New and Revised Pharmacy and Medical Coverage Policies Available

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 by selecting "Medical and Pharmacy Coverage Policies" under "Resources." Policies can be reviewed by name or revision date. Users also may search for a particular policy using the search box. More detailed information can be found by reviewing "How to Read a Medical Coverage Policy" and "Understanding the Medical Coverage Policy Development Process" under “Helpful Links.”

Recent changes to medical and pharmacy coverage policies are listed below:

New pharmacy coverage policies

  • Basaglar (insulin glargine)
  • Rayaldee (calcifediol)

New medical coverage policies

  • No new policies

Revised pharmacy coverage policies

  • Clobex (clobetasol)
  • Compounded medications
  • Opdivo (nivolumab)
  • Taclonex (calcipotriene and betamethasone dipropionate)
  • Vivitrol (naltrexone for extended release injectable suspension)

Revised medical coverage policies

  • Bariatric Surgery
  • Bone Graft Substitutes
  • Cardioverter Defibrillators/Cardiac Resynchronization Therapy
  • Cardiac Monitoring Devices
  • Colorectal Cancer Screening
  • Cryoablation
  • Durable Medical Equipment (DME)
  • Electric Tumor Treatment Fields
  • Gene Expression Profiling
  • Genetic Testing for Breast and/or Ovarian Cancer Susceptibility
  • Genetic Testing for Cancer Susceptibility
  • Genetic Testing for Marfan Syndrome and Related Conditions
  • Genetic Testing for Muscular Dystrophy and Spinal Muscular Atrophy
  • Headache and Occipital Neuralgia Treatments
  • Home Oximetry Monitoring
  • Janus Kinase 2 (JAK2) V617F, Exon 12 & 13, and MPL Mutation Analysis
  • Lymphedema – Diagnosis and Treatments
  • Negative Pressure Wound Therapy (NPWT)
  • Noninvasive Tests for Hepatic Fibrosis
  • Transcatheter Valve Implantation
  • Tumor Markers for Diagnosis and Monitoring of Cancer
  • Vocal Cord Insufficiency Treatments