Medicare AdvantagePrior AuthMedium impact
Lofexidine (Lucemyra) tablet (Revised)
Humana·Psychiatry, Pain Management, Family Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Lofexidine (Lucemyra) tablets used for opioid withdrawal symptoms. Patients must be undergoing abrupt opioid discontinuation and have previous treatment failure, contraindication, or intolerance to clonidine before approval.
Action Required
Before January 1, 2026: Billing team and providers must obtain prior authorization for all Lofexidine (Lucemyra) prescriptions for Medicare Advantage patients. Verify patient meets criteria: undergoing abrupt opioid discontinuation and has contraindication/intolerance to clonidine. Update pharmacy benefit verification procedures to check for prior auth requirements. Claims will be denied without proper authorization.