Cimzia-Starter Subcutaneous

Prefilled Syringe

Tumor Necrosis Factor Blocker

Also known as: Cimzia-Starter Subcutaneous Prefilled Syringe Kit

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Checked: 10 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Premier + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Bronze Signature + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Signature + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Gold Premier + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Gold Signature + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Bronze Essential + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals Tier 5 - Specialty PA
AmeriHealth Caritas Next Silver Essential + No Referrals Tier 5 - Specialty PA
Source: CMS QHP JSON  ·  Formulary date: Jun 10, 2026  ·  Checked: 10 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic 3 per 180 days PA | QL
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic 3 per 28 days PA | QL
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic 3 per 28 days PA | QL
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic 3 per 28 days PA | QL
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic 3 per 28 days PA | QL
Liberty Medicare Advantage (HMO C-SNP) Tier 5 - Specialty 3 per 28 days PA | QL
Troy Medicare (HMO) Tier 5 - Specialty 3 per 28 days PA | QL
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Tier 5 - Specialty 3 per 28 days PA | QL
AmeriHealth Caritas VIP Care (HMO D-SNP) Tier 5 - Specialty 3 per 28 days PA | QL
Senior Care (HMO I-SNP) Tier 5 - Specialty 3 per 28 days PA | QL
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