FillMapModa Health Affinity Silver 4500

Does Moda Health Affinity Silver 4500 cover ustekinumab?

Moda Health Affinity Silver 4500
39424-39424OR1680004-0 · ACA · ACA Marketplace
ustekinumab
ustekinumabunder Moda Health Affinity Silver 4500
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
40%of the price your plan negotiates

Medicare hasn’t published this plan’s negotiated price for this drug yet — that file is updated every three months, and newly launched drugs appear in it late. Your pharmacy can quote the exact amount today. From the first fill — no deductible on this drug.

This is the standard amount. If you qualified for a cost-sharing reduction when you enrolled, set your level above and this will follow it.

Amount limit applies — you can still fill it, but your plan caps how much you get at a time. This plan's drug list records the cap without stating the amount — your pharmacy can tell you when they fill it.
Tier
Specialty drugs
Approval first
Required
Try another first
No
Amount limit
Yes
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.

Covered forms and strengths (38)

  • 0.5 ML ustekinumab 90 MG/ML InjectionApproval firstAmount limit
  • 0.5 ML ustekinumab 90 MG/ML Injection [Stelara]Approval firstAmount limit
  • 0.5 ML ustekinumab 90 MG/ML Prefilled SyringeApproval firstAmount limit
  • 0.5 ML ustekinumab 90 MG/ML Prefilled Syringe [Stelara]Approval firstAmount limit
  • 0.5 ML ustekinumab-aauz 90 MG/ML Injection [Otulfi]Approval firstAmount limit
  • 0.5 ML ustekinumab-aauz 90 MG/ML Prefilled SyringeApproval firstAmount limit
  • 0.5 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi]Approval firstAmount limit
  • 0.5 ML ustekinumab-aekn 90 MG/ML Injection [Selarsdi]Approval firstAmount limit
  • 0.5 ML ustekinumab-aekn 90 MG/ML Prefilled SyringeApproval firstAmount limit
  • 0.5 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe [Selarsdi]Approval firstAmount limit
  • 0.5 ML ustekinumab-auub 90 MG/ML Injection [Wezlana]Approval firstAmount limit
  • 0.5 ML ustekinumab-auub 90 MG/ML Prefilled Syringe [Wezlana]Approval firstAmount limit
  • 0.5 ML ustekinumab-hmny 90 MG/ML Injection [Starjemza]Approval firstAmount limit
  • 0.5 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza]Approval firstAmount limit
  • 0.5 ML ustekinumab-kfce 90 MG/ML Injection [Yesintek]Approval firstAmount limit
  • 0.5 ML ustekinumab-kfce 90 MG/ML Prefilled Syringe [Yesintek]Approval firstAmount limit
  • 0.5 ML ustekinumab-srlf 90 MG/ML Prefilled Syringe [Imuldosa]Approval firstAmount limit
  • 0.5 ML ustekinumab-stba 90 MG/ML Injection [Steqeyma]Approval firstAmount limit
  • 0.5 ML ustekinumab-stba 90 MG/ML Prefilled Syringe [Steqeyma]Approval firstAmount limit
  • 0.5 ML ustekinumab-ttwe 90 MG/ML Auto-Injector [Pyzchiva]Approval firstAmount limit
  • 0.5 ML ustekinumab-ttwe 90 MG/ML InjectionApproval firstAmount limit
  • 0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva]Approval firstAmount limit
  • 0.5 ML ustekinumab-ttwe 90 MG/ML Prefilled SyringeApproval firstAmount limit
  • 0.5 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe [Pyzchiva]Approval firstAmount limit
  • 1 ML ustekinumab 90 MG/ML Prefilled SyringeApproval firstAmount limit
  • 1 ML ustekinumab 90 MG/ML Prefilled Syringe [Stelara]Approval firstAmount limit
  • 1 ML ustekinumab-aauz 90 MG/ML Prefilled SyringeApproval firstAmount limit
  • 1 ML ustekinumab-aauz 90 MG/ML Prefilled Syringe [Otulfi]Approval firstAmount limit
  • 1 ML ustekinumab-aekn 90 MG/ML Prefilled SyringeApproval firstAmount limit
  • 1 ML ustekinumab-aekn 90 MG/ML Prefilled Syringe [Selarsdi]Approval firstAmount limit
  • 1 ML ustekinumab-auub 90 MG/ML Prefilled Syringe [Wezlana]Approval firstAmount limit
  • 1 ML ustekinumab-hmny 90 MG/ML Prefilled Syringe [Starjemza]Approval firstAmount limit
  • 1 ML ustekinumab-kfce 90 MG/ML Prefilled Syringe [Yesintek]Approval firstAmount limit
  • 1 ML ustekinumab-srlf 90 MG/ML Prefilled Syringe [Imuldosa]Approval firstAmount limit
  • 1 ML ustekinumab-stba 90 MG/ML Prefilled Syringe [Steqeyma]Approval firstAmount limit
  • 1 ML ustekinumab-ttwe 90 MG/ML Auto-Injector [Pyzchiva]Approval firstAmount limit
  • 1 ML ustekinumab-ttwe 90 MG/ML Prefilled SyringeApproval firstAmount limit
  • 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe [Pyzchiva]Approval firstAmount limit

← All coverage for ustekinumab