Errata Sheet to the GEMCare Medicare Plus (HMO) Comprehensive Drug Formulary
This letter is to let you know of some corrections to your 2013 GEMCare Medicare Plus (HMO) Comprehensive Formulary Booklet. The corrections to the GEMCare Medicare Plus (HMO) formulary are found in the paragraph and chart below. There is no action required on your part; however, if you have any questions after reviewing this notice you may contact GEMCare Medicare Plus (HMO) at 1-800-546-5677 (TTY 1-866-706-4757), 24 hours a day, seven days a week. Updates have been made to the index provided in your Comprehensive Formulary Booklet. Additions have been made to this section. A listing of drugs that were not originally noted in the index are noted below. This notice serves as an amendment to your GEMCare Medicare Plus (HMO) comprehensive formulary and updates the applicable sections noted in the chart below. Please keep this updated information with your current GEMCare Medicare Plus (HMO) formulary materials for future reference. Updates to your 2013 Comprehensive Formulary Index Location of Change In 2013 Comprehensive Formulary Page 125, Index of Drugs 1st Generation/Typical . 51 2nd Generation/Atypical . 53 Alcohol Deterrents/Anti-craving . 12
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Alkylating Agents . 40, 41 Androgens . 92 ANESTHETICS . 12 Angiotensin II Receptor Antagonists Angiotensin-converting Enzyme Alpha-adrenergic Agonists . 68, 69 (ACE) Inhibitors . 71 Alpha-adrenergic Blocking Agents . 69 Anthelmintics. 50 ANTI-ADDICTION/ SUBSTANCE ABUSE TREATMENT AGENTS . 12 Antiandrogens . 97, 98 Antiangiogenic Agents . 41, 42 Antiarrhythmics . 72 ANTIBACTERIALS . 13 Antibacterials, Other . 14 Aminoglycosides . 13 Anticholinergics . 50 Anticoagulants . 63 Aminosalicylates . 104, 105 ANTICONVULSANTS . 24 Anticonvulsants, Other . 24 Anti-cytomegalovirus (CMV) Agents ANTIDEMENTIA AGENTS . 27 ANTIDEPRESSANTS . 28 Antidepressants, Other . 28 Antidiabetic Agents . 62 ANTIEMETICS . 33 Antiemetics, Other . 33 Antiestrogens/Modifiers . 42 Antifungals . 37 ANTIFUNGALS . 37 Antigout Agents . 39 ANTIGOUT AGENTS . 39 Antihepatitis Agents . 57 Antiherpetic Agents . 58 Antihistamines . 109, 110 Anti-HIV Agents, Non-nucleoside Reverse Transcriptase Inhibitors 58 Anti-HIV Agents, Nucleoside and Nucleotide Reverse Transcriptase Inhibitors . 59 Anti-HIV Agents, Other . 59 Anti-HIV Agents, Protease Inhibitors Anabolic Steroids . 92 Anti-inflammatories, Inhaled ANALGESICS . 7 Corticosteroids . 110
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Anti-influenza Agents . 60 Antileukotrienes . 110, 111 Antimetabolites . 42 Attention Deficit Hyperactivity ANTI-MIGRAINE AGENTS . 39 Disorder Agents, Amphetamines 80, ANTIMYASTHENIC AGENTS . 40 ANTIMYCOBACTERIALS . 40 Attention Deficit Hyperactivity Antimycobacterials, Other . 40 Disorder Agents, Non- ANTINEOPLASTICS . 40 amphetamines . 81 Antineoplastics, Other . 42 ANTIPARASITICS . 50 ANTIPARKINSON AGENTS . 50 Antiparkinson Agents, Other . 50 Antiprotozoals . 50 ANTIPSYCHOTICS . 51 Antispasmodics, Gastrointestinal . 85, Antispasmodics, Urinary . 88 Antispasticity Agents . 57 ANTISPASTICITY AGENTS . 57 Antithyroid Agents . 98 Antituberculars . 40 ANTIVIRALS . 57 ANXIOLYTICS . 60 Anxiolytics, Other . 60 Aromatase Inhibitors, 3rd Generation Benign Prostatic Hypertrophy Agents Beta-adrenergic Blocking Agents . 73 Beta-lactam, Cephalosporins . 15 Beta-lactam, Other . 19 Beta-lactam, Penicillins . 19
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Calcium Channel Modifying Agents 24 BIPOLAR AGENTS . 61 Bipolar Agents, Other . 61 Blood Formation Modifiers . 66 CARDIOVASCULAR AGENTS . 3, 68 Blood Glucose Regulators . 63 Cardiovascular Agents, Other . 76 BLOOD GLUCOSE REGULATORS . 62 BLOOD PRODUCTS/MODIFIERS/ VOLUME EXPANDERS . 63 Bronchodilators, Anticholinergic . 111 Bronchodilators, Phosphodiesterase Inhibitors (Xanthines) . 111 Bronchodilators, Sympathomimetic CENTRAL NERVOUS SYSTEM AGENTS . 80 Central Nervous System, Other . 82 Calcium Channel Blocking Agents . 75
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Cholinesterase Inhibitors . 27 Dental and Oral Agents . 82, 83 DENTAL AND ORAL AGENTS . 82 Coagulants . 68 Dermatological Agents . 83 DERMATOLOGICAL AGENTS . 83
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Electrolyte/Mineral Modifiers . 115 Electrolyte/Mineral Replacement . 116 Emetogenic Therapy Adjuncts . 35 Diuretics, Carbonic Anhydrase Inhibitors . 77 Diuretics, Loop . 77 Diuretics, Potassium-sparing . 77 Diuretics, Thiazide . 77 Enzyme Inhibitors. 46 Enzyme Replacements/ Modifiers . 84 ENZYME REPLACEMENTS/ MODIFIERS . 84 Dopamine Agonists . 50 Dopamine Precursors/L-Amino Acid Decarboxylase Inhibitors . 51 Ergot Alkaloids . 39 DRUG NAME . 7 Dyslipidemics, Fibric Acid Derivatives . 78 Dyslipidemics, HMG CoA Reductase Inhibitors . 78 Dyslipidemics, Other . 79
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Estrogens . 93 GABA Receptor Modulators . 115 Gamma-aminobutyric Acid (GABA) Augmenting Agents . 25 GASTROINTESTINAL AGENTS . 85 Fibromyalgia Agents . 82 Gastrointestinal Agents, Other . 86 GENITOURINARY AGENTS . 88 Genitourinary Agents, Other . 89
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Glucocorticoids . 89, 105 (Parathyroid) . 96 Glucocorticoids/Mineralocorticoids Hormonal Agents, Suppressant (Pituitary) . 96 Glutamate Reducing Agents . 26 HORMONAL AGENTS, SUPPRESSANT (PITUITARY) . 96 HORMONAL AGENTS, Glycemic Agents . 63 SUPPRESSANT (THYROID) . 98 Immune Suppressants . 98 Immunizing Agents, Passive . 103 IMMUNOLOGICAL AGENTS . 98 Immunomodulators . 103 Histamine2 (H2) Receptor Antagonists . 86 HORMONAL AGENTS, STIMULANT/ REPLACEMENT/ . 89, 91, 92, 95 INFLAMMATORY BOWEL DISEASE Hormonal Agents, AGENTS . 104 Stimulant/Replacement/Modifying (Pituitary) . 91 Hormonal Agents, Insulins . 63 Stimulant/Replacement/Modifying (Thyroid) . 95 HORMONAL AGENTS, SUPPRESSANT . 96, 97, 98 Hormonal Agents, Suppressant (Adrenal). 96 HORMONAL AGENTS, SUPPRESSANT (ADRENAL) . 96 Hormonal Agents, Suppressant
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Irri table Bowel Syndrome Agents . 87 Local Anesthetics . 12 Laxatives . 87
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Macrolides . 22 Mast Cell S tabilizers . 112 Metabolic Bone Disease Agents . 105 METABOLIC BONE DISEASE AGENTS . 105 Molecular Target Inhibitors . 47 Monoamine Oxidase B (MAO-B) Inhibitors . 51 Monoamine Oxidase Inhibitors . 29 Monoclonal Antibodies . 48, 49 Mood Stabilizers . 61 Multiple Sclerosis Agents . 82
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
OPHTHALMIC AGENTS . 108 Ophthalmic Agents, Other . 108 Ophthalmic Anti-inflammatories . 109 Ophthalmic Prostaglandin and Prostamide Analogs . 109 Opioid Analgesics, Short-Acting . 10 Opioid Antagonists . 12 Otic Agents . 109 OTIC AGENTS . 109 N-methyl-D-aspartate (NMDA) Receptor Antagonist . 28 Nonsteroidal Anti-Inflammatory Drugs
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Platelet Modifying Agents . 68 Parasympathomimetics . 40 Pediculicides/Scabicides . 50 Progestins . 95 Phosphate Binders . 89
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Prophylactic . 39 Protectants . 87 Proton Pump Inhibitors . 87 Pulmonary Antihypertensives . 112 Selective Estrogen Receptor Quinolones . 23 Modifying Agents . 95 Serotonin (5-HT) 1b/1d Receptor Agonists . 39 Serotonin/ Norepinephrine Reuptake Inhibitors . 29 RESPIRATORY TRACT AGENTS . 109 Skeletal Muscle Relaxants . 114 Respiratory Tract Agents, Other . 113 SKELETAL MUSCLE RELAXANTS SLEEP DISORDER AGENTS . 114 Sleep Disorders, Other . 115
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Smoking Cessation Agents . 13 Sodium Channel Agents . 26 Tetracyclines . 24 THERAPEUTIC NUTRIENTS/MINERALS/ELECTRL YTES . 115 Sulfonamides . 23, 105
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
Vaccines . 103 Treatment Resistent . 56 Vasodilators, Direct-acting Arterial 80 Vasodilators, Direct-acting Arterial/Venous . 80 Tricyclics . 32
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
What to do if you have any questions. If you have questions, please call toll-free 1-800-546-5677, 24 hours a day, seven days a week or, visit www.gemcarehealthplan.com on the web. TTY users should call 1-866-706-4757.
This information is available for free in other languages. Please contact our customer service number at 1-800-546-5677 for additional information. Esta información está disponible de forma gratuita en otros idiomas. Por favor, póngase en contacto con nuestro número de servicio al cliente al 1-800-546-5677 para obtener información adicional.
H5609_PartD_38_2012_FrmlryErrataSht CMS Approved 01/03/2012 A Federally-Qualified HMO with a Medicare contract.
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