Expanded Coverage for STELARA® in Crohn’s Disease*
|Commercial Plan||Medical IV Coverage||Medical SubQ Coverage||Pharmacy SubQ Coverage|
|ConnectiCare||1st Line Biologic||1st Line Biologic||1st Line Biologic|
|Contra Costa Health Plan||Covered||Covered||Covered|
|County Medical Services Program (CMSP)||Covered||Covered||Covered|
|Coventry Health Care||1st Line Biologic||1st Line Biologic||1st Line Biologic|
|Cox HealthPlans||Covered||Covered||Biologic Trial Required|
|Crystal Run Health Plans||Covered||Covered||Covered|
|CVS Caremark Advanced Control (Indication-Managed)||N/A||N/A||Biologic Trial Required|
|CVS Caremark Performance - Standard Control (Drug-Managed)||N/A||N/A||Biologic Trial Required|
|CVS Caremark Performance - Standard Opt Out (Copay-Managed)||N/A||N/A||1st Line Biologic|
|Dean Health Plan||Biologic Trial Required||Not Covered by Plan||Biologic Trial Required|
|EmblemHealth||1st Line Biologic||1st Line Biologic||Biologic Trial Required|
|Empire Blue Cross Blue Shield||1st Line Biologic||1st Line Biologic||1st Line Biologic|
|EnvisionRx Standard Formulary||N/A||N/A||Biologic Trial Required|
|Excellus BlueCross BlueShield||1st Line Biologic||1st Line Biologic||1st Line Biologic|
|Express Scripts||Covered||Covered||1st Line Biologic|
|Fallon Health||Biologic Trial Required||Biologic Trial Required||Biologic Trial Required|
|First Medical Health Plan||Covered||Covered||Covered|
|FirstCare Health Plans||Covered||Covered||Covered|
|FirstCarolinaCare||N/A||N/A||Biologic Trial Required|
|Florida Blue||1st Line Biologic||1st Line Biologic||1st Line Biologic|
|Florida Health Care Plans||Biologic Trial Required||Biologic Trial Required||Biologic Trial Required|
|Geisinger Health Plan||Biologic Trial Required||Biologic Trial Required||Biologic Trial Required|
|Government Employees Health Association (GEHA)||Covered||Covered||Biologic Trial Required|
|Group Health Cooperative of South Central Wisconsin (GHC-SCW)||Covered||Covered||Covered|
|Gundersen Health Plan||Covered||Covered||Covered|
|Harvard Pilgrim Health Care||1st Line Biologic||1st Line Biologic||1st Line Biologic|
|Hawaii Medical Assurance Association (HMAA)||Covered||Covered||Covered|
|Hawaii Medical Service Association (HMSA)||1st Line Biologic||1st Line Biologic||1st Line Biologic|
|Health Advantage||1st Line Biologic||1st Line Biologic||Biologic Trial Required|
Your One Source for Access, Affordability, and Treatment Support For Your Patients
Janssen CarePath helps verify insurance coverage for your patients, provides reimbursement information, helps find financial assistance options for eligible patients, and provides ongoing support to help them start and stay on STELARA® as prescribed.
Call a Janssen Care Coordinator at 877-CarePath (877-227-3728) Monday to Friday, 8 am to 8 pm ET
The information provided represents no statement, promise, or guarantee of Janssen Biotech, Inc., concerning levels of reimbursement, payment, or charge. Please consult your payer organization with regard to local or actual coverage, reimbursement policies, and determination processes. Information is subject to change without notice. Nothing herein may be construed as an endorsement, approval, recommendation, representation, or warranty of any kind by any plan or insurer referenced herein. This communication is solely the responsibility of Janssen Biotech, Inc.
Helpful instructions on how to fill out the Benefit Investigation and Prescription Form.
Please note: Prior authorization may be required.
*First-line biologic: brand name drugs that do not require trial on another biologic product prior to utilization. Biologic trial required: brand name drugs that require trial on another biologic product prior to utilization. First-line biologic tier 2: brand-name drugs that are covered at a lower copayment, and/or with fewer restrictions, than higher-tiered brands in the same pharmacologic class.