Confirming prior authorization requirements

Search by CPT code, procedure or drug name to see if prior authorization is required. 

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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 – Friday, 8 a.m. – 6 p.m., Eastern time.

Puerto Rico prior authorization requests

Prescribers should submit these requests to the Puerto Rico Medication Intake Team by fax at 1-800-594-5309 (Medicare requests) or 1-800-658-9457 (commercial requests).

Prescribers with questions about the prior authorization process for professionally administered drugs should call 1-866-488-5995 for Medicare requests and 1-800-314-3121 for commercial requests. Assistance is available Monday through Friday, 8:30 a.m. to 5:30 p.m. local time.

Forms for state mandates

Arizona authorization form

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

• Who reside in the state of Arizona
  and/or
• Whose prescription drug coverage was sold in the state of Arizona

Arizona prior authorization request form

Colorado authorization form

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

• Reside in the state of Colorado
  and/or
• Whose prescription drug coverage was sold in the state of Colorado

Prescription drug prior authorization request form

Illinois authorization request form

Physicians and healthcare practitioners in Illinois should use this form to submit authorization requests for their Humana commercial fully insured covered patients and residents. Please complete the form and submit it to Humana by following the instructions on the form.

Illinois authorization request form

Louisiana authorization request form

Physicians and healthcare practitioners may use this form to submit authorization requests for their Louisiana Humana-covered patients and Humana Healthy Horizons® in Louisiana-covered patients. Please complete the form and submit it to Humana by following the instructions listed for Humana on the cover page.

Louisiana Uniform Prescription Drug Prior Authorization Form

New Mexico authorization request form

Physicians and health care practitioners may use this form to submit authorization requests for their New Mexico Humana-Covered patients. Please complete the form and submit it to Humana by following the instructions on the form.

New Mexico authorization request form

Texas authorization form

Physicians and healthcare practitioners in Texas may use this form to submit authorization requests for their Humana-covered patients. Please complete the form and submit it to Humana by following the instructions on the form.

Texas authorization request form

Texas Prior Authorization Exemption Information:

Texas House Bill 3459 - Preauthorization Exemption

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/ProviderManual .

If you have questions about whether you should use the state-mandated form(s) above, please call the MIT at 1-866-461-7273, Monday – Friday, 8 a.m. – 6 p.m., Eastern time.

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

Fax forms

Please reference the below listing to use the proper fax form for the medication based on alphabetical or Medicaid. If a medication-specific one doesn’t exist, please use the Universal form

Prescribers can submit electronically for any plan by a free service. Humana partners with CoverMyMeds to provide real-time determinations for online requests. You can access this service directly (registration required) or review the flyer below for details.

Visit CoverMyMeds

CoverMyMeds overview flyer

Universal medical fax form