Medicare AdvantagePrior AuthMedium impact
Noxafil® (posaconazole) (Revised)
Humana·Infectious Disease, Oncology, Hematology +1 more·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated prior authorization requirements for Noxafil (posaconazole) antifungal medication effective January 1, 2025. The policy establishes specific criteria for coverage of prophylaxis and treatment of invasive fungal infections, requiring documentation of severely compromised immune systems or resistance to standard antifungal agents.
Action Required
By January 1, 2025: Billing team must ensure prior authorization is obtained for all Noxafil (posaconazole) prescriptions for Medicare Advantage patients. Providers must document patient meets specific criteria including severely weakened immune system for prophylaxis or resistance/intolerance to standard antifungals for treatment. Update prior auth checklists to include these requirements. Claims will be denied without proper authorization and documentation.