Humana Prior Authorization Lookup
Latest Humana prior authorization updates25
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01H1036-280 Humana Fully Integrated Florida prior authorization and notification listDefines medications and certain services that require prior authorization or notification for Humana Fully Integrated Florida HMO D-SNP Medicare Advantage members and explains how providers should request authorization and what information is required.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01H1036-280 Humana Fully Integrated Florida prior authorization and notification listDefines medications and related services that require prior authorization or notification for Humana Fully Integrated Florida HMO D-SNP plans and explains how providers should request authorizations; affects participating providers and delegated networks serving Humana MA HMO/HMO POS members in the plan.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Dual Fully Integrated Illinois prior authorization and notification listDefines prior authorization and notification requirements for medications and certain services for Humana Dual Fully Integrated (HMO D-SNP) Illinois plans; applies to providers furnishing covered items or services to affected Humana members.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Dual Fully Integrated Illinois prior authorization and notification listGoverns prior authorization and notification requirements for medications and certain services for Humana Dual Fully Integrated (HMO D-SNP) Illinois members; affects participating providers, facilities, and delegated networks who must obtain prior authorization or provide notifications as specified.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Dual Fully Integrated Illinois prior authorization and notification list (medications/services)Governs prior authorization and notification requirements for medications (including professionally administered drugs) and certain services for Humana Dual Fully Integrated Illinois HMO D‑SNP and related Humana Medicare Advantage plans; affects participating providers and delegated networks submitting authorization requests.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Dual Highly Integrated Michigan Prior Authorization and Notification ListGoverns prior authorization and notification requirements for services and medications for Humana Dual Highly Integrated Michigan members; affects participating providers, IPAs/risk networks, and delegated vendors managing authorizations.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Dual Highly Integrated South Carolina Prior Authorization and Notification ListGoverns prior authorization and notification requirements for Humana Dual Highly Integrated members in South Carolina; affects providers submitting requests for listed services and delegated networks/IPAs.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Dual Integrated South Carolina prior authorization and notification listDefines prior authorization and notification requirements for medications (professionally administered/in-office, outpatient, home) and related services for Humana Dual Integrated (HMO D-SNP) members in South Carolina; affects participating providers, facilities, and delegated networks.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Dual Integrated South Carolina prior authorization and notification list (medications and administered services)Governs prior authorization and notification requirements for medications (administered in-office, outpatient or home) and certain services for Humana Dual Integrated (HMO D-SNP) members in South Carolina; affects participating providers, delegated networks, and pharmacies that supply preferred medications.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Dual Integrated South Carolina prior authorization and notification list (medications/services)Governance of prior authorization and notification requirements for medications (including professionally administered drugs) and related services for Humana Dual Integrated (HMO D-SNP) members in South Carolina; affects participating providers, delegated risk networks, and providers requesting advance coverage determinations.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Fully Integrated Florida prior authorization and notification list (HMO D-SNP)Governs prior authorization and notification requirements for medications and certain services for Humana Fully Integrated Florida (HMO D-SNP) Medicare Advantage members; affects participating providers and delegated networks in Florida.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana HMO D-SNP Michigan prior authorization and notification list (PAL)Governs prior authorization and notification requirements for medications and related services for Humana Dual Integrated HMO Dual Eligible Special Needs Plan (HMO D-SNP) members in Michigan; affects participating providers, facilities, and delegated networks.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana HMO D-SNP Michigan prior authorization and notification list (PAL)This document lists medications and services that require prior authorization or notification for Humana Dual Integrated HMO D-SNP members in Michigan and describes how providers should request prior authorization, required information, and related operational notes.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana HMO D-SNP Michigan prior authorization and notification list (PAL) for provider-administered medicationsGoverns prior authorization and notification requirements for medications administered in provider settings for Humana Dual Integrated HMO D-SNP members in Michigan; affects participating providers, delegated IPAs/risk networks, and pharmacies involved in office/clinic/outpatient or home administration.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons SC Prior Authorization and Notification List (PAL)Defines services, procedures, devices and medications that require prior authorization or provider notification for Humana Healthy Horizons members in South Carolina; applies to providers serving South Carolina Medicaid recipients under this product.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in Florida Preauthorization and Notification ListDefines preauthorization and notification requirements for a range of services for Humana Healthy Horizons Medicaid members in Florida and explains who manages specific service categories and how providers should request preauthorization or submit notifications.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in Kentucky Prior Authorization and Notification List (PAL)Lists services, categories, and codes that commonly require prior authorization or notification for Humana Healthy Horizons enrollees in Kentucky; it affects providers submitting authorization/notification requests and claims for those members.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in Kentucky Prior Authorization and Notification List (PAL)A list of services commonly reviewed by Humana Healthy Horizons in Kentucky that may require prior authorization or notification; applies to providers serving Humana Healthy Horizons enrollees in Kentucky.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in Louisiana Prior Authorization and Notification List (PAL)Lists services, procedures, and medications that commonly require prior authorization or notification for Humana Healthy Horizons members in Louisiana; applies to providers and facilities delivering covered services under this Medicaid product.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in Louisiana Prior Authorization and Notification List (PAL)Defines services, procedures, devices, and medications that may require prior authorization or notification for Humana Healthy Horizons Medicaid members in Louisiana and explains how providers should request authorizations and notifications.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in Louisiana Prior Authorization and Notification List (PAL)Governs prior authorization and notification requirements for services, procedures, durable medical equipment, medications, and behavioral health services for Humana Healthy Horizons Medicaid members in Louisiana; affects participating and nonparticipating providers delivering covered services.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in Ohio Prior Authorization and Notification List (PAL)Lists services, procedures, and codes that require prior authorization or notification for Humana Healthy Horizons members in Ohio; affects healthcare providers submitting requests and coordinating care for covered members.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in South Carolina Prior authorization and Notification List (PAL)This document lists services, procedures, durable medical equipment, medications and other items that may require prior authorization or notification for Humana Healthy Horizons Medicaid members in South Carolina and explains how providers request authorizations and notifications.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana Healthy Horizons in Virginia Prior Authorization and Notification List (PAL)This document lists services, procedures, and supplies that require prior authorization or notification for Humana Healthy Horizons members in Virginia and explains how providers should request authorizations and notifications.All Humana updates
- Prior AuthAdministrative/Operational PolicyEff. 2026-07-01Humana PathWays Dual Care (HMO-POS DSNP) Indiana Prior Authorization and Notification ListDefines the services, codes, and processes that require prior authorization or notification for Humana PathWays Dual Care (HMO-POS DSNP) members in Indiana; affects participating providers and delegated networks handling these members.All Humana updates
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Tool Description
Search Humanaprior authorization policies by drug name, procedure, or policy title. Results include any policy that mentions prior authorization requirements (drug coverage criteria, imaging guidelines, site-of-service rules) not just documents titled “prior authorization.” Every result links to a full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
Filter by payer, specialty, policy type, or effective year; or search directly for a drug (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee arthroplasty”), or a policy number.
Coverage spans 110+ payers. Jump straight to the busiest prior-auth publishers: UnitedHealthcare, Cigna, Aetna, Anthem, and Centene. You can also browse the full policy updates feed.
Pair a prior-auth search with the billing code lookup to confirm the CPT or J-code on the claim, the payer lookup for plan footprint, and payer profiles for contacts and coverage context.
FAQ
Type a drug name (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee”), or a policy title into the search bar. Filter results by payer, specialty, policy type, or effective year. Open any result for the full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
Prior Authorization by Payer
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Prior auth requirements change all the time. Keep up with every payer policy update in the live policy feed, or browse payers with prior authorization policies.
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