Medicare Part D coverage · 0.4 · RxCUI 2640428
0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima]
Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima] is covered by 2,550 Medicare Part D plans (50.5% of enrollable products), averaging Tier 4.1, with prior authorization required on 98.8% of covering formularies.
- 50.5%
- Plan coverage
- 2,550
- Plans covering
- T4.1
- Avg tier
- 98.8%
- Prior auth required
What the CMS Formulary Data Shows for 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima]
Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima] (RxNorm concept RXCUI 2640428, generic name 0.4) appears on 250 distinct formulary files spanning 2,550 Medicare Part D plan offerings - 50.5% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.1.
Real-world access to 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima] depends on utilization management as much as tier placement: 98.8% of covering formularies require prior authorization. 0% require step therapy. 76% 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 [Hadlima] today.
Coverage Details
- Formularies covering
- 250
- Plans covering
- 2,550
- Coverage rate
- 50.5%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 98.8% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 76% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| 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 |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| 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 |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| 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 |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima] covered by Medicare Part D?
Yes, 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima] is covered by 2,550 Medicare Part D plans (50.5% of all Part D formularies).
What tier is 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima] on Medicare Part D plans?
0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima] require prior authorization?
98.8% of Part D formularies require prior authorization for 0.4 ML adalimumab-bwwd 100 MG/ML Prefilled Syringe [Hadlima]. Step therapy: 0%. Quantity limits: 76%.
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
- {14 (cenobamate 100 MG Oral Tablet [Xcopri]) / 14 (cenobamate 50 MG Oral Tablet [Xcopri]) } Pack [Xcopri Titration Pack - 50 MG (14), 100 MG (14) 28 Count] T4.1
- {28 (cenobamate 150 MG Oral Tablet [Xcopri]) / 28 (cenobamate 200 MG Oral Tablet) } Pack [Xcopri 350 MG Maintenance Pack] T4.1
- atazanavir 50 MG Oral Powder [Reyataz] T4.1
- cenobamate 50 MG Oral Tablet [Xcopri] T4.1
- clobazam 10 MG Oral Film [Sympazan] T4.1
- pimavanserin 10 MG Oral Tablet [Nuplazid] T4.1
Similar prior-authorization rate
- amphotericin B 50 MG Injection 98.8% PA
- alanine 27.6 MG/ML / arginine 19.6 MG/ML / aspartate 6 MG/ML / glutamate 10.2 MG/ML / glycine 20.6 MG/ML / histidine 11.8 MG/ML / isoleucine 10.8 MG/ML / leucine 10.8 MG/ML / lysine 13.5 MG/ML / methionine 7.6 MG/ML / phenylalanine 10 MG/ML / proline 13.4 MG/ML / serine 10.2 MG/ML / threonine 9.8 MG/ML / tryptophan 3.2 MG/ML / tyrosine 0.5 MG/ML / valine 14.4 MG/ML Injectable Solution [Prosol] 98.8% PA
- 28 ACTUAT teriparatide 0.02 MG/ACTUAT Pen Injector [Bonsity] 98.8% PA
- 0.5 ML ustekinumab 90 MG/ML Prefilled Syringe [Stelara] 98.8% PA
- 1 ML ustekinumab 90 MG/ML Prefilled Syringe [Stelara] 98.8% PA
- sapropterin dihydrochloride 500 MG Powder for Oral Solution [Javygtor] 98.8% PA