Beginning Jan. 1, 2018, certain drugs will have new limitations or will require utilization management — e.g., prior authorization (PA) requirements, step therapy (ST) modifications and nonformulary (NF) changes — under the Humana commercial and Medicare formularies for the 2018 plan year. These changes could mean higher costs or new requirements for Humana-covered patients who use these drugs. Humana encourages the use of generic and cost-effective brand medications whenever possible.
Below are links to formularies containing some commonly used medications that will be impacted by Humana Medicare formulary changes in 2018:
Also, effective Jan. 1, 2018, Humana will limit the amount of prescription opioid pain medications that can be filled at one time. Pharmacies will be allowed only to fill an opioid pain medication prescription that is for 30 days or less.
Prescription drug information for patients with Humana commercial or Medicare coverage is available at https://www.humana.com/provider/medical-providers/pharmacy/rx-tools/drug-list. Click “Drug list search” and enter the drug name. Choose either “Commercial” or “Medicare” to see the drug’s tier placement in commercial or Medicare formularies and restrictions that may apply.
If prescribers have questions regarding these changes, they can call 1-800-457-4708, Monday through Friday from 8 a.m. to 8 p.m. local time.