stethoscope

Join our network and find credentialing information.

Log in to Availity Essentials™ to access patient benefits, claims information and more.

Find tools and materials to support doing business with us.

Learn more about research and trends that impact your practice.

Find self-service info and phone numbers and update your provider data.

Review prior authorization lists for services, medications and submission guidance.

Prior authorization submission information

Professionally administered drugs prior authorization

Find appeals guidelines and payment policy information.

Learn how to submit claims and find coding guidance.

Find policies for procedures, devices and medications.

Review guidelines and health programs to support your patients and practice.

Find dental benefits, tools and resources.

Prior authorization for professionally administered drugs 

Locate state-specific resources for Humana Healthy Horizons® (Medicaid).

compass

Shop plans, learn about Medicare and explore member resources.

Search for in-network medical, vision, dental and pharmacy providers.

Pharmacy news

A woman reads information about her precription drugs on her tablet

A couple researching a prescription online

For a list of pharmacy news bulletins, pharmacists may sign in to the Pharmacist Portal. If you do not have access, you can register for a new account.

The Inflation Reduction Act (IRA) became law on August 16, 2022 and includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government

Learn more about the IRA

Notifications and prior authorizations

PD-1/PD-L1 non-small cell lung cancer update for 2025 for Humana Medicare Advantage members

GLP-1 medically accepted indication update

Drug recalls

Drug recall notice for cyclobenzaprine hydrochloride tablets 

Drug recall notice for sucralfate tablets

Drug recall notice for sulfamethoxazole/trimethoprim tablets

Drug recall notice for fentanyl transdermal system

Drug recall notice for Prograf and Astagraf XL capsules

Drug recall notice for clonazepam orally disintegrating tablets

Drug withdrawal notice for Oxbryta 


Drug recall notice for atovaquone oral suspension


Drug recall notice for potassium chloride 750 mg extended-release capsules (Glenmark Pharmaceuticals)

Drug recall notice for potassium chloride 750 mg extended-release capsules (BluePoint Laboratories)

Drug recall notice for clonazepam orally disintegrating tablets

Market withdrawal of Relyvrio

Drug recall notice for all Akorn drug products


Market withdrawal of Makena (hydroxyprogesterone caproate injection)


Drug recall notice for quinapril products

Drug recall notice for quinapril and hydrochlorothiazide tablets

Market withdrawal of Ukoniq tablets

Drug recall notice for orphenadrine citrate tablets

Drug recall notice for Symjepi (epinephrine) injection

Drug recall notice for Hizentra 20% (10 g/50 mL)

Drug recall notice for irbesartan tablets

Drug recall notice for Glucagon Emergency Kit

Drug recall notice for Lotrimin AF and Tinactin spray products

Drug recall notice for Ruzurgi (amifampridine) 10 mg tablets

Drug recall notice for Chantix (varenicline) tablets

Drug recall notice for NP Thyroid tablets

Drug recall notice for metformin extended-release products

Drug recall notice for Nature-Throid and WP Thyroid tablets

Drug recall notice for Belviq, Belviq XR (lorcaserin)

Drug recall notice for Taro Pharmaceuticals phenytoin oral suspension

Drug recall notice for nizatidine capsules

Market withdrawal of all ranitidine products

Drug recall notice for Natpara

Impact of ongoing angiotensin II receptor blocker drug recalls

Additional notifications

Drug Coverage Communication Center

Medicare Advantage: Continuous glucose monitors available with a $0 copay in 2026

Effective Jan. 1, 2026, continuous glucose monitor (CGM) access is expanding to include a $0 copay when using in-network pharmacies. You can find the details here. 

An important update regarding prescription drug coverage for HIV PrEP

Currently, antiretroviral drugs used for the prevention of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) are covered under Medicare Part D. To assist you in the care of your patients, we are notifying you that HIV PrEP drugs (Apretude, cabotegravir, Descovy®, emtricitabine and tenofovir disoproxil fumarate, and Truvada®) may be covered under Medicare Part B for prevention of pre-exposure, effective late September 2024. However, if these prescription drugs are used to treat HIV, they will remain covered under Medicare Part D. This change is occurring in response to a proposed National Coverage Determination from the Centers for Medicare & Medicaid Services. 

If your patients have their Medicare Part B benefit covered with a different health plan, they may need to inform their pharmacy to use that plan for coverage when these prescription drugs are being administered for pre-exposure prevention.

You can submit a request for Humana to make an exception by calling Humana Clinical Pharmacy Review at 800-555-CLIN (2546) (TTY:711), Monday – Friday, 8 a.m. – 6 p.m., Eastern time. For prescription drug coverage requests in Puerto Rico, please call 866-773-5959.

Formulary changes for Revlimid

Lenalidomide, the generic version of Revlimid®, is covered by Humana with a prior authorization and will remain covered in 2023. Effective Jan. 1, 2023, Humana Medicare plans will no longer cover Revlimid. If the generic version is not available at your patient’s pharmacy, please include this information in your coverage exception request. We have notified your patients who had a claim for Revlimid in 2022 about this formulary change.

Prescribers with questions regarding this change may call 800-555-CLIN (2546), Monday – Friday, 8 a.m. – 8 p.m., Eastern time. Prescribers in Puerto Rico should call 866-488-5991.

Updates could mean new requirements for Humana members

Beginning Jan. 1, 2022, 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 2022 plan year.

These changes could mean higher costs or new requirements for Humana members who use these drugs. Humana encourages the use of generic and cost-effective brand medications whenever possible. Depending on the member’s plan, Humana also may make positive and negative midyear changes for both commercial and Medicare formularies.

Drug recall

Drug recall

Drug recall

Pharmacy news bulletins available on the portal