MedicarePartD.guide

A non-government resource built from CMS public data

HADLIMA 40 mg/.4mL Solution

Also known as Adalimumab-Bwwd. Coverage in Mississippi (CMS PDP Region 20).

3 of 10 stand-alone Part D plans in Mississippi cover this drug on tier 5.

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

43 Medicare Advantage plans in MS 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. MS: 43 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible5Specialty Tier25%—$1155.3700$3,466.113 units
  • Prior authorization
  • Quantity limit 2.4 per 28 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible5Specialty Tier25%—$1155.3700$3,466.113 units
  • Prior authorization
  • Quantity limit 2.4 per 28 days
SilverScript Choice (PDP)$98.30/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 →