Changes to Humana’s 2009 Drug List

Effective Jan. 1, 2009, several changes will be made to the Humana Drug List for most members. (Please note that for Texas groups, these changes will not become effective until the groups’ renewal effective date. This date is not necessarily Jan. 1, 2009.)

To help facilitate safe, appropriate and cost-effective drug benefits for all members, all Humana plans will utilize additional prior authorization (PA), step therapy protocols (ST) and quantity limit (QL) edits.

Providers can view the entire list of changes by visiting Humana.com. Click on “Providers” and then “Prescription Tools” in the “Quick Links” box. Click on “Humana’s Drug List” and scroll down to see “Drug List Changes” for 2009.

Providers can search for a drug by taking the following steps:

1. Select a Humana prescription drug plan category, either Medicare or commercial.
   
2. Search using one of four methods:

   a. Drug name — enter first three letters
   b. Alphabetical search — search by first letter
   c. Therapeutic class search — search for drugs according to therapeutic class, such as cardiology, oncology and other specialties
   d. Most commonly referenced drugs list — click directly on the names of some of the most searched drugs

The search provides you with information on whether a drug requires any type of prior authorization, dispensing limits, authorization for continued therapy, quantity limits or step therapy. Prescribing providers also are given a list of possible alternative prescription drugs that are available in the same therapeutic class.

Some other helpful tools offered as part of the Drug List search include:

• A link that allows users to toggle back and forth between Medicare and commercial plans for the same drug
  
• A printable version of the List
  
• A Medicare Part D exception and appeals page

The Drug List is updated weekly and contains information on approximately 12,000 drugs.

Humana continues to encourage members to use generic and cost-effective brand medications whenever possible. When filling prescriptions, Humana encourages members to take advantage of RightSourceRx^SM, Humana’s prescription home-delivery service. Physicians can order new prescriptions for members by calling RightSourceRx at 1-800-379-0092 or by fax at 1-800-379-7617. For more information about RightSourceRx, to download forms and to view frequently asked questions, visit RightSourceRx.com, or call 1-800-379-0092 weekdays between 8 a.m. and 11 p.m. and on Saturday from 8 a.m. to 6:30 p.m., EST.

For more information about the drug list, call 1-800-4-HUMANA (1-800-448-6262).

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Changes to Humana’s 2009 Medicare Formulary

Humana is changing its formulary in 2009. As always, Humana continues to evaluate the Drug List to make sure the drugs covered are safe and cost effective for Medicare members. Beginning Jan. 1, 2009, in most markets, Humana will introduce a closed formulary. If a member remains on a closed formulary prescription, it will mean a higher drug cost in 2009.

Since October, we have been alerting our members about which drugs will no longer be covered. The message encourages members to contact their providers to assist in selecting alternatives that will be covered in 2009. We have supplied each member with a possible alternative, but ask providers to suggest alternatives that will work for each of their individual patients.

To the right are the most commonly used drugs that will be removed from our formulary, along with the possible alternative.

For a complete list of all formulary changes, visit Humana.com. Click on “Providers” and then “Prescription Tools” in the “Quick Links” box. Click on “Humana’s Drug List” and scroll down to see “Drug List Changes” for 2009.

To make your experience with Humana more efficient, we have developed an Interactive Voice Response system (IVR), which will be active on Jan. 1, 2009. With this IVR, you will be able to check on the status of a Prior Authorization (PA) request, check the availability of a drug for a member, and receive information on initiating the PA or exception process. To access the IVR, call
1-800-555-2546.

Please note: The following plans will continue to use an open formulary covering all Part D medications:

• Humana MAPD HMO and Local PPO plans in:
  • Florida
    
  • Louisiana
    
  • Las Vegas
• CarePlus MAPD HMO Plans

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