Varies by plan

Does Humana require prior authorization for Humira?

Prior authorization for Humira differs across Humana's Medicare Part D plans and product strengths — 6 of 7 Humira products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm product	Plans covering	Require prior auth	Qty limit	Status
0.8 ML adalimumab 50 MG/ML Auto-Injector [Humira]1655728	715 / 817	715	715	Prior authorization required
0.4 ML adalimumab 100 MG/ML Prefilled Syringe [Humira]1726846	715 / 817	715	715	Prior authorization required
0.4 ML adalimumab 100 MG/ML Auto-Injector [Humira]1872980	715 / 817	715	715	Prior authorization required
0.1 ML adalimumab 100 MG/ML Prefilled Syringe [Humira]1921010	715 / 817	715	715	Prior authorization required
0.2 ML adalimumab 100 MG/ML Prefilled Syringe [Humira]1921017	715 / 817	715	715	Prior authorization required
0.8 ML adalimumab 100 MG/ML Auto-Injector [Humira]1921240	715 / 817	715	715	Prior authorization required
0.8 ML adalimumab 50 MG/ML Prefilled Syringe [Humira]727705	0 / 817	0	0	Not on formulary

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — 0.8 ML adalimumab 50 MG/ML Auto-Injector [Humira]

Humira has 7 products in the corpus; this table is for 0.8 ML adalimumab 50 MG/ML Auto-Injector [Humira], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Humana Cleveland Clinic Preferred (HMO-POS)	H6622-023	5	Yes	No	Yes
Humana Community (HMO-POS)	H4623-002	5	Yes	No	Yes
Humana Community (HMO)	H0292-001	5	Yes	No	Yes
Humana Community (HMO)	H1036-236	5	Yes	No	Yes
Humana Community (HMO)	H1036-332	5	Yes	No	Yes
Humana Community (HMO)	H5178-002	5	Yes	No	Yes
Humana Community (HMO)	H5619-159	5	Yes	No	Yes
Humana Community HMO Diabetes and Heart (HMO C-SNP)	H1036-234	5	Yes	No	Yes
Humana Community HMO Diabetes and Heart (HMO C-SNP)	H1468-017	5	Yes	No	Yes
Humana Community HMO SNP-DE (HMO D-SNP)	H1036-235	5	Yes	No	Yes
Humana Direct Choice Giveback (PPO)	H5216-406	5	Yes	No	Yes
Humana Direct Choice Giveback (PPO)	H5216-424	5	Yes	No	Yes
Humana Direct Choice Giveback (PPO)	H5216-431	5	Yes	No	Yes
Humana Direct Choice Giveback (PPO)	H5216-452	5	Yes	No	Yes
Humana Direct Choice Giveback (PPO)	H5970-031	5	Yes	No	Yes
Humana Direct Choice Giveback (PPO)	H7617-112	5	Yes	No	Yes
Humana Direct Choice GIveback (PPO)	H5970-032	5	Yes	No	Yes
Humana Dual Fully Integrated (HMO D-SNP)	H4329-001	5	Yes	No	Yes
Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)	H2875-001	5	Yes	No	Yes
Humana Dual Fully Integrated H2875-003 (HMO D-SNP)	H2875-003	5	Yes	No	Yes
Humana Dual Integrated (HMO D-SNP)	H0963-001	5	Yes	No	Yes
Humana Dual Integrated (HMO D-SNP)	H1036-339	5	Yes	No	Yes
Humana Dual Integrated (HMO D-SNP)	H1036-340	5	Yes	No	Yes
Humana Dual Integrated (HMO D-SNP)	H1036-341	5	Yes	No	Yes
Humana Dual Integrated (HMO D-SNP)	H1396-001	5	Yes	No	Yes
Humana Dual Select H0028-078 (HMO D-SNP)	H0028-078	5	Yes	No	Yes
Humana Dual Select H0028-079 (HMO D-SNP)	H0028-079	5	Yes	No	Yes
Humana Dual Select H1036-307 (HMO D-SNP)	H1036-307	5	Yes	No	Yes
Humana Dual Select H1036-329 (HMO D-SNP)	H1036-329	5	Yes	No	Yes
Humana Dual Select H1951-056 (HMO D-SNP)	H1951-056	5	Yes	No	Yes
Humana Dual Select H2875-005 (HMO D-SNP)	H2875-005	5	Yes	No	Yes
Humana Dual Select H2875-006 (HMO-POS D-SNP)	H2875-006	5	Yes	No	Yes
Humana Dual Select H4939-002 (HMO-POS D-SNP)	H4939-002	5	Yes	No	Yes
Humana Dual Select H5216-206 (PPO D-SNP)	H5216-206	5	Yes	No	Yes
Humana Dual Select H5216-298 (PPO D-SNP)	H5216-298	5	Yes	No	Yes
Humana Dual Select H5216-361 (PPO D-SNP)	H5216-361	5	Yes	No	Yes
Humana Dual Select H5216-385 (PPO D-SNP)	H5216-385	5	Yes	No	Yes
Humana Dual Select H5525-046 (PPO D-SNP)	H5525-046	5	Yes	No	Yes
Humana Dual Select H5525-072 (PPO D-SNP)	H5525-072	5	Yes	No	Yes
Humana Dual Select H5619-075 (HMO D-SNP)	H5619-075	5	Yes	No	Yes
Humana Dual Select H5619-093 (HMO D-SNP)	H5619-093	5	Yes	No	Yes
Humana Dual Select H5619-126 (HMO-POS D-SNP)	H5619-126	5	Yes	No	Yes
Humana Dual Select H5619-165 (HMO D-SNP)	H5619-165	5	Yes	No	Yes
Humana Dual Select H6622-027 (HMO-POS D-SNP)	H6622-027	5	Yes	No	Yes
Humana Dual Select H7617-039 (PPO D-SNP)	H7617-039	5	Yes	No	Yes
Humana Dual Select H7617-074 (PPO D-SNP)	H7617-074	5	Yes	No	Yes
Humana Dual Select H7617-083 (PPO D-SNP)	H7617-083	5	Yes	No	Yes
Humana Essentials Plus Giveback H0028-063 (HMO)	H0028-063	5	Yes	No	Yes
Humana Essentials Plus Giveback H1036-271 (HMO)	H1036-271	5	Yes	No	Yes
Humana Essentials Plus Giveback H5216-308 (PPO)	H5216-308	5	Yes	No	Yes
Humana Essentials Plus Giveback H5216-358 (PPO)	H5216-358	5	Yes	No	Yes
Humana Essentials Plus Giveback H5216-405 (PPO)	H5216-405	5	Yes	No	Yes
Humana Essentials Plus Giveback H5216-429 (PPO)	H5216-429	5	Yes	No	Yes
Humana Essentials Plus Giveback H5216-430 (PPO)	H5216-430	5	Yes	No	Yes
Humana Essentials Plus Giveback H5216-435 (PPO)	H5216-435	5	Yes	No	Yes
Humana Essentials Plus Giveback H5216-435 (PPO)	H5216-435	5	Yes	No	Yes
Humana Essentials Plus Giveback H5216-435 (PPO)	H5216-435	5	Yes	No	Yes
Humana Essentials Plus Giveback H7617-017 (PPO)	H7617-017	5	Yes	No	Yes
Humana Essentials Plus Giveback H7617-024 (PPO)	H7617-024	5	Yes	No	Yes
Humana Essentials Plus Giveback H7617-035 (PPO)	H7617-035	5	Yes	No	Yes
Humana Essentials Plus Giveback H7617-100 (PPO)	H7617-100	5	Yes	No	Yes
Humana FMOL Baton Rouge H1951-053 (HMO)	H1951-053	5	Yes	No	Yes
Humana Full Access Giveback H5216-306 (PPO)	H5216-306	5	Yes	No	Yes
Humana Full Access Giveback H5216-311 (PPO)	H5216-311	5	Yes	No	Yes
Humana Full Access Giveback H5216-393 (PPO)	H5216-393	5	Yes	No	Yes
Humana Full Access Giveback H7617-058 (PPO)	H7617-058	5	Yes	No	Yes
Humana Full Access Giveback H7617-110 (PPO)	H7617-110	5	Yes	No	Yes
Humana Full Access Giveback H7617-111 (PPO)	H7617-111	5	Yes	No	Yes
Humana Full Access H5216-011 (PPO)	H5216-011	5	Yes	No	Yes
Humana Full Access H5216-124 (PPO)	H5216-124	5	Yes	No	Yes
Humana Full Access H5216-192 (PPO)	H5216-192	5	Yes	No	Yes
Humana Full Access H5216-287 (PPO)	H5216-287	5	Yes	No	Yes
Humana Full Access H5216-333 (PPO)	H5216-333	5	Yes	No	Yes
Humana Full Access H5216-384 (PPO)	H5216-384	5	Yes	No	Yes
Humana Full Access H5216-407 (PPO)	H5216-407	5	Yes	No	Yes
Humana Full Access H5216-410 (PPO)	H5216-410	5	Yes	No	Yes
Humana Full Access H5216-411 (PPO)	H5216-411	5	Yes	No	Yes
Humana Full Access H5216-412 (PPO)	H5216-412	5	Yes	No	Yes
Humana Full Access H5216-432 (PPO)	H5216-432	5	Yes	No	Yes
Humana Full Access H5525-034 (PPO)	H5525-034	5	Yes	No	Yes
Humana Full Access H5525-042 (PPO)	H5525-042	5	Yes	No	Yes
Humana Full Access H7617-008 (PPO)	H7617-008	5	Yes	No	Yes
Humana Full Access H7617-009 (PPO)	H7617-009	5	Yes	No	Yes
Humana Full Access H7617-020 (PPO)	H7617-020	5	Yes	No	Yes
Humana Full Access H7617-025 (PPO)	H7617-025	5	Yes	No	Yes
Humana Full Access H7617-026 (PPO)	H7617-026	5	Yes	No	Yes
Humana Full Access H7617-028 (PPO)	H7617-028	5	Yes	No	Yes
Humana Full Access H7617-029 (PPO)	H7617-029	5	Yes	No	Yes
Humana Full Access H7617-052 (PPO)	H7617-052	5	Yes	No	Yes
Humana Full Access H7617-053 (PPO)	H7617-053	5	Yes	No	Yes
Humana Full Access H7617-055 (PPO)	H7617-055	5	Yes	No	Yes
Humana Full Access H7617-069 (PPO)	H7617-069	5	Yes	No	Yes
Humana Full Access R0110-003 (Regional PPO)	R0110-003	5	Yes	No	Yes
Humana Full Access R0110-005 (Regional PPO)	R0110-005	5	Yes	No	Yes
Humana Full Access R0110-014 (Regional PPO)	R0110-014	5	Yes	No	Yes
Humana Full Access R0110-020 (Regional PPO)	R0110-020	5	Yes	No	Yes
Humana Fully Integrated H1036-280 (HMO D-SNP)	H1036-280	5	Yes	No	Yes
Humana Gold Choice H8145-004 (PFFS)	H8145-004	5	Yes	No	Yes
Humana Gold Choice H8145-006 (PFFS)	H8145-006	5	Yes	No	Yes
Humana Gold Choice H8145-032 (PFFS)	H8145-032	5	Yes	No	Yes

Showing 100 of 715 covering plans.

Source

Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File

Effective: 2026-06-30
Retrieved: 2026-07-19
SHA-256: e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Humira at other payers

Or see Humira across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.