Otulfi
Generic: ustekinumab-aauz
45 MG, 90 MG, 130 MG — Prefilled Syringe
Also known as:
ustekinumab-aauz
OTULFI SOLN 130MG/26ML
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Focus 2026
via ustekinumab-aauz |
Tier 2 - Preferred Brand | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via ustekinumab-aauz |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via ustekinumab-aauz |
Tier 4 - Preferred Specialty | ✓ | — | — | PA |
Medicare Part D
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| HumanaChoice Giveback H5525-035 (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| HumanaChoice H5525-049 (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| HumanaChoice H5525-050 (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| HumanaChoice H5525-070 (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Dual Select H5525-072 (PPO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus H6622-025 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus H6622-026 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus H6622-057 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus H6622-060 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus H6622-061 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Choice H8145-004 (PFFS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| HumanaChoice H5525-083 (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
|
Troy Medicare (HMO)
via ustekinumab-aauz |
Tier 3 - Preferred Brand | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via ustekinumab-aauz |
Tier 3 - Preferred Brand | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via ustekinumab-aauz |
Tier 3 - Preferred Brand | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| Humana Gold Plus H1036-137 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus H1036-233 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Dual Select H1036-307 (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus Giveback H1036-318 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Gold Plus H1036-335 (HMO-POS) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| HumanaChoice Giveback H5216-017 (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| HumanaChoice H5216-211 (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
| Humana Full Access H5525-034 (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 1.5 per 84 days | PA | QL |
NC Medicaid PDL
1 planNC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - HDHP 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via ustekinumab-aauz |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via ustekinumab-aauz |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via ustekinumab-aauz |
Not Covered | — | — | — | None |