Medicare AdvantagePrior AuthMedium impact
Trelstar (triptorelin pamoate) (Revised)
Humana·Oncology, Urology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has updated their prior authorization policy for Trelstar (triptorelin pamoate) injections effective January 1, 2026. The policy requires prior authorization for all Trelstar intramuscular injections used to treat advanced prostate cancer, with specific criteria requiring diagnosis of advanced prostate cancer or high risk of disease recurrence.
Action Required
By January 1, 2026: Billing team must ensure prior authorization is obtained for all Trelstar (triptorelin pamoate) intramuscular injection claims for Medicare Advantage patients. Verify patients meet criteria of having advanced prostate cancer or high risk of disease recurrence before submitting claims. Update billing system to flag Trelstar claims requiring prior auth. Claims without prior authorization will be denied.