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Medicare AdvantagePrior AuthMedium impact

DPP-IV inhibitors (New)

Humana·Endocrinology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires prior authorization for DPP-IV inhibitor diabetes medications effective January 1, 2026. Members must have tried and failed specific first-line medications (Januvia/Janumet/Janumet XR AND Tradjenta/Jentadueto/Jentadueto XR) before approval for covered DPP-IV inhibitors including Nesina, Oseni, Kazano, Zituvio, and others.

Action Required

Action needed
By January 1, 2026: Providers must obtain prior authorization for all DPP-IV inhibitor prescriptions for Humana Medicare Advantage patients. Document previous treatment failure, contraindication, or intolerance to both Januvia/Janumet/Janumet XR AND Tradjenta/Jentadueto/Jentadueto XR. Visit www.humana.com/PAL for preauthorization requirements. Claims without prior auth will be denied.