HADLIMA 40 mg/.8mL Solution

Also known as Adalimumab-Bwwd. Coverage in North Carolina (CMS PDP Region 08).

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

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

84 Medicare Advantage plans in NC 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. NC: 84 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$576.8800	$2,884.405 units	Prior authorization Quantity limit 4.8 per 28 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$613.5600	$3,067.805 units	Prior authorization Quantity limit 4.8 per 28 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$638.3752	$2,553.504 units	Prior authorization Quantity limit 44.8 per 365 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$576.8800	$2,884.405 units	Prior authorization Quantity limit 4.8 per 28 days
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible	5Specialty Tier	33%	—	$613.5600	$3,067.805 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 →