Medicare AdvantagePrior AuthMedium impact
Namzaric (memantine-donepezil ER) (New)
Humana·Neurology, Geriatrics, Family Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has implemented a new prior authorization policy for Namzaric (memantine-donepezil ER) for Medicare Advantage plans, requiring approval for patients with moderate to severe Alzheimer's disease who cannot use the individual components separately. This is a brand new policy effective January 1, 2026.
Action Required
By January 1, 2026: Billing team must implement prior authorization requirements for all Namzaric prescriptions for Medicare Advantage patients. Update pharmacy billing system to flag Namzaric orders and verify patients meet criteria: (1) moderate to severe Alzheimer's diagnosis and (2) cannot use memantine and donepezil separately. Train staff on new approval process as claims will be denied without prior authorization.