1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi]
ustekinumab-aauz
RxCUI: 2702613
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.
18.5%
Plan Coverage
939
Plans Covering
T4
Avg Tier
100%
Prior Auth Required
What the CMS Formulary Data Shows for 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi]
Per the CMS 2026 Part D formulary file, 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi] (RxNorm concept RXCUI 2702613, generic name ustekinumab-aauz) appears on 27 distinct formulary files spanning 939 Medicare Part D plan offerings - 18.5% 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.
Real-world access to 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi] 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 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi] today.
Coverage Details
- Formularies covering
- 27
- Plans covering
- 939
- Coverage rate
- 18.5%
- 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
- 100% of formularies
Tier Distribution Across Plans
15 plans
Tier 1, Preferred Generic
85 plans
Tier 5, Specialty
Standalone Drug Plans (PDP) Covering 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi]
26 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Basic Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
| Humana Value Rx Plan (PDP) | Humana Insurance Co. & Humana Insurance Co. of NY | T5 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi]
74 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 |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| 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 |
| 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 |
| 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 |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | IL, MO |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | AR, MO |
| Essence Advantage Select (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | IL, MO |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | IN, KY |
| Essence Advantage Select (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | IL |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T5 | Yes | $0 | IL, MO |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T5 | Yes | $0 | AR, MO |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T5 | Yes | $0 | IL |
| CareSource Dual Advantage Plus (HMO D-SNP) | CARESOURCE GEORGIA CO. | T5 | Yes | $0 | GA |
| CareSource MyCare Ohio (HMO D-SNP) | CARESOURCE OHIO, INC. | T5 | Yes | $0 | OH |
| Blue adVantage Liberty (PPO) | LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | T5 | Yes | $0 | LA |
| Blue adVantage Thrive (PPO) | LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | T5 | Yes | $0 | LA |
| Blue adVantage Classic (HMO-POS) | HMO LOUISIANA, INC. | T5 | Yes | $0 | LA |
| Blue adVantage Giveback (HMO-POS) | HMO LOUISIANA, INC. | T5 | Yes | $0 | LA |
| MedMutual Advantage Access (PPO) | MEDICAL MUTUAL OF OHIO | T5 | Yes | $0 | OH |
| MedMutual Advantage Classic (HMO) | MEDICAL MUTUAL OF OHIO | T5 | Yes | $0 | OH |
| MedMutual Advantage Signature (HMO-POS) | MEDICAL MUTUAL OF OHIO | T5 | Yes | $0 | OH |
| Humana Gold Plus H0028-014 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | IL, MO |
| Humana Gold Plus H0028-019 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | NM |
| Humana Gold Plus H0028-021 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | AZ |
| Humana Gold Plus H0028-024 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | AZ |
| Humana Gold Plus H0028-028 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | AZ |
| Humana Gold Plus H0028-029 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | TX |
| Humana Gold Plus H0028-030 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | TX |
| Humana Gold Plus SNP-DE H0028-032 (HMO D-SNP) | CHA HMO, INC. | T5 | Yes | $0 | TX |
| Humana Gold Plus H0028-035 (HMO) | CHA HMO, INC. | T5 | Yes | $0 | TX |
| Humana Gold Plus SNP-DE H0028-036 (HMO D-SNP) | CHA HMO, INC. | T5 | Yes | $0 | TX |
Frequently Asked Questions
Is 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi] covered by Medicare Part D?
Yes, 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi] is covered by 939 Medicare Part D plans (18.5% of all Part D formularies).
What tier is 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi] on Medicare Part D plans?
1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi] require prior authorization?
100% of Part D formularies require prior authorization for 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi]. Step therapy: 0%. Quantity limits: 100%.
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