Starjemza

Generic: ustekinumab-hmny

45MG/0.5ML, 90MG — Solution

Interleukin-12 Antagonist

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

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 15 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic 0.5 per 28 days PA | QL
Liberty Medicare Advantage Nursing Home Plan (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
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic 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
Troy Medicare (HMO) Tier 3 - Preferred Brand 0.5 per 28 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
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
AARP Medicare Advantage from UHC NC-26 (HMO-POS) 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 Guardian (HMO-POS I-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
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
UHC Complete Care NC-25 (HMO-POS C-SNP) 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 Champion (HMO-POS C-SNP) 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
Senior Care (HMO I-SNP) Tier 4 - Non-Preferred 0.5 per 28 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
AARP Medicare Advantage from UHC NC-0021 (HMO-POS) Tier 4 - Non-Preferred 3 per 84 days PA | QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 15 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Preferred PA | ST
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 15 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered None
NC State Health Plan - HDHP 2026 Not Covered None
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 15 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via ustekinumab-hmny
Tier 3 - Non-Formulary PA
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