Prior Authorization Documents

This is the place for providers to find Prior Authorization-related forms and other documents. You can also find them on the Provider Documents page.

To locate a Medicare Advantage coverage policy referenced in a letter you received, please refer to Humana's Medical and Pharmacy Coverage Policies; iCare is a subsidiary of Humana, and coverage policies are located on Humana's Medical and Pharmacy Coverage Policies page. Enter the number or name of the policy referenced in your letter in the keyword search box on this page.

iCare Health Plan also utilizes Care Guidelines to determine medical necessity for the plans that we manage. The Guidelines are the protected intellectual property of MCG. iCare Health Plan is not able to distribute them without the permission of MCG. MCG has provided a tool that allows iCare Health Plan members and prospective members to view relevant MCG guidelines, however you will not be able to print them.

Follow the instructions below to access the MCG Guidelines:

1. Access guidelines here, read the disclaimer, and accept the terms and conditions.
2. Complete the User information form.
3. Complete the verification process to continue.
4. Click on the arrow icon.
5. Click on the guidelines you wish to view.

iCare has prepared some FAQs​​​​​​​ for Medicare Advantage coverage policies.