Medicare AdvantagePrior AuthMedium impact
GnRH Receptor Antagonists (Myfembree®, Oriahnn®) (New)
Humana·OB-GYN, Family Medicine, Internal Medicine·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for GnRH receptor antagonists (Myfembree and Oriahnn) used to treat heavy menstrual bleeding from uterine fibroids and endometriosis pain. Specific medical criteria must be met including prior treatment failures and exclusions for osteoporosis.
Action Required
Before January 1, 2026: Clinical staff must obtain prior authorization for all Myfembree and Oriahnn prescriptions for Medicare Advantage patients. Update provider workflow to verify patient meets specific criteria (premenopausal status, appropriate diagnosis, prior treatment failures, no osteoporosis). Add prior auth checklist to encounter forms for uterine fibroid and endometriosis visits.