Medicare AdvantagePrior AuthMedium impact
Zunveyl tablet,delayed release (benzgalantamine) (New)
Humana·Neurology, Geriatrics, Psychiatry +2 more·Medicare Advantage
Effective date
Sep 24, 2025
We identified it
Jun 25, 2026
Summary
Humana Medicare Advantage has introduced a new prior authorization policy for Zunveyl (benzgalantamine), a delayed-release tablet indicated for mild to moderate Alzheimer's disease. Coverage requires members to have failed or been intolerant to at least two of the following: donepezil, galantamine, or rivastigmine. This is effective immediately and applies to all new Zunveyl prescriptions.
Action Required
By September 24, 2025: Billing team must implement prior authorization requirements for all Zunveyl (benzgalantamine) delayed-release tablet prescriptions. When submitting claims for Zunveyl to Humana Medicare Advantage plans, verify in member's medical record documentation of: (1) diagnosis of mild to moderate Alzheimer's disease AND (2) prior therapy failure, contraindication, or documented intolerance to at least TWO of the following agents: donepezil, galantamine, or rivastigmine. Obtain prior authorization through Humana's PAL system before dispensing. Route all Zunveyl requests to Humana Medicare Advantage plans through the prior authorization process. Claims submitted without proper authorization will be denied. Notify prescribing providers of this requirement and provide documentation checklist to support their clinical notes with failure/intolerance history.