Prior authorization for professionally administered drugs

Some drugs require prior authorization before they can be delivered or administered in a physician’s office, clinic, outpatient or home setting. Prior authorization is required for the drugs listed below in the “Customized fax forms” section.

Submitting a prior authorization request

Prescribers should complete the applicable form below and fax it to Humana’s Medication Intake Team (MIT) at 1-888-447-3430. To obtain the status of a request or for general information, you may contact the MIT by calling 1-866-461-7273 Monday through Friday, 8 a.m. to 6 p.m. EST.

Forms for state mandates

Universal form for state mandates

The use of this form is mandated for prior authorization requests concerning commercial fully insured members who:

  • reside in Arkansas, Louisiana or Mississippi and/or
  • whose prescription drug coverage was sold in a state listed above

Medical prior authorization request form

California authorization form

The use of this form is mandated for prior authorization requests concerning commercial fully insured members who:

  • reside in the state of California and/or
  • whose prescription drug coverage was sold in the state of California

Prescription drug prior authorization request form

If you have questions about whether you should use the state-mandated forms above, please call the MIT at 1-866-461-7273.

Prescriber quick reference guide

This guide helps prescribers determine which Humana medication resource to contact for prior authorization, step therapy, quantity limits, medication exceptions, appeals, prior authorization and claims. It also provides phone, fax and Web contact information.

Prescriber quick reference guide (0.2 MB)

Customized fax forms

General fax forms

Universal B vs. D medical fax form (452 Kb)