ustekinumab-auub

Generic: Wezlana

45 mg/0.5 mL, 90 mg/mL — Vial

TARGETED IMMUNOMODULATORY BIOLOGICS

Also known as: WEZLANA
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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: Jun 10, 2026  ·  Checked: 16 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via Wezlana 		Tier 1 - Preferred Generic ✓ — ✓ 3 per 84 days PA | QL
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via Wezlana 		Tier 1 - Preferred Generic ✓ — ✓ 3 per 84 days PA | QL
Provider Partners North Carolina Community Plan (HMO I-SNP)
via Wezlana 		Tier 1 - Preferred Generic ✓ — ✓ 3 per 84 days PA | QL
HealthTeam Advantage Plan I (PPO)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ 3 per 84 days PA | QL
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ 3 per 84 days PA | QL
HealthTeam Advantage Vitality Plan (PPO)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ 3 per 84 days PA | QL
HealthTeam Advantage Plan II (PPO)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ 3 per 84 days PA | QL
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 16 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026
via Wezlana 		Not Covered — — — None
NC State Health Plan - 70/30 Standard PPO 2026
via Wezlana 		Not Covered — — — None
NC State Health Plan - 80/20 Plus PPO 2026
via Wezlana 		Not Covered — — — None
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 16 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 16 hours, 22 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Standard (No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Gold Standard (No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Bronze Standard (No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Wezlana 		Tier 5 - Specialty ✓ — ✓ PA | QL
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