Gemcarehealthplan.com

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.

Source: http://gemcarehealthplan.com/cms-assets/documents/85809-783505.corrections-2013-formulary-gemcare.pdf

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