0.4 ML adalimumab-ryvk 100 MG/ML Prefilled Syringe [Simlandi]

Verify with CMS →

adalimumab-ryvk

RxCUI: 2688827

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.
20.8%
Plan Coverage
1,052
Plans Covering
T4.1
Avg Tier
97.9%
Prior Auth Required

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

Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-ryvk 100 MG/ML Prefilled Syringe [Simlandi] (RxNorm concept RXCUI 2688827, generic name adalimumab-ryvk) appears on 145 distinct formulary files spanning 1,052 Medicare Part D plan offerings - 20.8% 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 4.1.

Real-world access to 0.4 ML adalimumab-ryvk 100 MG/ML Prefilled Syringe [Simlandi] depends on utilization management as much as tier placement: 97.9% of covering formularies require prior authorization. 0% require step therapy. 93.8% 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-ryvk 100 MG/ML Prefilled Syringe [Simlandi] today.

Coverage Details

Formularies covering
145
Plans covering
1,052
Coverage rate
20.8%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
97.9% of formularies
Step therapy required
0% of formularies
Quantity limits
93.8% of formularies

Tier Distribution Across Plans

69 plans
Tier 1, Preferred Generic
2 plans
Tier 2, Generic
12 plans
Tier 3, Preferred Brand
17 plans
Tier 4, Non-Preferred

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

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
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
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
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
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 Yes $0 CA
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 Yes $4.80 FL
Senior Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 Yes $4.80 FL
ProCare Advantage (HMO-POS I-SNP) PROCARE ADVANTAGE, LLC T1 Yes $4.80 TX
ProCare Advantage - Kidney Care (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 Yes $4.80 TX
American Health Advantage of Florida (HMO I-SNP) AMERICAN HEALTH PLAN OF FL, INC. T1 Yes $4.80 FL
SECUR Advantage (HMO I-SNP) SECUR INC T1 Yes $4.80 FL
SECUR Enhanced (HMO I-SNP) SECUR INC T1 Yes $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 Yes $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 Yes $5.00 OK
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF MICHIGAN, INC. T1 Yes $8.80 MI
Senior Care (HMO I-SNP) ALIGN SENIOR CARE MI, LLC T1 Yes $8.80 MI
AgeRight Advantage Health Plan (HMO I-SNP) MARQUIS ADVANTAGE, INC. T1 Yes $10.50 OR, WA
Senior Care (HMO I-SNP) ALIGN SENIOR CARE CALIFORNIA INC. T1 Yes $12.00 CA
Liberty Medicare Dual Plan (HMO D-SNP) LIBERTY ADVANTAGE, LLC T1 Yes $14.70 NC
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF ILLINOIS, INC. T1 Yes $15.20 IL
WellSense Added Value (HMO) BOSTON MEDICAL CENTER HEALTH PLAN, INC. T1 Yes $21.70 NH
KeyCare Advantage (HMO I-SNP) ISNP VENTURES, LLC T1 Yes $23.20 MD
American Health Advantage of Mississippi (HMO I-SNP) AMERICAN HEALTH PLAN OF MS, INC. T1 Yes $23.80 MS
Senior Care (HMO I-SNP) LIFEWORKS ADVANTAGE, LLC T1 Yes $24.60 VA
PruittHealth Premier (HMO I-SNP) PRUITTHEALTH PREMIER, INC. T1 Yes $25.40 GA
Georgia Health Advantage (HMO I-SNP) GEORGIA ASSURANCE, INC. T1 Yes $25.40 GA
Georgia Health Advantage Choice (HMO I-SNP) GEORGIA ASSURANCE, INC. T1 Yes $25.40 GA
American Health Advantage of Tennessee (HMO I-SNP) AMERICAN HEALTH PLAN, INC. T1 Yes $27.70 TN
Simpra Advantage Nursing Home Plan (PPO I-SNP) SIMPRA ADVANTAGE, INC. T1 Yes $27.70 AL
American Health Advantage of Oklahoma (HMO I-SNP) OKLAHOMA SUPERIOR SELECT, INC. T1 Yes $28.20 OK
NHC Advantage (HMO I-SNP) NHC ADVANTAGE, LLC T1 Yes $31.00 MO, NC, SC, TN
Perennial Advantage Strive (HMO I-SNP) PERENNIAL ADVANTAGE OF OHIO, INC. T1 Yes $31.40 OH
Perennial Advantage Strive (HMO I-SNP) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 Yes $32.70 PA
American Health Advantage of Pennsylvania (HMO I-SNP) AMERICAN HEALTH PLAN OF PENNSYLVANIA INC T1 Yes $32.70 PA
Lagniappe Advantage (PPO I-SNP) LAGNIAPPE ADVANTAGE INSURANCE COMPANY T1 Yes $32.90 LA
American Health Advantage of Louisiana (HMO I-SNP) DIGNITY CARE CORPORATION T1 Yes $32.90 LA

Frequently Asked Questions

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

Yes, 0.4 ML adalimumab-ryvk 100 MG/ML Prefilled Syringe [Simlandi] is covered by 1,052 Medicare Part D plans (20.8% of all Part D formularies).

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

0.4 ML adalimumab-ryvk 100 MG/ML Prefilled Syringe [Simlandi] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.

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

97.9% of Part D formularies require prior authorization for 0.4 ML adalimumab-ryvk 100 MG/ML Prefilled Syringe [Simlandi]. Step therapy: 0%. Quantity limits: 93.8%.

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