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 Humana.com/provider 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

  • Erectile dysfunction medications
  • Ezetimibe (generic Zetia)
  • Glucagon-like peptide-1 (GLP-1) analogs
  • Lartruvo (olaratumab)
  • Soliqua 100/33 (insulin glargine and lixisenatide)
  • Topical metronidazole

New medical coverage policies

  • Carpal Tunnel Syndrome Surgical Treatments
  • Extended Ophthalmoscopy

Revised pharmacy coverage policies

  • Actemra (tocilizumab) intravenous
  • Actemra (tocilizumab) subcutaneous
  • Cimzia (certolizumab pegol)
  • Orencia (abatacept) subcutaneous
  • Sevelamer carbonate (generic Renvela)
  • Simponi (golimumab)

Revised medical coverage policies

  • Biofeedback
  • Colorectal Cancer Screening
  • Gene Expression Profiling
  • Hip, Knee and Shoulder Arthroscopic Surgeries
  • Nasal Surgical Treatments (Balloon Dilation and Endoscopic)
  • Noninvasive Prenatal Screening
  • Pharmacogenomics and Companion Diagnostics
  • Urinary and Fecal Incontinence Treatments