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Medicare AdvantagePrior AuthMedium impact

Saphris® (asenapine) (Revised)

Humana·Psychiatry·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage now requires prior authorization for Saphris (asenapine) effective January 1, 2025. Patients must have tried and failed at least 2 other antipsychotics (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, or lurasidone) before approval.

Action Required

Action needed
Immediately: Update prior authorization workflow for Saphris (asenapine) prescriptions for Humana Medicare Advantage patients. Ensure documentation shows treatment for schizophrenia or bipolar I disorder and prior therapy failure/intolerance to at least 2 of the following: risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, or lurasidone. Submit requests through www.humana.com/PAL. Without proper prior authorization, pharmacy claims will be denied.

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