{4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack
adalimumab-aacf
RxCUI: 2640864
What the CMS Formulary Data Shows for {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack
Per the CMS 2026 Part D formulary file, {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack (RxNorm concept RXCUI 2640864, 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 5 to Tier 5, with a cross-plan average of Tier 5.
Real-world access to {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack 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 {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 15
- 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
- 0% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack
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 | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| Keystone 65 Basic Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $0 | PA |
| AmeriHealth Medicare Core (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $0 | NJ |
| Keystone 65 Essential Rx (HMO-POS) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $31.00 | PA |
| AmeriHealth Medicare Enhanced (PPO) | AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY | T5 | Yes | $36.00 | NJ |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $47.00 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | Yes | $79.70 | PA |
| Personal Choice 65 Plus Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $81.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T5 | Yes | $112.70 | PA |
Frequently Asked Questions
Is {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack covered by Medicare Part D?
Yes, {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack is covered by 15 Medicare Part D plans (0.3% of all Part D formularies).
What tier is {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack on Medicare Part D plans?
{4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack averages Tier 5 across Part D plans, ranging from Tier 5 to Tier 5.
Does {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack require prior authorization?
100% of Part D formularies require prior authorization for {4 (0.8 ML adalimumab-aacf 50 MG/ML Auto-Injector) } Pack. Step therapy: 0%. Quantity limits: 0%.
Read our methodology - how this data is sourced, computed, and verified.