Medicare AdvantagePrior AuthMedium impact
Bimzelx (bimekizumab-bkzx) (New)
Humana·Dermatology, Rheumatology, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has introduced a new prior authorization policy for Bimzelx (bimekizumab-bkzx), effective January 1, 2026. This medication requires prior auth for treating plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, and hidradenitis suppurativa, with specific step therapy requirements for each condition.
Action Required
By January 1, 2026: Billing team must update prior authorization processes for Bimzelx (bimekizumab-bkzx) prescriptions for Humana Medicare Advantage members. Providers must verify patients meet step therapy requirements (failed at least 2 preferred medications like Humira, Enbrel, Cosentyx, or Skyrizi depending on condition) before prescribing. Update clinical documentation to capture prior medication failures and ensure patients are 18+ years old. Claims will require prior authorization approval before dispensing.