Medicare AdvantagePrior AuthMedium impact
Vaginal Atrophy Agents (New)
Humana·OB-GYN, Family Medicine, Internal Medicine·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 be post-menopausal with moderate to severe dyspareunia and have tried or cannot use estradiol vaginal cream or Premarin vaginal cream first.
Action Required
Before January 1, 2026: Billing team must update prior authorization requirements for Intrarosa vaginal inserts and Imvexxy vaginal inserts (starter and maintenance packs) for Humana Medicare Advantage plans. Providers must document that patient is post-menopausal, has vulvar/vaginal atrophy with moderate to severe dyspareunia, and has previous treatment failure, intolerance, or contraindication to estradiol vaginal cream or Premarin vaginal cream. Claims without prior authorization will be denied.