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2010 Medicare Assured® HMO Formulary
A formulary (sometimes called a “Drug List”) is a list of Part D prescription drugs covered by Gateway Health Plan Medicare Assured® HMO. The drugs on this list are selected by the Plan with the help of a team of doctors and pharmacists. The list must meet requirements set by Medicare. Medicare has approved the Medicare Assured® HMO Drug List.
*Notes
GC - Generic Covered PA - Prior Authorization
ST - Step Therapy QL - Quantity Limited
GA - Generic Available SP - Specialty Pharmacy
Drug Tier 1 = Generic Drug Tier 2 = Preferred Brand
Drug Tier 3 = Brand Drug Tier 4 = Specialty
Last updated: 6/24/2010 (00010020 20)
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  • Search by Generic Name or Brand Name of a Drug. Enter first few letters if the full name or correct spelling is not known.
  • Get a list of Drugs in Therapeutic Class or Therapeutic Category if the exact Drug name is not known.
Gateway Health Plan Medicare Assured® HMO covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.