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Medicare AdvantagePrior AuthHigh impact

Long Acting Insulins (Revised)

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 specific long-acting insulin products (Semglee, Basaglar, Rezvoglar, insulin degludec, and others). Members must have tried preferred insulins (Lantus, Lantus Solostar, Toujeo, or Tresiba) before these products will be covered.

Action Required

Action needed
By January 1, 2026: Billing team must verify prior authorization for all listed long-acting insulin products before prescribing or dispensing. Providers must document that patients have tried and failed/cannot tolerate Lantus, Lantus Solostar, Toujeo, or Tresiba first. Update EMR templates to include this requirement checklist. Claims will be denied without proper prior authorization.