MedicarePartD.guide

A non-government resource built from CMS public data

HADLIMA 40 mg/.4mL Solution

Also known as Adalimumab-Bwwd. Coverage in Michigan (CMS PDP Region 13).

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

3 of 3 plans apply a prior authorization, step therapy or quantity limit.

93 Medicare Advantage plans in MI 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. MI: 93 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$1138.6983$3,416.093 units
  • Prior authorization
  • Quantity limit 2.4 per 28 days
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible5Specialty Tier25%—$1142.3082$3,426.923 units
  • Prior authorization
  • Quantity limit 2.4 per 28 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible5Specialty Tier25%—$1276.7503$2,553.502 units
  • Prior authorization
  • Quantity limit 22.4 per 365 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 →