0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita]

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adalimumab-atto

RxCUI: 2663907

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.
2.8%
Plan Coverage
142
Plans Covering
T4.3
Avg Tier
66.7%
Prior Auth Required

What the CMS Formulary Data Shows for 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita]

Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita] (RxNorm concept RXCUI 2663907, generic name adalimumab-atto) appears on 6 distinct formulary files spanning 142 Medicare Part D plan offerings - 2.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 3 to Tier 5, with a cross-plan average of Tier 4.3.

Real-world access to 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita] depends on utilization management as much as tier placement: 66.7% of covering formularies require prior authorization. 0% require step therapy. 50% 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-atto 100 MG/ML Prefilled Syringe [Amjevita] today.

Coverage Details

Formularies covering
6
Plans covering
142
Coverage rate
2.8%
Tier range
Tier 3 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
66.7% of formularies
Step therapy required
0% of formularies
Quantity limits
50% of formularies

Tier Distribution Across Plans

100 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita]

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

Plan Insurer Tier PA Premium States
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Ventura Value (HMO) KAISER FOUNDATION HP, INC. T3 No $0 CA
Kaiser Permanente Senior Advantage Core DM (HMO) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Dual Essential (HMO D-SNP) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Silver DM (HMO-POS) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Core South (HMO) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Core North (HMO) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Enhanced (HMO-POS) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Dual Complete Pueblo (HMO D-SNP) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF CO T3 No $0 CO
Kaiser Permanente Dual Essential Plan 1 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Senior Advantage Basic 1 (HMO) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Dual Essential Plan 2 (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Senior Advantage Basic 2 (HMO) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Senior Advantage Care Plus (HMO-POS) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Dual Complete (HMO D-SNP) KAISER FOUNDATION HP OF GA, INC. T3 No $0 GA
Kaiser Permanente Senior Advantage Basic (HMO) KAISER FOUNDATION HP, INC. T3 No $0 HI
Kaiser Permanente Medicare Advantage Value 1 VA (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 VA
Kaiser Permanente Dual Complete Plan 1 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD
Kaiser Permanente Dual Complete Plan 2 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD
Kaiser Permanente Dual Essential Plan 1 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD
Kaiser Permanente Dual Essential Plan 2 MD (HMO D-SNP) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD
Kaiser Permanente Medicare Advantage Standard DC (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 DC
Kaiser Permanente Medicare Advantage Standard 2 MD (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD
Kaiser Permanente Medicare Advantage Value 2 VA (HMO-POS) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 VA
Kaiser Permanente Medicare Advantage Value 1 MD (HMO) KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES T3 No $0 MD

Frequently Asked Questions

Is 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita] covered by Medicare Part D?

Yes, 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita] is covered by 142 Medicare Part D plans (2.8% of all Part D formularies).

What tier is 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita] on Medicare Part D plans?

0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita] averages Tier 4.3 across Part D plans, ranging from Tier 3 to Tier 5.

Does 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita] require prior authorization?

66.7% of Part D formularies require prior authorization for 0.4 ML adalimumab-atto 100 MG/ML Prefilled Syringe [Amjevita]. Step therapy: 0%. Quantity limits: 50%.

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