Changes to 2012 Formularies

We frequently review our Drug List to make sure it is safe and cost-effective for our Medicare members. Effective January 1, 2012, certain drugs will have new limitations or will require utilization management under the Humana Medicare formularies for the 2012 plan year.

These changes could mean higher costs, new limitations or new requirements for Humana members who choose to continue to use these impacted prescribed drugs. Humana encourages the use of generic and cost-effective brand medications whenever possible.

Below is a list of some commonly used medications that will be impacted by Humana Medicare formulary changes in 2012 [i.e., prior authorization (PA) requirements, step therapy (ST), tier change (TC) and nonformulary (NF)]. Humana members are asked to talk to their health care provider about possible alternatives.

Impacted Drug 2012 Formularies Possibile Alternatives
Select Preferred National-4 (PDP) National-4 (MAPD) National-5 Plus-5 Puerto Rico
Bupropion HCL TC TC TC TC Determined by physician
Carisoprodol PA PA PA PA PA PA PA Tizanidine
Combivent TC NF TC TC TC TC Spiriva
Cyclobenzaprine PA NF NF NF NF PA NF Tizanidine
Dicyclomine PA NF NF NF NF PA NF Loperamide
Diphenoxylate-Atropine PA PA PA PA PA PA PA Loperamide
Exelon Capsules PA/TC NF NF NF NF PA/TC   Donepezil ODT
Hydrocodone-Acetaminophen TC TC TC TC   TC   Determined by physician
Hyroxyzine HCL PA NF NF NF NF PA NF Determined by physician
Hydroxyzine Pamoate PA NF NF NF NF PA NF Determined by physician
Levaquin   NF NF NF NF   NF Levofloxacin
Methocarbamol PA PA PA PA PA PA PA Tizanidine
Nifedipine PA NF TC TC TC PA NF Nifedipine Extended Release
Nitrofurantoin Macrocrystal PA PA/TC PA/TC PA/TC PA/TC PA/TC PA Sulfamethozazole-Trimethoprim
Nitrofurantoin Monohyd/M-Cryst PA PA/TC PA/TC PA/TC PA/TC PA/TC PA Sulfamethozazole-Trimethoprim
Summary
Select CareOne & CareOne Plus, CareFree & CareFree Plus, CareNeeds & CareNeeds Plus, Humana Gold Plus®, Humana Gold Plus SNP-DE, Humana Gold Plus SNP-DB, CareDirect, Humana Gold Plus SNP-CVD/CHF/DM
Preferred HumanaChoiceSM, Humana Reader's Digest Healthy Living Plan, Humana Gold Choice®, Humana Gold Plus, Humana Walmart-Preferred Rx Plan
National-4 (PDP) Humana Enhanced, Humana Complete
National-4 (MAPD) Humana Reader's Digest Healthy Living Plan, HumanaChoice, Humana Gold Plus, Humana Gold Plus SNP-DE, Humana Gold Choice
National-5 Humana Gold Plus, HumanaChoice, Humana Reader's Digest Healthy Living Plan, CareOne, CareNeeds Plus, Humana Gold Plus SNP-DE
Plus-5 CareNeeds & CareNeeds Plus, CareFree, Humana Gold Plus, Humana Gold Plus SNP-DE
Puerto Rico Humana Gold Plus, Humana Gold Plus SNP-DE

For prescription drug information for Humana Medicare members, please visit Humana Medicare Drug List. Click "Drug List Search" and enter the drug name. You will then be asked to enter the CMS Plan ID listed on the bottom right corner of the member's ID card.

For more information on these drug lists, please visit Humana Drug Lists.

Please note: Many medications considered to be high-risk in the elderly will have a formulary status change or a utilization management requirement for 2012. Please review a list of high-risk medications (HRM) and possible alternatives.

If you have any questions regarding this notice, please call 1-800-457-4708. (In Puerto Rico, please call 1-866-773-5959.)