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HumanaMedicare Advantage · Prior Auth · Medicare Advantage · Sleep Medicine, PsychiatryMedium impact

Quviviq (daridorexant) (Revised)

Effective date
Jan 1, 2024
Identified
Oct 21, 2026
Replaced. This version was replaced by Quviviq (daridorexant) (Revised) (published Jan 1, 2024).

Summary

This is a historical policy document (issued 2024-01-01, newly discovered 2026-10-21) establishing Humana Medicare Advantage step-therapy coverage for Quviviq (daridorexant) for insomnia treatment. The policy requires members to have failed or been intolerant to Belsomra (suvorexant) or trazodone before Quviviq approval. The most recent revision date is 2025-12-17, indicating this remains current policy; billing teams should verify current applicability with Humana's online policy portal before processing claims.

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What to do

Action · 4 steps
01Verify current applicability: Billing and prior authorization teams should confirm on https://dctm.humana.com/Mentor/Web/ or www.humana.com/PAL that this Quviviq step-therapy policy remains active for Medicare Advantage members.
02For all Quviviq pharmacy requests from Humana MA plans: Prior authorization staff must verify member has documented previous treatment failure, contraindication, or intolerance to Belsomra (suvorexant) OR trazodone tablet before submitting approval requests.
03Claims will be denied without evidence of step-therapy criteria completion.
04Note: Policy includes a narcolepsy contraindication—screen for this diagnosis before authorization.

Original notice

Quviviq (daridorexant) (Revised)
mcp.humana.com · Always check the source before changing claims.
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Related changes

See all Humana changes →
Quviviq (daridorexant) (Revised)MediumNo effective date · Medicare AdvantageQuviviq (daridorexant) (Revised)MediumEffective Jan 1, 2024 · Medicare AdvantageDayvigo™ (lemborexant) (Revised)LowEffective Jan 1, 2022 · Medicare AdvantageDayvigo™ (lemborexant) (Revised)MediumEffective Jan 1, 2022 · Medicare AdvantageBrowse every Humana change in the policy list

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