ENHANCED FORMULARY for Medicare Plus Group Members

Similar documents
Notice of Denial of Medical Coverage

2019 Formulary Monthly Notice of Change

Appendix A to Part 92 Notice Informing Individuals About Nondiscrimination and

Healthy Moves. A better flu season for you

Preventive Health Care Guide Adults. Save and share with your doctor! Primary Care Office Visits. Screening Schedule. Immunization Schedule

TRANSITION OF CARE APPLICATION

Summary of Benefits. Humana Walmart Rx Plan (PDP) State of North Carolina. Our service area includes the following state(s): North Carolina.

APPOINTMENT OF REPRESENTATIVE

2019 Summary of Benefits Medicare Prescription Drug Plans. BlueMedicare Value Rx (PDP) S

Kaiser Permanente 2018 Pharmacy Directory

Healthy Moves. Top Five Tips for Aging Better. Summer 2017

Ready. Set. CAPTURE LIFE REWARDS. Earn plenty of Points. GET ACTIVE ENJOY LIVE HEALTHY REWARDS GCHJMJXEN 0916

2019 Over-the-Counter Drugs and Vitamins - Puerto Rico*

Community Care Family Care Partnership Program (HMO SNP) (Community Care) 2019 Pharmacy Directory

There are 2 kinds of appeals with Blue Cross of Idaho Care Plus

Personal Dental Coverage with Optional VisionBlueSM. Affordable Dental Plans for Individuals of All Ages

Ready. Set. CAPTURE LIFE REWARDS. Earn plenty of Points. GET ACTIVE ENJOY LIVE HEALTHY REWARDS GCHJMJXEN 0916

COMPOUNDED PRESCRIPTION DRUG PRODUCTS

Ready. Set. CAPTURE LIFE REWARDS. Earn plenty of Points. GET ACTIVE ENJOY LIVE HEALTHY REWARDS GCHJMJXEN 0916

2018 Formulary Annual Notice of Change

Our dental plan for individuals age 65 and over

SENSIPAR 1 (CINACALCET) UTILIZATION MANAGEMENT CRITERIA

Kadlec Regional Medical Center 0118 KMC-002B

GCHJUV2EN Member Registration Guide

Page 1. Utilization Management Policy Name: Topical Tretinoin Products Restricted Product(s): Unrestricted/Suggested Alternative(s):

2019 Pharmacy Directory

SELECTIONS. Welcome to the UPMC MyHealth Selections program

Community Health Access Program Account Change Form

2018 PDP Summary of Benefits

Kaiser Permanente 2019 Sample Fee List-Signature *

FRM016178CO00 (10/17)

Doxazosin Dutasteride Finasteride Tamsulosin Viagra (sildenafil) benefit limitations apply

2018 Pharmacy Directory

Health Net Transition of Care Form. Welcome to Health Net! To be completed by agent: New member medical care checklist. Agent name M M D D Y Y Y Y

A healthy smile just got easier with our dental benefit!

Dental Blue 65. Outline of Coverage. Dental Blue 65 Preventive Dental Blue 65 Basic Dental Blue 65 Premier Effective January 1, 2017

Kaiser Permanente 2018 Sample Fee List *

IN THIS ISSUE MEMBER NEWSLETTER AUGUST Dear Amida Care Members,

Provides free aids and services to people with disabilities to communicate effectively with us, such as:

Indemnity PPO Medical Plan Preventive Care Guidelines

Optional Supplemental Benefits Gold Benefits Enrollment Form

Member Matters Newsletter

Complete. Pennsylvania. How your plan works. Calendar year deductible This is the amount you will pay out-of-pocket for services in a calendar year

BUPROPION/NALTREXONE (Contrave 1 ) LORCASERIN (Belviq 1, Belviq XR 1 ) PHENTERMINE/TOPIRAMATE ER (Qsymia 1 )

UTILIZATION MANAGEMENT CRITERIA

Getting to the BOTTOM OF BACK PAIN

Sore Throat or Strep? ALWAYS GET A STREP TEST BEFORE TAKING AN ANTIBIOTIC

Josette E. Spotts, MD, FACS W. Warm Springs Road, Suite 105 Henderson, NV Tel: Fax:

CONTACT PERSON PRESCRIBER PHONE PRESCRIBER FAX. PRESCRIBER ADDRESS CITY STATE ZIP Formulary Drug? Yes No

Your Feelings Matter WITH TYPE 2 DIABETES

Affordable Care Act Section 1557 Nondiscrimination Policy for Kentucky

Take Charge of YOUR COPD

2017 Pharmacy Directory

Family and Self Health History for Genetic Counseling. Your Personal Health History

Federal DentalBlue. Standard and Basic Options

ATYPICAL ANTIPSYCHOTICS

Life After a Heart Attack WHAT ARE MY CHANCES OF HAVING ANOTHER HEART ATTACK?

Oncology OUTPATIENT GUIDE

Member Registration Guide GCHJUV2EN 0117

Get $150 back! WELL-BEING. Start your well-being journey today! Complete 120 workouts at an approved fitness center ACHIEVE

Notice of Appeal Resolution

Living with DIABETES

Member Grievance Form

TRIPTAN RESTRICTED ACCESS; QUANTITY LIMIT EXCEPTION CERTIFICATION FAX REQUEST FORM

NOTICE OF ADVERSE BENEFIT DETERMINATION About Your Treatment Request

Health TALK. Mammograms save lives. Plan to quit.

Notice of Appeal Resolution

Advantage Plus. Get dental, hearing aid, and additional vision benefits. Enroll now for Kaiser Permanente Senior Advantage (HMO) Georgia

One mission: you Dental Plans. for Groups. Policy Form Numbers: (11-09) (11-09) (09-12) (01-15) Form No.

2018 Pharmacy Directory

GET REWARDED. by connecting your fitness device to Go365 COMPATIBLE FITNESS DEVICES GCHJHTFEN 0718

The FitnessCoach Program

Healthy Kids Dental Handbook

Expand your employees health care literacy by educating them about safe and simple ways to dispose of unused or expired prescription drugs.

ATTENTION- DEFICIT HYPERACTIVITY DISORDER (ADHD) PRIOR REVIEW/CERTIFICATION FAXBACK FORM

TruHearing. Supplemental Benefit Directory. RMHP is a Medicare-approved Cost plan. Enrollment in RMHP depends on contract renewal.

CCCN Patient Questionnaire

Growth Hormones (GH) UTILIZATION MANAGEMENT CRITERIA

CheckUp. Today. Free Diabetes Education Class. Sign Up. Fall More Diabetes Tips

The benefit of knowing

Notice of Receipt of Appeal/Grievance Macomb County Community Mental Health (MCCMH)

Solutions Fitness Program

Luana i ke ola maika i

Notice of Appeal Approval Macomb County Community Mental Health (MCCMH)

Description of Benefits and Copayments. AvMed Medicare. Broward / Miami-Dade Counties

Ready. Set. CAPTURE LIFE REWARDS. Earn plenty of Points. GET ACTIVE ENJOY LIVE HEALTHY REWARDS GCHJMJXEN 0916

2018 Annual Notice of Changes

Healthy. Now Men: Take Care of Your Health

Notice of Grievance Resolution Macomb County Community Mental Health (MCCMH)

NOTICE OF ADVERSE BENEFIT DETERMINATION Macomb County Community Mental Health (MCCMH)

Appeals & Grievances Department REQUEST FOR RECONSIDERATION (APPEAL) Part C MEMBER NAME: HNET Member ID Number:

MARIPOSA COUNTY HUMAN SERVICES PROVIDER LIST

Johns Hopkins Medicine Entities:

Transcription:

ENHANCED FORMULARY for Medicare Plus Group Members H2150_EG_17_38 Kaiser Permanente 2018 Medicare Plus enhanced formulary for group members

DRUG NAME DRUG TIER REQUIRE MENTS/ LIMITS ANTICHOLINERGICS ANTIMUSCARINICS/ANTISPASMODICS hyoscyamine LIBRAX EYE, EAR, NOSE, AND THROAT (EENT) PREPARATIONS MISCELLANEOUS phenylephrine (ophth) ELECTROLYTIC, CALORIC, AND WATER BALANCE ACIDIFYING AND ALKALINIZING AGENTS potassium citrate-citric acid HORMONE AND SYNTHETIC SUBSTITUTES ESTROGEN esterified estrogens & methlytestosterone GONADOTROPINS GANIRELIX ACETATE BRAVELLE clomiphene FOLLISTIM GONAL-F MENOPUR THYROID AGENTS NP thyroid RESPIRATORY TRACT AGENTS ANTITUSSIVES benzonatate DRUG NAME DRUG TIER REQUIRE MENTS/ LIMITS guaifenesin/codeine hydrocodone/ homatropine SKIN AND MUCOUS MEMBRANE AGENTS MISCELLANEOUS (SKIN AND MUCOUS MEMBRANE) hydrocortisone/ iodoquinol urea lotion 40% VASODILATING AGENTS NITRATES nitroglycerin capsules PHOSPHODIESTERASE INHIBITORS CAVERJECT EDEX MUSE sildenafil for erectile dysfunction indication MISCELLANEOUS yohimbine VITAMINS iron polysaccharide complex-vit B-12-folic acid folic acid phytonadione (Vitamin K) potassium aminobenzoate vitamin B-12 injectable / Certain strengths or forms of the drug (e.g., tablet, gel capsule, liquid) are only available as brand drugs and are subject to the brand cost share. Drugs with this designation may be subject to a higher cost share. 1 Kaiser Permanente 2018 Medicare Plus enhanced formulary for group members

Notice of nondiscrimination Kaiser Permanente complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Kaiser Permanente does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. We also: Provide no cost aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters. Written information in other formats, such as large print, audio, and accessible electronic formats. Provide no cost language services to people whose primary language is not English, such as: Qualified interpreters. Information written in other languages. If you need these services, call Member Services at 1-888-777-5536 (TTY 711), 8 a.m. to 8 p.m., seven days a week. If you believe that Kaiser Permanente has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with our Civil Rights Coordinator by writing to 2101 East Jefferson Street, Rockville, MD 20852 or calling Member Services at the number listed above. You can file a grievance by mail or phone. If you need help filing a grievance, our Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 1-800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. In Maryland and the District of Columbia, Kaiser Permanente is an HMO plan and a Cost plan with a Medicare contract. In Virginia, Kaiser Permanente is a Cost plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. H2150_H2172_17_05 accepted

Multi-language Interpreter Services English ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-888-777-5536 (TTY: 711). Spanish ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-777-5536 (TTY: 711). Chinese 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 1-888-777-5536 (TTY:711) Vietnamese CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-777-5536 (TTY: 711). Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-888-777-5536 (TTY: 711). Korean 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다. 1-888-777-5536 (TTY: 711) 번으로전화해주십시오. Russian ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-888-777-5536 (телетайп: 711). Japanese 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます 1-888-777-5536(TTY:711) まで お電話にてご連絡ください Thai เร ยน: ถ าค ณพ ดภาษาไทยค ณสามารถใช บร การช วยเหล อทางภาษาได ฟร โทร 1-888-777-5536 (TTY: 711). Hindi ध य न द : य द आप ह द ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह 1-888-777-5536 (TTY: 711) पर क ल कर Amharic ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ 1-888-777-5536 (መስማት ለተሳናቸው: 711). H2150_H2172_17_06 accepted

Farsi توجھ: اگر بھ زبان فارسی گفتگو می کنید تسھیلات باشد. با( 711 (TTY: 1-888-777-5536 تماس بگیری زبانی بصورت رایگان برای شما می فراھم Arabic ملحوظة: إذا كنت ت حدثت اذكر اللغة ف خدماتا ن ھاتف الصم والبكم: المس عا دة اللغویة تتوافر لك بالمج ن.ا برقم ا صلت رقم( -711). German ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-777-5536 (TTY: 711). French ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-888-777-5536 (ATS : 711). Yoruba AKIYESI: Ti o ba nso ede Yoruba ofe ni iranlowo lori ede wa fun yin o. E pe ero ibanisoro yi 1-888-777-5536 (TTY: 711). Portuguese ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-888-777-5536 (TTY: 711). 1-888-777-5536 Italian ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-888-777-5536 (TTY: 711). Bengali ল ক ন য দ আপ ন ব ল, কথ বল ত প রন, ত হ ল ন খরচ য় ভ ষ সহ য়ত প র ষব উপলৱ আ ছ ফ ন ক ন 1-888-777-5536 (TTY: 711) Urdu خبردار: اگر آپ اردو بولتے ہیں تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں کریں کال 1-888-777-5536 (TTY: 711). French Creole ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-888-777-5536 (TTY: 711). Gujarati ચન : જ તમ જર ત બ લત હ, ત ન: લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર 1-888-777-5536 (TTY: 711).

kp.org/seniormedrx Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. 2101 East Jefferson Street Rockville, MD 20852 60675011 10/1/17-12/31/18