Steqeyma Subcutaneous

45 MG/0.5ML — Prefilled Syringe

Interleukin-12 Antagonist

Also known as: Steqeyma Subcutaneous Solution Steqeyma 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.
Source: CMS QHP JSON  ·  Formulary date: Sep 22, 2026  ·  Checked: 13 hours, 58 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
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 Silver Off-Marketplace Low + 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 Premier + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Enhanced + 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 Silver Signature + 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 Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 13 hours, 58 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
Provider Partners North Carolina Essential Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 3 per 84 days PA | QL
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
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 3 per 84 days PA | QL
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 0.5 per 28 days PA | QL
Provider Partners North Carolina Community Plan (HMO I-SNP) Tier 1 - Preferred Generic ✓ — ✓ 3 per 84 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-0021 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0022 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0007 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
UHC Dual Complete NC-D001 (HMO-POS D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0008 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0009 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0012 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
UHC Dual Complete NC-V001 (HMO-POS D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Erickson Advantage Signature (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Erickson Advantage Guardian (HMO-POS I-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Erickson Advantage Champion (HMO-POS C-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Erickson Advantage Freedom (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Erickson Advantage Liberty (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 0.5 per 28 days PA | QL
UHC Dual Complete NC-S2 (PPO D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Wellcare Simple Open (PPO) Tier 3 - Preferred Brand ✓ — ✓ 0.5 per 28 days PA | QL
Wellcare Dual Liberty Open (PPO D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 0.5 per 28 days PA | QL
Wellcare Assist Open (PPO) Tier 3 - Preferred Brand ✓ — ✓ 0.5 per 28 days PA | QL
Wellcare Giveback Open (PPO) Tier 3 - Preferred Brand ✓ — ✓ 0.5 per 28 days PA | QL
AARP Medicare Advantage Access from UHC NC-23 (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0001 (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0004 (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0016 (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0017 (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0019 (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Wellcare Simple (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 0.5 per 28 days PA | QL
Wellcare Dual Access (HMO-POS D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 0.5 per 28 days PA | QL
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 0.5 per 28 days PA | QL
UHC Dual Complete NC-S001 (PPO D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 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
AARP Medicare Advantage from UHC NC-24 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
UHC Complete Care NC-25 (HMO-POS C-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
UHC Complete Care NC-27 (HMO-POS C-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
UHC Complete Care NC-28 (HMO-POS C-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-26 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
UHC Dual Complete NC-S3 (HMO-POS D-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
HealthTeam Advantage Plan I (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
AARP Medicare Advantage from UHC NC-0015 (HMO-POS) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
HealthTeam Advantage Plan II (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
HealthTeam Advantage Vitality Plan (PPO) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
UHC Nursing Home Plan NC-F001 (PPO I-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) Tier 3 - Preferred Brand ✓ — ✓ 3 per 84 days PA | QL
Blue Medicare Choice (HMO) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Experience Health Medicare Advantage (HMO) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Blue Medicare Enhanced (HMO-POS) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Liberty Medicare Advantage (HMO C-SNP) Tier 4 - Non-Preferred ✓ — ✓ 0.5 per 28 days PA | QL
Alignment Health AVA (PPO) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Alignment Health Platinum Select (HMO) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Blue Medicare Essential Plus (HMO-POS) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Blue Medicare PPO Enhanced (PPO) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Alignment Health smartHMO (HMO) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Alignment Health Platinum (HMO) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Alignment Health NC Duals (HMO-POS D-SNP) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Senior Care (HMO I-SNP) Tier 4 - Non-Preferred ✓ — ✓ 0.5 per 28 days PA | QL
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
Blue Medicare Essential (HMO) Tier 4 - Non-Preferred ✓ — ✓ 1.5 per 84 days PA | QL
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