Medicare AdvantagePrior AuthMedium impact
Alphagan® P (brimonidine) (Revised)
Humana·Ophthalmology, Optometry·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires step therapy for Alphagan P (brimonidine) eye drops, meaning patients must first try generic brimonidine 0.2% before the brand name version will be covered. This affects glaucoma and ocular hypertension treatment approvals.
Action Required
By January 1, 2025: Billing team and providers must verify patients have tried generic brimonidine 0.2% eye drops before prescribing Alphagan P for Humana Medicare Advantage patients. Update prior authorization workflows to document previous generic treatment. Claims for Alphagan P without step therapy documentation will be denied.