MedicarePartD.guide

A non-government resource built from CMS public data

ADALIMUMAB 40 mg/.4mL Injection, Solution

Also known as Adalimumab-Adaz. Coverage in Louisiana (CMS PDP Region 21).

3 of 10 stand-alone Part D plans in Louisiana cover this drug on tier 5.

3 of 3 plans apply a prior authorization, step therapy or quantity limit.

33 Medicare Advantage plans in LA do cover it

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. LA: 33 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$1579.7897$4,739.373 units
  • Prior authorization
  • Quantity limit 2.4 per 28 days
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible5Specialty Tier26%—$1579.7897$4,739.373 units
  • Prior authorization
  • Quantity limit 2.4 per 28 days
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible5Specialty Tier33%—$1579.7897$4,739.373 units
  • Prior authorization
  • Quantity limit 2.4 per 28 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.

See coverage in all 39 regions →