yes | $0 | NJ |
| Wellcare Simple (HMO) | Sunshine State Health Plan, Inc. | T5 | Yes | $0 | FL |
| Wellcare Simple (HMO) | Sunshine State Health Plan, Inc. | T5 | Yes | $0 | FL |
| Wellcare Simple (HMO) | Sunshine State Health Plan, Inc. | T5 | Yes | $0 | FL |
| Wellcare Simple (HMO) | Sunshine State Health Plan, Inc. | T5 | Yes | $0 | FL |
| Wellcare Simple (HMO) | Sunshine State Health Plan, Inc. | T5 | Yes | $0 | FL |
| Wellcare Simple (HMO) | Sunshine State Health Plan, Inc. | T5 | Yes | $0 | FL |
| Wellcare Simple (HMO) | Sunshine State Health Plan, Inc. | T5 | Yes | $0 | FL |
| Wellcare Simple (HMO-POS) | Wellcare OF Georgia, Inc. | T5 | Yes | $0 | GA |
| Wellcare Simple (HMO-POS) | Wellcare OF Georgia, Inc. | T5 | Yes | $0 | GA |
| Wellcare Simple (HMO-POS) | Wellcare OF Georgia, Inc. | T5 | Yes | $0 | GA |
| Wellcare Simple (HMO-POS) | Wellcare OF Georgia, Inc. | T5 | Yes | $0 | GA |
| Wellcare Giveback (HMO-POS) | Nebraska Total Care, Inc. | T5 | Yes | $0 | NE |
| Wellcare Simple (HMO-POS) | Nebraska Total Care, Inc. | T5 | Yes | $0 | NE |
| Wellcare Simple Open (PPO) | Nebraska Total Care, Inc. | T5 | Yes | $0 | NE |
| Wellcare Low Premium (HMO-POS) | Harmony Health Plan, Inc. | T5 | Yes | $0 | MS |
| Wellcare Simple Preferred (HMO-POS) | Harmony Health Plan, Inc. | T5 | Yes | $0 | AR |
| Wellcare Simple (HMO-POS) | Harmony Health Plan, Inc. | T5 | Yes | $0 | MS |
| Wellcare Simple (HMO-POS) | Harmony Health Plan, Inc. | T5 | Yes | $0 | MS |
| Wellcare Simple (HMO-POS) | Harmony Health Plan, Inc. | T5 | Yes | $0 | TN |
| Wellcare Simple Value (HMO-POS) | Harmony Health Plan, Inc. | T5 | Yes | $0 | IL |
| Wellcare Simple (HMO-POS) | Home State Health Plan, Inc. | T5 | Yes | $0 | MO |
| Wellcare Simple (HMO-POS) | Wellcare OF Iowa, Inc. | T5 | Yes | $0 | IA |
| Wellcare Simple Open (PPO) | Wellcare Health Insurance OF Connecticut, Inc. | T5 | Yes | $0 | CT |
| Wellcare Giveback Open (PPO) | Wellcare Health Insurance OF Connecticut, Inc. | T5 | Yes | $0 | CT |
| Wellcare Simple Open (PPO) | Wellcare Health Insurance OF Connecticut, Inc. | T5 | Yes | $0 | NC |
| Wellcare Simple Open (PPO) | Meridian Health Plan OF Michigan, Inc. | T5 | Yes | $0 | MI |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe covered by Medicare Part D?
Yes, 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe is covered by 341 Medicare Part D plans (6.7% of all Part D formularies).
What tier is 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe on Medicare Part D plans?
1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe averages Tier 5 across Part D plans, ranging from Tier 5 to Tier 5.
Does 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe require prior authorization?
87.5% of Part D formularies require prior authorization for 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe. Step therapy: 0%. Quantity limits: 87.5%.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector T5
- metronidazole 10 MG/ML Topical Cream [Noritate] T5
- formoterol fumarate 0.01 MG/ML Inhalation Solution [Perforomist] T5
- deferiprone 1000 MG Oral Tablet [Ferriprox] T5
- ruxolitinib 15 MG/ML Topical Cream [Opzelura] T5
- cyclosporine 1 MG/ML Ophthalmic Suspension [Verkazia] T5
Similar prior-authorization rate
- Once-Daily gabapentin 300 MG Oral Tablet 87.5% PA
- 0.5 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe 87.5% PA
- crinecerfont 100 MG Oral Capsule [Crenessity] 87.5% PA
- 1.7 ML denosumab-bmwo 70 MG/ML Injection [Osenvelt] 87.3% PA
- tetrabenazine 12.5 MG Oral Tablet 87.8% PA
- tetrabenazine 25 MG Oral Tablet 87.8% PA