CommercialCoverageHigh impact
Hidradenitis Suppurativa (HS)
Blue Cross & Blue Shield of Mississippi·MS · Dermatology·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their Hidradenitis Suppurativa policy, making Hadlima and Simlandi the only covered adalimumab options effective January 1, 2025, while removing coverage for multiple other adalimumab biosimilars including Humira. Prior authorization remains required for all covered biologics (Cosentyx, Hadlima, Simlandi) with specific criteria for Hurley Stage II or III disease.
Action Required
By January 1, 2025: Update billing system and prior authorization workflows to reflect that only Hadlima and Simlandi are covered adalimumab options for HS patients. Remove Humira, Abrilada, Amjevita, Cyltezo, Hulio, Hyrimoz, Idacio, Yuflyma, and Yusimry from covered drug lists. Ensure prior authorization requests for Cosentyx, Hadlima, and Simlandi include documentation of Hurley Stage II or III disease, conventional therapy failure, and prescriber is board-certified dermatologist. Claims for non-covered adalimumab products will be denied.