MEMBER - WellCare

Safety First
Check out the safety tips below. If you’re in the hospital, they’ll help you
improve the quality of care you receive.
1. Look for experience. If you have a scheduled hospital visit, choose a
network hospital that performs that test or procedure often.
Here’s why: According to the Agency for Healthcare Research and Quality,
patients have better results when they are treated in hospitals with lots of
experience with their procedure
2. Pay attention. Watch to see whether the health care workers are washing
their hands before and after direct contact with you.
Here’s why: Hand-washing is one of the most important ways to prevent
infection
3. Understand your treatment plan. Ask your doctor or nurse to explain what
will happen and what you should do once you get home.
Here’s why: At home, it’ll be up to you to remember what medicines to
take when and what after-care you need—knowing your plan can help
prevent emergencies and a repeat hospital visit
Stay tuned! We’ll give more safety tips in our upcoming newsletters.
Source: ahrq.gov
GEORGIA | 2012 | ISSUE I
MEMBER
FOCUS
Did you know OTC items can now be ordered online? See page 3 for details.
In This Issue
We hope you’ll take a minute from
your day to read through this issue.
Think of it as a little “hello” from us,
full of information and articles that’ll
help you and your family get the
most from your plan and live better.
This quarter features:
• Formulary updates
• A NEW way to order OTC items
• Weighing in on weight
• And more
Numbers to Know
We’re just a phone call
(or click) away!
Call Member Services:
1-866-231-1821
TTY/TDD 1-877-247-6272
Monday–Friday,
7 a.m. to 7 p.m. Eastern
georgia.wellcare.com

Weighing In On Weight
Was your child’s BMI too high? Weighing more than what’s
ideal can have some serious consequences, putting children
at increased risk for heart disease, diabetes, arthritis-related
conditions, high blood pressure and some cancers. These
tips will help you dial up activity levels and scale back on
calories.
Be Active
The gym isn’t the only place for exercise. When it comes to
being active, challenge your family to think outside the box.
Incorporate tasks like washing and waxing the car or raking
leaves. Get playful too. Organize a game of basketball,
volleyball or touch football. Grab a jump rope. Swim, ride a
bike or play tag. These things may not sound like much but
they add up – and that matters. Make time for 30 minutes a
day, 5 days a week and you’re doing great.
Make playtime count as exercise.
Try a game of basketball, volleyball or even tag.
Wake Up To Breakfast
Here’s a reason to fill up their cereal bowl: Studies show
that people who skip breakfast are more likely to be
overweight than those who eat it. Without that morning
meal, kids may overeat at lunch or snack more often.
Setting the alarm a few minutes earlier is a great way to
sneak breakfast time into your day. Take the chance to
sit down with your child. Ask them how they’re feeling
or what they expect to happen at school during the day.
Simply no time? Pack a “breakfast bag” the night before.
Put together peanut butter on whole-grain bread, yogurt,
fresh fruit or trail mix. They all travel easily.
2 Member Newsletter
Slow Down On Fast Food
Hitting the drive-through may be quick, but it’s not good
for your little one. Fast food is usually high in calories and
fat – two things that are bad for weight loss. Try to limit
the number of these meals you serve up every week.
Instead, look for options that are lower in fat and offer
up fruits and veggies as snacks rather than junk food.
Find Out More
Visit www.cdc.gov/healthyweight/children/index.html
for more ideas on how to help your child maintain a
healthy weight.
Source: WebMD, Kidshealth.org

Notice Of Privacy Practices
We keep your health information private, just like the law says we should. Find out how we can use your health info, along
with what your control and access rights are, by checking out our Notice of Privacy Practices.
If we change anything about these practices, we’ll post a new one to our website, georgia.wellcare.com. If there are a lot
of changes, we’ll mail you a copy. But, we also want you to know that you can ask for a hard copy at any time. Just give
Customer Service a call. The number and hours are on the cover of this newsletter.
Easy = Ordering OTC Items On The Web
Did you know that you can place your monthly order for over-the-counter (OTC) items on the member website?
If you have not registered, just go to our website (georgia.wellcare.com). Click on the words “Member Sign Up.” This will bring
you to the registration page. Answer a few simple questions and you’re ready to go!
Look under the Member Toolbox and click on Over the Counter (OTC) Items. You can place your order anytime during the
month. If you choose to call Customer Service and place your order with an agent, you may be able to save time by calling later
in the month. Call wait times can sometimes be higher in the first week of the month. Wait times are usually lower toward the
middle or end of the month.
Our automated phone system is another great way to order your OTC items. To place an OTC order using this system, just call
1-877-389-9457; then press “0.” The phone system will ask for your member ID number and date of birth. Once verified by the
system, you will hear an option to place an OTC order or to review a prior order. Just follow the prompts.
You can make use of the website and automated phone system 24 hours a day, 7 days a week.
Member Newsletter
3

Keep Your Member ID Card
Handy
It lets your doctor know the “ins and outs” of your plan. Be sure
you have it on you and it is up to date at all times. Call Customer
Service to make personal changes.
Did You Know?
Sometimes it’s okay for a provider to bill you. One reason is
relevant co-pays. Also, when you agree to be seen as a self-pay
patient before getting services, you’re responsible for the costs.
Know you may get a bill in the mail.
4 Member Newsletter
Brush Up On
Speaking Up
Striking up a conversation with your child’s
dentist can seem like a tough task – but it
doesn’t have to be. Brush up on ways to share
what’s on your mind.
First, find a dentist who makes you both
smile. Then visit often! If you go once every
6 months like we recommend, the staff will
get to know you and your family and you’ll
feel welcome there. In fact, we hope you’ll
come to think of it as your dental home.
Once you find your dental home and feel
comfortable, it’s easier to bring up questions.
Ask these 3 (or more!) after every appointment:
• How does my child’s mouth look?
• What treatments were done?
• How can I help my child improve?
Take note of the answers and work with your
child on their routine.
Need help finding a smile-worthy dentist?
Go to www.dentaquestgov.com for all-hours
access to your options.
Member ID #:
Member:
Effective Date:
Primary Care Physician
Phone:
After Hours:
Medicaid #:
CO-PAY INFORMATION
Office Visit___________ $
Emergency Room _____ $
Pharmacy ___________ $
Hospital _____________ $
Ambulatory Surg. _____$

Don’t Wait To Vaccinate
It’s important to get your child vaccinated on time. Talk to
his or her primary care physician (PCP) for help deciding what
shots are needed when.
What Are Vaccines?
Vaccines, also called immunizations, are shots that help keep
people from getting certain diseases. Some common ones
protect against:
• Whooping cough
• Hepatitis
• Mumps
• Diphtheria
• Chicken pox
• Polio
• Tetanus
• Measles
When Does a Child Need Shots?
From birth on, you should expect your child to receive a shot at
almost every checkup.
Questions?
If a Child Has a Fever, Can He or She Still
Get Immunized?
Your child’s PCP is the best judge as to whether or not this is
a good idea.
Do Shots Hurt Babies?
First, remember that a shot’s sting is temporary and much less
difficult than any of the diseases mentioned above. Second,
know that your baby picks up feelings from your expression
and body language – which means staying calm helps. Talk
quietly and offer a soft touch. Make eye contact and smile.
Why Should a Child Receive the Chicken
Pox Vaccine?
Grownups are more likely to die from chicken pox and its
complications, and the chicken pox (varicella) vaccine protects
children into adulthood. If an immunized person gets chicken pox,
the illness will be much milder than for someone who is not.
Talk to your child’s PCP, call the Personal Health Advisor line 24/7 at 1-800-919-8807 or reach out to Customer Service.
Member Newsletter
5

Q1 Medicaid Formulary Update 2012
The generic drugs listed below are now available to WellCare of Georgia members at the lowest co-payment, and the brand-name
drugs have been removed from the WellCare of Georgia Preferred Drug List:
BRAND NAMe GeNeRIC NAMe
The following changes have been made to the WellCare of Georgia Medicaid Preferred Drug List:
THeRAPeUTIC ClASS
Cleocin HCl® 75mg capsules Clindamycin HCl 75mg capsules Anti-infective Agent
Derma-Smoothe/FS® 0.01% Topical Body Oil
Derma-Smoothe/FS® 0.01% Topical Scalp Oil
Malarone® Pediatric 62.5mg-25mg tablets
Malarone® 250mg-100mg tablets
Atorvastatin Calcium 10mg, 20mg, 40mg, 80mg tablets (ST)
Diabetic Tussin® DM liquid (AL = 21 years of age and younger)
Fluoxetine 40mg capsules
Fosinopril 10mg, 20mg, 40mg tablets
Fluocinolone Acetanide 0.01% Topical
Body Oil
Fluocinolone Acetanide 0.01% Topical
Scalp Oil
Atovaquone/Proguanil Hydrochloride
Pediatric 62.5mg-25mg Tablet
Atovaquone/Proguanil Hydrochloride
250mg-100mg Tablet
ADDITIONS
Gemcitabine 200mg/5.26mL, 2gm/52.6mL, 1gm/26.3mL injection (PA)
Incivek 375mg tablet (PA, QL = #504 tablets/365 days)
Jakafi® 5mg, 10mg, 15mg, 20mg, 25mg tablets (PA)
Juvisync® 100mg/10mg, 100mg/20mg, 100mg/40mg tablets (ST)
Pegasys ProClick 135mg/0.5mL, 180mg/0.5mL Autoinjector (PA)
Q-Tapp DM elixir (AL = 21 years of age and younger)
Quinapril 5mg, 10mg, 20mg, 40mg tablets
Ramipril 1.25mg, 2.5mg, 5mg, 10mg capsules
Robafen AC syrup (AL = 21 years of age and younger)
Suprax® 400mg tablet (QL = #1 tablet/31 days)
Trospium 20mg tablets
Victrelis® 200mg capsules (PA, QL = #372 capsules/31 days)
Vyvanse® 20mg, 30mg, 40mg, 50mg, 60mg, 70mg capsules (QL = #31 tablets/31 days)
Xarelto® tablets (10mg tablets; QL = #35 tablets/365 days)
Zenpep® (Lipase 25,000unit) DR capsules
PA = Prior Authorization
6 Member Newsletter
QL = Quantity Limit
ST = Step Therapy
AL= Age Limit
Topical Anti-inflammatory Agents
Topical Anti-inflammatory Agents
Antimalarial Agent
Antimalarial Agent

BPM PE liquid
Bromphenex® DM liquid
Clotrimazole/betamethasone cream, lotion
Cytomel® 5mcg, 25mcg tablets
Doxycycline monohydrate 50mg, 75mg, 100mg capsules
Doxycycline monohydrate 25mg/mL powder for suspension
Gani-Tuss NR liquid
Gani-Tuss-DM NR liquid
K-Vescent 20mEq effervescent tablets
Mebendazole 100mg chewable tablets
Optics 0.9% eye wash solution
Poly-Pred® ophthalmic suspension
Vesicare® 5mg, 10mg tablets
ReMOVAlS
We have changed the utilization management criteria for the following medications on the WellCare of Georgia Medicaid Preferred Drug List:
DRUG NAMe CHANGe
Bupap 650-50 tablets Added QL = #93 tablets/31 days
Butalbital/acetaminophen/caffeine 50mg-325mg-40mg tablets
and capsules
Butalbital/acetaminophen/caffeine 50mg-500mg-40mg tablets
and capsules
Added QL = #186/31 days
Added QL = #124/31 days
Clindamycin Palmitate HCl 75mg/mL oral solution Increased QL = #2400mL/31 days
Diazepam 2.5mg, 10mg, 20mg rectal gel Removed PA, QL remains #3/31 days
Nortriptyline 10mg/5mL solution Added QL = #1500mL/31 days
Ovide® Lotion, 0.5% Increased QL = # 118mL/31 days
Accu-Chek® Active; Accu-Chek® Aviva Plus, Accu-Chek® Comfort
Curve; Accu-Chek® Compact; FreeStyle®; FreeStyle® Lite;
Precision Xtra® Test Strips
PA = Prior Authorization
QL = Quantity Limit
Please visit georgia.wellcare.com to view the current preferred drug list and pharmacy updates
Increased QL: for members 21 years of age and younger
#200/31 days
Member Newsletter
7

211 Perimeter Center Parkway
Suite 800
Atlanta, GA 30346
Para solicitar este documento en español, llame al Servicio
al Cliente al 1-866-231-1821 (TTY/TDD 1-877-247-6272).
GA018199_CAD_NEW_ENG State Approved 04132012
©WellCare 2012 GA_03_12 43644
What Is BMI?
Underweight. Average. Overweight. Obese. Body
Mass Index (BMI) is a number calculated from a
child’s weight and height that corresponds to
these categories. It can help show body fatness
in most children and teens – which is important,
because sometimes weight issues can lead to health
problems.
Health experts Say…
BMI is a good tool for children and teens aged 2–19.
An easy way to find out your child’s BMI is to ask
their doctor. Or, visit www.cdc.gov/bmi and click
Child and Teen BMI Calculator to get your little
one’s number. Keep in mind that, for children, BMI
is used as a first screen. If your child has a high BMI,
their health care provider would need to do more
evaluations.
Source: Center for Disease Control and Prevention