certolizumab pegol
Generic: Cimzia
200 mg/mL, 400 mg (200 mg X 2), 400 mg/2 mL (200 mg/mL X 2) — Prefilled Syringe
TARGETED IMMUNOMODULATORY BIOLOGICS
Also known as:
CIMZIA (2 PACK)
CIMZIA
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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.
Blue Cross Blue Shield Federal
4 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBS Federal Basic Option 2026
via Cimzia |
Tier 5 - Non-Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Basic Option 2026
via Cimzia Starter |
Tier 5 - Non-Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Cimzia |
Tier 5 - Non-Preferred Specialty | ✓ | — | — | PA |
|
BCBS Federal Standard Option 2026
via Cimzia Starter |
Tier 5 - Non-Preferred Specialty | ✓ | — | — | PA |
Blue Cross Blue Shield of NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Care 2026
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Advantage 2026
via Cimzia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Cimzia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Cimzia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Care 2026
via Cimzia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Value 2026
via Cimzia Starter |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Advantage 2026
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
|
BCBSNC Blue Local 2026
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ Restricted Access | PA | QL |
Medicare Part D
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
PruittHealth Premier (HMO I-SNP)
via Cimzia |
Tier 1 - Preferred Generic | ✓ | — | ✓ 3 per 28 days | PA | QL |
|
Liberty Medicare Dual Plan (HMO D-SNP)
via Cimzia |
Tier 1 - Preferred Generic | ✓ | — | ✓ 3 per 28 days | PA | QL |
|
Longevity Health Plan (HMO I-SNP)
via Cimzia |
Tier 1 - Preferred Generic | ✓ | — | ✓ 3 per 180 days | PA | QL |
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via Cimzia |
Tier 1 - Preferred Generic | ✓ | — | ✓ 3 per 28 days | PA | QL |
|
NHC Advantage (HMO I-SNP)
via Cimzia |
Tier 1 - Preferred Generic | ✓ | — | ✓ 3 per 28 days | PA | QL |
|
Senior Care (HMO I-SNP)
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ 3 per 28 days | PA | QL |
|
Liberty Medicare Advantage (HMO C-SNP)
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ 3 per 28 days | PA | QL |
|
Troy Medicare (HMO)
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ 3 per 28 days | PA | QL |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ 3 per 28 days | PA | QL |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via Cimzia |
Tier 5 - Specialty | ✓ | — | ✓ 3 per 28 days | PA | QL |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via Cimzia |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Cimzia |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Cimzia |
Not Covered | — | — | — | None |