New and Revised Pharmacy and Medical Coverage Policies Available

Pharmacist with prescription

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

  • Exondys 51 (eteplirsen)
  • Clinical trials pharmacy policy

Revised medical coverage policies

  • Bunion Surgical Treatments
  • Cardiovascular Disease (CVD) Risk Testing
  • Clinical Trials
  • Continuous Glucose Monitoring Systems and Insulin Pumps
  • Dynamic Spinal Stabilization Devices
  • Genetic Testing for Carrier Screening
  • Joint Resurfacing Arthroplasty
  • Pharmacogenomics and Companion Diagnostics
  • Vagus Nerve Stimulation
  • Ventricular Assist Device (VAD), Total Artificial Heart (TAH)