It’s important to have the right treatment
Here’s an example of prior authorization: you have diabetes and your doctor wants you to try a new medicine. Humana may need to pre-approve before you fill the prescription.
You may be able to appeal Humana’s decision if your medication is not authorized. You can get the forms you need by contacting us directly or through your doctor. Medicare patients can use the Medicare Part D Coverage Redetermination Request form for their appeal.
Getting your medications approved
To see if any of your drugs need to be pre-approved, you can:
You can get your doctor involved
If you learn that you need prior authorization for a prescription, your doctor will contact Humana Clinical Pharmacy Review (HCPR). Here are contacts your doctor can use:
- Call 1-800-555-CLIN (2546): Hours are 8 a.m. to 6 p.m., local time, Monday through Friday.
- Use fax or mail: Your doctor can visit our provider prior authorization page and complete the appropriate form. A statement of medical necessity may also be needed, possibly including specific patient medical information as well as peer-reviewed literature related to the request.
Fax number: 1-877-486-2621
Humana Pharmacy Operations
P.O. Box 33008
Louisville, KY 40232-3008