MedicaidPrior AuthMedium impact
Beovu® (brolucizumab) (New)
Humana·OH · Ophthalmology, Endocrinology·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana is introducing a new prior authorization policy for Beovu (brolucizumab) intravitreal injections for Ohio Medicaid patients effective October 1, 2025. Prior authorization will be required for both wet age-related macular degeneration and diabetic macular edema, with specific criteria requiring contraindication/intolerance to bevacizumab or documented failure to respond to bevacizumab therapy.
Action Required
By October 1, 2025: Billing team must update prior authorization workflows for Beovu (brolucizumab) intravitreal injections for Ohio Medicaid patients. Providers must document contraindication/intolerance to bevacizumab OR prior bevacizumab therapy failure before prescribing Beovu. Visit www.humana.com/PAL for specific medical and procedural coding information. Claims without proper prior authorization will be denied.