MedicaidPrior AuthMedium impact
Aveed® (testosterone undecanoate) (Revised)
Humana·FL, KY, SC, VA · Endocrinology, Urology, Family Medicine +1 more·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has updated its prior authorization policy for Aveed (testosterone undecanoate) injections effective January 1, 2025. The policy requires specific hypogonadism diagnosis criteria and documented testosterone lab values below reference range for approval in Medicaid plans across four states.
Action Required
Immediately: Billing team must ensure prior authorization is obtained for all Aveed (testosterone undecanoate) prescriptions for Medicaid patients in FL, KY, SC, and VA. Verify providers document qualifying hypogonadism diagnosis (primary or secondary) and low testosterone lab values before submitting PA requests. Claims will be denied without proper prior authorization.