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 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 Strep Therapy Criteria

DSNP 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 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
  • Download, fill out and fax the Medicare Prescription Drug Coverage Determination form to 877-486-2621
  • Call 800-555-CLIN (2546), Monday – Friday, 8 a.m. – 8 p.m., local time.

Learn more about prior authorization.

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

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 service to find an in-network specialty pharmacy near you.

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.

Over-the-counter benefits

Your pharmacy benefit lets you order certain over-the-counter (OTC) health and wellness items through the mail. 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 will get the generic versions of the OTC items you order. Generic medicine is the same as a brand-name medicine in:

• Dosage
• Effectiveness
• Quality
• Safety
• Stability
• Strength

Be sure to ask your doctor before taking any OTC medicines or vitamins.

You can find a full list of the OTC health and wellness items that you can get in the mail on the OTC order form:

Over-the-Counter Order Form – English

Over-the-Counter Order Form – Spanish

If you have questions about this mail-order service, call CenterWell Pharmacy at 800-526-1490 (TTY:711), Monday – Friday. 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 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 to file a reimbursement claim.

Mail the form to:

Humana Pharmacy Operations
P.O. Box 14601
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

Questions?

If you have any questions about your pharmacy benefits, call 866-274-9834 (TTY:711), Monday – Friday, 8 a.m. – 8 p.m., Central time.