For information on how to submit a preauthorization for frequently requested services/procedures for your patients with Humana commercial or Medicare coverage, please use the drop-down function below. For all other services, please reference the inpatient and outpatient requests to complete your request online or call 800-523-0023.

Preauthorization and notification lists

View documents that list services and medications for which preauthorization may be required for patients with Humana Medicaid, Medicare Advantage, dual Medicare-Medicaid and commercial coverage.

Preauthorization and notification lists

Important links

Specific medical and pharmacy coverage criteria and updates

Medical and pharmacy coverage criteria

Medical coverage criteria updates and recent changes, PDF

Submitting a request with Availity

How to register for the Availity Portal

Streamline preauthorizations and referrals, PDF

Availity.com

Optional fax form

Authorization/referral request form, PDF

State-specific preauthorization forms

Arizona preauthorization request form, PDF

Texas preauthorization request form, PDF

Texas House Bill 3459 – Preauthorization Exemptions, PDF

To designate your preferred contact and delivery information for communications, please refer to the “Address Change or Other Practice Information” section of the Humana Provider Manual at Humana.com/Provider Manual.

Indiana preauthorization request form, PDF

New Mexico preauthorization request form, PDF

State-specific preauthorization statistics

Colorado preauthorization statistics – medical

Colorado preauthorization statistics – pharmacy

Georgia preauthorization statistics – medical

Georgia preauthorization statistics – pharmacy

Illinois preauthorization statistics – medical

Illinois preauthorization statistics – pharmacy

Texas preauthorization statistics – medical

Texas preauthorization statistics – pharmacy

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System Requirements

“Humana” is the brand name for plans, products and services provided by one or more of the subsidiaries and affiliate companies of Humana Inc. (“Humana Entities”). Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state.

Medical Plans

Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Administered by Humana Insurance Company.

Go365^® is not an insurance product. Not available with all Humana health plans.

Individual Dental and Vision Plans

Humana Individual dental and vision plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc. or Humana Health Benefit Plan of Louisiana, Inc. Discount plans offered by HumanaDental Insurance Company or Humana Insurance Company. For Arizona residents: Insured by Humana Insurance Company. For New Mexico residents: Insured by Humana Insurance Company. For Texas residents: Insured or offered by Humana Insurance Company, HumanaDental Insurance Company or DentiCare, Inc (d/b/a Compbenefits).

In states, and for products where applicable, the premium may include a $1 administrative fee. If you have purchased an association plan, an association fee may also apply. Some plans may also charge a one-time, non-refundable enrollment fee. (This fee is non-refundable as allowed by state).

A minimum one-year, initial contract period may be required for some dental and vision plans, excluding Dental Savings Plus.

Group Dental and Vision Plans (Insurance through your employer)

Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., Humana Medical Plan of Utah, Humana Health Benefit Plan of Louisiana, Inc., CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits). Humana group vision plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Health Benefit Plan of Louisiana, Humana Insurance Company of Kentucky, Humana Insurance Company of New York, CompBenefits Insurance Company, CompBenefits Company, or The Dental Concern, Inc.

New Mexico: Humana group dental and vision plans are insured by Humana Insurance Company.

Life Insurance Plans

Humana group life plans are offered by Humana Insurance Company or Humana Insurance Company of Kentucky.

Limitations and exclusions

This communication provides a general description of certain identified insurance or non-insurance benefits provided under one or more of our health benefit plans. Our health benefit plans have exclusions and limitations and terms under which the coverage may be continued in force or discontinued. For costs and complete details of the coverage, refer to the plan document or call or write your Humana insurance agent or the company. In the event of any disagreement between this communication and the plan document, the plan document will control.

Individual applications are subject to eligibility requirements.

Before applying for group coverage, please refer to the pre-enrollment disclosures for a description of plan provisions which may exclude, limit, reduce, modify or terminate your coverage. View plan provisions or check with your sales representative.

For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits.

Statements in languages other than English contained in the advertisement do not necessarily reflect the exact contents of the policy written in English, because of possible linguistic differences. In the event of a dispute, the policy as written in English is considered the controlling authority.

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