HADLIMA 40 mg/.4mL Solution

Also known as Adalimumab-Bwwd. Coverage in Texas (CMS PDP Region 22).

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

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

172 Medicare Advantage plans in TX 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. TX: 172 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)$70.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1251.0567	$3,753.173 units	Prior authorization Quantity limit 2.4 per 28 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1276.7503	$2,553.502 units	Prior authorization Quantity limit 22.4 per 365 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1233.1018	$3,699.313 units	Prior authorization Quantity limit 2.4 per 28 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1250.6433	$3,751.933 units	Prior authorization Quantity limit 2.4 per 28 days
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1233.1018	$3,699.313 units	Prior authorization Quantity limit 2.4 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 →