Medicare Part D coverage · 0.4 · RxCUI 2640425
0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe
Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe is covered by 1,280 Medicare Part D plans (25.3% of enrollable products), averaging Tier 4.3, with prior authorization required on 100% of covering formularies.
- 25.3%
- Plan coverage
- 1,280
- Plans covering
- T4.3
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe
Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe (RxNorm concept RXCUI 2640425, generic name 0.4) appears on 59 distinct formulary files spanning 1,280 Medicare Part D plan offerings - 25.3% 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 4.3.
Real-world access to 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% 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 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe today.
Coverage Details
- Formularies covering
- 59
- Plans covering
- 1,280
- Coverage rate
- 25.3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
| VIVA Medicare Extra Care (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
Show the next 30 plans
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | Elderplan, Inc. | T1 | Yes | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | Metroplus Health Plan, Inc. | T1 | Yes | $58.80 | NY |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO) | Aetna Health Inc. (GA) | T5 | Yes | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T5 | Yes | $0 | WI |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T5 | Yes | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | Coventry Health Care OF Illinois, Inc. | T5 | Yes | $0 | IL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe covered by Medicare Part D?
Yes, 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe is covered by 1,280 Medicare Part D plans (25.3% of all Part D formularies).
What tier is 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe on Medicare Part D plans?
0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe require prior authorization?
100% of Part D formularies require prior authorization for 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe. Step therapy: 0%. Quantity limits: 100%.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- {4 (selinexor 80 MG Oral Tablet [Xpovio]) } Pack [Xpovio 80 MG Once Weekly Carton-80 MG Tablet] T4.3
- 3.5 ML paliperidone palmitate 312 MG/ML Prefilled Syringe [Invega] T4.3
- 5 ML paliperidone palmitate 312 MG/ML Prefilled Syringe [Invega] T4.3
- ceftaroline fosamil 600 MG Injection T4.3
- 0.5 ML ustekinumab 90 MG/ML Prefilled Syringe T4.3
- 1 ML ustekinumab 90 MG/ML Prefilled Syringe T4.3
Similar prior-authorization rate
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- 0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA
- mycophenolate mofetil 250 MG Oral Capsule 100% PA