Does Medicare Cover Humira?
Yes — Part D covers Humira (and its biosimilars) for approved autoimmune conditions.
Drug Coverage · Autoimmune & Skin
Humira (adalimumab) is used for rheumatoid arthritis, psoriasis, Crohn’s, and more.
Does Medicare cover Humira?
Yes — Part D covers Humira (and its biosimilars) for approved autoimmune conditions. Covered for approved diagnoses like rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, and Crohn’s. Self-injected pens are Part D; biosimilars may be preferred.
Which part of Medicare covers it?
Part D. These are self-administered prescriptions, so they fall under your Part D drug plan (or the drug coverage built into a Medicare Advantage plan), not Part B.
Typical formulary tier
Specialty tier (typically Tier 5). Your exact tier — and copay — depend on the plan you choose, which is why matching the formulary to your medications matters.
| Drug | Used for | Covered by Medicare? | Typical formulary tier |
|---|---|---|---|
| Humira (adalimumab) | rheumatoid arthritis, psoriasis, Crohn’s, and more | Yes, with conditions | Specialty tier (typically Tier 5) |
| Enbrel (etanercept) | rheumatoid arthritis and psoriasis | Yes, with conditions | Specialty tier (typically Tier 5) |
| Rinvoq (upadacitinib) | rheumatoid arthritis, eczema, and more | Yes, with conditions | Specialty tier (typically Tier 5) |
| Skyrizi (risankizumab) | plaque psoriasis and Crohn’s disease | Yes, with conditions | Specialty tier (typically Tier 5) |
| Dupixent (dupilumab) | eczema, asthma, and COPD | Yes, with conditions | Specialty tier (typically Tier 5) |
Prior authorization & plan rules
Prior authorization is standard for biologics, and plans often prefer a biosimilar first (step therapy).
If it isn’t covered (or costs too much)
If cost is high, biosimilars can be cheaper, and manufacturer/foundation grants help many people. Ask us to compare.
- Help paying for Humira — assistance programs and grants.
- Compare Part D plans that cover Humira on a better tier.
- How drug tiers work · Extra Help for lower-income beneficiaries.
Related medications
- Does Medicare cover Enbrel? — etanercept
- Does Medicare cover Rinvoq? — upadacitinib
- Does Medicare cover Skyrizi? — risankizumab
Related Medicare guides
- All drug coverage · Part D plans · how drug tiers work.
- Medicare costs · Glossary · Medicare Help Center.
Get a Real Answer for Your Plan — Free
Coverage and cost depend on your specific plan and diagnosis. Call us free at 435-219-5120 (TTY: 711) with your medication list, and we’ll tell you exactly what Humira costs on your plan — and whether a different plan would cover it better. No cost, no pressure.
Frequently Asked Questions
Does Medicare cover Humira?
Which part of Medicare covers Humira?
What if my plan doesn’t cover Humira?
Sources
- Medicare.gov — drug coverage (Part D) — Medicare.gov
Talk to a local, licensed agent
Rocco DeLuca can walk you through your options — free, no pressure.