Humana's Medicare Drug List

Check Which Drugs Humana Covers

This page links you to prescription drug information for members with Humana Medicare prescription drug coverage. This can be either through a Medicare Advantage plan with prescription drug coverage or a stand-alone Prescription Drug Plan.

The Drug List is a list of prescription drugs developed and maintained by doctors and pharmacists. The type of coverage you – if you are enrolled through an employer group retiree plan – or your former employer purchased may cause variances in drug coverage. Certain drugs may have coverage limits. Some may require pre-approval.

If you have specific questions about a medication that doesn't appear on the list, please call the Customer Service number on the back of your member ID card.

Drug List Search

To look up a specific drug and view coverage details, possible generic equivalents, and alternatives, use our Drug List Search

Drug Pricing

To find out if your plan covers a certain drug and view estimated prices based on the pharmacy you select, log in to MyHumana and use the Drug Pricing Tool

Printable Drug Lists

Download a printable list of the most widely prescribed drugs on our Drug List:

2013 Printable Drug Lists

2012 Printable Drug Lists

Specialty Drugs

Your plan's Drug List may include specialty drugs, which are specialized therapies developed for chronic, complex illnesses. Many, but not all, of these drugs may be obtained through Humana's own specialty pharmacy, RightSource Specialty. Members in Puerto Rico will need to use CVS/Caremark for specialty drugs.

Members: Mail your new written prescription, payment and a completed Member Registration and Order Form to RightSource Specialty, P.O. Box 1017, Cincinnati, OH 45201-1017. A specialty care coordinator will contact you to arrange the delivery of your order.

Member Registration and Order Form
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For more details, visit RightSource.com/Specialty

Retail Pharmacy and Mail-order Information

Rate information: If a retail pharmacy agrees to accept the mail-order reimbursement rate for an extended supply of medications, you should have no out-of-pocket payment differences.

If a retail pharmacy doesn't agree to accept the mail-order reimbursement rate but has accepted an alternative retail/mail-order pharmacy rate for an extended supply of medications, you will have to pay for any difference in charge.

For more information about RightSource, Humana's preferred prescription mail-order pharmacy, visit RightSource.com

If you are a member of a qualified State Pharmaceutical Assistance Program, please contact the Program to verify that the mail order pharmacy will coordinate with that Program.

You must use network pharmacies, except under non-routine circumstances. Other pharmacies are available in our network.

More about Humana's Drug List

Drugs may be added, changed, or deleted from the Drug List at any time, which could affect the amount you pay for prescription drugs.

Humana doesn't determine brand or generic status for the medications on our Drug List. A nationally recognized, contracted healthcare vendor determines whether a drug is classified as a generic or brand-name drug.

One of the main factors for determining the status of a drug is the price. If pricing for a particular drug changes – as determined by using the average wholesale price – the brand or generic status also may change.

Pharmacy Coverage Policies

Concurrent DUR Quality Assurance
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Retrospective DUR Quality Assurance
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Out-of-Network Pharmacy Access Policy
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Medicare Updates

2013 Medicare Transition Policy
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Spanish
Chinese
Part D Transition Policy 2012
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Spanish

Quick Reference Guide for Manual Reimbursement

Over-the-Counter (OTC) Medicines and Products for Emergency Use
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Claim Forms

Prescription Drug Claim Form
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LI NET Prescription Drug Claim Form
(700 KB) Download PDF
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The Humana Family Medicaid Formulary

The Humana Family Medicaid formulary is a list of covered drugs selected by Humana in consultation with a team of health care providers which represents the prescription therapies believed to be a necessary part of a quality treatment program. Members can learn more about filling a prescription by reviewing their Evidence of Coverage.

The Humana Family Medicaid Formulary
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