Pharmacy Tools

Humana Drug Lists

View commercial or Medicare coverage details and a listing of high-risk medications for elderly patients.

  • Drug list search

    Look up a specific drug and view commercial or Medicare coverage details, possible generic equivalents and alternatives. Drug list search

  • Drug guides

    These printable documents include the most widely prescribed drugs on Humana's Drug List. Our drug lists in Portable Document Format (PDF) require Adobe Reader for viewing and printing. To get the plug-in, visit Adobe's Website and Download Adobe Reader.


Medicare formularies

Commercial formularies

Widely Prescribed Drugs - click here to view or print drug list

Coverage determinations

Get the resources you need for prescription drug coverage determinations and exceptions and appeals. You can submit prior authorization requests electronically or by phone or fax.
Puerto Rico Prior Authorization

Prescription Drug Exceptions

Coverage determinations are decisions made by Humana as a Medicare Part D plan sponsor and may include whether Humana will cover a drug for a member, the portion of the drug’s cost the member will be responsible for, quantity limits and step therapy requirements. Providers can use the form below to request a coverage determination:

Provider Request for Coverage Determination Form
(89.9 KB) Download PDF
English | Spanish

Another option is to use the coverage determination request form on the Centers for Medicare & Medicaid Services (CMS) website.


Exceptions are a type of coverage determination. Providers should request a tiering exception if they want Humana to cover a non-preferred drug at the same cost-share that would apply to drugs in the preferred tier. Formulary exception requests ask Humana to cover a drug not currently on its formulary. For each type of request, the member’s prescriber must submit a supporting statement.

To ask for a standard decision on an exception request, the patient, patient’s physician, another prescriber or the patient’s appointed representative should call Humana Clinical Pharmacy Review (HCPR) at 1-866-488-5991. These individuals may also send a written request to:

Puerto Rico HCPR
Humana Health Plans of Puerto Rico, Inc.
P.O. Box 191920
San Juan, PR 00919-1920

Exception requests can be faxed to 1-855-681-8650. Prescribers will receive a response to standard exception requests within 72 hours. Prescribers can submit an expedited request if they believe waiting for a standard decision could seriously jeopardize the patient's life, health or ability to regain maximum function. Expedited requests receive a response within 24 hours. Members who submit an expedited request should include a statement from their prescriber. Reimbursement requests cannot be expedited.

Medical and pharmacy coverage

Learn more about Humana's Medical and Pharmacy Coverage Policies

Medical and Pharmacy Coverage Policies

Prescription Drug Plans

Electronic Prescribing

Electronic prescribing (also known as e-prescribing) is the secure transmission via electronic means of prescriptions or prescription-related information between the prescriber, dispenser, pharmacy benefit manager and/or health plan.

E-prescribing can prevent medication errors by electronically checking prescriptions for dosage, interactions with other medications and therapeutic duplication. E-prescribers also can access information about their patients’ drug allergies.

Humana encourages physicians to prescribe medications electronically in order to reduce medication errors and increase patient safety. Electronic prescribing allows physicians to access Humana eligibility, formulary and medication history information at the point of care through Surescripts and other intermediaries, via Argus.

Why use electronic prescribing?

Electronic prescribing may improve patient safety, efficiency and consumer convenience.

The value of e-prescribing in preventing medication errors is that each prescription can be electronically checked at the time of prescribing for dosage, interactions with other medications and therapeutic duplication. Prescribers also have access to information on a patient’s drug allergies.

E-prescribing may improve quality and efficiency and reduce costs by:

  • Promoting appropriate drug usage, such as following a medication regimen for a specific condition
  • Providing information about formulary-based drug coverage, including formulary alternatives and copayment information
  • Speeding up the process of refilling medications
    E-prescribing capabilities are available from retail and mail-order pharmacies, including RightSource, Humana's mail-order pharmacy. Download the flier below to learn more about e-prescribing with RightSource. Other mail-order pharmacy options are available for Humana-covered patients.


RightSource, Humana's prescription mail-order pharmacy, focuses on accuracy, safety, convenience, cost savings and service. RightSource mails a three-month supply of maintenance medications to Humana members' homes or other locations of their choice.

You can access RightSource through this link.

Humana recognizes that members have the sole discretion to choose their pharmacy. You must use your independent medical judgment when advising patients regarding pharmacy choices. Other pharmacies are available in Humana’s network. Prescription drug plan members should refer to their plan benefit information to verify their pharmacy mail-order benefit. Below are some of the benefits RightSource offers.

Accuracy and safety

  • Two RightSource pharmacists review each new prescription for accuracy and possible drug-to-drug and drug-to-disease interactions.
  • Pharmacists compare each filled prescription to a drug catalog photo.
  • Barcoding, radio frequency identification (RFID) and state-of the-art technology reduce the chances of errors when medication orders are filled and when they are shipped.
  • RightSource uses foil-sealed containers to prevent tampering.

Integrated service

  • RightSource lets patients know the status of their order via email or phone. It also notifies patients when their prescriptions are ready to be refilled.
  • Health care providers can speak with a pharmacist or technician when questions arise.

Prescription drug plan members should refer to their plan benefit information to verify their pharmacy mail-order benefit.

Potential cost savings

With 90-day pricing and low-cost alternatives, RightSource may help reduce your Humana-insured patient's prescription drug costs. Some Medicare members may receive Tier 1 generic medications for a $0 copayment.

Three convenient ways to prescribe with RightSource

If your patients choose RightSource, you can submit their prescriptions via these methods:

  • FASTEST electronically: If you have electronic prescribing capabilities, you can transmit your patient's three-month-supply prescription directly to RightSource. Simply choose "RightSource Rx" from the list of available pharmacies.
  • E-prescribing with RightSource
  • FASTER By fax: Fax the physician fax form below to 1-800-379-7617. RightSource will only accept faxes from health care providers.
  • FAST By phone: Call RightSource at 1-800-379-0092.


Medicare patient consent: Please ask Medicare members to call us at 1-800-379-0092 to consent to the shipment of new prescriptions submitted to us by your office. The Centers for Medicare & Medicaid Services requires mail-order pharmacies to obtain Medicare member permission for each shipment of a new prescription sent to RightSource by a prescriber. RightSource customers can provide advance consent for RightSource to mail any new prescriptions sent directly to RightSource within a 12-month period.

Questions about RightSource?

Call RightSource at 1-800-379-0092. Health care providers who use a TTY should call 711Representatives are available Monday through Friday, 8 a.m. to 11 p.m., and Saturday, 8 a.m. to 6:30 p.m. EST. For additional information on why RightSource may be a good option for your patients, please download the flier below.

RightSource overview flier for health care providers - English (161KB)
RightSource overview flier for health care providers - Spanish (161KB)