HADLIMA 40 mg/.4mL Solution
Also known as Adalimumab-Bwwd. Coverage in Alabama and Tennessee (CMS PDP Region 12).
5 of 12 stand-alone Part D plans in Alabama and Tennessee cover this drug on tier 5.
5 of 5 plans apply a prior authorization, step therapy or quantity limit.
140 Medicare Advantage plans in AL, TN 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. AL: 60 plans · TN: 80 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible | 5Specialty Tier | 25% | 25% | $1277.7200 | $3,833.163 units |
|
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1236.4416 | $3,709.323 units |
|
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1236.6087 | $3,709.833 units |
|
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1276.7503 | $2,553.502 units |
|
| BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible | 5Specialty Tier | 31% | 31% | $1277.7200 | $3,833.163 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.