Medicare AdvantagePrior AuthLow impact
Cycloset® (bromocriptine) (Revised)
Humana·Endocrinology, Internal Medicine, Family Medicine·Medicare Advantage
Effective date
Jan 1, 2017
We identified it
Jul 22, 2026
Summary
This is a revised Medicare Advantage pharmacy policy for Cycloset® (bromocriptine) that clarifies step therapy approval criteria. Members automatically qualify for Cycloset coverage if they have prior treatment experience with, contraindication to, or intolerance of metformin-containing medications. The policy maintains plan-year approval durations for both initial and renewal requests.
Action Required
Billing team should verify current member eligibility against the step therapy criterion (prior metformin experience, contraindication, or intolerance) before submitting Cycloset® claims. Update prior authorization workflows to reflect automatic approval for qualifying members. No immediate action required as this is clarification of existing policy framework; however, ensure pharmacy billing staff are aware that Cycloset requires documented metformin history for Medicare Advantage members.