Medicare AdvantagePrior AuthMedium impact
Preferred Continuous Glucose Monitoring Systems (Revised)
Humana·Endocrinology, Family Medicine, Internal Medicine +1 more·Medicare Advantage
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana has updated its Medicare Advantage prior authorization policy for continuous glucose monitoring systems (CGMs) including Dexcom G6/G7 and FreeStyle Libre devices. The policy requires diabetes diagnosis plus either insulin treatment or documented problematic hypoglycemia for coverage approval.
Action Required
Billing team must ensure prior authorization is obtained for all Humana Medicare Advantage patients requiring CGM devices (Dexcom G6/G7, FreeStyle Libre series). Verify patients meet criteria: diabetes diagnosis AND either insulin treatment OR documented problematic hypoglycemia with specific glucose thresholds. Update workflows to check authorization status before dispensing CGM supplies.