Humana - Guidance when you need it most

Prior Authorization

Certain drugs require prior authorization (PA) or a medical exception for coverage. If the drug requires this step, a member’s doctor will need to request and receive approval from Humana before the drug may be covered by their insurance plan.

Instructions for: United States | Puerto Rico

Request Submission

Doctors can submit their requests to the Humana Clinical Pharmacy Review (HCPR) through the following methods.

Phone & Fax Requests:

Hours: 8:00 a.m. – 6:00 p.m. EST, Monday-Friday.
Phone Requests: 866-488-5991
Fax Requests: Complete the forms below and fax to 866-423-0486

General Fax Form

If a drug does not have a custom form below, please use the General Fax Form.
General Fax Form
(44 KB) Download PDF
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Customized Fax Forms

Aciphex Download PDF
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Actimmune Download PDF
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Actiq Download PDF
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Allegra Download PDF
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Allegra-D Download PDF
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Amevive Download PDF
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Amrix Download PDF
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Aralast Download PDF
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Aranesp Download PDF
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Arranon Download PDF
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Avonex Download PDF
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Betaseron Download PDF
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Boniva Download PDF
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Byetta Download PDF
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Bystolic Download PDF
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Celebrex Download PDF
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Clarinex Download PDF
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Clarinex-D Download PDF
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Copaxone Download PDF
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Coreg CR Download PDF
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Eligard Download PDF
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Enbrel Download PDF
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Epogen Download PDF
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Euflexxa Download PDF
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Fentora Download PDF
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Flector Download PDF
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Flolan Download PDF
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Forteo Download PDF
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Genotropin Download PDF
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Gleevec Download PDF
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Hemophilia Download PDF
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Herceptin Download PDF
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Humatrope Download PDF
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Humira Download PDF
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Hyalgan Download PDF
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Increlex Download PDF
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Iplex Download PDF
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IVIG medications Download PDF
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Janumet Download PDF
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Januvia Download PDF
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Kineret Download PDF
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Lamisil Download PDF
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Leukine Download PDF
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Lucentis Download PDF
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Lupron Download PDF
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Lupron (Infertility) Download PDF
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Mobic Download PDF
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Multi-Source Brand-Name Review Request Download PDF
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Neulasta Download PDF
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Neupogen Download PDF
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Nexavar Download PDF
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Nexium Download PDF
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Norditropin Download PDF
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Nutropin Download PDF
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Orencia Download PDF
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Orthovisc Download PDF
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Pegasys Download PDF
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Peg-Intron Download PDF
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Penlac Download PDF
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Prevacid Download PDF
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Prilosec Download PDF
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Procrit Download PDF
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Prolastin Download PDF
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Protonix Download PDF
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Provigil Download PDF
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Raptiva Download PDF
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Rebif Download PDF
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Reclast Download PDF
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Remicade Download PDF
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Remodulin Download PDF
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Revatio Download PDF
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Revlimid Download PDF
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Ribavirin Download PDF
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Rituxan Download PDF
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Saizen Download PDF
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Sandostatin Download PDF
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Sandostatin LAR Download PDF
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Serostim Download PDF
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Simcor Download PDF
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Soliris Download PDF
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Somavert Download PDF
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Sporanox Download PDF
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Sprycel Download PDF
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Supartz Download PDF
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Sutent Download PDF
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Symlin Download PDF
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Synvisc Download PDF
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Tekturna Download PDF
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Tev-Tropin Download PDF
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Thalomid Download PDF
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Tobi Download PDF
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Tracleer Download PDF
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Trelstar Download PDF
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Tykerb Download PDF
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Vectibix Download PDF
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Ventavis Download PDF
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Vidaza Download PDF
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Vivitrol Download PDF
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Xolair Download PDF
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Zegerid Download PDF
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Zemaira Download PDF
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Zoladex Download PDF
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Zolinza Download PDF
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