Will Humana cover the newly approved ketamine nasal treatment for those that have drug resistant major depression?
Thank you for your inquiry.
Humana's Pharmacy and Therapeutic Committee determines which drugs are included in the formulary and which tier the drug is placed on. The Pharmacy and Therapeutic Committee is comprised of licensed clinical pharmacists and medical physicians. Considerations are given to drugs' side effects, drug interactions, cost, and effectiveness and physician preference when making formulary decisions. Typically updates to Formularies occur at the first of each year.
When a drug is not on the plan's Drug Formulary list, it is considered a non-covered drug. A member can request a drug exception for non-covered drugs, by requesting a prior authorization. To request the prior authorization the prescribing physician may contact the Humana Clinical Pharmacy Review Department (HCPR) by phone at 1-800-555-2546, or they may complete the attached fax form and return the fax to 1-877-486-2621. The review will be completed in approximately five days upon receipt of all necessary information from the physician.
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