Humana Waives Prior Authorization for Cancer Care

Humana, Evolent Health and American Oncology Network launch a pathway-based oncology model that exempts adherent clinics from individual drug approvals.

Updated on Nov. 11, 2026 in Cancer

Humana Waives Prior Authorization for Cancer Care

Live Poll

Do you trust your insurer to speed up cancer care approvals without cutting corners?

Humana, Evolent Health and American Oncology Network launched an oncology care model that waives prior authorization for most anticancer drug therapies at participating AON community clinics that adhere to evidence-based treatment pathways. The model currently covers Humana Medicare Advantage members at AON clinics across eight states.

Why it matters

Prior authorization has been a major source of delay in cancer care, and the model shifts review from individual drug requests to a practice-level check of protocol adherence. It is intended to remove administrative friction before it starts, a approach Evolent previously launched with Highmark in May 2026.

A 2025 CancerCare survey of 1,201 insured cancer patients found that 95% of prior authorization requests were eventually approved, yet 29% of patients faced diagnostic delays and 40% faced treatment delays. The survey does not show whether the new model will reduce these delay rates.

The players

Humana

Humana is a major American health insurer that offers Medicare Advantage plans, and it is the insurer participating in the new oncology model for its Medicare Advantage members.

Evolent Health

Evolent Health is a health care services company that provides clinical pathway infrastructure, quality improvement programs and provider performance reporting, and it has also launched a similar arrangement with Highmark.

American Oncology Network

American Oncology Network is a network of community oncology clinics whose participating practices in eight states are covered by the new model.

The details

The model applies to Humana Medicare Advantage members at AON community clinics in eight states. Practices that demonstrate adherence to evidence-based treatment pathways are exempt from submitting individual prior authorization requests for most anticancer drug therapies, and Evolent supplies the pathway infrastructure, quality programs and performance reporting. The model also includes automated reminders in AON's electronic health record system that prompt periodic immunotherapy response testing.

November 11, 2026: Humana, Evolent Health and American Oncology Network announce the oncology care model launch.
May 2026: Evolent launches a similar pathway-based arrangement with Highmark.
January 2027: Highmark's self-funded employer plan coverage is scheduled to follow.

Big Picture

The model responds to the prior authorization burden documented in the 2025 CancerCare survey, which found that 87% of respondents with employer plans faced at least one such review for cancer care in the past year. It moves the review from individual drug requests to a practice-level check, a structure Evolent is extending to Highmark's commercial plans in January 2027.

Patients at participating AON clinics on Humana Medicare Advantage may face fewer approval waits for most anticancer drug therapies, since individual prior authorization requests are waived for adherent practices. The change affects how quickly covered treatments can begin, though the source does not specify the expected reduction in delays.

The takeaway

Patients in cancer care should ask whether their treating clinic participates in pathway-based insurance arrangements, since those practices may begin treatment without waiting for individual drug approvals. Checking with a clinic about its prior authorization process can help set expectations before treatment starts.