HADLIMA 40 mg/.8mL Solution
Also known as Adalimumab-Bwwd. Coverage in New Mexico (CMS PDP Region 26).
4 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 5.
4 of 4 plans apply a prior authorization, step therapy or quantity limit.
32 Medicare Advantage plans in NM 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. NM: 32 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% | — | $729.6687 | $3,648.345 units |
|
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $638.3700 | $2,553.484 units |
|
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $613.5600 | $3,067.805 units |
|
| Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $613.5600 | $3,067.805 units |
|
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.