MedicarePartD.guide

A non-government resource built from CMS public data

HADLIMA 40 mg/.8mL Solution

Also known as Adalimumab-Bwwd. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).

4 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 5.

4 of 4 plans apply a prior authorization, step therapy or quantity limit.

51 Medicare Advantage plans in CT, MA, RI 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. CT: 17 plans · MA: 24 plans · RI: 10 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible5Specialty Tier25%—$661.0638$3,305.325 units
  • Prior authorization
  • Quantity limit 4.8 per 28 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible5Specialty Tier25%—$674.8471$2,699.394 units
  • Prior authorization
  • Quantity limit 44.8 per 365 days
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible5Specialty Tier25%—$618.3092$3,091.555 units
  • Prior authorization
  • Quantity limit 4.8 per 28 days
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible5Specialty Tier33%—$661.0638$3,305.325 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 →