adalimumab-atto

Generic: Amjevita

10 mg/0.2 mL, 20 mg/0.2 mL, 20 mg/0.4 mL, 40 mg/0.4 mL, 40 mg/0.8 mL, 80 mg/0.8 mL — Prefilled Syringe

TARGETED IMMUNOMODULATORY BIOLOGICS

Also known as: AMJEVITA(CF) AUTOINJECTOR AMJEVITA(CF)
GoodRx Compare Prices

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 2 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 2 hours, 24 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Gold Standard (No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Bronze Standard+ Dental + Vision (No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Bronze Standard (No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Standard (No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via Amjevita 		Tier 5 - Specialty ✓ — ✓ PA | QL
Something not right?