Your South Carolina DSNP plan covers a full range of safe and effective medicines. These medicines are part of a formulary, or Humana drug list. The Humana drug list will help you to learn what you will pay for your prescribed medicines. 

Your doctor will use the Humana drug list to help choose the best medicine to treat you and your condition.

Some medicines on the Humana drug list may be limited to certain plans 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

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

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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 pharmacy for any reason, you may have to pay the full cost of your medicine.

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Find a Pharmacy

To fill a prescription, you can go to one of the many pharmacies that accepts your Humana 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 one of your plan’s preferred cost-sharing mail-order pharmacies. It is safe, convenient, and easy to use. Other pharmacies may be available in our network. You can locate network pharmacies by visiting the Pharmacy Finder opens in new window . CenterWell Pharmacy is the preferred cost-sharing mail-order pharmacy under many Humana MAPD and PDP plans. There are other pharmacies, including preferred cost-sharing retail pharmacies, that are available in our network. Members can choose any network pharmacy for their prescriptions.

When you place an order with CenterWell pharmacy, they will fill it and double check it for accuracy. 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

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

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 800-486-2668 (TTY:711), Monday – Friday, 8 a.m. – 11 p.m., and Saturday, 8 a.m. – 6:30 p.m., Eastern time.

Over the counter benefits

You can use your Humana Spending Account Card to access your allowance and buy eligible over-the-counter products like vitamins, pain relief, incontinence products, cold and flu medicine and first aid.

Learn more about participating stores and eligible items at MyHumana.com. In store, scan products with the MyHumana mobile app to see if they are approved.

You can find participating stores in your area by using the Store Finder at MyHumana.com.

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

If you have questions about this mail-order service, call CenterWell Pharmacy at 855-211-8370 (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 opens in new window  to price a drug based on your plan. 
• Find the What is my copay? section in the Humana drug list, or look for more information in your Evidence 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.

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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 (coming soon) 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 14169
Lexington, KY 40512-4169

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-1 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 Medication Therapy Management Program, call Humana Clinical Programs at 833-349-4114 (TTY: 711), Monday – Friday, 9 a.m. – 5:30 p.m., Eastern Time.

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Questions?

If you have any questions about your pharmacy benefits, call Member Services at 866-274-5888 (TTY:711), 8 a.m. to 8 p.m. seven days a week from Oct. 1 - Mar. 31, and 8 a.m. to 8 p.m. Monday - Friday from Apr. 1 - Sept. 30.