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Medicare AdvantagePrior AuthMedium impact

Savaysa® (edoxaban) (Revised)

Humana·Cardiology, Internal Medicine, Family Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage has revised prior authorization requirements for Savaysa (edoxaban), an oral anticoagulant. The policy now requires patients to have tried and failed at least two other anticoagulants (Eliquis, dabigatran, or Xarelto) before Savaysa will be approved for both atrial fibrillation and blood clot treatment.

Action Required

Action needed
Before January 1, 2026: Billing team must ensure prior authorization requests for Savaysa (edoxaban) include documentation that patients have tried, failed, or have contraindications to at least two of the following: Eliquis (apixaban), dabigatran, or Xarelto (rivaroxaban). Update prior auth submission templates to include this requirement. Also verify patient's creatinine clearance is between 15-95 mL/min for atrial fibrillation patients. Claims will be denied without proper prior authorization.