Medicare AdvantagePrior AuthMedium impact
Miebo® (perfluorohexyloctane ophthalmic solution) (Revised)
Humana·Ophthalmology, Optometry·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Miebo eye drops (perfluorohexyloctane) for dry eye disease treatment, effective January 1, 2025. Patients must have a dry eye diagnosis and have tried/failed cyclosporine and Eysuvis before Miebo will be approved.
Action Required
Immediately: For all Miebo (perfluorohexyloctane) prescriptions for Humana Medicare Advantage patients, providers must obtain prior authorization by documenting: 1) dry eye disease diagnosis, 2) previous treatment failure/contraindication/intolerance to cyclosporine eye drops (generic Restasis), and 3) previous treatment failure/contraindication/intolerance to Eysuvis (loteprednol) if short-term treatment is appropriate. Visit www.humana.com/PAL for prior authorization submission. Claims will be denied without proper prior authorization.