Medicare AdvantagePrior AuthMedium impact
Emrosi™ (minocycline) (Revised)
Humana·Dermatology, Pharmacy·Medicare Advantage
Effective date
Jul 23, 2025
We identified it
Jul 21, 2026
Summary
Humana Medicare Advantage has implemented a prior authorization requirement for Emrosi™ (minocycline 40mg extended-release) for rosacea treatment. Coverage now requires documented failure, intolerance, or contraindication with both topical metronidazole AND non-delayed release oral doxycycline before approval. This is a new pharmacy prior authorization policy effective July 23, 2025.
Action Required
By July 23, 2025: Billing team and pharmacy staff must implement prior authorization requirements for all Emrosi (minocycline 40mg extended-release capsule) claims under Humana Medicare Advantage plans. Update billing software and pharmacy systems to flag Emrosi prescriptions for prior authorization review. Providers must document in patient records: (1) that Emrosi is being used for inflammatory lesions of rosacea, (2) previous treatment attempts, intolerance, or contraindications with topical metronidazole, and (3) previous treatment attempts, intolerance, or contraindications with non-delayed release oral doxycycline (specifically doxycycline monohydrate 50mg or 100mg, or doxycycline hyclate 20mg or 100mg). Front desk and clinical staff should add checklist items to encounter templates to ensure providers capture required prior authorization documentation. Claims submitted without prior authorization or missing required documentation will be denied. Reference Humana's Preauthorization and Notification List (PAL) at www.humana.com/PAL for current claim codes and submission procedures.