Managing your medicines can be a lot of work. We want to make it easier. Learn what medicines your plan covers and where to get them.
What drugs are covered?
Your Humana Dual Fully Integrated plan covers a full range of safe and effective medicines. These medicines are part of a formulary, or Prescription Drug Guide (PDG). The medicines on the PDG are available at no cost to you.
Your doctor will use the PDG to 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
View printable copies of the Prescription Drug Guide and pharmacy policies:
2026 Prescription Drug Guide (HMO D-SNP) – English
2026 Prescription Drug Guide (HMO D-SNP) – Spanish
2026 Prior Authorization Criteria
2026 Step Therapy Criteria
D-SNP Transition Policy
Prior authorizations
You may need to get approval before you can get a certain medicine. This approval is also known as prior authorization.
Whether a medicine needs this approval or not may change. Check the Humana Drug List (PDL)
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.
- 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), Monday – Friday, 8 a.m. – 8 p.m., local time.
- Submit an online request for Part D prior authorization
- You can complete your own request in 3 ways:
Learn more about prior authorization
Where can I get my medicine?
You will need to fill your prescription at a Humana network pharmacy. If you use an out-of-network phar¬macy for any reason, you will have to pay the full cost of your medicine.
Learn more about cost-share pharmacy options
Find a pharmacy
To fill a prescription, you can go to one of the many pharmacies that accepts Humana Dual Fully Integrated (HMO D-SNP). Not sure where to go? Find an in-network pharmacy near you using our find a pharmacy service.
Find a pharmacy
CenterWell Pharmacy
CenterWell Pharmacy® is Humana’s mail order pharmacy. It is safe, convenient, and easy to use.
When you place an order with CenterWell Pharmacy, we fill it and double check it for accuracy. Then we 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.
Learn more about CenterWell Pharmacy
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
CenterWell Specialty Pharmacy®
You may be able to fill your specialty prescriptions at our CenterWell Specialty Pharmacy. This pharmacy will fill and mail your specialty prescription to your house.
For more information, call CenterWell Specialty Pharmacy at 844-486-2668 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., and Saturday, 8 a.m. – 6 p.m., Central 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
opens in new window 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 Member Handbook .
Medicare Prescription Payment Plan
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
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
Mail the form to:
Humana Pharmacy Operations
P.O. Box 14601
Lexington, KY 20512
Medication Therapy Management
Medication Therapy Management (MTM), is a Medicare-designed program that Humana offers to eligible D-SNP members. This program allows you to get a one-on-one review 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 MTM program, call our partner organization MedWatchers at 833-677-4088 (TTY: 771), Monday – Friday, 7 a.m. – 8 p.m., Central time.
Learn more about MTM and find out if you qualify
Questions?
If you have any questions about your pharmacy benefits, call 800-787-3311 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., Central time.
