Every October, Medicare Advantage plans like

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1 A Newsletter For Members of Vi va Medicare Plus Volume 8 Issue 14 Fall 2009 Changes for the 2010 Plan Year Every October, Medicare Advantage plans like Vi va Medicare Plus announce the plans and benefits they will offer in the coming. People with Medicare can then look at their options and decide whether to stay with their current plan or join a new plan that might better meet their needs. The period from November 15th December 31st of each is called the Annual Election Period. During this time, you can make changes to how H1N1 (Swine) Flu Update Vi va Medicare Plus has already started receiving inquiries from our members regarding concerns about the H1N1 flu pandemic. We understand that this virus has the potential to be extremely virulent, so we wanted to take this opportunity to give you some information on how you can help recognize and prevent this illness. The H1N1 influenza virus originally appeared in the U.S. during Spring 2009, and it has been shown to spread in the same fashion as the traditional influenza that we are all familiar with. It is most commonly transmitted by infected people who cough and sneeze which leads to the virus landing on common surfaces where it can live for more than two hours. Once infected, you become contagious even before the onset of symptoms. The good news is that recent studies by the CDC have shown that of the early cases of swine flu victims, only 1% of those infected were aged 65 or older. Public health officials believe that this is most continued on page 5 you get your Medicare for January 1st. To be sure you have everything you need to understand your Vi va Medicare Plus plan, Medicare asks us to send you a letter about what changes we are making for We include the 2010 formulary (list of covered drugs) and a new Evidence of Coverage. If you qualify for Extra Help with your prescription drugs, you will also get a document called the lowincome subsidy rider that talks about how the Extra Help changes your drug benefit to lower your out-ofpocket costs. Due to changes in Medicare payment policies and rising medical costs, out-of-pocket costs are increasing in 2010 for some services on the Vi va Medicare Plus Rx, Vi va Medicare Plus Select, and the Vi va Medicare Plus Rx Premier plans. Despite the increases, we think the benefits these plans offer remain extremely attractive. We continue to expand our plan choices so members can find a plan that best meets their personal needs. For 2010 Vi va Medicare Plus offers plans with and without Part D prescription drugs, plans custom-made for our members who have both Medicare and Medicaid, and plans that combine different levels of premiums and out-of-pocket costs. Whether you stay with the Vi va Medicare Plus plan you have now or change to another Vi va plan, we are confident we have an option that will work well for you. That said, you will probably get information from other companies offering Medicare Advantage plans in Alabama. Take a look and see how our Vi va Medicare Plus plans compare. We think you will see that our plan designs are very attractive compared to both our competitors and Original Medicare. H0154_mcdoc842A

2 Page 2 A Plan for All Budgets! A Newsletter for Members of VIVA MEDICARE Plus Vi va Medicare Plus is excited to announce the addition of Vi va Medicare Plus Rx Gold. In 2010 we are offering three standard plans that include Part D prescription drugs with plan premiums of $0, $71, or $127 per month (you still pay your Part B monthly premium). More information on the three plans is included in the table below. If you think you might like to swap plans please do not hesitate to call Member Services at TTY users should call We will be more than happy to discuss our different plan options and what plan might best suit your healthcare needs. Just give us a call today! Amount You Pay SERVICE Rx Premier Gold Monthly Plan Premium $0 $71 $127 Personal Care Physician (PCP) Visit $20 $10 $0 Specialist Visit (includes chiropractors and $30 $10 $0 podiatrists) Inpatient Hopital Care $500 per stay; $2,500 Outpatient Services/Surgery $335 per visit, $2010 $150 per stay; $750 $150 per visit, $900 Drugs Covered under Medicare Part D Part D Deductible $265 $0 $0 Initial Coverage (Up to $2,830 in total costs) Tier 1: Generics $5 for 31 day supply; $15 for 90 day supply; $12.50 Preferred Mail Order 90 day supply Tier 2: Preferred Brand $30 for 31 day supply; $90 for 90 day supply; $75 Preferred Mail Order supply Tier 3: Non-Preferred Brand $55 for 31 day supply; $165 for 90 day supply; $ Preferred Mail Order supply Tier 4: Specialty 26% 33% 33% Coverage Gap You pay 100% Tier 1 generics are covered in the gap at copayments listed above. You pay 100% for Tiers 2, 3, and 4 Catastrophic Coverage (after you have spent The greater of $2.50 generic (including brands treated as ge- $4,550 out-of-pocket) Eyewear neric) and $6.30 all other drugs, or 5% $0 copay for one pair of eyeglasses or contact lenses after cataract surgery. $0 $0 $0 copay for one pair of eyeglasses or contact lenses after cataract surgery. Also covers up to $100 for prescription eyewear/. Preventive Dental Services Not Covered Plan covers one oral exam and teeth cleaning every up to $100 All plans include a Sports Fitness benefit. Each plan will pay up to $20 per month towards dues for each month you use a participating sports fitness club. The member pays any amount over $20. ***This table is a brief comparison of copays for frequently used benefits among the three standard plans offered by Vi va Medicare Plus that include Part D prescription drug coverage. Other plans not shown here are available if you do not need prescription drug coverage or if you have both Medicare and Medicaid.

3 LAMAR SUMTER CHOCTAW PICKENS WASHINGTON MOBILE MARION GREENE LAUDERDALE COLBERT FRANKLIN FAYETTE TUSCALOOSA HALE MARENGO CLARKE BALDWIN LAWRENCE WINSTON WALKER PERRY WILCOX MONROE LIMESTONE BIBB DALLAS ESCAMBIA MORGAN CULLMAN JEFFERSON CONECUH MADISON BLOUNT SHELBY CHILTON AUTAUGA LOWNDES BUTLER MARSHALL ST. CLAIR COVINGTON JACKSON ETOWAH TALLADEGA COOSA ELMORE MONTGOMERY CRENSHAW DE KALB CALHOUN CHEROKEE CLAY TALLAPOOSA PIKE COFFEE CLEBURNE MACON BULLOCK GENEVA RANDOLPH DALE CHAMBERS LEE BARBOUR RU SS E L L HENRY HOUSTON A Newsletter for Members of VIVA MEDICARE Plus Page 3 Viva Wii Bowling Vi va Medicare Plus is always excited when new sponsorship opportunities arise. Earlier this, we were presented with the opportunity to sponsor the Wii Bowling League through the Homewood Senior Center. The league consisted of 8 teams from six different senior centers throughout Birmingham, and there were many skilled Wii bowlers among the group. Each team consisted of anywhere from 4-6 members, and it was not uncommon to see teams average well over 150 pins per member in any given match. In fact, the league most valuable player (MVP) averaged over 180 pins during the season with a high game of almost 240. The league consisted of separate events that were held at the various senior centers that participated. Teams competed head to head, and points were tallied for end of the awards given at an awards banquet held at the Homewood Senior Center. The following were recognized: top three teams, MVP from each team, top three individual bowlers, Most Experienced and Mature Award, the Baby Bowler Award, and the Wii Spirit Award. Both Vi va Medicare Plus and the Homewood Senior Center are already fielding calls from other Senior Centers who are inquiring about how to either get involved in the VIVA Wii Bowling League in Homewood or possibly start their own league. Vi va Medicare Plus is excited about the continued growth of this event, and we look forward to what the future brings. The Nintendo Wii is a gaming console that includes wireless remotes that can detect movements in three dimensions and also be used as a pointing device. Wii Sports, the game that is included with the console, includes baseball, golf, tennis, boxing, and bowling. In the case of bowling, the user swings the wireless remote just as they would a bowling ball. The remote is so sensitive that with a flick of the wrist you can even spin the ball. We have all seen people sitting in front of gaming consoles for hours on end, but the Wii is completely different. Although the games may prove to be as entertaining, it is much more interactive. Do not be surprised if you actually find yourself sweating while participating in some of the games! The games have proven to be great for memory, hand eye coordination, reaction time, and overall physical endurance and strength. The Vi va Medicare Plus Wii Bowling League also proved itself to be a great place for social interaction and camaraderie. Several of the participants met old friends and acquaintances that they had not seen since high school! Next time someone offers you a chance to play a Nintendo Wii do not pass it up. You would be surprised how much fun you will have. Also, contact your local senior center and see if they have a Wii or know of any leagues that you can participate in. As with any new exercise plan, always check with your Primary Care Physician before you begin. p.s. Keep your eyes open for Vi va Medicare Plus in the community this Fall. We have several great sponsorships lined up. Vi va Medicare Plus Expands in 2010! Everyone at Vi va Medicare Plus truly believes that we work for the best Medicare Advantage plan in Alabama. Our valued members have let us know this in and out from your positive responses on the annual member survey conducted by Medicare. Our goal is to give the option of enrolling with Vi va Medicare Plus to as many people in Alabama as possible. For 2010, Vi va Medicare Plus is expanding into Cullman, Cherokee, and DeKalb counties. This will help increase our footprint around the Birmingham area while continuing to support our expansion into East Alabama. If you know someone in these counties that you think would be a great candidate for membership in Vi va Medicare Plus, please have them call We can show them exactly why our members continue to rate us the best Medicare Advantage plan in Alabama (Based on the 2008 CAHPS Survey Overall Rating of Health Plan).

4 Page 4 A Newsletter for Members of VIVA MEDICARE Plus Ways to help with Coverage Gap cost Unless you get extra help, your prescription drug benefit has a coverage gap. In 2009, you hit the gap after the amount you and Vi va Medicare Plus spend on your drugs reaches $2,700. During the coverage gap you pay 100% of the costs for your drugs until the amount you have spent in the reaches $4,350. Here are some ways you can avoid or delay entering the gap and continue to save money on drug costs while in the gap: Considering switching to generics or other lower cost drugs. Ask your doctor about generics or lessexpensive brand name drugs that would work just Important Membership Information There are a lot of great things happening at Vi va Medicare Plus that you should know about. Here are just a few: Your Vi va Medicare Plus membership card may change to reflect your 2010 plan and benefits. Once you receive your new ID card, be sure to show it to your physician, even if they already have your information. There will be new copays that your provider will need to know. New cards will be mailed in December. Vi va Medicare Plus has added a comprehensive formulary search tool to the website. You will be able to search for your drug by name, and the tool will return the tier the drug is on, any special notes on the dispensing of the drug, and any generics for the drug that could help you save money. Vi va Medicare Plus has also added a comprehensive provider search tool that includes our pharmacy network. In case you don t know exactly how to spell that provider or pharmacy name that your friend mentioned to you, this tool includes a predictive text function that will help you. You now have access to much more information than ever before. You can even find out if that pharmacy around the corner delivers! Be sure to visit com to see all the changes to the website! as well as the ones you are taking now. Switching to lowercost drugs is often enough to help you avoid the coverage gap. Check on a one tablet per day regimen or pill splitting. There are some medications on the market that are available in multiple strengths at the very same price. By taking the higher dosage it is possible to lower the cost of therapy and possibly help you to stay in compliance with your therapy. For example, if you take Lipitor 10mg at 2 tablets per day, you might be able to take the higher dosage Lipitor 20mg once a day. Or, if you take one Paxil 10mg a day, you might be able to lower your cost by taking half of a higher dosage of Paxil 20mg a day. Remember this will not apply to all drugs so before making any changes to your medication regimen be sure to check with your physician. Consider receiving medications through a mailorder pharmacy. Members are able to receive a 90 day supply through the mail by contacting Caremark at Look at Manufacturer & State Pharmaceutical Assistance Programs. To learn about help offered through the drug manufacturers or the state, you can access information through the web under or These are great tools for finding out about all types of drug assistance programs. You can also contact your physician or the Alabama Department of Senior Services at You may be able to get help with drug costs if you are taking a non-formulary drug or you are in the coverage gap. Keep showing your Vi va Medicare Plus ID Card. Always remember that while you are in the coverage gap you should continue to show your ID card. This will make sure that you will continue to receive the benefit of our discounted rates, plus all amounts spent out of pocket will be applied toward your Catastrophic Coverage.

5 A Newsletter for Members of VIVA MEDICARE Plus Page 5 Attention: Nexium Users Did you know that plan participants can save an average of 30% to 80% when they fill their prescriptions with a generic medicine instead of a brand name medicine? CVS Caremark, the prescription benefit manager for Viva Medicare Plus, is always looking for ways to help you save money. At this time, there isn t a generic equivalent (or exact match) for Nexium, which is used to treat gastroesophageal reflux disease (GERD) or ulcers. However, there are generic alternative drugs available called omeprazole and pantoprazole. If you are currently taking NEXIUM, ask your doctor if one of these generics is right for you? Omeprazole Pantoprazole Like Nexium, omeprazole and pantoprazole are safe and effective proton pump inhibitors (PPIs). Drugs like omeprazole and pantoprazole decrease the amount of acid your stomach produces and help prevent injury to your esophagus. There are additional medications that are prescribed to treat the amount of acid your stomach produces. These medications are also available as generics. Ask your doctor if the following generics are right for you. Ranitidine Why Generics? Famotidine Choosing generic drugs whenever possible is an easy and effective way to keep health care costs down. Here s why: Research shows that people can save an average of 30% to 80% when they fill their prescriptions with a generic instead of a brand-name drug. Generics cost less because their manufacturers do not have to spend the hundreds of millions of dollars it takes to discover the new, original drug. Switching to lower cost medications may also postpone or eliminate you reaching the coverage gap. The FDA requires that a generic have the same quality and strength as the brand named product. To save money on your prescriptions, ask your doctor to prescribe generics and allow generic substitution at your local pharmacy. Flu Update continued from page 1 likely due to the fact that this demographic has come across a similar strain to the swine flu at some point in their life and they have developed pre-existing antibodies to this particular strain. What are the signs and symptoms that you might be infected? The symptoms of the swine flu are almost the exact same as those of traditional flu. The symptoms include fever, fatigue, runny/stuffy nose, chills, body aches, cough, sore throat and headache. If you or someone you know is starting to experience flu like symptoms, please stay at home. This will help in preventing the spread of this virus. Adequate rest and maintaining your current diet will be crucial to regaining your health. If you think you may have contracted either the swine flu or the common flu, contact your health provider and they will tell you if an office visit is necessary or if you can treat the symptoms with over the counter medications How can you prevent catching the swine flu? We have all heard the saying that an ounce of prevention is worth a pound of cure. This definitely holds true with the flu. A vaccine is currently in production, but it is expected to only be available in a limited supply. Just a few methods of prevention are washing your hands with soap and water several times during the day, covering your mouth when you sneeze/ cough, avoiding touching your eyes/nose/mouth, avoiding others who you think might be sick, and following any public notifications regarding public building closings. Also, be sure to visit to find out the latest updates regarding the different flu strains. Remember that Vi va Medicare Plus covers your flu shot immunization once a in the fall or winter and will also cover administration of the swine flu vaccine. You can get your flu shot without a referral from your PCP, but make sure that you receive your shot from a plan provider in your selected system. If you have any other questions please call Member Services at TTY users should call the Alabama Relay Services at

6 VIVA MEDICARE Plus MEMBER OF THE HEALTH SYSTEM a Medicare Advantage Organization Brought to you by Viva Health, a member of the UAB Health System th Avenue South Birmingham, AL PRSRT-STD U.S. POSTAGE PAID BIRMINGHAM, AL PERMIT NO A Newsletter For Members of Viva Medicare Plus PUMPKIN SWEET POTATO STUFFING APPLE PECAN CRANBERRIES SQUASH COBBLER HAM CARROTS TURNIPS FOOTBALL ALABAMA AUBURN UAB BLAZERS Fall Fun LEAF HALLOWEEN HARVEST AUTUMN MAPLE THANKSGIVING TURKEY CORN ACORN RAKE SCARECROW HAY PIE SAmFORD Hornets Troy s B A U S J Y O R T C O R N H H t S N F E B N I K P M U P A W C e A M E I O E K A R K A L F I C n m U R R T U R K E Y L O K O D r F T E R A P B B C O O E B S A o O U L E T G I A W T L B H C N H R A P B O Y H E B P L S S A R N D Z A N P W E A P E P U A R O R P M M A T N L A R I N F U E C U E S B R E L R Y N V A R Q C A B C R Z C E K P R A E E T S R Y U A E E B W U U J L H X S P O L A N Z H Z S T U F F I N G T W Q N Z A T H A N K S G I V I N G N W M L M Q N A M A B A L A V C J Z P B D E O C A R R O T S E U V H0154_mcdoc842A