{2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit]
adalimumab-adaz
RxCUI: 2641671
What the CMS Formulary Data Shows for {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit]
Per the CMS 2026 Part D formulary file, {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit] (RxNorm concept RXCUI 2641671, generic name adalimumab-adaz) appears on 1 distinct formulary file spanning 14 Medicare Part D plan offerings - 0.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 5 to Tier 5, with a cross-plan average of Tier 5.
Real-world access to {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% 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 {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 14
- Coverage rate
- 0.3%
- Tier range
- Tier 5, Specialty
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit]
14 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gundersen Quartz Med Advantage Basic D (w/Rx) (HMO) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $0 | IA, WI |
| UW Health Quartz Med Advantage Basic D (w/Rx) (HMO) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $0 | WI |
| Gundersen MN Quartz Med Advantage Basic D (w/Rx) (HMO) | QUARTZ HEALTH PLAN MN CORPORATION | T5 | Yes | $0 | MN |
| Gundersen MN Quartz Med Advantage Core D (w/Rx) (HMO) | QUARTZ HEALTH PLAN MN CORPORATION | T5 | Yes | $8.20 | MN |
| Gundersen Quartz Med Advantage Dual Eligible (HMO D-SNP) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $21.10 | WI |
| UW Health Quartz Med Advantage Dual Eligible (HMO D-SNP) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $21.10 | WI |
| Gundersen Quartz Med Advantage Core D (w/Rx) (HMO) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $25.70 | IA, WI |
| UW Health Quartz Med Advantage Core D (w/Rx) (HMO) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $34.00 | WI |
| Gundersen MN Quartz Med Advantage Value D (w/Rx) (HMO) | QUARTZ HEALTH PLAN MN CORPORATION | T5 | Yes | $67.40 | MN |
| Gundersen Quartz Med Advantage Value D (w/Rx) (HMO) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $71.40 | IA, WI |
| UW Health Quartz Med Advantage Value D (w/Rx) (HMO) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $76.90 | WI |
| Gundersen Quartz Med Advantage Elite D (w/Rx) (HMO) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $83.30 | IA, WI |
| UW Health Quartz Med Advantage Elite D (w/Rx) (HMO) | QUARTZ HEALTH PLAN CORPORATION | T5 | Yes | $162.00 | WI |
| Gundersen MN Quartz Med Advantage Elite D (w/Rx) (HMO) | QUARTZ HEALTH PLAN MN CORPORATION | T5 | Yes | $184.00 | MN |
Frequently Asked Questions
Is {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit] covered by Medicare Part D?
Yes, {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit] is covered by 14 Medicare Part D plans (0.3% of all Part D formularies).
What tier is {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit] on Medicare Part D plans?
{2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit] averages Tier 5 across Part D plans, ranging from Tier 5 to Tier 5.
Does {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit] require prior authorization?
100% of Part D formularies require prior authorization for {2 (0.4 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) / 1 (0.8 ML adalimumab-adaz 100 MG/ML Auto-Injector [Hyrimoz]) } Pack [Hyrimoz Plaque Psoriasis Starter Kit]. Step therapy: 0%. Quantity limits: 100%.
Read our methodology - how this data is sourced, computed, and verified.