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Humana Healthy Horizons in Indiana

Indiana PathWays for Aging

Prescription coverage

Learn about your coverage, how your provider picks the medicine you can take, and more.

Prescription medicine

Humana Healthy Horizons in Indiana members can access a full range of safe and effective medicines. These medicines are part of a formulary (also known as a Preferred Drug List). Medicines on this list are the medicines we prefer your provider use when choosing the best medicines to treat you and/or any condition(s) you have.

Preferred Drug List (PDL)

Your provider will use the Preferred 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 (also known as prior authorization) for certain medicine.

We will cover your use of a medicine from the Preferred 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.

The PDL may change during the year. If any medicine of the PDL changes, we will notify you. You always can refer to the below versions of the PDL to see the current version.

2024 Preferred Drug List (English)

2024 Preferred Drug List (Spanish)

Preferred Drug List-Machine Readable

Indiana Medicaid Preferred Drug List

Prior authorization

PathWays members may need to get approval (also known as prior authorization) for certain medicine. Whether a medicine needs this approval or not may change. The Preferred Drug List has information about the medicine that needs prior authorization. Only your provider can send us a prior authorization request for you. We will let your provider know our decision within 24 hours of getting the request.

Your provider will need to get approval if covered medicines have limits such as:

  • Age limit: covered for certain age group
  • Quantity limits: a limit on the number of drugs you can get at one time
  • Step therapy: a preferred drug(s) must be tried first.

We will not cover some medications, including:

  • Drugs used for eating problems or weight gain
  • Drugs used for erectile dysfunction
  • Drugs that are for cosmetic purposes or to help you grow hair
  • Drug Efficacy Study Implementation (DESI) drugs and drugs that are identical, related, or like such drugs
  • Investigational or experimental drugs
  • Drugs used for any purpose that is not medically accepted

Participating pharmacies

You can fill your prescription at any pharmacy that accepts Humana Healthy Horizons. Use our online Find a Pharmacy service to find an in-network pharmacy near you.

When you go to a pharmacy, make sure to bring your member ID card with you.

As a Humana Healthy Horizons in Indiana member, you can use Humana’s mail-order pharmacy, CenterWell Pharmacy®, which will send medicine to your home.

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

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 home or provider.

To learn more about CenterWell Pharmacy

Humana Healthy Horizons in Indiana

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