Medicare AdvantagePrior AuthMedium impact
Glucagon Products (Revised)
Humana·Endocrinology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires step therapy for glucagon products used to treat severe hypoglycemia (diabetes emergencies). Patients must try Baqsimi nasal spray first before other glucagon products like Gvoke injections and emergency kits will be covered.
Action Required
By January 1, 2026: Billing team must ensure prior authorization is obtained for all glucagon products except Baqsimi for Humana Medicare Advantage patients. Providers must document that patient has tried Baqsimi before prescribing alternative glucagon products (Gvoke, GlucaGen, Glucagon Emergency Kits). Update encounter forms to remind providers of step therapy requirement. Claims will be denied without proper prior authorization and step therapy documentation.