Benefits Investigation Support
- Benefits Investigation & Prescription Form - Dermatology & RheumatologyA way to find out if STELARA® is covered by the patient's insurance plan, including requirements for coverage or prior authorization, any out-of-pocket costs, and approved pharmacies.
Benefits Investigation & Prescription Form - Dermatology & Rheumatology (en español para Puerto Rico) - Benefits Investigation & Prescription Form - Dermatology & Rheumatology (en español para Puerto Rico)A way to find out if STELARA® is covered by the patient's insurance plan, including requirements for coverage or prior authorization, any out-of-pocket costs, and approved pharmacies. En español.
- Business Associate AgreementComplete a Business Associate Agreement for your practice only once. No individual patient authorizations are required.
- Delay & Denial Support Reverification GuideUse this guide to learn how to confirm your patient's eligibility for Delay & Denial Support/Janssen Link if they have previously been eligible.
- Enrollment & Prescription Form - GastroenterologyA way to find out if STELARA® is covered by the patient's insurance plan, including requirements for coverage or prior authorization, any out-of-pocket costs, and approved pharmacies.
- Enrollment & Prescription Form - Gastroenterology (en español para Puerto Rico)A way to find out if STELARA® is covered by the patient's insurance plan, including requirements for coverage or prior authorization, any out-of-pocket costs, and approved pharmacies. En español.
- Letter of Exception (Crohn’s Disease)A template that you can fill out and submit to a patient’s health insurance provider asking them to cover a medication that is not on formulary.
- Letter of Exception (Plaque Psoriasis)A template that you can fill out and submit to a patient’s health insurance provider asking them to cover a medication that is not on formulary.
- Letter of Exception (Psoriatic Arthritis)A template that you can fill out and submit to a patient’s health insurance provider asking them to cover a medication that is not on formulary.
- Letter of Exception (Ulcerative Colitis)A template that you can fill out and submit to a patient’s health insurance provider asking them to cover a medication that is not on formulary.
- Letter of Medical NecessityA template that you can fill out and submit to a patient’s health insurance provider. You may use it to explain why STELARA® is medically necessary for your patient.
- Patient Affordability OptionsDiscover options that can make STELARA® more affordable for your patients.
- Patient Authorization FormIndividual patient form for offices without a Business Associate Agreement.
Patient Authorization Form (en español) - Patient Authorization Form (en español)Individual patient form for offices without a Business Associate Agreement.
- Prescribing Information & Medication Guide (en español)Product information for STELARA®. En español.
- Resource GuideA comprehensive summary of support tools for your office to help patients start and stay on treatment.
- Savings Program Additional Co-pay Support Form
- Savings Program Assignment of Benefits FormA form the patient can submit that allows Janssen CarePath to reimburse the provider directly.
- Savings Program EOB Clarification FormUse this form when the Explanation of Benefits (EOB) statement does not indicate that the patient received STELARA®.
- Savings Program OverviewEligible patients using commercial or private insurance can save on out-of-pocket costs for STELARA®.
- Savings Program Patient Enrollment FormFax or mail this completed form to enroll your patient in the Savings Program for STELARA®.
- Savings Program Rebate FormA form the patient can submit if the pharmacy isn’t able to process the Janssen CarePath Savings Program card.
- Specialty Distributors for IV Infusion
- Verification of Benefits Guide (Medical)A guide to understanding the Verification of Benefits for your patient’s medical benefits.
- Verification of Benefits Guide (Pharmacy)A guide to understanding the Verification of Benefits for your patient’s pharmacy benefits.

Benefits Investigation Support
Register Today for the Provider Portal for 24-hour Online Access to Support Your Patients
With a Provider Portal account, you can:
- Upload signed Patient Authorization forms
- Get Benefits Investigation (BI) and Prior Authorization (PA) support when you need it
- See the status of BIs
- Complete and submit PAs with or without doing a BI
- Create medical necessity and exception letters
- Request exceptions and appeals information
- Enroll your eligible patients in the STELARA withMe Savings Program
- Manage your patients’ Savings Program benefits
- See Patient Dashboard at a glance
- Get timely notifications
Complete Benefits Investigations and Request Prior Authorizations Right in the Provider Portal
Or You Can Download Faxable Forms Below
Benefits Investigation & Prescription Form - Dermatology & Rheumatology (en español para Puerto Rico)
Patient Authorization Form (en español)