Do I qualify for the Stelara copay card & how can I save?
To qualify for the Stelara copay card you must have commercial or private insurance for Stelara, enroll in the Stelara with Me Savings Program, be at least 6 years of age and not use government-funded insurance programs like Medicare or Medicaid. If you are eligible, you pay $5 per dose with a maximum of $9,450 savings per calendar year.
These savings do not cover the costs that are charged to give you your treatment, such as healthcare provider costs associated with your injections or facility charges at an infusion clinic.
These savings may be in the form of a reduced copay at the pharmacy or as a rebate to you if you receive your medicine from a healthcare provider. The program ends on December 31, 2024 but patients are automatically re-enrolled.
This program can help you save on your out-of-pocket medication costs for Stelara. Depending on your health insurance plan, your savings may apply towards your deductible, co-pay, and co-insurance.
You can find the Stelara copay card on the Janssen website or you can call 844-4withMe (844-494-8463), Monday to Friday, 8:00 AM to 8:00 PM ET.
To Learn More: Stelara Stelara Coupons, Copay Cards and Rebates
How much does Stelara cost without insurance?
Most people do not pay the full cash price for Stelara, even if they do not have insurance. How much you will pay depends upon your dose and any savings you may get from patient financial assistance programs.
Stelara is an expensive medicine if you do not have prescription insurance coverage and must pay by cash. For example:
- An intravenous (IV) solution (5 mg/mL) in a single dose, 26 mL vial costs $2,141 per vial. IV means it is injected into a vein with a needle.
- A subcutaneous solution (45 mg/0.5mL) in a prefilled syringe that is injected under the skin with a needle costs $14,669 for 0.5 mL.
These prices can vary and may depend on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans. This price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies.
If you do not have insurance, you may be able to receive financial patient assistance from Janssen, the manufacturer.
You can also contact your insurance carrier who can suggest covered medicines for your condition that may be more affordable. Discuss this information with your healthcare provider.
Several biosimilars for Stelara are also now approved, which may be covered by your insurance and help with cost savings. Wezlana is an interchangeable biosimilar, which means that your pharmacist may be able to make an automatic switch.
Biosimilars for Stelara include:
- Imuldosa (ustekinumab-srlf)
- Otulfi (ustekinumab-aauz)
- Pyzchiva (ustekinumab-ttwe)
- Selarsdi (ustekinumab-aekn)
- Wezlana (ustekinumab-auub)
Related: What are biosimilars? Learn about cost-savings, clinical use, and safety.
How do I use the Stelara copay card?
Eligible patients using commercial or private insurance can save on out-of-pocket medication costs through the Stelara withMe Savings Program if they have been prescribed Stelara and their commercial insurance covers this medication as a benefit.
- If you get your medicine from the pharmacy, give the copay card to your pharmacist who will process the out-of-pocket cost savings as they fill the prescription.
- If your healthcare provider gives you your injections at their office or clinic, and you use your medical (not prescription) insurance to pay for your medication, you can receive a rebate on your costs by filling out the rebate form from Janssen. This form is called the Stelara withMe Savings Program Patient Enrollment Form. Your healthcare provider may also submit this rebate request on your behalf.
- If you use your prescription insurance at the pharmacy to pay for Stelara, but the pharmacy is unable to process your copay card for instant savings, you will need to submit a rebate request.
If you have more questions, call Janssen at 844-4withMe (844-494-8463), Monday to Friday, 8:00 AM to 8:00 PM ET and ask about the Stelara copay cards or rebate programs.
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What is the difference between private or commercial insurance and government insurance?
- Private insurance is typically provided through your current or former employer, government employee insurance or insurance you purchased through the Health Insurance Marketplace on Healthcare.gov.
- Government insurance includes plans like Medicare Part A (hospital insurance), Part B (medical provider insurance), Part C (a Medicare Advantage Plan), Medicare Part D (prescription drug coverage through Medicare) and Medicare Supplements (to help pay deductibles, copays or co-insurance), Medicaid, CHIP, TRICARE, Department of Defense (DoD), or Veterans Administration (VA).
Many copay cards offered by drug companies do not cover prescription copays costs for people who have government-sponsored insurance, but some may, so it's always best to check with the company itself.
What if I don’t have insurance?
Patient assistance programs (PAPs) offered by the Johnson & Johnson Patient Assistance Foundation may be able to provide help for prescription costs.
- PAPs are typically sponsored by pharmaceutical companies, but you must qualify.
- These programs can offer free or discounted medicines, or copay programs, to people with low income or those who are not fully insured or uninsured.
- Eligibility requirements for each program may vary.
Learn more about the Johnson & Johnson Patient Assistance Foundation here or call 800-652-6227 (toll free) Monday – Friday from 8AM to 8PM ET.
What is Stelara used for?
Stelara (ustekinumab) is used to treat:
- adults and children 6 years of age and older with moderate or severe psoriasis who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet [UV] light alone or with pills).
- adults and children 6 years and older with active psoriatic arthritis.
- adults 18 years and older with moderately to severely active Crohn’s disease.
- adults 18 years and older with moderately to severely active ulcerative colitis.
This is not all the information you need to know about Stelara (ustekinumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.
References
- Stelara Medication Guide. Revised 3/2024. Horsham, PA. Janssen Pharmaceuticals. Accessed Sept 23, 2024 at https://www.janssenlabels.com/package-insert/product-patient-information/STELARA-medication-guide.pdf
- Paying for Stelara. Janssen Carepath. Accessed Sept 23, 2024 at https://www.janssencarepath.com/patient/stelara/cost-support
- Stelara Prescribing Information. Revised 3/2024. Horsham, PA. Janssen Pharmaceuticals. https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/STELARA-pi.pdf
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