HADLIMA 40 mg/.8mL Solution

Also known as Adalimumab-Bwwd. Coverage in California (CMS PDP Region 32).

5 of 12 stand-alone Part D plans in California cover this drug on tier 5.

5 of 5 plans apply a prior authorization, step therapy or quantity limit.

214 Medicare Advantage plans in CA 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. CA: 214 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$618.3092	$3,091.555 units	Prior authorization Quantity limit 4.8 per 28 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$618.2257	$3,091.135 units	Prior authorization Quantity limit 4.8 per 28 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$674.8471	$2,699.394 units	Prior authorization Quantity limit 44.8 per 365 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$630.6090	$3,153.055 units	Prior authorization Quantity limit 4.8 per 28 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible	5Specialty Tier	33%	—	$630.6090	$3,153.055 units	Prior authorization Quantity limit 4.8 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 →