Medicare AdvantagePrior AuthMedium impact
Fetzima® (levomilnacipran) (Revised)
Humana·Psychiatry·Medicare Advantage
We identified it
Jul 22, 2026
Summary
Humana has revised its Prior Authorization policy for Fetzima® (levomilnacipran), a psychiatric medication used to treat major depressive disorder. The policy update affects Medicare Advantage members and requires prior authorization before dispensing. Billing teams must verify authorization requirements before claims submission to avoid denials.
Action Required
Immediately: Billing and clinical staff must review the updated Fetzima® prior authorization requirements at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a5867f6. Before submitting claims for Fetzima® to Humana Medicare Advantage plans: (1) Verify current prior authorization status in the policy summary, (2) Obtain prior authorization from Humana if required before dispensing or billing, (3) Update pharmacy and medical billing software to flag Fetzima® prescriptions for Medicare Advantage members requiring pre-authorization review. Failure to obtain prior authorization will result in claim denials and may require patient out-of-pocket payment.