Find Prior Authorization Guidelines and Forms

Coverage for certain high-risk or high-cost medications, particularly controlled substances, requires prior authorization to ensure effectiveness and safety. Patients must obtain approval from Humana before filling prescriptions, or they may face out-of-pocket costs for medications without prior authorization. Key limitations include the potential denial of coverage based on safety concerns, alternative treatment availability, or specific therapeutic criteria.

"Prior authorization is required for select high-risk or high-cost medications."

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