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Preferred Adalimumab Products (New)
Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Jun 24, 2026
Summary
Humana Medicare Advantage has established new prior authorization requirements for adalimumab products (Humira and biosimilars) effective January 1, 2026. Each indication has specific age requirements and prior therapy criteria that must be met for approval.
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What to do
by Jan 1, 2026 · 4 steps
01Billing team must implement prior authorization requirements for all adalimumab products (Humira and biosimilars) for Humana Medicare Advantage patients.
02Update billing system to flag these medications for prior auth.
03Providers must document age requirements and prior therapy attempts/contraindications based on specific indication before prescribing.
04Claims will be denied without proper prior authorization approval.
Original notice
Preferred Adalimumab Products (New)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →Preferred Adalimumab Products (Revised)HighEffective Jan 1, 2026 · Medicare AdvantagePreferred Adalimumab Products (New)HighEffective Jan 1, 2026 · Medicare AdvantageNon-preferred adalimumab products (Revised)HighEffective Jan 1, 2026 · Medicare AdvantageNon-preferred adalimumab productsHighEffective Jan 1, 2026 · Medicare AdvantageBrowse every Humana change in the policy list