Medicare AdvantagePrior AuthHigh impact
Imatinib products (Gleevec, Imkeldi) (Revised)
Humana·Oncology, Hematology, Pediatrics·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated prior authorization requirements for imatinib products (Gleevec, Imkeldi) effective January 1, 2025. The policy requires prior authorization for all covered oncology indications including CML, ALL, GIST, melanoma, and other rare cancers, with brand products requiring documented intolerance to generic imatinib.
Action Required
Immediately: Update prior authorization workflows for all imatinib products (Gleevec, Imkeldi) for Humana Medicare Advantage patients. Billing team must obtain prior authorization before dispensing for any covered oncology indication. For brand products, documentation of generic imatinib intolerance/contraindication is required. Add prior auth alerts to pharmacy and billing systems. Claims without prior authorization will be denied.