On Jan. 1, 2019, Humana will update its preauthorization and notification lists, opens new window for all commercial fully insured, Medicare Advantage (MA) plans and dual Medicare-Medicaid plans.

Preauthorization will be required for the following medical services:

  • Ablation (bone, liver, kidney, prostate)
  • Capsule endoscopy
  • Decompression of peripheral nerve, i.e., carpal tunnel surgery (required for patients with Humana commercial coverage only)
  • EGD endoscopy (required for patients 59 and younger with Humana commercial coverage only, includes site-of-service evaluation)
  • Gastric pacing (required for patients with Humana commercial coverage only)
  • Noninvasive home ventilators
  • Peripheral revascularization (atherectomy, angioplasty)
  • Thyroid surgeries (thyroidectomy and lobectomy)

New medication preauthorization requirements include all medications noted with an asterisk (*) on the preauthorization lists posted on Humana.com/PAL.

Find all the details here, opens new window