HADLIMA 40 mg/.8mL Solution
Also known as Adalimumab-Bwwd. Coverage in Colorado (CMS PDP Region 27).
3 of 10 stand-alone Part D plans in Colorado cover this drug on tier 5.
3 of 3 plans apply a prior authorization, step therapy or quantity limit.
38 Medicare Advantage plans in CO 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. CO: 38 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)$61.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $618.3092 | $3,091.555 units |
|
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $618.2257 | $3,091.135 units |
|
| SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $674.8471 | $2,699.394 units |
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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.