Medicare AdvantagePrior AuthMedium impact
Ophthalmic Beta Blockers (Revised)
Humana·Ophthalmology·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires step therapy for brand-name ophthalmic beta blockers (Betoptic S, Betimol, Timoptic, Timoptic Ocudose), effective January 1, 2025. Patients must have previously tried TWO generic options (timolol, levobunolol, or betaxolol) before brand medications will be covered.
Action Required
Immediately: Update prior authorization workflows for Humana Medicare Advantage patients prescribed brand-name ophthalmic beta blockers (Betoptic S, Betimol, Timoptic, Timoptic Ocudose). Before prescribing, ensure patients have documented trial of TWO generic alternatives: timolol, levobunolol, or betaxolol. Providers must document previous treatments in medical records. Claims without proper step therapy documentation will be denied.