Medicare AdvantagePrior AuthMedium impact
Opzelura™ (ruxolitinib) (Revised)
Humana·Dermatology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated prior authorization requirements for Opzelura (ruxolitinib) cream, effective January 1, 2026. The policy establishes specific criteria for coverage of atopic dermatitis and nonsegmental vitiligo treatments, requiring failure of first-line therapies and other clinical conditions.
Action Required
By January 1, 2026: Billing team must ensure prior authorization is obtained for all Opzelura (ruxolitinib) prescriptions for Medicare Advantage patients. Providers must document failure of topical corticosteroids and calcineurin inhibitors for atopic dermatitis cases, or meet specific vitiligo criteria including dermatologist consultation and BSA limitations. Claims will be denied without proper prior authorization.