Medicare AdvantagePrior AuthMedium impact
Vaginal Atrophy Agents (New)
Humana·OB-GYN, Family Medicine, General Practice +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for vaginal atrophy agents Intrarosa and Imvexxy effective January 1, 2026. Members must meet three criteria: be post-menopausal, have moderate to severe dyspareunia, and have tried or be unable to use standard estradiol or Premarin vaginal creams first.
Action Required
Before January 1, 2026: Billing team must update prior authorization requirements for Intrarosa and Imvexxy prescriptions for Humana Medicare Advantage members. Providers must document that patients are post-menopausal, have moderate to severe dyspareunia with vulvar/vaginal atrophy, and have previous treatment failure, intolerance, or contraindication to estradiol or Premarin vaginal creams. Claims without proper prior authorization will be denied.