Stelara® (ustekinumab)

Authorization forms

Subcutaneous (covered under pharmacy benefit):

Traditional & Optimized (11/2018)

Medicare Part D (01/2019)

IV (covered under medical benefit)

Traditional & Optimized (11/2018)

Medicare Part B (10/2019)

 

Stelara is not covered for Medicaid

No prior authorization required for:

  • Emergency room
  • Inpatient
  • Skilled nursing facility

For further information, please see the Injectable Drugs page