adalimumab-ryvk
Generic: Simlandi
20 mg/0.2 mL, 40 mg/0.4 mL, 80 mg/0.8 mL — Prefilled Syringe
TARGETED IMMUNOMODULATORY BIOLOGICS
Also known as:
ADALIMUMAB-RYVK(CF) AUTOINJECT
SIMLANDI(CF)
ADALIMUMAB-RYVK(CF)
SIMLANDI(CF) AUTOINJECTOR
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Everyday Bronze with Atrium Health
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze with Atrium Health
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Focused Silver with Atrium Health
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold with Atrium Health
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze with Atrium Health
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver with Atrium Health
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold with Atrium Health
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Complete Gold
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze + Vision + Adult Dental
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Everyday Bronze
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Elite Bronze
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Clear Silver with $0 Insulin Options
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Expanded Bronze
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Silver
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
|
Standard Gold
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ | PA | QL |
Blue Cross Blue Shield of NC
15 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Advantage 2026
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Advantage 2026
via Simlandi 1-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Simlandi 1-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Simlandi 1-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Simlandi 1-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Simlandi 1-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Advantage 2026
via Simlandi 2-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Simlandi 2-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Simlandi 2-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Simlandi 2-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Simlandi 2-Pen |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
Medicare Part D
24 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Liberty Medicare Dual Plan (HMO D-SNP)
via Simlandi |
Tier 1 - Preferred Generic | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
Longevity Health Plan (HMO I-SNP)
via Simlandi |
Tier 1 - Preferred Generic | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
NHC Advantage (HMO I-SNP)
via Simlandi |
Tier 1 - Preferred Generic | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
PruittHealth Premier (HMO I-SNP)
via Simlandi |
Tier 1 - Preferred Generic | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Simlandi |
Tier 1 - Preferred Generic | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Simlandi |
Tier 3 - Preferred Brand | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Simlandi |
Tier 3 - Preferred Brand | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
Troy Medicare (HMO)
via Simlandi |
Tier 3 - Preferred Brand | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
Healthy Blue + Medicare (HMO-POS D-SNP)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Alignment Health Platinum (HMO)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Alignment Health NC Duals (HMO-POS D-SNP)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Alignment Health smartHMO (HMO)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Alignment Health Platinum Select (HMO)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Alignment Health AVA (PPO)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Senior Care (HMO I-SNP)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
Liberty Medicare Advantage (HMO C-SNP)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 6 per 28 days | PA | QL |
|
Blue Medicare PPO Enhanced (PPO)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Blue Medicare Essential Plus (HMO-POS)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Blue Medicare Enhanced (HMO-POS)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Blue Medicare Choice (HMO)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Blue Medicare Essential (HMO)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
|
Experience Health Medicare Advantage (HMO)
via Simlandi |
Tier 5 - Specialty | ✓ | — | ✓ 4 per 28 days | PA | QL |
NC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 70/30 Standard PPO 2026
via Simlandi 1-Pen |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Simlandi 2-Pen |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Simlandi 2-Pen |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Simlandi 1-Pen |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Simlandi 1-Pen |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Simlandi 2-Pen |
Not Covered | — | — | — | None |