Medicare Part D coverage · 0.4 · RxCUI 2677787

0.4 ML adalimumab-ryvk 100 MG/ML Auto-Injector [Simlandi]

Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-ryvk 100 MG/ML Auto-Injector [Simlandi] is covered by 1,050 Medicare Part D plans (20.8% of enrollable products), averaging Tier 4.1, with prior authorization required on 97.9% of covering formularies.

20.8%
Plan coverage
1,050
Plans covering
T4.1
Avg tier
97.9%
Prior auth required

Verify with CMS →

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.

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

Per the CMS 2026 Part D formulary file, 0.4 ML adalimumab-ryvk 100 MG/ML Auto-Injector [Simlandi] (RxNorm concept RXCUI 2677787, generic name 0.4) appears on 144 distinct formulary files spanning 1,050 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 Auto-Injector [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 Auto-Injector [Simlandi] today.

Coverage Details

Formularies covering
144
Plans covering
1,050
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 Auto-Injector [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
Show the next 30 plans
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

Showing top 50 of 100 plans.

Frequently Asked Questions

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

Yes, 0.4 ML adalimumab-ryvk 100 MG/ML Auto-Injector [Simlandi] is covered by 1,050 Medicare Part D plans (20.8% of all Part D formularies).

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

0.4 ML adalimumab-ryvk 100 MG/ML Auto-Injector [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 Auto-Injector [Simlandi] require prior authorization?

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

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.

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