10/17/2023

Humana

Aetna Managed Care Committee Member

Mary Stubitsch - Newland Medical Associates

Commercial Preauthorization and Notification List
Humana requests notification for some services on this list. This is used to best serve our members. It allows us to place them in programs to provide support for their condition. This process is not the same as preauthorization. Humana does not approve or deny a notification.

It is important that preauthorization is obtained for services on this list. By not obtaining a preauthorization, the healthcare

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Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List
The list details services and medications (i.e., medications that are delivered in the physician’s office, clinic, outpatient or home setting) that require preauthorization prior to being provided or administered. Services must be provided according to Medicare coverage guidelines, established by the Centers for Medicare & Medicaid Services (CMS). According to the guidelines, all medical care, services, supplies and equipment must be medically necessary. You can review Medicare coverage guidelines at http://www.cms.gov/medicare-coverage-database.

Investigational and experimental procedures and devices usually are not covered benefits. Please consult the patient’s Evidence of Coverage or contact Humana for confirmation of coverage.

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