Does Standard Gold VALUE cover adalimumab?
Standard Gold VALUE
86382-86382FL0050019-0 · ACA · ACA Marketplace
adalimumab
adalimumabunder Standard Gold VALUE
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$250per 30-day fill
From the first fill — no deductible on this drug.
This is the standard amount. If you qualified for a cost-sharing reduction when you enrolled, set your level above and this will follow it.
Amount limit applies — you can still fill it, but your plan caps how much you get at a time. This plan's drug list records the cap without stating the amount — your pharmacy can tell you when they fill it.
- Tier
- Specialty drugs
- Approval first
- Required
- Try another first
- No
- Amount limit
- Yes
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.
Covered forms and strengths (41)
- {2 (0.4 ML adalimumab 100 MG/ML Auto-Injector [Humira]) / 1 (0.8 ML adalimumab 100 MG/ML Auto-Injector [Humira]) } Pack [Humira Pen 80 MG/0.8 ML and 40 MG/0.4 ML - Psoriasis/Uveitis Starter Package]Approval firstAmount limit
- {3 (0.8 ML adalimumab 100 MG/ML Auto-Injector [Humira]) } Pack [Humira Pen 80 MG/0.8 ML - Starter Package for Crohn's Disease, Ulcerative Colitis or Hidradenitis Suppurativa]Approval firstAmount limit
- {3 (0.8 ML adalimumab-aaty 100 MG/ML Auto-Injector [Yuflyma]) } Pack [Yuflyma Auto-Injector 80 MG/0.8 ML Starter Package for Crohn's Disease, Ulcerative Colitis or Hidradenitis Suppurativa]Approval firstAmount limit
- {3 (0.8 ML adalimumab-aaty 100 MG/ML Auto-Injector) } PackApproval firstAmount limit
- {4 (0.4 ML adalimumab-adbm 100 MG/ML Auto-Injector) } PackApproval firstAmount limit
- {4 (0.8 ML adalimumab 100 MG/ML Auto-Injector [Humira]) } Pack [Humira Pen 80 MG/0.8 ML - Starter Package for Pediatric Ulcerative Colitis]Approval firstAmount limit
- {4 (0.8 ML adalimumab 50 MG/ML Auto-Injector [Humira]) } Pack [Humira Pen - Psoriasis Starter Pack]Approval firstAmount limit
- {4 (0.8 ML adalimumab-adbm 50 MG/ML Auto-Injector) } PackApproval firstAmount limit
- {6 (0.4 ML adalimumab-adbm 100 MG/ML Auto-Injector) } PackApproval firstAmount limit
- {6 (0.8 ML adalimumab-adbm 50 MG/ML Auto-Injector) } PackApproval firstAmount limit
- 0.1 ML adalimumab 100 MG/ML Prefilled Syringe [Humira]Approval firstAmount limit
- 0.1 ML adalimumab-adaz 100 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.2 ML adalimumab 100 MG/ML Prefilled Syringe [Humira]Approval firstAmount limit
- 0.2 ML adalimumab-aaty 100 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.2 ML adalimumab-aaty 100 MG/ML Prefilled Syringe [Yuflyma]Approval firstAmount limit
- 0.2 ML adalimumab-adaz 100 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.2 ML adalimumab-adbm 50 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.2 ML adalimumab-ryvk 100 MG/ML Prefilled Syringe [Simlandi]Approval firstAmount limit
- 0.4 ML adalimumab 100 MG/ML Auto-Injector [Humira]Approval firstAmount limit
- 0.4 ML adalimumab 100 MG/ML Prefilled Syringe [Humira]Approval firstAmount limit
- 0.4 ML adalimumab-aaty 100 MG/ML Auto-InjectorApproval firstAmount limit
- 0.4 ML adalimumab-aaty 100 MG/ML Auto-Injector [Yuflyma]Approval firstAmount limit
- 0.4 ML adalimumab-aaty 100 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.4 ML adalimumab-aaty 100 MG/ML Prefilled Syringe [Yuflyma]Approval firstAmount limit
- 0.4 ML adalimumab-adaz 100 MG/ML Auto-InjectorApproval firstAmount limit
- 0.4 ML adalimumab-adaz 100 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.4 ML adalimumab-adbm 100 MG/ML Auto-InjectorApproval firstAmount limit
- 0.4 ML adalimumab-adbm 100 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.4 ML adalimumab-adbm 50 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.4 ML adalimumab-ryvk 100 MG/ML Auto-Injector [Simlandi]Approval firstAmount limit
- 0.4 ML adalimumab-ryvk 100 MG/ML Prefilled Syringe [Simlandi]Approval firstAmount limit
- 0.8 ML adalimumab 100 MG/ML Auto-Injector [Humira]Approval firstAmount limit
- 0.8 ML adalimumab 50 MG/ML Auto-Injector [Humira]Approval firstAmount limit
- 0.8 ML adalimumab 50 MG/ML Prefilled Syringe [Humira]Approval firstAmount limit
- 0.8 ML adalimumab-aaty 100 MG/ML Auto-InjectorApproval firstAmount limit
- 0.8 ML adalimumab-aaty 100 MG/ML Auto-Injector [Yuflyma]Approval firstAmount limit
- 0.8 ML adalimumab-adaz 100 MG/ML Auto-InjectorApproval firstAmount limit
- 0.8 ML adalimumab-adbm 50 MG/ML Auto-InjectorApproval firstAmount limit
- 0.8 ML adalimumab-adbm 50 MG/ML Prefilled SyringeApproval firstAmount limit
- 0.8 ML adalimumab-ryvk 100 MG/ML Auto-Injector [Simlandi]Approval firstAmount limit