0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe

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adalimumab-adaz

RxCUI: 2641644

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
17.5%
Plan Coverage
886
Plans Covering
T4.7
Avg Tier
69.2%
Prior Auth Required

What the CMS Formulary Data Shows for 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe

Per the CMS 2026 Part D formulary file, 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe (RxNorm concept RXCUI 2641644, generic name adalimumab-adaz) appears on 13 distinct formulary files spanning 886 Medicare Part D plan offerings - 17.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.7.

Real-world access to 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe depends on utilization management as much as tier placement: 69.2% of covering formularies require prior authorization. 0% require step therapy. 69.2% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe today.

Coverage Details

Formularies covering
13
Plans covering
886
Coverage rate
17.5%
Tier range
Tier 1 – Tier 5
Average tier
Tier 5, Specialty

Restrictions

Prior authorization required
69.2% of formularies
Step therapy required
0% of formularies
Quantity limits
69.2% of formularies

Tier Distribution Across Plans

1 plans
Tier 1, Preferred Generic
99 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe

26 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Basic Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -
Humana Value Rx Plan (PDP) Humana Insurance Co. & Humana Insurance Co. of NY T5 Yes No $0 -

Medicare Advantage Plans (MA-PD) Covering 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe

74 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
PriorityMedicare Key (HMO-POS) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare Smart Savings (HMO-POS) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare Edge (PPO) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare Vital (PPO) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare Thrive (PPO) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare D-SNP (HMO D-SNP) PRIORITY HEALTH CHOICE, INC. T5 Yes $0 MI
PriorityMedicare Dual Premier (HMO D-SNP) PRIORITY HEALTH CHOICE, INC. T5 Yes $0 MI
Humana Gold Plus H0028-014 (HMO) CHA HMO, INC. T5 Yes $0 IL, MO
Humana Gold Plus H0028-019 (HMO) CHA HMO, INC. T5 Yes $0 NM
Humana Gold Plus H0028-021 (HMO) CHA HMO, INC. T5 Yes $0 AZ
Humana Gold Plus H0028-024 (HMO) CHA HMO, INC. T5 Yes $0 AZ
Humana Gold Plus H0028-028 (HMO) CHA HMO, INC. T5 Yes $0 AZ
Humana Gold Plus H0028-029 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-030 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus SNP-DE H0028-032 (HMO D-SNP) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-035 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus SNP-DE H0028-036 (HMO D-SNP) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-037 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-041 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-042 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-043 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-046 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-053 (HMO) CHA HMO, INC. T5 Yes $0 IA, NE
Humana Gold Plus H0028-054 (HMO-POS) CHA HMO, INC. T5 Yes $0 KS, MO
Humana Gold Plus H0028-059 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-062 (HMO) CHA HMO, INC. T5 Yes $0 AZ
Humana Essentials Plus Giveback H0028-063 (HMO) CHA HMO, INC. T5 Yes $0 CO
Humana Gold Plus Giveback H0028-065 (HMO) CHA HMO, INC. T5 Yes $0 IL, MO
Humana Gold Plus Giveback H0028-066 (HMO-POS) CHA HMO, INC. T5 Yes $0 KS, MO
Humana Gold Plus H0028-072 (HMO) CHA HMO, INC. T5 Yes $0 TX
Humana Gold Plus H0028-074 (HMO) CHA HMO, INC. T5 Yes $0 AZ
Humana Dual Select H0028-078 (HMO D-SNP) CHA HMO, INC. T5 Yes $0 CO
Humana Dual Select H0028-079 (HMO D-SNP) CHA HMO, INC. T5 Yes $0 CO
Humana Gold Plus SNP-DE H0028-080 (HMO D-SNP) CHA HMO, INC. T5 Yes $0 NE
Humana Total Complete H0028-081 (HMO) CHA HMO, INC. T5 Yes $0 CO
Humana Gold Plus H0028-082 (HMO) CHA HMO, INC. T5 Yes $0 HI
Humana Community (HMO) HUMANA HEALTH PLAN OF OHIO, INC. T5 Yes $0 KY
Humana Gold Plus H0292-002 (HMO) HUMANA HEALTH PLAN OF OHIO, INC. T5 Yes $0 KY
Humana Gold Plus H0292-003 (HMO) HUMANA HEALTH PLAN OF OHIO, INC. T5 Yes $0 KY
HumanaChoice H0473-004 (PPO) HUMANA INSURANCE COMPANY OF KENTUCKY T5 Yes $0 TX
HumanaChoice H0473-005 (PPO) HUMANA INSURANCE COMPANY OF KENTUCKY T5 Yes $0 TX
Humana Gold Plus H0783-004 (HMO) HUMANA BENEFIT PLAN OF TEXAS, INC. T5 Yes $0 TX
Humana Gold Plus H1036-137 (HMO-POS) HUMANA MEDICAL PLAN, INC. T5 Yes $0 NC
Humana Gold Plus H1036-151 (HMO) HUMANA MEDICAL PLAN, INC. T5 Yes $0 MS
Humana Gold Plus H1036-153 (HMO) HUMANA MEDICAL PLAN, INC. T5 Yes $0 OR
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) HUMANA MEDICAL PLAN, INC. T5 Yes $0 NC
Humana Gold Plus SNP-DE H1036-222 (HMO D-SNP) HUMANA MEDICAL PLAN, INC. T5 Yes $0 MS
Humana Gold Plus H1036-229 (HMO) HUMANA MEDICAL PLAN, INC. T5 Yes $0 FL
Humana Gold Plus H1036-233 (HMO-POS) HUMANA MEDICAL PLAN, INC. T5 Yes $0 NC

Frequently Asked Questions

Is 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe covered by Medicare Part D?

Yes, 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe is covered by 886 Medicare Part D plans (17.5% of all Part D formularies).

What tier is 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe on Medicare Part D plans?

0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe averages Tier 4.7 across Part D plans, ranging from Tier 1 to Tier 5.

Does 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe require prior authorization?

69.2% of Part D formularies require prior authorization for 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe. Step therapy: 0%. Quantity limits: 69.2%.

Read our methodology - how this data is sourced, computed, and verified.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial