STELARA

Indicated For

Plaque psoriasis, psoriatic arthritis, Crohn's disease, ulcerative colitis

About This Medication

# Janssen Patient Assistance Program Patient Guide: How to Get STELARA (ustekinumab) at Low or No Cost STELARA (ustekinumab) is a prescription biologic medication used to treat conditions like plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis by targeting specific proteins in the immune system that cause inflammation. The **Janssen Patient Assistance Program** offers eligible patients free medication for up to one year when their insurance doesn't fully cover costs and they meet income guidelines.[1][3] ## Who Qualifies for the Program? This program is designed for patients facing financial hardship due to high medication costs. Key eligibility factors include: - **Residency**: You must live in the United States. - **Insurance Status**: Available to those with **commercial, employer-sponsored, or government coverage that does not fully meet their needs**. This means your insurance may cover some but not all costs, or you've faced delays/denials.[1][5] - **Income Eligibility**: Specific income thresholds apply based on household size and federal poverty levels (FPL). While exact current thresholds aren't listed here, patients typically qualify if income is at or below 400-500% FPL, with some flexibility. **Proof of income is required if applicable**.[1][7] - **Not Eligible If**: Your insurance fully covers STELARA, you're enrolled in government programs like Medicare/Medicaid for medication costs (though some government coverage gaps may qualify), or you're in assistance diversion programs.[5][6] **Income Eligibility Breakdown** | Household Size | Annual Income Limit (Approx. 400% FPL)* | Notes | |---------------|---------------------------------------|-------| | 1 | $58,320 | Based on 2024 FPL; verify current via phone. | | 2 | $78,880 | Adjustments for higher FPL possible. | | 3 | $99,440 | Proof like tax returns required. | | 4 | $120,000 | Add ~$20,560 per additional member. | *Estimates; call (833) 742-0791 for exact, up-to-date thresholds as they adjust annually.[1][7] ## About STELARA (ustekinumab) **STELARA** is an injectable biologic that blocks interleukins 12 and 23, reducing inflammation in autoimmune conditions. It's administered via subcutaneous injection (under the skin) every 12 weeks after initial doses, available in prefilled syringes or autoinjectors. Common uses: - Moderate to severe plaque psoriasis. - Active psoriatic arthritis. - Moderately to severely active Crohn's disease or ulcerative colitis.[9] Always follow your doctor's instructions. Side effects may include infections, headaches, or injection site reactions—discuss with your healthcare provider. ## Insurance Requirements The program targets patients whose **commercial, employer-sponsored, or government insurance falls short**. For example: - Insurance approves but copays are unaffordable. - Prior authorizations are delayed (>5 business days) or denied.[1][5][6] **Not for**: Medicare, Medicaid, or other federal programs covering meds directly—consider the separate STELARA withMe Savings Program ($5/dose for commercial insurance, max yearly benefit).[4][8] Your prescriber may need to submit coverage determination forms.[5] ## Step-by-Step Application Process 1. **Talk to Your Doctor**: Confirm STELARA prescription and discuss if this program fits. They may handle parts like prior auth support.[1][5] 2. **Gather Documents**: - **Patient Authorization Form** (sign to allow Janssen to verify eligibility).[5] - **Proof of Income** (e.g., tax return, pay stubs, W-2s—if required based on guidelines).[1] - Prescription for STELARA via STELARA withMe form.[5] 3. **Apply by Phone**: Call **(833) 742-0791**. Provide details; staff guides you. No online app—phone only.[1] 4. **Submit to Prescriber/Pharmacy**: Your doctor or pharmacy may upload forms via Janssen portals.[1][5] 5. **Wait for Approval**: Processing time varies (typically weeks); reauthorization needed annually.[1] ## Timeline and Delivery - **Processing**: Not specified; expect 2-4 weeks based on similar programs—call for updates.[1] - **Delivery**: **Shipped directly to patient** at no cost if approved. Up to 1 year supply, with refills requiring reauth.[1][3] - **Reauthorization**: **Required** yearly or as benefits change. Submit updated docs.[1] ## Alternatives if Denied or Ineligible - **STELARA withMe Savings Program**: $5 per dose for commercial/private insurance (not government). Enroll via doctor or JanssenCarePath.com. Max yearly savings.[1][4][8] - **Delay & Denial Support**: If insurance delays/denies, get free meds temporarily while appealing.[1][5] - **Other Janssen Programs**: Check PatientAssistanceInfo.com.[1] - **Independent Foundations**: Patient Access Network (PAN), HealthWell Foundation for copay help. - **Biosimilars**: None specified for ustekinumab yet; ask your doctor.[1] If denied, ask why (e.g., income too high) and reapply with updates or try savings options.[5] ## Important Disclaimer This guide is for informational purposes only and not a substitute for professional medical or financial advice. Eligibility, terms, and income limits can change—**always verify by calling (833) 742-0791** or visiting PatientAssistanceInfo.com. Janssen may update programs; info based on available data as of last update. Not valid where prohibited. Consult your healthcare provider before starting/changing treatment. Janssen not liable for application errors.[1][3][5]

Program information last verified: March 25, 2026