Physical activity decreases your risk of heart disease by:

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1 Winter 2012 Viva Vitality A newsletter for Viva Medicare Plus members. Be Good to Your Heart It s important to take care of your heart to help prevent a heart attack or stroke. Start today by talking to your doctor about getting a cardiovascular screening. Learn more about reaching your heart health goals through Million Hearts, a national campaign from the Centers for Disease Control (CDC) and the Centers for Medicare & Medicaid Services (CMS) aimed at preventing heart attacks and strokes. WHAT IS MILLION HEARTS? Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over the next five years. Heart disease and stroke are two of the leading causes of death in the United States. Million Hearts brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke. Million Hearts Focuses on Two Goals: 1. Empowering Americans to make healthy choices such as preventing tobacco use and reducing sodium and trans fat consumption. This can reduce the number of people who need medical treatment such as blood pressure or cholesterol medications to prevent heart attacks and strokes. 2. Improving care for people who do need treatment by encouraging a targeted focus on the ABCS - Aspirin for people at risk, Blood pressure control, Cholesterol management and Smoking cessation - which address the major risk factors for cardiovascular disease and can help to prevent heart attacks and strokes. Viva Medicare Plus wants to help you decrease your risk of cardiovascular disease. It s as easy as A-B-C-D-E: A - Avoid tobacco. Smoking is a major risk factor for heart disease. B - Blood Pressure. High blood pressure is a risk factor for heart disease. C - Cholesterol. The higher your total blood cholesterol and LDL (bad) cholesterol, the greater your risk for heart disease. For HDL (good) cholesterol, the higher the number is, the lower your risk of heart disease. D - Diet. Limit unhealthy fats and cholesterol. Choose low-fat protein sources such as lean meat, egg whites, skim milk, and fish. Eat more vegetables and fruits. Select whole grains like brown rice and whole grain bread instead of white bread, corn bread, biscuits, cakes and pies. Shake the salt habit to help decrease blood pressure. E - Exercise. Get moving! If you have been inactive for some time, check with your doctor before increasing activity. Physical activity decreases your risk of heart disease by: Lowering blood pressure / Increasing good cholesterol / Decreasing the bad cholesterol / Aiding weight loss A 30 to 40 minute brisk walk three times a week is enough to improve your fitness level and reduce your cardiovascular risk. Viva Medicare Plus pays up to $20 per month toward a gym membership at a participating fitness facility. H0154_mcdoc1111A File and Use 03/04/2012

2 High Risk Medications Enhancing medication safety for older members enrolled in Viva Medicare Plus is a very important focus at Viva Medicare Plus in High Risk Medications (HRMs) are medications that are considered useless in most patients over 65 years of age or pose unnecessary risks when safer treatment choices may be available. We recognize that your doctor is the best qualified to balance quality and risks when selecting the right treatment for you. If you have been on the following HRMs, Viva Medicare Plus may have already contacted your doctor and recommended the alternatives listed below: Drug Class Drug Name Reason For Risk Alternative Musculoskeletal therapy agents Antihistamines Anti-emetics carisoprodol cyclobenzaprine metaxalone methocarbamol orphenadrine citrate er orphenadrine compound ds orphenadrine/asa/caffeine cyproheptadine hydroxyzine hydrochloride hydroxyzine pamoate phenadoz promethazine promethegan promethazine; phenylephrine scopolamine trimethobenzamide Side effects: worsened mental confusion involuntary leakage of urine; drowsiness; weakness Side effects: worsened mental confusion involuntary leakage of urine; drowsiness Side effects: worsened mental confusion involuntary leakage of urine; questionable effectiveness Antispasmodics dicyclomine capsule, tablet, oral solution Side effects: worsened mental confusion involuntary leakage of urine; uncertain effectiveness Gastrointestinal miscellaneous diphenoxylate/atropine Side effects: slowed breathing; drowsiness; dizziness; urinary retention OR involuntary leakage of urine baclofen dantrolene ROBAXIN INJECTION tizanidine ASTEPRO SPRAY, azelastine nasal spray, cetirizine syrup, clemastine fumarate, diphenhydramine hcl injection, fexofenadine, hydroxyzine im soln, levocetirizine compro suppository, DRONABINOL CAP, EMEND, granisetron, meclizine metoclopramide, ondansetron, prochlorperazine, promethazine injection, SANCUSO CUVPOSA SOLUTION, dicyclomine injection, glycopyrrolate Loperamide LOTRONEX Platelet aggregation inhibitors Estrogens dipyridamole estropipate, PREMARIN ortho-est Decreased blood pressure when standing up causing lightheadedness, weakness or blurred vision Increased risk of breast and endometrial cancer Estrogen/progestins PREMPHASE, PREMPRO Increased risk of breast and endometrial cancer AGGRENOX, EFFIENT, PLAVIX ESTRACE vaginal cream, ESTRADERM, estradiol tablet, estradiol td weekly patch, ESTRING, FEMRING, PREMARIN injection, PREMARIN vaginal cream, VAGIFEM, VIVELLE-DOT COMBIPATCH, jinteli

3 Flu Shot - It s not too late Are you at risk of developing flu-related complications? Most people who get the flu will have mild illness, will not need medical care and will recover in less than two weeks. Some people, however, are more likely to have flu complications that result in being hospitalized. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. The flu also can make chronic health problems worse. People at High Risk: Adults 65 years of age and older COPD (Chronic Obstructive Pulmonary Disease) Morbidly obese (BMI of 40 or greater) asthma Heart Disease Diabetes Flu prevention tips: Wash your hands - The flu virus can be spread by touch or by touching an object that has been touched by an infected person. The influenza virus can live 2 to 8 hours on surfaces. Cover sneezes and coughs - Cover your nose and mouth with a tissue, then toss it in the trash. Flu activity most commonly peaks in the U.S. in January or February. The flu shot is the most effective method for preventing the flu. Viva Medicare Plus will let you get your flu shot in any of the following three (3) ways: 1. Take the voucher you received several weeks ago to any CVS Pharmacy of your choice and receive a flu shot at no cost to you. 2. Go to any Viva Medicare Plus participating provider including your PCP, a specialist, or any other provider who accepts Viva Medicare Plus. Participating providers bill Viva Medicare Plus directly with no charge to you. 3. From any other flu shot provider including any drug store that offers flu shots. If you get your flu shot from a non-participating provider or at a drug store, they will probably ask you to pay. Viva Medicare Plus will pay you back for a flu shot if you send your receipt together with your first and last name, member number, and date of birth to: Viva Medicare Plus, P. O. Box 55209, Birmingham, AL (To make sure you are giving us all the information we need, you can fill out our claim form to make your request for payment. Either download a copy of the form from our website ( or call Member Services and ask for the form.) Member Services Spotlight Janeria has worked as a Medicare Member Services Representative at VIVA Health for over five years. Her job responsibilities include assisting members with questions and issues related to their coverage with VIVA Medicare Plus. What she enjoys most about her job is resolving issues that members have and the satisfaction she feels when those issues are resolved. She strives to provide exceptional customer service to ensure member loyalty. On a personal note, Janeria enjoys spending time with her family and friends and at church.

4 March is Colorectal Cancer Screening Month What is colorectal cancer? Colorectal cancer is a disease in which cells in the colon or rectum become abnormal and divide without control, forming a mass called a tumor. It is the second leading cause of cancer death in the United States after lung cancer. Reducing your risk of colorectal cancer: Get routine screenings Eat a healthy diet including whole grains, fruits and vegetables Regular exercise If you smoke, try to stop. Determining your risk for colorectal cancer Your doctor may look at the following factors to help determine your risk for colorectal cancer: o Age Colorectal cancer is more likely to occur in people 50 years of age or older. o Personal history A history of polyps may increase your risk. Polyps are abnormal growths that protrude from the inner wall of the colon or rectum. They are relatively common in people over age 50. Most polyps are benign (noncancerous). Detecting and removing these growths may help prevent colorectal cancer. o A person who has already had colorectal cancer is at an increased risk of developing colorectal cancer a second time. o Family history Close relatives (parents, siblings, or children) of a person who has had colorectal cancer are somewhat more likely to develop this type of cancer themselves. o Inflammatory disease of the bowels- People who have ulcerative colitis or Crohn colitis may be more likely to develop colorectal cancer than people who do not have these conditions. o Other factors that can increase the risk of colorectal cancer: Diet A diet high in red and processed meats may be associated with colorectal cancer. Exercise People who get little or no exercise may be at increased risk. Smoking cigarette smoking may increase the risk of colorectal cancer. Obesity-being overweight may increase the risk of developing colorectal cancer. If you are years of age you should have one of the following screenings: o Yearly-Fecal occult blood test (FOBT) This test checks for hidden blood in fecal material (stool). Currently, two types of FOBT are available. Depending on the type of FOBT, stool samples from one to three bowel movements are collected. o Every 5 years-sigmoidoscopy In this test, the rectum and lower colon are examined using a lighted instrument called a sigmoidoscope. During sigmoidoscopy, precancerous and cancerous growths in the rectum and lower colon can be found and either removed or biopsied. o Every 10 years-colonoscopy In this test, the rectum and entire colon are examined using a lighted instrument called a colonoscope. During colonoscopy, precancerous and cancerous growths throughout the colon can be found and either removed or biopsied. Viva Medicare Plus Puts Members First A Medicare Satisfaction Survey is conducted each year by the Centers for Medicare & Medicare Services (CMS) to learn more about the health care and services you receive. VIVA Health recently received the results of the 2011 Medicare Satisfaction Survey, and our members showed their support by giving us outstanding scores. A special thank you goes out to all those members who participated in the survey. To the right are some of the categories we were rated on for 2011 and the results: Category Rating of Health Plan Responsiveness and Care Getting Needed Care Overall Rating of Health Care Quality Overall Rating of Health Plan Customer Service Member Experience with Drug Plan Getting Needed Prescription Drugs Getting Information from Plan About Prescription Drugs Overall Rating of Prescription Drug Plan Star Rating 5 Stars = Excellent (the highest possible score) 2 Stars = Below Average 4 Stars = Above Average 1 Star = Poor 3 Stars = Average

5 Preventive care keeps you, your budget healthy You know that preventive care is good for your health. But did you know that prevention is good for your wallet, too? Viva Medicare Plus covers many preventive services at 100%, free of charge to you. Examples of free preventive services include an annual wellness visit, mammograms, colonoscopies and flu shots. Your annual wellness visit with your Personal Care Physician (PCP) is one of the most important preventive services you can receive. During the visit, your physician should update your medical history, check your weight and blood pressure, update the list of screenings you need and refer you to follow-up care, if needed. The list of preventive services free to you continues to grow. Please review the list below of newly added preventive services that Viva Medicare Plus will pay at 100%. Make an appointment with your physician to get the care you need. You should receive most of the new preventive services from your PCP. New preventive services Alcohol misuse screening: One visit per year to your PCP or, for women, your obstetrician/gynecologist (OB/GYN) to screen for alcohol misuse. Alcohol behavioral counseling: If you screen positive for alcohol misuse, you may receive up to four brief counseling sessions per year by your PCP or OB/GYN. Depression screening: One visit per year to your PCP to screen for depression. Cardiovascular disease risk reduction visit: One visit per year to your PCP to receive: counseling for aspirin use screening for high blood pressure counseling to promote a healthy diet. Sexually transmitted infections screening: The available screenings depend on the member. Screenings are to be done by your PCP or OB/GYN. This service also covers appropriate laboratory tests: Pregnant women are eligible for chlamydia, gonorrhea, syphilis and hepatitis B screenings Women at increased risk of infection are eligible for chlamydia and gonorrhea screenings Men at increased risk are eligible for syphilis screening Sexually transmitted infection counseling: Up to two, 20 to 30-minute counseling sessions per year with your PCP or OB/GYN for sexually active adolescents and adults at increased risk for sexually transmitted infections. Your doctor can tell you if you are at increased risk. Obesity screening: One screening per year by your PCP to determine your body mass index (BMI). Obesity counseling: If your BMI is 30 or greater, you may receive brief counseling visits with your PCP to help you lose weight: One visit weekly for the first month One visit every other week for months 2-6 One visit every month for months 7-12 if you lose at least 6.6 pounds during the first six months of counseling Baby Boomers Did you know that there are currently over 10,000 people in the U.S. that are aging in to Medicare every day? To help better service these new Medicare beneficiaries we are holding group meetings every Wednesday at 10 a.m. at the Café locations listed in this newsletter. Medicare can be confusing so we want to help answer any questions you may have. If you know of anyone who is turning 65 this year let them know about these group meetings.

6 Viva Vitality th Ave S Birmingham, AL PRSRT STD Viva Medicare Café Viva Medicare Plus has locations in Montgomery, Birmingham, and Mobile designed to assist our members in all parts of their healthcare. This assistance ranges from enrolling with the plan all the way to learning how to cook healthier. There is even a book nook at each Café where you are free to borrow any book you wish! See the events below for each location. Remember, these events are at no charge to you and are just one of the ways we try to make your experience with Viva Medicare Plus as enjoyable as possible. Montgomery Café: 2107B Eastern Boulevard Montgomery, AL (334) Friday, March 16th 10 a.m. How to be properly fit for diabetic shoes and other equipment Friday, March 23rd 10 a.m. Healthy Cooking class Friday, April 20th 10 a.m. Healthy Cooking class Birmingham Café: 1550J Montgomery Highway Hoover, AL (205) Thursday, March 15th 10 a.m. Healthy Cooking class Thursday, April 12th 10 a.m. Healthy Cooking class Mobile Café: 907 Hillcrest Road Ste E Mobile, AL (251) Starting in March, events will be held the first and third Thursday of the month. Call to find out the schedule of upcoming events.