STELARA® (ustekinumab) Has Expanded
First-Line Biologic* Access for Your Patients1
STELARA® COVERAGE AT TOP NATIONAL PLANS1
Not all plans that cover STELARA® are listed. Coverage relevant to your patients may vary.
*First-line biologic: Brand-name drugs that do not require trial on another biologic product prior to utilization.
Collected on February 2019 and subject to change.
The information provided is not a guarantee of coverage or payment (partial or full). Actual benefits are determined by each plan administrator in accordance with its respective policy and procedures. This document is presented for informational purposes only and is not intended to provide reimbursement or legal advice, nor does it promise or guarantee coverage, levels of reimbursement, payment, or charge. It is not intended to increase or maximize reimbursement by any payer. Laws, regulations, and policies concerning reimbursement are complex and are updated frequently. While we have made an effort to be current as of the issue date of this document, the information may not be as current or comprehensive when you view it. Please refer to the applicable plan’s website, or contact the plan for more information about coverage or any restrictions or prerequisites that may apply. We strongly recommend you consult the payer organization for its reimbursement policies. All information is subject to change. 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.
Reference: 1. Coverage Data Provided by Managed Markets Insight and Technology, LLCTM, a trademark of MMIT, as of February 2019.
A streamlined, all-in-one, web-based solution designed to help start patients on STELARA®
iAssist† Provides...
Electronic
Prescribing
Prescribe STELARA®
electronically in 1 simple
transaction
Electronic Prior
Authorizations
Real-time ePA capability—
improves accuracy and
accelerates coverage determination
Janssen Support Within iAssist
Patient Support at
Your Fingertips
iAssist.com provides online
access to Janssen Patient
Support Programs
†AssistRx is a third-party technology solutions provider. iAssist is an AssistRx online platform to support the processes of prescribing and distributing prescription therapies, and connects patients to the services that support them throughout treatment.
Janssen CarePath Can Help Make It Simple for You to Help Your Patients
Your one source for access, affordability, and treatment support for your patients
Your one source for access, affordability, and treatment support for your patients

Access support
to help navigate payer processes
Janssen CarePath helps verify insurance coverage for your patients taking STELARA® and provides reimbursement information.

Affordability support
to help your patients start and stay on treatment you prescribe
Janssen CarePath can help you find out what affordability assistance may be available for your patients taking STELARA®.

Treatment support
to help your patients get informed and stay on STELARA®
Janssen CarePath provides additional support to your patients, including patient education, web-based resources, and personalized reminders.
Call a Janssen CarePath Care Coordinator at 877-CarePath (877-227-3728), Monday–Friday, 8:00 am to 8:00 pm ET.
Multilingual phone support available.
Sign Up or Log In to the Provider Portal at JanssenCarePathPortal.com
where you can request and review benefits investigations, enroll eligible patients in the Janssen CarePath Savings Program and view Savings Program transactions as requested by the patient.
Prescribe STELARA®
Complete the Benefits Investigation and Prescription Form online in the Provider Portal or download the digital form, fill it in online (recommended), and fax to 855-224-5072
Supports eligible, commercially insured patients until they receive coverage for their prescribed treatment
Janssen Link enables eligible patients to receive subcutaneous STELARA® at no cost until they receive coverage or until the end of the current program year if the following program requirements are met.
Janssen Link Program Requirements
- Patient has been prescribed subcutaneous STELARA® for an on-label, FDA-approved indication
- Patient has commercial insurance that has delayed (>5 business days) or denied their treatment
- Patient does not use any state or federal government-funded healthcare program to cover a portion of medication costs, such as Medicare, Medicaid, TRICARE, Department of Defense, or Veterans Administration
- Patient cannot submit the value of the free product as a claim for payment to any third-party payer
- Patient is not eligible if the prior authorization is denied due to missing information on coverage determination form, use for a non-FDA-approved indication, or invalid clinical rationale
- Patient must contact Janssen CarePath if the patient switches from commercial health insurance coverage to a government-funded healthcare program at any point during the program year
-
Prescriber must complete and submit an electronic enrollment in the Provider Portal or fax the Benefits Investigation and Prescription Form to Janssen CarePath to enroll patient in Janssen Link
- Janssen CarePath cannot accept any information without an executed Business Associate Agreement or Patient Authorization on file. The patient authorization can be found on the Benefits Investigation and Prescription Form. Or patient can create an account on MyJanssenCarePath.com and electronically sign a patient authorization there
- Prescriber agrees to not purchase the Janssen medication on behalf of Janssen Link patient participants, and not bill commercial payers for any part of the prescribed subcutaneous treatment
- Prescriber completes and submits a form of coverage determination (ie, prior authorization or prior authorization with exception) to the commercial insurance
- If coverage is denied, prescriber challenges the coverage denial with an exception, Letter of Medical Necessity, or appeal
How Janssen Link Works
- Program covers the cost of therapy only – not associated administration cost
- No portion of the value of the free product will count towards the patient’s applicable out-of-pocket cost-sharing obligations
- Program year runs March 1 – February 28
- Janssen CarePath reserves the right to cancel or modify Janssen Link at any time
Getting Started With Janssen Link
Prescribe STELARA®
Complete the Benefits Investigation and Prescription Form online in the Provider Portal or fax it to 866-769-3903
Janssen CarePath Savings Program
Eligible commercial patients pay $5 for each injection

Janssen CarePath Savings Program allows eligible patients to save on their out-of-pocket medication costs. Depending on the health insurance plan, savings may apply toward co-pay, co-insurance, or deductible.
- Eligible patients pay $5 for each injection, with a $20,000 maximum program benefit per calendar year
- Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medications. Terms expire at the end of each calendar year and may change. There is no income requirement
- For medication costs only; program does not cover cost to give patients their treatment
- The Savings Program for STELARA® provides a rebate when used with medical/primary insurance and provides instant savings when used with pharmacy/prescription insurance
See full eligibility requirements at Stelara.JanssenCarePathSavings.com.
Janssen Biotech, Inc., the maker of STELARA®, is not liable for unintended or unauthorized use of the STELARA® Mastercard® if it is lost or stolen. The Janssen CarePath Savings Program for STELARA® Prepaid Mastercard is issued by MetaBank®, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circles design is a trademark of Mastercard International Incorporated. Janssen CarePath Savings Program is not a MetaBank or Mastercard product or service, nor is the optional offer endorsed by them.