No coverage of Humira in 2026. (Also Taltz)

HeyMOE Tip

Don’t panic if you see “Not Covered” next to Humira (also Taltz) — you’re not missing something. Every 2026 Part D plan excludes Humira, and we’re already one step ahead by identifying biosimilar options that are covered through our "flagged" manual review process of HeyMOE results.
Switching to a biosimilar can save you thousands and keep your medication covered by insurance.

What’s Happening

Early HeyMOE results show that no stand-alone Medicare Part D drug plans will cover Humira in 2026.

That means if you take Humira, your Part D plan will not pay anything toward the cost of that medication next year — and since it’s not covered, your spending will not count toward your Part D out-of-pocket limit.

In other words, you’d be responsible for the full retail cost of Humira.

What This Means for You

If you currently take Humira, you’ll have two main options for 2026:

1. Pay Out of Pocket

The cash price of Humira averages $90,000–$100,000 per year — clearly not realistic for most people.

2. Switch to a Biosimilar

A biosimilar is a near-identical version of a complex biologic drug (like Humira) that’s been approved by the FDA as just as safe and effective.
They provide the same treatment benefits, have the same potential side effects, and are typically much more affordable.

Several Humira biosimilars are included on 2026 Part D formularies, such as:

• Adalimumab-adaz

• Adalimumab-adbm

Talk to your prescribing doctor before December 7 to see whether switching to one of these biosimilars makes sense for you.

What HeyMOE Is Doing

HeyMOE automatically checks your medication list to determine whether a drug is covered under any Part D plan and, if not, your account is flagged for manual review.

If Humira is the only uncovered medication on your list, we get in touch with you with the information in this support article.  

Please open a new support ticket if you need additional HeyMOE assistance.