Humana · Prior auth
Humana prior authorization criteria
Submission criteria, documentation packets, and P2P prep by drug — for prescribers and PA staff. 30-day standard PA decision.
Standard PA decision
30 days
Appeal window if denied
60 days
Drugs covered
62
Humana reviews prior-authorization requests against its published medical policies — diagnosis with ICD-10 code, documented step-therapy history, and prescriber attestation of medical necessity. Standard PA decisions return in 30 days; if denied, prescribers and members have 60 days to appeal. Criteria by drug below.
Prior authorization criteria by drug
Each page covers Humana's submission criteria, the documentation packet, and peer-to-peer prep for that drug.
- Adalimumab at Humana →
- Aflibercept at Humana →
- Apixaban at Humana →
- Atezolizumab at Humana →
- Atogepant at Humana →
- Benralizumab at Humana →
- Bevacizumab at Humana →
- Bictegravir at Humana →
- Buprenorphine at Humana →
- Dapagliflozin at Humana →
- Dulaglutide at Humana →
- Dupilumab at Humana →
- Eculizumab at Humana →
- Elexacaftor Tezacaftor Ivacaftor at Humana →
- Empagliflozin at Humana →
- Erenumab at Humana →
- Evolocumab at Humana →
- Faricimab at Humana →
- Fingolimod at Humana →
- Fremanezumab at Humana →
- Galcanezumab at Humana →
- Glecaprevir Pibrentasvir at Humana →
- Guselkumab at Humana →
- Ibrutinib at Humana →
- Imatinib at Humana →
- Inclisiran at Humana →
- Infliximab at Humana →
- Ixekizumab at Humana →
- Lenalidomide at Humana →
- Liraglutide at Humana →
- Lisdexamfetamine at Humana →
- Mepolizumab at Humana →
- Methylphenidate at Humana →
- Naltrexone at Humana →
- Natalizumab at Humana →
- Nintedanib at Humana →
- Nivolumab at Humana →
- Nusinersen at Humana →
- Ocrelizumab at Humana →
- Ofatumumab at Humana →
- Omalizumab at Humana →
- Ozanimod at Humana →
- Palbociclib at Humana →
- Pembrolizumab at Humana →
- Pirfenidone at Humana →
- Ribociclib at Humana →
- Rimegepant at Humana →
- Risankizumab at Humana →
- Rituximab at Humana →
- Rivaroxaban at Humana →
- Sacubitril Valsartan at Humana →
- Secukinumab at Humana →
- Semaglutide at Humana →
- Sofosbuvir at Humana →
- Tafamidis at Humana →
- Tenofovir Alafenamide at Humana →
- Tezepelumab at Humana →
- Tirzepatide at Humana →
- Tofacitinib at Humana →
- Trastuzumab at Humana →
- Upadacitinib at Humana →
- Ustekinumab at Humana →
Generate a Humana PA packet
Open ApprovalHelp — generate a prior-auth packet tailored to Humana's criteria, with prescriber attestation and step-therapy documentation pre-filled.
Get started →Contact: hello@approvalhelp.com