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Quviviq (daridorexant) (Revised)
Effective date
Not stated in the notice
Identified
Nov 7, 2026
Previous versions
- Quviviq (daridorexant) (Revised) · effective Jan 1, 2024
- Quviviq (daridorexant) (Revised) · effective Jan 1, 2024
Summary
Humana published a revised Medicare step therapy policy for Quviviq (daridorexant) tablets for insomnia, with a revision date of October 28, 2026. Members must have previously tried, been contraindicated to, or been intolerant of Belsomra (suvorexant) or trazodone tablets before Quviviq is covered, and Quviviq is contraindicated in patients with narcolepsy. The policy was originally effective January 1, 2024.
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What to do
Action · 3 steps
01Published October 2026 (revision date October 28, 2026; the original policy was effective January 1, 2024): Billing team should confirm whether Quviviq (daridorexant) 25 mg or 50 mg claims for Humana Medicare members now need a documented prior trial, contraindication, or intolerance to Belsomra (suvorexant) or trazodone before the claim is submitted.
02Providers and front desk staff should be told to collect and document this step-therapy history at the time of prescribing, and charge entry or the prior authorization tracker should flag Quviviq requests for Humana Medicare members so the supporting history is attached.
03Claims submitted without that documentation are likely to be denied, so the team should watch Humana's next notice for any changes to these criteria.
Original notice
Quviviq (daridorexant) (Revised)
mcp.humana.com · Always check the source before changing claims.