CommercialCoverageMedium impact
State and School Employees' Health Insurance Plan - Crohn's Disease and Ulcerative Colitis
Blue Cross & Blue Shield of Mississippi·MS · Gastroenterology·Medical Policy
Effective date
Aug 1, 2025
We identified it
Jun 20, 2026
Summary
State and School Employees' Health Insurance Plan updated their Crohn's Disease and Ulcerative Colitis policy, changing from 'Stelara IV' to just 'Stelara' in the Medical Covered Agents table. Additionally, several ustekinumab biosimilars (Selarsdi, Steqeyma, and Yesintek) will become the formulary options effective August 1, 2025, while Stelara and other branded options will no longer be covered.
Action Required
By August 1, 2025: Billing team must update systems to reflect that Stelara (ustekinumab) and other branded ustekinumab products (Avsola, Imuldosa, Otulfi, Pyzchiva, Renflexis, Wezlana) are no longer covered for State and School Employees' Health Insurance Plan members. Update billing software to use biosimilar alternatives (Selarsdi, Steqeyma, Yesintek) for ustekinumab. Notify providers treating Crohn's Disease and Ulcerative Colitis patients to transition patients to covered formulary options before the effective date.