Humana Healthy Horizons in Louisiana members are eligible for pharmacy benefits. Humana Pharmacy Solutions provides pharmacy benefits for Humana Healthy Horizons in Louisiana Medicaid recipients. This coverage includes prescription medications and certain over-the-counter medications with a written order from a Humana Healthy Horizons provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.
Louisiana Medicaid: Prescription coverage
Preferred Drug List
The Louisiana Department of Health (LDH) Single Preferred Drug List (PDL) is a list of medicine Louisiana Medicaid recipients can use if prescribed. A Pharmacy and Therapeutics (P&T) Committee recommends medicine to include on or remove from the PDL. Medicine on the PDL is identified as preferred or nonpreferred and includes information about prior authorization requirements.
Find a pharmacy
Humana has a large network of pharmacies at https://finder.humana.com/finder/pharmacy?customerId=1 . There is also a full PDF directory on the website, or one can be mailed to you by calling the Member Pharmacy Call Center at 1-800-448-3810.
At a pharmacy
When visiting a pharmacy, please show your Humana Healthy Horizons® in Louisiana member ID card.
If you have any questions, please call the Member Pharmacy Help Desk: 1-800-448-3810. You received your Humana Healthy Horizons in Louisiana member ID card in the mail. You also can see a copy of it in your secure MyHumana account. Don’t have a secure MyHumana account?
Copays
Some medications are free, but some adult members may need to pay a small copay for their prescriptions based on the calculated state payment. Your cost for this medicine should not be more than $3. Your total copays for the month depend on your family’s income each month. If the state shows you have paid 5% of your monthly income on copays, you will not have to pay for your medicine for the rest of that month.
The co-pays for medication are as follows:
Copayment amount
$0.00
$0.50
$1.00
$2.00
$3.00
Calculated state payment
$5.00 or less
$5.01 to $10.00
$10.01 to $25.00
$25.01 to $50.00
$50.01 or more
However, there are no copayments for medication on the PDL for the following types of members and services:
- Alaskan Eskimos
- Members 20 and younger
- Members receiving hospice services
- Members receiving services on the basis of breast or cervical cancer diagnoses
- Members who are inpatient in long-term care facilities or other institutions
- Native Americans
- Pregnant women
- Enrollees of an Home and Community Based Waive
- U.S. Preventive Services Task Force (USPSTF) A and B recommendations
There never is a copayment for family-planning services and supplies and/or emergency services.
Over-the-counter health and wellness
Humana Healthy Horizons in Louisiana members have a $75 per quarter allowance for over-the-counter (OTC) health and wellness items, and these items:
- Will be sent by UPS, FedEx, or the U.S. Postal Service in 10–14 working days after the order is made
- Are generic versions of brand-name medicine and will be the same as a brand-name medicine in:
- Dosage
- Effectiveness
- How to take the medicine
- How the medicine works
- Quality
- Safety
- Stability
- Strength
Examples of available OTC items include:
- Pain relievers
- Diaper rash cream
- Cough and cold medicine
- First-aid items
View a full list of available OTC health and wellness items:
Over-the-Counter Health and Wellness Catalog and Order Form – English
Over the Counter Health and Wellness Catalog and Order Form – Spanish
If you have questions about this mail-order service, call CenterWell Pharmacy™ at 1-855-211-8370 (TTY: 711), Monday – Friday, 7 a.m. – 10 p.m. and Saturday, 7 a.m. – 5:30 p.m.
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