Starjemza
Generic: ustekinumab-hmny
45MG/0.5ML, 90MG — Solution
Also known as:
STARJEMZA SOLN 45MG/0.5ML; SOSY 90MG/ML
ustekinumab-hmny
Starjemza Vial
biosimilar to Stelara
Starjemza Sosy
STARJEMZA SOSY 45MG/0.5ML, 90MG/ML
STARJEMZA SOLN 130MG/26ML
Starjemza Subcutaneous Solution Prefilled Syringe
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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
9 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
| AmeriHealth Caritas Next Gold Copay Focus + $0 Deductible + Free PCP + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals | Tier 5 - Specialty | ✓ | — | — | PA |
Medicare Part D
41 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| NHC Advantage (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| PruittHealth Premier (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| Liberty Medicare Dual Plan (HMO D-SNP) | Tier 1 - Preferred Generic | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| Troy Medicare (HMO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Complete Care NC-25 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Complete Care NC-27 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Complete Care NC-28 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| Erickson Advantage Signature (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| Erickson Advantage Champion (HMO-POS C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| Erickson Advantage Freedom (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| Erickson Advantage Liberty (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| Liberty Medicare Advantage (HMO C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| Senior Care (HMO I-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 0.5 per 28 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 4 - Non-Preferred | ✓ | — | ✓ 3 per 84 days | PA | QL |
NC Medicaid PDL
1 planNC State Health Plan
3 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 |