Humira coverage ends for commercial members on Dec. 31, 2023
To maintain our commitment to providing our members with the most effective therapies at the lowest possible cost, Humira coverage will end for our commercial group and individual members on Dec. 31, 2023. This includes both new-start and existing prescriptions.
Humira will remain on the Medicare formulary, with prior authorization requirements, through 2024. Effective Oct. 1, 2023, coverage for the Humira biosimilars, Hadlima and Adalimumab-adaz (manufactured by Sandoz) was added to our Medicare, commercial and individual member formularies. Members will need a new prescription to transition to Hadlima or Adalimumab-adaz Medicare members with existing prescriptions for Humira will continue through 2024. To avoid interruptions in their Tumor Necrosis Factor (TNF) inhibitor therapy, members are encouraged to speak with their providers about whether transitioning to Hadlima or Adalimumab-adaz is right for them. Thank you for partnering with us in our commitment to providing affordable and effective therapies to your patients, our members.How will this impact providers?
- Authorizations
- Billing & payment
- Procedures & services
- Reviews & appeals
- Drugs
- Medical policies
- Provider forms
- Seeing Cigna members
- Requirements & responsibilities
- Clinical resources
- News
- Fraud, waste & abuse policy
- Join our networks
- Check patient eligibility
- Data exchange
- Set up electronic claims
- Set up electronic funds transfer (EFT)
- Check claim status