Your Medicaid prescription coverage

Learn what medicines are covered on your Medicaid medical plan, how to find a pharmacy, get important forms and more.

A doctor writes out a prescription at a pharmacy counter next to a girl sitting on the counter.

Find the medicines you need

Managing your medicines is important. We want you to feel comfortable knowing that your prescriptions will be covered by your plan. Learn about your Medicaid prescription benefits and more.

What drugs are covered?

Your Humana medical plan covers a full range of safe and effective medicines. These medicines are part of a formulary, or Drug List. The medicines on the Drug List are available at no cost to you.

Your doctor will use the Drug List to choose the best medicine to treat you and your condition.

Some covered medicines may have extra steps you need to take or limits on what is covered. You may need to get approval before you can be covered for a certain medicine (also known as prior authorization).

Humana will cover your use of a medicine from the Drug List as long as there is a medical need for you to be on it. You also need to fill your prescription at a Humana network pharmacy and follow other plan rules.

Check Drug List

Prior authorizations

You may need to get approval before you can be covered for a certain medicine –also known as prior authorization.

Whether a medicine needs this approval or not may change.

Check the Drug List to see which medicines need prior authorization.

Learn more about Florida Medicaid Drug List criteria, opens in new window from the Agency for Health Care Administration.

How to get prior authorization

Ask your doctor to send a request to Humana’s Clinical Pharmacy Review department by phone or online. Only your doctor can send a prior authorization request for you. We will let your doctor know our decision within 24 hours.

Get help with prior authorizations

If you need prior authorization for a prescription, your doctor can contact Humana Clinical Pharmacy Review (HCPR).

By phone:
1-800-555-CLIN (2546) (TTY: 711)
Available Monday—Friday, 8 a.m. – 6 p.m., local time,

By fax or mail:
Your doctor can visit our provider prior authorization page to complete the preauthorization form. They may need to include a statement of medical necessity, specific patient medical information, or peer-reviewed literature related to the request.

Fax number: 1-(877)-486-2621

Mailing address:
Humana Pharmacy Operations
P.O. Box 33008
Louisville, KY 40232-3008.

Find a pharmacy

If you have a prescription that you need to fill, head to one of the many pharmacies that takes your Humana medical plan.

Not sure where to go? Find an in-network pharmacy near you using our online pharmacy finder tool.

Note: If you use an out-of-network pharmacy for any reason, you’ll have to pay the full cost of your medicine.

Find a pharmacy

Specialty pharmacy

If you need medicine to treat a complex or long-lasting condition like HIV, cancer or multiple sclerosis, for example, you may need to get your prescription filled at a specialty pharmacy.

These are specialty prescriptions that only certain locations will have in stock.

You can use the pharmacy finder tool to find a specialty pharmacy near you.

Find a pharmacy

Humana Specialty Pharmacy

Some Humana plans give you access to the Humana Specialty Pharmacy® that will fill your specialty prescriptions for you and send them to your house directly by mail.

For more information, call:
Humana Specialty Pharmacy
1-800-486-2668 (TTY: 711)
Available Monday – Friday, 8 a.m. – 8 p.m., Eastern time; Saturday, 8 a.m. – 6 p.m., Eastern time.

Over-the-counter health and wellness

Your pharmacy benefit lets you order certain over-the-counter (OTC) health and wellness items through the mail. You will get the generic versions of the OTC items you order—they will be the same as the name brand. Be sure to ask your doctor before taking any OTC medicines or vitamins.

These medicines will be sent by UPS or the U.S. Postal Service within 10–14 working days after the order is made. There is no charge to you for shipping.

You can find a full list of the OTC medicines that you can get in the mail on the OTC order form.

Visit Documents and Forms to download and complete the OTC order form.

If you have questions about this mail-order service, call:
PrescribeIT Rx
1-800-526-1490 (TTY: 711)

If you paid out of pocket

We hope you don’t have to pay for any medicines out of pocket. If it happens, let us know by filling out a reimbursement claim form, and you may get a refund.

Fill in the form below to send a reimbursement claim.

Prescription Drug Claim Form for Member Reimbursement

Looking for help?

Contact Us

If you have questions, find the number you need to get help and support.

Find a doctor

Find a doctor, hospital or pharmacy.

Documents & forms

Find the documents and forms you need, including your member handbook.