New and Revised Pharmacy and Medical Coverage Policies Available

Prescription process

Humana's medical and pharmacy coverage policies are based on evidence published in peer-reviewed medical literature, technology assessments obtained from independent medical research organizations, evidence-based consensus statements and evidence-based guidelines from nationally recognized professional health care organizations.

Information about medical and pharmacy coverage policies can be found at Humana.com/provider by selecting "Medical and pharmacy coverage policies" under "Resources". Medical and pharmacy coverage policies can be reviewed by name or revision date. Users also may search for a particular policy using the search box. More detailed information may be found by reviewing "How to Read a Medical Coverage Policy" and "Understanding the Medical Coverage Policy Development Process."

Below are the new and revised policies:

New pharmacy coverage policies

  • Alecensa (alectinib)
  • Daklinza (daclatasvir)
  • Esbriet (pirfenidone)
  • Portrazza (necitumumab)
  • Vraylar (cariprazine)
  • Xuriden (uridine triacetate)
  • Zepatier (elbasvir/grazoprevir)

Pharmacy coverage policies with significant revisions

  • No policies with significant revisions

New medical coverage policies

  • Genetic testing for mitochondrial disorders

Medical coverage policies with significant revisions

  • Continuous passive motion (CPM) and mechanical stretching devices
  • Femoroacetabular impingement (FAI) and iliopsoas impingement hip surgery (open or arthroscopic)
  • Glaucoma – emerging treatments
  • Negative pressure wound therapy (NPWT)
  • Prophylactic mastectomy
  • Transcatheter valve implantation

Retired medical coverage policies

  • No retired coverage policies