New and Revised Pharmacy and Medical Coverage Policies Available

Female doctor taking vitals from female patient

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 under “Helpful Links” by reviewing "How to Read a Medical and Pharmacy Coverage Policy" and "Understanding the Medical and Pharmacy Coverage Policy Development Process.”

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

New pharmacy coverage policies

  • Aliqopa (copanlisib)
  • Asthma interleukin inhibitors (Cinqair, Nucala, Fasenra)
  • Bowel-prep agents
  • Calquence (acalabrutinib)
  • Cinvanti (aprepitant)
  • Gocovri (amantadine)
  • Granix (tbo-filgrastim)
  • Hemlibra (emicizumab-kxwh)
  • Long-acting muscarinic antagonist/Long-acting beta agonist combination inhalers
  • Luxturna (voretigene neparvovec)
  • Lyrica CR (pregabalin)
  • Mepsevii (vestronidase alfa-vjbk)
  • Naftin gel (naftifine)
  • Nuedexta (dextromethorphan and quinidine)
  • Opioid Utilization Program — morphine equivalent dose (MED) edits
  • Parsabiv (etelcalcetide)
  • Prevymis (letermovir)
  • Qtern (dapagliflozin and saxagliptin)
  • SGLT2 inhibitors
  • Shingrix (zoster vaccine recombinant, adjuvanted)
  • Solosec (secnidazole)
  • Steglujan (ertugliflozin and sitagliptin)
  • Sublocade (buprenorphine extended-release)
  • Symproic (naldemedine)
  • Taclonex (calcipotriene and betamethasone)
  • Tracleer (bosentan) tablet for oral suspension
  • Trelegy (fluticasone furoate, umeclidinium, vilanterol)
  • Verzenio (abemaciclib)
  • Yescarta (axicabtagene ciloleucel)
  • Zilretta (triamcinolone acetonide extended-release)

New medical coverage policies

  • Genetic testing for diagnosis and monitoring of cancer and molecular profiling

Revised pharmacy coverage policies

  • No revised policies

Revised medical coverage policies

  • Acne treatments
  • Allergy Testing
  • Allograft transplantation of the knee
  • Bariatric surgery
  • Bone graft substitutes
  • Cardioverter defibrillators/cardiac resynchronization therapy
  • Cryoablation
  • Durable medical equipment (DME)
  • Genetic testing for celiac disease
  • Headache and occipital neuralgia treatments
  • Hip, knee and shoulder arthroscopic surgeries
  • Home oximetry monitoring
  • Nasal surgical treatments (balloon dilation and endoscopic)
  • Negative pressure wound therapy (NPWT)
  • Noninvasive tests for hepatic fibrosis
  • Pharmacogenomics and companion diagnostics
  • Pneumatic compression pumps
  • Skin and tissue substitutes
  • Tumor markers for diagnosis and monitoring of cancer
  • Varicose vein treatments