Your Humana Dual Integrated plan covers a full range of safe and effective medicines. These medicines are part of a formulary, or Prescription Drug Guide (PDG). The PDG will help you to learn what you will pay for your prescribed medicines.

Your doctor will use the PDG to help choose the best medicine to treat you and your condition. Some medicines on the PDG may be limited or require approval. This approval is known as prior authorization. If a medicine requires prior authorization, your healthcare provider can help you.

Search the Humana Drug List opens in new window

View printable copies of the Prescription Drug Guide and pharmacy policies:

2026 Prescription Drug Guide (HMO D-SNP) – English pdf opens in new window

2026 Prescription Drug Guide (HMO D-SNP) – Spanish pdf opens in new window

2026 Prior Authorization Criteria opens in new window

2026 Step Therapy Criteria pdf opens in new window

DSNP Transition Policy opens in new window

Prior authorization

You may need to get approval before you can get some high-risk or high-cost medicines. This approval is also known as prior authorization. Whether a medicine needs this approval or not may change. Check the Humana Drug List opens in new window  to see which medicines need prior authorization.

How to get prior authorization

To receive coverage for a medication requiring prior authorization, you can:

• Ask your healthcare provider to submit the request. Your healthcare provider can submit the request online, by fax or phone. Once your request has been processed, your healthcare provider will be notified. If you are a Medicare member, you will also receive a determination letter in the mail.
  
  
• Submit your own prior authorization request. You can complete your own request in 3 ways:
  • Submit an online request for Part D prior authorization opens in new window
  • Download, fill out and fax the Medicare Prescription Drug Coverage Determination form opens in new window  to 877-486-2621
  • Call 800-555-CLIN (2546) (TTY:711), Monday – Friday, 8 a.m. – 8 p.m.,local time.

Learn more about prior authorization opens in new window

Where can I get my medicine?

We recommend that you fill your prescription at a Humana network pharmacy. You can save time and money by ordering a 100-day supply of covered prescriptions at an in- network pharmacy. If you use an out-of-network pharmacy for any reason, you may have to pay the full cost of your medicine.

Learn more about cost-share pharmacy options opens in new window

Find a pharmacy

To fill a prescription, you can go to one of the many pharmacies that accepts your Humana DSNP. Not sure where to go? Find an in-network pharmacy near you using our find a pharmacy service opens in new window

CenterWell pharmacy

CenterWell pharmacy is one of your plan’s preferred cost-sharing mail-order pharmacies. It is safe, convenient, and easy to use. When you place an order with CenterWell pharmacy, they fill it and double check it for accuracy. Then they ship your medications safely and securely by mail so you can:

• Avoid waiting in pharmacy lines
• Save time with a 90-day supply of your prescriptions
• Get support from 600+ pharmacists from the comfort of home
• Track your refill and get refill reminders

Getting started with CenterWell pharmacy

Filling your prescriptions with CenterWell is easy. To get started, download the CenterWell Pharmacy app for Apple iOS or Android, or sign in online.

Specialty pharmacy

You may need medicines to treat a complex or long-lasting condition like cancer, HIV, or multiple sclerosis. You may need to fill these prescriptions at a specialty pharmacy. Medicines to treat complex or long-lasting conditions may only be available at certain locations. You can use our Find a Pharmacy opens in new window  service to find an in-network specialty pharmacy near you.

CenterWell Specialty Pharmacy

One option you may use to fill your specialty prescriptions is CenterWell Specialty Pharmacy. This pharmacy will fill and mail your specialty prescription to your house.

For more information, call CenterWell Specialty Pharmacy at 800-486-2668 (TTY: 711), Monday – Friday, 8 a.m. – 11 p.m., and Saturday, 8 a.m. – 6:30 p.m., Eastern time.

How much will I pay for my medicine?

There are two ways to learn what you will pay for your Medicare Part D prescriptions:

• Sign in to your MyHumana account to price a drug based on your plan.
• Find the What is my copay? section in the Prescription Drug  Guide, or look for more information in your Explanation of Coverage (EOC)

Medicare Prescription Payment Plan (MPPP)

Eligible Part D enrollees can pay out-of-pocket prescription drug costs in monthly payments instead of all at once. This program does not save you money or lower your drug costs—it’s a monthly installment payment plan.

Learn more about the Medicare Prescription Payment Plan opens in new window

What if I paid out of pocket?

We hope you don’t have to pay for any medicines out of pocket. If you do, let us know by filling out a Pharmacy Direct Member Reimbursement form, and you may get a refund.

Fill out the Pharmacy Direct Member Reimbursement Form pdf opens in new window  to file a reimbursement request and include your receipt. If your form is missing information, we will contact you or your pharmacy.

Mail the form and your receipt to:

Humana Pharmacy Operations
P.O. Box 14359
Lexington, KY 40512

Medication Therapy Management

Medication Therapy Management (MTM), is a Medicare-designed program that Humana offers to eligible DSNP members. This program allows you to get a 1-on-1review of your medications with a qualified pharmacist or other trained healthcare provider. We can help you make sure your medications are working for you, identify any potential lower-cost options and answer any questions or concerns you may have about your medications.

If you have questions about our Medicine Therapy Management program, call our partner organization MedWatchers at 833-677-4088 (TTY: 771), Monday – Friday 8am – 9pm, EST

Learn more about Medication Therapy Management and find out if you qualify opens in new window

Questions?

If you have any questions about your pharmacy benefits, call Customer Care at 800-477-6931 (TTY:711), Monday – Friday, 8 a.m. – 8 p.m., Eastern time