Medicare AdvantagePrior AuthLow impact
Cometriq (cabozantinib) (Revised)
Humana·Oncology, Endocrinology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has revised its prior authorization policy for Cometriq (cabozantinib), a cancer medication used to treat progressive, metastatic medullary thyroid carcinoma. The policy requires prior authorization and specifies that patients must have a diagnosis of progressive, metastatic medullary thyroid carcinoma and cannot have experienced disease progression while previously on this medication.
Action Required
By January 1, 2026: Billing and clinical teams must ensure prior authorization is obtained from Humana Medicare Advantage before prescribing Cometriq (cabozantinib) for patients with metastatic medullary thyroid carcinoma. Verify patient meets criteria: progressive, metastatic medullary thyroid carcinoma diagnosis and no prior disease progression on this medication. Claims will be denied without proper prior authorization.