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 healthcare 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

  • Erleada (apalutmiade)
  • Noctiva (desmopressin)
  • Proton pump inhibitors
  • Rhopressa (netarsudil)
  • Soliqua
  • Trintellix (vortioxetine)
  • Trogarzo (ibalizumab-uiyk)
  • Xultophy

New medical coverage policies

  • Janus Kinase 2 (JAK2) V617F, Exon 12 – 15, Calreticulin (CALR) and MPL mutation analysis

Revised pharmacy coverage policies

  • No revised policies

Revised medical coverage policies

  • Achalasia and gastroesophageal reflux disease (GERD) treatments
  • Breast reconstruction
  • Genetic testing for diagnosis and monitoring – noncancer indications
  • Infertility evaluation and treatments
  • Rhinoplasty/Septoplasty
  • Sleep studies, adult
  • Spinal cord stimulators
  • Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT)