Medium impactPrior AuthMedicare Advantage
Humana: Eprontia® (topiramate) oral solution - Medicare Advantage (New, Listed Oct 6, 2026)
Effective dateJan 1, 2026
Found onOct 6, 2026
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Summary
Published Jan 2026: Humana's Medicare Advantage policy for Eprontia (topiramate) oral solution sets prior authorization criteria for migraine prevention, epilepsy adjunct therapy, and epilepsy monotherapy. Migraine prevention requires age 12 or older, a prior trial of or intolerance to immediate-release topiramate, and a prior trial, intolerance, or contraindication to a serotonin-norepinephrine reuptake inhibitor or tricyclic antidepressant. The policy has been in effect since Jan 1, 2026 and was revised Apr 22, 2026.
PolicyChanges checks Humana and other payers every day and shows what to do before a change takes effect.
See every Humana changeWhat to do
Action · 6 steps
- Already in effect since Jan 1, 2026: Billing team and providers should get prior authorization before scheduling Eprontia for Medicare Advantage members.
- This covers the 25 mg/mL oral solution only.
- For migraine prevention, document the member's age (12 or older), the immediate-release topiramate history, and the antidepressant or reuptake inhibitor history.
- For epilepsy, document a diagnosis of partial-onset (focal) seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome, and an age of 2 or older.
- Adjunct use requires another seizure drug taken with Eprontia and a trial of or inability to use immediate-release topiramate, and monotherapy requires a trial of or inability to use immediate-release topiramate.
- Front desk staff should file these records in the prior auth tracker, providers should keep them in the chart, and the billing team should calendar renewals for each plan year.
Related changes
See all Humana changes →Eprontia® (topiramate) oral solution (New)Humana Medicare Advantage has implemented a new prior authorization policy for Eprontia (topiramate) oral solution effective January 1, 2026. Prior authorization is required for…Effective Jan 1, 2026 · Medicare AdvantageMediumEprontia® (topiramate) oral solution (New)Humana Medicare Advantage now requires prior authorization for Eprontia (topiramate) oral solution effective January 1, 2026. This affects patients with epilepsy (age 2+) and…Effective Jan 1, 2026 · Medicare AdvantageMedium