Medicare AdvantagePrior AuthMedium impact
Nurtec® ODT (rimegepant) (Revised)
Humana·Neurology, Family Medicine, Internal Medicine +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 Nurtec ODT (rimegepant) effective January 1, 2025. For acute migraine treatment, patients must have prior treatment, intolerance, or contraindication to Ubrelvy. For migraine prevention, patients must have tried both Emgality AND Qulipta first.
Action Required
Immediately: Update prior authorization processes for Nurtec ODT prescriptions. Billing team must verify patients meet step therapy requirements - prior use of Ubrelvy for acute treatment or both Emgality AND Qulipta for prevention. Document trial history in prior auth requests to avoid denials. Notify providers of new step therapy requirements.