Prior Authorization for Medications
For some medications, you must get advance approval from Humana before your plan covers any of the costs. This is called "prior authorization." If your drug has a prior authorization, your prescription may not be covered unless your doctor requests and receives approval from Humana.
Why We Require Prior Authorization
This step is designed to help you make the best use of your plan. For example, if you have diabetes, and your doctor wants you to try a new medication, we may need to authorize this drug before you fill the prescription. We want to make sure the medication won't interfere with others you take or add to your costs unnecessarily.
How to Find Out if a Drug Needs Prior Authorization
To find out if a certain drug requires prior authorization, you can:
- Search online – Use Humana's Medicare Drug List Search
- Call us – Call the Humana Customer Service number on the back of your Humana member ID card.
How Prior Authorization Works
For drugs that require prior authorization, your doctor must contact Humana Clinical Pharmacy Review (HCPR) in one of these ways:
- Call 1-800-555-CLIN (2546) – Hours are 8 a.m. to 9 p.m., Eastern time, Monday through Friday.
Fax or mail the form – The provider must complete the form in its entirety, and include a supporting statement of medical necessity. The supporting statement may include specific patient medical information as well as peer-reviewed literature related to the request if applicable.
Fax number:
1-877-486-2621
Mailing address:
Humana Clinical Pharmacy Review
1951 Bishop Lane, Suite 500
Louisville, KY 40218
- Prior Authorization Fax Form
- (34KB) Download PDF
- English
M0006_GHA06F2HH KC0909Back to top
