HADLIMA 40 mg/.4mL Solution

Also known as Adalimumab-Bwwd. Coverage in New York (CMS PDP Region 03).

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

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

139 Medicare Advantage plans in NY 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. NY: 139 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1148.8777	$3,446.633 units	Prior authorization Quantity limit 2.4 per 28 days
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1149.1457	$3,447.443 units	Prior authorization Quantity limit 2.4 per 28 days
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$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 →