Medicare AdvantagePrior AuthMedium impact
Opioid Use Disorder (Suboxone Film) (Revised)
Humana·Psychiatry, 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 Suboxone sublingual film for opioid use disorder treatment. Patients must have tried and failed or had intolerance to both generic buprenorphine/naloxone sublingual tablets AND Zubsolv sublingual tablets before Suboxone film will be approved.
Action Required
Before January 1, 2026: Billing team must update prior authorization protocols for Suboxone film prescriptions for Humana Medicare Advantage patients. Ensure documentation shows patient has tried and failed or cannot tolerate both generic buprenorphine/naloxone sublingual tablets AND Zubsolv sublingual tablets. Providers must submit prior authorization requests demonstrating these criteria are met. Claims without proper prior authorization will be denied.