High-risk medications (HRM) have the potential to be problematic in those 65 years of age or older. Below is a list of some commonly used HRMs that will be impacted by Humana Medicare formulary changes in 2013 (i.e., prior authorization (PA) requirements, step therapy (ST) modifications and nonformulary (NF) changes). Humana members are asked to talk to their health care provider about possible alternatives.
||Humana Gold Plus, Humana Gold Plus SNP-DE
||Human Gold Plus, Humana Gold Choice, HumanaChoice, Humana Walmart-Preferred Rx Plan
|National-4 PDP Complete Formulary Humana Complete
|National-4 MAPD Formulary
||Humana Gold Choice, Humana Gold Plus, Humana Gold Plus SNP-CHF/DM, Humana Gold Plus SNP-DB, Humana Gold Plus SNP-DE, Humana Prime Choice, Humana Choice
|National-5 PDP Enhanced Formulary Humana Enhanced
Arcadian Community Care-Plus, Arcadian Health Plan-Plus, CareFree, CareNeeds Plus, Desert Canyon Community Care-Plus Humana Gold Choice
Humana Gold Plus, Humana Gold Plus SNP-CHF/DM, Humana Gold Plus SNP-CVS/CHF/DM, Humana Gold Plus SNP-DB, Humana Gold Plus SNP-DE, Humana Prime Choice
Humana Reader's Digest Healthy Living Plan Humana Total Care Advantage, HumanaChoice, MD Care, Texas Community Care-Plus, Arkansas Community Care, Care One
||CareFree, CareNeeds, CareNeeds PLUS, CareOne, CareOne PLUS, Humana Gold Plus, Humana Gold Plus SNP-DB, Humana Gold Plus SNP-DE
CareDirect, CareFree, CareFree PLUS, CareHeart
CareNeeds, CareNeeds PLUS, CareOne, CareOne PLUS
Humana Gold Plus, Humana Gold Plus SNP-CHF/DM, Humana Gold Plus SNP-CLD, Humana Gold Plus SNP-CVD/CHF
Humana Gold Plus SNP-CVD/CHF/DM, Humana Gold Plus SNP-DB, Humana Gold Plus SNP-DE,Humana Gold Plus SNP-I
For prescription drug information for Humana Medicare members, visit our website at www.humana.com/providers/pharmacy/drug_list.aspx. Click "Drug List Search" and enter the drug name. Choose "Medicare" to see the drug’s tier placement in Medicare formularies and any restrictions that apply.
Please note: Many medications considered to be high-risk in the elderly will have a formulary status change or a utilization management requirement for 2013. For a more comprehensive list of high-risk medications (HRM) and possible alternatives, please go to http://apps.humana.com/marketing/documents.asp?file=1578031.
If you have any questions regarding this document, please call 1-800-457-4708. This line is open from 8 a.m. to 8 p.m., local time, Monday through Friday. (In Puerto Rico, please call 1-866-773-5959.)