Medicare AdvantagePrior AuthMedium impact
Inluriyo (imlunestrant) (New)
Humana·Oncology·Medicare Advantage
Effective date
Nov 26, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has implemented a new prior authorization policy for Inluriyo (imlunestrant), a new breast cancer medication. Prior authorization is required for patients with ER-positive, HER2-negative breast cancer with specific genetic mutations and treatment history.
Action Required
By November 26, 2025: Billing and clinical teams must implement prior authorization requirements for Inluriyo (imlunestrant) prescriptions for Medicare Advantage patients. Providers must document ER-positive, HER2-negative breast cancer diagnosis, ESR1 mutation test results, and previous endocrine therapy failure before prescribing. Submit prior auth requests through www.humana.com/PAL. Claims will be denied without proper authorization.