Medicare AdvantagePrior AuthMedium impact
Elidel® (pimecrolimus) (Revised)
Humana·Dermatology, Family Medicine, Pediatrics +1 more·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Elidel (pimecrolimus) cream prescriptions. Patients must have a diagnosis of atopic dermatitis and have failed treatment with specific generic topical medications before approval.
Action Required
Immediately: Billing and clinical staff must obtain prior authorization before prescribing Elidel (pimecrolimus) cream for Humana Medicare Advantage patients. Providers must document atopic dermatitis diagnosis and previous treatment failure with triamcinolone, mometasone, or betamethasone dipropionate. For brand Elidel requests, also document previous pimecrolimus treatment. Claims will be denied without prior authorization.