0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe
adalimumab-aacf
RxCUI: 2640851
What the CMS Formulary Data Shows for 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe
Per the CMS 2026 Part D formulary file, 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe (RxNorm concept RXCUI 2640851, generic name adalimumab-aacf) appears on 2 distinct formulary files spanning 15 Medicare Part D plan offerings - 0.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 3 to Tier 3, with a cross-plan average of Tier 3.
Real-world access to 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 0% 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 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 15
- Coverage rate
- 0.3%
- Tier range
- Tier 3, Preferred Brand
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe
15 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Personal Choice 65 Achieve Rx (PPO) | QCC INSURANCE COMPANY | T3 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T3 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T3 | Yes | $0 | PA |
| Keystone 65 Basic Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T3 | Yes | $0 | PA |
| AmeriHealth Medicare Core (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T3 | Yes | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T3 | Yes | $0 | NJ |
| Keystone 65 Essential Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T3 | Yes | $31.00 | PA |
| AmeriHealth Medicare Enhanced (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T3 | Yes | $36.00 | NJ |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T3 | Yes | $47.00 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T3 | Yes | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T3 | Yes | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T3 | Yes | $79.70 | PA |
| Personal Choice 65 Plus Rx (PPO) | QCC INSURANCE COMPANY | T3 | Yes | $81.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T3 | Yes | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T3 | Yes | $112.70 | PA |
Frequently Asked Questions
Is 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe covered by Medicare Part D?
Yes, 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe is covered by 15 Medicare Part D plans (0.3% of all Part D formularies).
What tier is 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe on Medicare Part D plans?
0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe averages Tier 3 across Part D plans, ranging from Tier 3 to Tier 3.
Does 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe require prior authorization?
100% of Part D formularies require prior authorization for 0.8 ML adalimumab-aacf 50 MG/ML Prefilled Syringe. Step therapy: 0%. Quantity limits: 0%.
Read our methodology - how this data is sourced, computed, and verified.