Submit your redetermination request online
It's fast, easy and secure to submit your request online.
Request for Redetermination of Medicare Prescription Drug Denial Online Form – English, opens new window
Submit your redetermination request via fax or mail
Request for Redetermination of Medicare Prescription Drug Denial Form – English, PDF opens new window
Request for Redetermination of Medicare Prescription Drug Denial Form – Spanish, PDF opens new window
Submit your appeal request via fax or mail
Appeal, Complaint, or Grievance Form – English, PDF opens new window
Appeal, Complaint, or Grievance Form – Spanish, PDF opens new window
Include the following information on the form:
- Your prescription drug information.
- The reason you're appealing the denial.
- 3. Any clinical rationale given to you by your prescribing doctor or other prescriber. You can add this as an attachment in the online form or fax it to us. If you live in Puerto Rico, use fax number 1-800-595-0462.
- The prescribing doctor's information.
Fax number:
1-855-251-7594
Mailing address:
Humana Grievances and Appeals
P.O. Box 14165
Lexington, KY 40512-4165
Puerto Rico members:
Fax Number:
1-800-595-0462
Mailing Address:
Humana Puerto Rico
Grievances and Appeals Unit
P.O. Box 191920
San Juan, PR 00919-1920
Call the number on the back of your ID card
You can submit a redetermination by calling Customer Service. You can also get help with any questions or problems you have filling out the form or check the status on a previously filed appeal. Call Customer Service toll free at the number on the back of your ID card. If you have a speech or hearing impairment and use a TTY, call 711. Puerto Rico members, call 1-866-773-5959. Our hours are 5 a.m. to 8 p.m. EST, 7 days a week.
Be sure to submit all supporting information for your appeal request. You or your prescribing doctor or other prescriber can send this to fax number 1-855-251-7594. If you live in Puerto Rico, please fax to 1-800-595-0462. After we receive the request, Humana will make our decision and send written notice within seven (7) calendar days.