New and Revised Pharmacy and Medical Coverage Policies Available

Coverage policies

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.”

Below are new, revised and retired policies:

New pharmacy coverage policies

  • Byvalson (nebivolol and valsartan)
  • Cabometyx (cabozanitib)
  • Epclusa (sofosbuvir/velpatasvir)
  • GLP-1 Analogs
  • Ocaliva (obeticholic acid)
  • Otovel (ciprofloxacin-fluocinolone otic solution)
  • Pediatric Antipsychotic Utilization Program
  • Probuphine (buprenorphine) Implant
  • Tecentriq (atezolizumab)
  • Xiidra (lifitegrast ophthalmic solution)
  • Zinbryta (daclizumab)
  • Zurampic (lesinurad)

Revised pharmacy coverage policies

  • No revised pharmacy coverage policies

New medical coverage policies

  • No new medical coverage policies

Revised medical coverage policies

  • Acupuncture
  • Benign prostatic hyperplasia (BPH) treatments
  • Benign skin lesion removal
  • Clinical trials
  • Cosmetic surgery, reconstructive surgery, scar revision
  • Deep brain stimulation (DBS) and cortical brain stimulation
  • Drug testing
  • Electrical stimulators for pain and nausea/vomiting
  • Erectile dysfunction treatments
  • Fecal microbiota transplantation (FMT)
  • Gastrointestinal (GI) motility monitoring
  • Genetic testing for breast and/or ovarian cancer susceptibility
  • Genetic testing for cystic fibrosis
  • Injections for chronic pain conditions
  • Keratoconus – surgical treatments
  • Mobility assistive devices (wheelchairs)
  • Obstructive sleep apnea (OSA) surgical treatments
  • Osteochondral defects surgery
  • Pharmacogenomics and companion diagnostics
  • Sleep studies, adult
  • Tissue Doppler imaging (tissue Doppler echocardiography, tissue Doppler ultrasound)
  • Ultraviolet light/laser therapy for skin conditions
  • Videofluoroscopy, dynamic MRI for musculoskeletal indications

Retired medical coverage policies

  • No retired medical coverage policies