Why orders may get canceled

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If for any reason your prescription medicine order is canceled, your Humana pharmacy team will be available to help. There are several reasons why an order may be canceled, but most issues can be easily resolved. It could take a quick phone call to Humana Pharmacy® or a discussion with your prescriber, depending on the situation. 

Here are some reasons an order may be canceled and ways to address order issues. 

No response from your prescriber in 7 days 

Whether you transfer a prescription to Humana Pharmacy or request to fill a new prescription, we require confirmation from your prescriber before processing the prescription. Your prescriber will have at least 7 days to respond to us with a new prescription, either sent electronically or by fax. Unfortunately, if we don’t hear back after 7 days, the prescription request is canceled. 

Solution: If you enter a new prescription request on HumanaPharmacy.com or over the phone, please make sure your prescriber also knows they have to provide a prescription to Humana Pharmacy within 7 days for your request to be processed. Your prescriber can send your prescription directly to Humana Pharmacy through ePrescribe™. This method enables a prescriber to send an error-free prescription directly to the pharmacy, which can speed up the processing time and get your prescription to you in just 5–7 business days. 

Medicine is not covered or needs approval 

Depending on your Humana plan and the medicine you were prescribed, we may not be able to process your prescription request because the medicine isn’t covered. Additionally, the medicine prescribed to you could be covered, such as a controlled substance, but may require prior authorization. If prior authorization isn’t approved by your prescriber or Humana, the prescription won’t be filled. 

Solution: If your medicine is not covered under your plan, please speak with your prescriber about using a different medicine, and have them review Humana’s Drug List to see which alternate medicines are covered by us. For a medicine requiring prior authorization, there are two simple steps.  

  1. Ask your prescriber to provide authorization. 
  2. Then, have your provider call Humana Clinical Pharmacy Review at 1-800-555-CLIN (1-800-555-2546), Monday – Friday, 8 a.m. – 8 p.m. or submit a prior authorization request online.

Credit card expired

If you request to fill a new prescription or are looking to refill a current medicine and your payment information isn’t up to date, your order may be canceled. Fortunately, there are some easy ways to solve this issue. 

Solution: In just a few steps online, you can update your payment information. Sign in to your Humana Pharmacy account using the same username and password across MyHumana, Humana Pharmacy and Go365®. Once there, you’ll see an alert on the Humana Pharmacy home page asking you to update your credit card information. Follow the on-screen prompts and you will be ready to go. 

You can also fix this problem quickly on the Humana Pharmacy mobile app or by calling Humana Pharmacy at 1-800-379-0092 (TTY: 711), Monday – Friday, 8 a.m. – 11 p.m., and Saturday, 8 a.m. – 6:30 p.m., Eastern time. 

Higher copay than what you approved

Depending on your Humana insurance plan, you may have a high copay for a specific medicine. If that copay amount exceeds $250, or the limit you’ve set in your preferences in your Humana Pharmacy profile, your order will be put on hold until you approve it. If you choose not to approve the copay amount, or no action is taken in 7 days, your order will be canceled. 

Solution: Thankfully, there are a couple of helpful options for you in this situation. If you approve the copay amount with the prescription medicine you’ve requested, we will immediately begin processing your order. If you don’t want to accept the copay amount, we recommend you speak with your prescriber about prescribing a generic version of your medicine, or a similar medicine that has generic options, which can save you money. 

Controlled substance refills

Depending on the medicine you’ve been prescribed, you may not be able to refill a medicine that is considered a controlled substance by the U.S. government. If you attempt to place a refill order for a Schedule II medicine, it will likely be canceled. 

Solution: Federal law requires prescribers to send prescriptions for controlled substances directly to Humana Pharmacy, so contact your prescriber and request a new prescription be sent to us. Once we receive your new prescription, we will start processing your order. 

Prescriber canceled prescription 

In some situations, you may discover that your prescription order has been canceled by your prescriber. This could be due to a number of reasons, including your prescriber wanting to stop a prescription or change the dosage for you. 

Solution: You can resolve this issue with a quick phone call or by scheduling an In-person appointment with your prescriber. From there, your prescriber can send us your new prescription directly and we can begin processing it. This eliminates the need for confirmation from your prescriber so we can get your medicine to you faster. 

Need help? 

If you have any questions about canceled orders, you can chat with us online at HumanaPharmacy.com or speak to a friendly Humana Pharmacy representative by calling 1-800-379-0092 (TTY: 711), Monday – Friday, 8 a.m. – 11 p.m., and Saturday, 8 a.m. – 6:30 p.m., Eastern time. 

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