Medicare AdvantagePrior AuthHigh impact
Non-Preferred GLP-1 Agonists and GLP-1/GIP Agonists (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 plans now require prior authorization for non-preferred GLP-1 diabetes medications (Victoza, liraglutide, exenatide) effective January 1, 2026. Patients must have tried and failed two preferred medications (Mounjaro, Ozempic, Rybelsus, or Trulicity) first, except for pediatric liraglutide cases.
Action Required
Before January 1, 2026: Update prior authorization workflows for Victoza, liraglutide, and exenatide prescriptions for Humana Medicare Advantage patients. Ensure documentation shows previous treatment with, contraindication to, or intolerance of at least two preferred GLP-1 medications (Mounjaro, Ozempic, Rybelsus, or Trulicity). Verify patients are NOT using these medications for weight loss as this will result in denial. Exception: Pediatric patients (10-17 years) requesting liraglutide do not need prior treatment documentation.