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 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.”

Below are new, revised and retired policies:

New pharmacy coverage policies

  • Briviact (brivaracetam)
  • Defitelio (defibrotide sodium)
  • Evomela (melphalan)
  • Nuplazid (pimavanserin)
  • Trintellix (vortioxetine)
  • Venclexta (venetoclax)

Revised pharmacy coverage policies

  • No policies with significant revisions

New medical coverage policies

  • Tilt table testing

Revised medical coverage policies

  • Cardiac monitoring devices
  • Cochlear implants, auditory brainstem implants
  • Genetic testing for diagnosis and monitoring – Noncancer indications
  • Reduction mammoplasty
  • Speech generating devices, voice prostheses

Retired medical coverage policies

  • No retired coverage policies