MedicaidPrior AuthMedium impact
Beovu® (brolucizumab) (Revised)
Humana·IN · Ophthalmology·Medicaid
Effective date
Jul 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has revised its prior authorization policy for Beovu (brolucizumab) intravitreal injections used to treat wet age-related macular degeneration and diabetic macular edema. The policy requires patients to have either a contraindication/intolerance to bevacizumab or documented failure to respond to bevacizumab before Beovu will be approved.
Action Required
Immediately: Billing team must ensure prior authorization is obtained before administering Beovu injections to Indiana Medicaid patients. Providers must document either contraindication/intolerance to bevacizumab OR prior bevacizumab therapy failure with attestation that patient did not demonstrate positive clinical response. Visit www.humana.com/PAL for medical and procedural coding requirements. Claims will be denied without proper prior authorization.