Better Living Newsletter

Transcription

1 Better Living Newsletter Spring/Summer 2015 In this issue Network pharmacies 2 Daily Challenge 3 Staying sharp 4 Doctor visit checklist 8 Stroke awareness 12 Fall risk and prevention 16 Diabetes and heart health 20 H0504_15_043A CMS Accepted blueshieldca.com

2 2 Better Living News Network pharmacies that offer preferred cost-sharing in 2015 With over 5,800 pharmacies, our pharmacy network includes all major chains and many other retail pharmacies throughout California. We have pharmacies that offer preferred cost-sharing and pharmacies that offer standard cost-sharing in our network. Although you can use any pharmacy in our network, you may pay less when you visit one of our network pharmacies that offers preferred cost-sharing. Prior to January 1, 2015, preferred cost-sharing only applied to 90-day supplies, but beginning January 1, 2015, you can save on a 30-day supply. Check your plan Evidence of Coverage or blueshieldca.com or call Member Services to see what you pay for a 30-day supply and a 90-day supply at pharmacies that offer preferred cost-sharing. We hope this information helps you find ways to save on your prescription drug costs. Network pharmacies that offer preferred cost-sharing: CVS/pharmacy Safeway and Vons Pharmacies Costco (membership not required) These pharmacies accept e-prescribing from your physician. Remember to always use your plan ID card whenever you get your prescriptions, even if they have a $0 copay. They could still contribute to moving you through the coverage gap phase, should you reach it.

3 Spring/Summer Take the Daily Challenge for fun and well-being We now offer you Daily Challenge an easy, social, fun way to fit healthy activity into even the busiest day. Daily Challenge is designed to improve your well-being one small action at a time. Once you sign up online, you do a simple health challenge each day, click the Done button, and share how you did it with friends, family, and colleagues. You can: 3 Get simple healthy actions to do each day 3 Learn why these actions matter 3 Earn points and track your progress 3 Share the experience with friends 3 Have fun and make lasting change Daily Challenge is simple Each morning we send you an or text message that highlights an activity you can do in just minutes. You can earn points and stamps, unlock special challenge tracks, and reach new levels, all while you're taking small steps that can add up to big changes. Senior exercise One of the Daily Challenge tracks available is called Senior Exercise. It can help keep your body strong, flexible, and energized with challenges that are safe and satisfying. This track features a wide variety of exercises that stretch different muscle groups, promote flexible joints, and help you with everyday activities. Go to mywellvolution.com to create an account and start your Daily Challenge well-being journey today. Daily Challenge is a registered trademark of MeYouHealth, a wholly owned subsidiary of Healthways, Inc. Wellvolution is a registered trademark of Blue Shield of California. Blue Shield and the Shield symbol are registered trademarks of the BlueCross BlueShield Association, an association of independent Blue Cross and Blue Shield plans.

4 4 Better Living News Staying sharp might help avoid Alzheimer s Although researchers may not be close to finding sure ways to prevent Alzheimer s disease, they have identified certain risk factors some of which you may be able to modify. The risk factors identified to date include age, genetics, environment, and lifestyle, says the National Institute on Aging (NIA), the lead federal agency for Alzheimer s research. In its publication Preventing Alzheimer s Disease: What Do We Know?, NIA says, Scientists are exploring prevention strategies to determine whether or not things like exercise, diet, and brain games can help delay or prevent Alzheimer s disease and age-related cognitive decline. And while research has not yet determined whether altering health and lifestyle factors can slow or prevent the disease, Staying cognitively active throughout life via social engagement or intellectual stimulation is associated with a lower risk of Alzheimer s disease, NIA says. Mental stimulation In addition to social engagement, Mentally stimulating activities such as reading books and magazines, going to lectures, and playing games are also linked to keeping the mind sharp, NIA says. One large study found that after four years, people who participated in those activities most often had a 47% lower risk of developing Alzheimer s than those who did them the least frequently, according to NIA. While reasons for the link between Alzheimer s risk and social and intellectual stimulation aren t entirely clear, scientists speculate it s possible those factors could help protect the brain s ability to operate effectively when damaged, and make up for some mental functions when others are declining, NIA says. The Alzheimer s Association, which is funding research on mental stimulation and other risk factors, says, Experts are not certain about the reason for this association. It may be due to direct mechanisms through which social and mental stimulation strengthen connections between nerve cells in the brain.

5 Spring/Summer Cognitive engagement Another federal agency, the Agency for Healthcare Research and Quality (AHRQ), commissioned a review of available research that stated, In conclusion, the available evidence supports an association between increased involvement in cognitive activities and decreased risk of Alzheimer s disease. The research examined in AHRQ s report Preventing Alzheimer s Disease and Cognitive Decline looked at activities such as going to museums, libraries, theaters, and community organizations, and gave examples of cognitively engaging activities as puzzles, reading, and board or card games. The AHRQ report also pointed out how social engagement and intellectual engagement can be closely related because intellectual engagement may often be conducted with others. Cognitive training Meanwhile, NIA is currently funding a clinical trial examining cognitive training such as with demanding video games. The research sponsorship is based in part on findings from another trial that seemed to demonstrate benefits from cognitive training. In that study, healthy people age 65 and older participated in sessions focused on training for memory, reasoning, or processing speed. According to NIA, that study found, The sessions improved participants mental skills in the area in which they were trained. These improvements could be found to persist as much as 10 years after the training was complete." Online resources Alzheimer s Association: Agency for Healthcare Research and Quality: National Institute on Aging:

6 6 Better Living News What's your game? The scrambled words below are names of popular games you can play to exercise your brain. When you've unscrambled the names, copy the numbered letters into the corresponding squares to form a message. The answers appear on the back cover. LEBSRACB MAGAMKCNOB 2 SHESC LAKBAKCJC EKPRO Puzzle message Copy the numbered letters into the corresponding squares below

7 Spring/Summer ECKSERCH 8 AESRCHAD 10 NOSDEMOI PLYMOONO KDOUSU GBION

8 8 Better Living News Write it down to get what s right for you We ve all done it. Left the grocery list at home and became frustrated at the store trying to remember crucial recipe ingredients or other needed items. While the glare of an examination room is quite different from the glare of a grocery store, there is a common principle: Having a list can help you get everything you need. Bringing a list of questions and concerns to your healthcare provider visit can also help you get better care and become more of a participant in your own health. Another list should contain information your doctor can use to tailor your care and treatments to best meet your individual needs, such as your medical history, your family s history of particular diseases or conditions, and all the prescription and over-the-counter medications you re taking. Here is a list of forms you can use to write your health information and questions and make notes: First Appointment Here s where you can log your personal and family medical history, as well as allergies and immunizations. Appointment for a New Problem This one can help you provide information about your symptoms and get information about proposed treatments. Follow-Up Appointment This lets you note information about continuing or recent issues such as treatment side effects and when tests are due. Regular Checkup for a Lifelong Condition This one may help you and your doctor stay on top of conditions such as type 1 diabetes. Your Family Medical History Having this information may help your doctor gauge your risk and take appropriate preventive actions. List of Medicines This is especially important if you re seeing more than one doctor and taking medicines that your doctor might not be aware of. Daily Medicine Schedule This may help you remember when to take medications and help your doctor verify you re taking them correctly.

9 Spring/Summer New Medicines: Questions to Ask the Doctor These questions may facilitate an important discussion about drug effects, doses, costs, and alternatives, including whether you should take a drug with food and what you should do if you miss a dose or are having problems taking a drug due to side effects. Medical Tests: Questions to Ask the Doctor This may be helpful for understanding the reason for a test, its accuracy, what it will feel like, and its results. Surgery: Questions to Ask the Doctor This may help you get answers to why, how, where, when, and what to expect from surgery. Other Treatment: Questions to Ask the Doctor This may help you guide discussions about treatments such as radiation and physical therapy. You can get these forms from our website or call the number on the back of your ID card to request the forms be sent to you. To see and print copies of these forms: 1. Go to blueshieldca.com and click Members. 2. Select Health & Wellness from the menu. 3. Click Health Library from the list on the left side of the page. 4. Click Topics A-Z from the Health Library options. 5. Click on the letter M and scroll to the article titled Making the Most of Your Appointment. You ll find links for each of these forms and other helpful information there.

10 10 Better Living News Ask these ten important questions The Agency for Healthcare Research and Quality (AHRQ) is the branch of the U.S. Department of Health & Human Services that s focused on helping to improve health care. Here are AHRQ s 10 Questions You Should Know : 1. What is the test for? 2. How many times have you done this procedure? 3. When will I get the results? 4. Why do I need this treatment? 5. Are there any alternatives? 6. What are the possible complications? 7. Which hospital is best for my needs? 8. How do you spell the name of that drug? 9. Are there any side effects? 10. Will this medicine interact with medicines that I m already taking?

11 Spring/Summer If you d like to see AHRQ s recommendations for questions to ask before, during, and after a doctor appointment, or use the AHRQ online Question Builder tool to create your own list of questions, go to From the drop-down menu, click on For Patients & Consumers, then choose Questions To Ask Your Doctor under Patient Involvement. Create a family history The U.S. Surgeon General offers an online tool you can use to create, update, share, and store a detailed family medical history. To learn about and use My Family Health Portrait, go to familyhistory.hhs.gov.

12 12 Better Living News Knowing about stroke: Sooner is better A stroke is when a blood vessel carrying oxygen and nutrients to the brain becomes blocked or bursts. When that happens, brain cells die. Every year, 795,000 people in the United States have a stroke, according to the American Heart Association (AHA). There are two types of strokes: 87% are ischemic stroke, which are due to clots; 13% are hemorrhagic stroke, caused by bleeding. There is also a condition called transient ischemic attack (TIA), sometimes called a mini stroke, that s caused by a temporary clot. At the first symptom of any of these, you should seek emergency care. While stroke prevention and treatment research is ongoing, the most important things you can do now is know the symptoms and fight as many of the risk factors as you can. Lower your risk An AHA report, Heart Disease and Stroke Statistics 2014 Update, lists the risk factors as high blood pressure, diabetes, atrial fibrillation (irregular heart rate), smoking, family history, physical inactivity, chronic kidney disease, and poor diet. You obviously can t do anything about the genetic aspects of your family history, and you may need a doctor s help for treating the health conditions listed, but you can work to quit smoking, eat better, and exercise more. And one crucial thing you can do is avoid or lower high blood pressure, which the National Stroke Association (NSA) calls the most important risk factor for ischemic stroke. If you have high blood pressure, talk with your doctor about which treatment is best for you. The AHA report says high blood pressure (hypertension) is a powerful determinant of risk for both ischemic stroke and intracranial hemorrhage. The report found that 77% of people experiencing a first stroke had blood pressure greater than 140/90. Therefore, it s important to check your blood pressure regularly.

13 Spring/Summer Women and stroke Women need to be extra diligent about stroke because it appears stroke is both more prevalent and more deadly in women than in men. The AHA report found that every year approximately 55,000 more women than men have a stroke. The report looked at age of menopause onset and the use of estrogen as possible factors. The study panel found the research on menopause conflicting, but suggested that estrogen use could play a role in stroke. In addition, the American Stroke Association (ASA) says, About 40 percent of stroke deaths occur in males, and 60 percent in females. This may be related to an AHA finding that on average, women are older at stroke onset than men, around age 75 versus age 71. Three stages of treatment The first of three stages of treatment involves treating underlying risk factors such as high blood pressure, diabetes, and atrial fibrillation, says the National Institute of Neurological Disorders and Stroke (NINDS). Next is treatment for the acute phase, with therapies aimed at stopping a stroke while it is happening by dissolving the blood clot in an ischemic stroke or stopping the bleeding of a hemorrhagic stroke. That s why emergency treatment is so important. The third stage is post-stroke rehabilitation to help people overcome the disabilities resulting from stroke, such as paralysis or weakness and problems speaking and thinking. NINDS is currently conducting or funding research on the mechanisms of stroke risk factors and the process of brain damage that results from stroke. Other research is focused on working to develop new and better ways to help the brain repair itself to restore important functions. Online resources for more information American Heart Association: American Stroke Association: National Institute of Neurological Disorders and Stroke: National Stroke Association:

14 14 Better Living News With stroke, you ve got to act FAST Time is of the essence when dealing with a stroke. That s why the American Stroke Association (ASA), a division of the American Heart Association, created the acronym FAST and this list of questions to alert people to immediately call 911 when someone exhibits stroke symptoms: Face drooping Does one side of the face droop or is it numb? Ask the person to smile. Is the person s smile uneven? Arm weakness Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward? Speech difficulty Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence like The sky is blue. Is the sentence repeated correctly? Time to call 911 If someone shows any of these symptoms, even if the symptoms go away, call 911 and get the person to the hospital immediately. Check the time, so you ll know when the first symptom appeared.

15 Spring/Summer ASA also created this more comprehensive list of symptoms: Signs that you may be having a stroke 1. Sudden numbness or weakness of the face, arm or leg, especially on one side of the body 2. Sudden confusion, trouble speaking or understanding 3. Sudden trouble seeing or blurred vision in one or both eyes 4. Sudden trouble walking, dizziness, loss of balance or coordination 5. Sudden severe headache with no known cause ASA warns, You should never wait more than five minutes to dial 911 if you experience even one of the signs above. Remember, you could be having a stroke even if you re not experiencing all of the symptoms. And remember to check the time. The responding emergency medical technician or ER nurse at the hospital will need to know when the first symptom occurred. ASA research shows that patients with ischemic stroke the most common type of stroke who get thrombolytic clot-busting drugs within three hours of the first symptom can have less long-term disability.

16 16 Better Living News Don t take the fall Millions of people age 65 and older fall in their homes each year. In fact, falls are the leading cause of fatal and non-fatal injuries among older adults, according to the U.S. Centers for Disease Control and Prevention (CDC). Injuries include hip fractures and head trauma. But there is good news: Fortunately, falls are a public health problem that is largely preventable, says the CDC.

17 Spring/Summer Safety checklist for your home The CDC s National Center for Injury Prevention and Control (NCIPC) says that falls are due to hazards that are easy to overlook and easy to fix. NCIPC offers this list for finding and fixing fall risks in your home: FLOORS Look at the floor in each room. Q: When you walk through a room, do you have to walk around furniture? Move the furniture so your path is clear, and get help if necessary. Q: Do you have throw rugs on the floor? Remove the rugs or use double-sided tape or a non-slip backing so the rugs won t slip. Q: Are there papers, books, towels, shoes, magazines, boxes, blankets, or other objects on the floor? Pick up things that are on the floor. Always keep objects off the floor. Q: Do you have to walk over or around wires or cords (like lamp, telephone, or extension cords)? Coil or tape cords and wires next to the wall so you can t trip over them. If needed, have an electrician put in another outlet. STAIRS AND STEPS Look at the stairs you use both inside and outside your home. Q: Are there papers, shoes, books, or other objects on the stairs? Pick up things on the stairs. Always keep objects off stairs. Q: Are some steps broken or uneven? Fix loose or uneven steps. Q: Are you missing a light over the stairway? Have an electrician put in an overhead light at the top and bottom of the stairs. Q: Do you have only one light switch for your stairs (only at the top or at the bottom of the stairs)? Have an electrician put in a light switch at the top and bottom of the stairs. You can get light switches that glow. Q: Has the stairway light bulb burned out? Have the light bulb replaced. Q: Is the carpet on the steps loose or torn? Make sure the carpet is firmly attached to every step, or remove the carpet and attach non-slip rubber treads to the stairs. Q: Are the handrails loose or broken? Is there a handrail on only one side of the stairs? Fix loose handrails or put in new ones. Make sure handrails are on both sides of the stairs and are as long as the stairs.

18 18 Better Living News KITCHEN Look at your kitchen and eating area. Q: Are the things you use often on high shelves? Move items in your cabinets. Keep things you use often on the lower shelves (about waist level). Q: Is your step stool unsteady? If you must use a step stool, get one with a bar to hold on to. Never use a chair as a step stool. BATHROOMS Look at all your bathrooms. Q: Is the tub or shower floor slippery? Put a non-slip rubber mat or self-stick strips on the floor of the tub or shower. Q: Do you need some support when you get in and out of the tub or up from the toilet? Have a carpenter put grab bars inside the tub and next to the toilet. BEDROOMS Look at all your bedrooms. Q: Is the light near the bed hard to reach? Place a lamp close to the bed where it s easy to reach. Q: Is the path from your bed to the bathroom dark? Put in a night-light so you can see where you re walking. Some night-lights go on by themselves after dark.

19 Spring/Summer Other things you can do to prevent falls Here are other recommendations from NCIPC: Exercise regularly. Exercise makes you stronger and improves your balance and coordination. Have your doctor or pharmacist look at all the medicines you take, even over-the-counter medicines. Some medicines can make you sleepy or dizzy. Have your vision checked at least once a year by an eye doctor. Poor vision can increase your risk of falling. Get up slowly after you sit or lie down. Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers. Improve the lighting in your home. Put in brighter light bulbs. Florescent bulbs are bright and cost less to use. It s safest to have uniform lighting in a room. Add lighting to dark areas. Hang lightweight curtains or shades to reduce glare. Paint a contrasting color on the top edge of all steps so you can see the stairs better. For example, use a light-colored paint on dark wood. Other safety tips from NCIPC Keep emergency numbers in large print near each phone. Put a phone near the floor in case you fall and can t get up. Think about wearing an alarm device that will bring help in case you fall and can t get up. Online resources For more helpful information from the CDC, check out:

20 20 Better Living News With diabetes, you need to guard your heart If you have diabetes, you hopefully do everything you should to manage your diabetes, such as check your blood sugar, take your medication as directed, visit your doctor regularly, eat right, and exercise. But have you discussed your heart health with your doctor recently? Diabetes is a risk factor for heart disease, and having both can increase the likelihood of heart attack, stroke, and circulation problems affecting your kidneys, eyes, and feet. According to the American Diabetes Association, death rates from heart disease are about two to four times higher in adults with diabetes. The risk of stroke is also higher in people with diabetes. It is sometimes difficult to notice the warning signs of heart disease, and having diabetes can mask some of the symptoms. For example, nerve damage from diabetes can make it less likely to experience chest pain during a heart attack. Instead, someone with diabetes who is having a heart attack may experience chest pressure, shortness of breath, sweating, or a sudden change in blood sugar levels. Because of this, it is important that you have your doctor regularly evaluate you for heart disease. Your doctor visits may include these tests, taking your individual and family medical history into consideration: Blood tests to measure cholesterol, blood sugar, inflammation, and other factors Diagnostic tests such as treadmill stress tests to evaluate blood flow through the heart Imaging tests to look for blockages in arteries (large blood vessels) Simple blood pressure cuff tests called the ankle brachial index (ABI) to check for reduced blood flow to the legs

21 Spring/Summer Depending on your test results, treatment may consist of a combination of several options: Lifestyle changes to improve diet, increase exercise, and quit smoking Medication adjustments or the addition of new medications A procedure to open a blockage in a blood vessel by inserting a thin tube called a catheter into an artery (large blood vessel) and sliding it to the site of the blockage, where a tiny balloon can be opened to push the blockage aside Surgery to remove a blockage in the arteries that supply the brain with blood, or a bypass surgery to reroute blood around a blockage in the arteries that supply the heart or legs with blood Here are some questions to ask your doctor about heart disease and diabetes: What risk factors do I have (high blood pressure, cholesterol, obesity, etc.), and how can I reduce my risk? What is the best exercise program for me? Be sure to ask what your body mass index (BMI) is and record it. BMI is a number calculated from a person's weight and height. BMI is a fairly reliable indicator of body fat for most people. Recording your BMI will give you a starting point to work toward improving. What are my treatment options? What combination of lifestyle, medications, and hospital treatments/surgery may be necessary to combat heart disease and diabetes? Do any blood vessels to my heart have serious blockages? If so, how many? What is my prognosis? What can I do to improve my prognosis? You should make an appointment and establish with your doctor what your baseline heart health is now. Then, periodically ask your doctor, Have we checked my heart health recently? Identifying and treating heart disease sooner rather than later will increase the odds of being able to work with your doctor to slow down or reverse heart disease. Resources Article adapted from Diabetes and Cardiovascular Disease, The Society for Cardiovascular Angiography and Intervention,

22 22 Better Living News More for members Blue Shield maintains its 4-Star rating In October 2014, the Centers for Medicare & Medicaid Services (CMS) announced that Medicare Star ratings for our Medicare Advantage plans stayed steady at 4 out of a possible 5 stars for the fourth year in a row. Our consistently high rating reflects Blue Shield s excellence in health prevention, managing chronic conditions, plan responsiveness, customer service, and pharmacy services. While we re very proud of this rating, we will continue to strive toward a 5-Star rating. Also, we re grateful to our members for getting the necessary checkups and screenings that contribute to our Star ratings and your better health. Medicare evaluates plans based on a 5-Star rating system. Star ratings are calculated each year and may change from one year to the next. Communicating with us in other languages If English is not your first language, we want you to be able to talk freely to your doctor and to our Member Services representatives. So, we make sure our Blue Shield physician network includes physicians who speak languages other than English. Your Provider Directory tells you which languages are spoken in each of our network doctor s offices. And our Member Services department includes representatives who speak several languages, including English, Spanish, Tagalog, Cantonese, and Mandarin. Plus, we can use telephone interpreters who can help us talk with you in nearly 150 languages. NurseHelp 24/7 is there when you need it Just call the number below whenever you have a health question, for immediate answers and information. For easy reference, cut out the box below and post it on your refrigerator or bulletin board to ensure you have the most recent number. You can also find the NurseHelp 24/7 SM number on the back of your member ID card. NurseHelp 24/7 (877) [TTY (800) ]

23 Spring/Summer Your rights and responsibilities Knowing your rights and responsibilities as a Blue Shield member will help you make the most of your health plan benefits. Please read your 2015 Evidence of Coverage booklet for complete information, including: What to do if you think your rights are not being respected Your responsibilities as a member of our plan How to make complaints if you have concerns or problems related to your coverage or care How to get information on: How we control the use of services and costs The number of appeals and grievances filed by our members How we pay our doctors Our financial condition, including a summary of our most recently audited statement Feel free to call our helpful Member Services representatives at the number shown on your Blue Shield ID card if you need help locating any of this information in your Evidence of Coverage or if you have any questions or concerns about your member rights and responsibilities. Your privacy is important to us We are committed to protecting the privacy of your personal information. Our HIPAA Notice of Privacy Practices ( HIPAA Notice ) describes your privacy rights and how we protect, use, and disclose your health information. Our HIPAA Notice has been updated. If you have not already done so, you should carefully review the revised HIPAA Notice. You can review and print a copy of our HIPAA Notice by going to our website, blueshieldca.com, and clicking the Privacy link at the bottom of the home page. You may also request a copy of our HIPAA Notice by calling the Member Services phone number on your Blue Shield member ID card. The information in this publication is intended to complement not take the place of the recommendations of your healthcare provider. Consult your physician before making major changes in your lifestyle or healthcare regimen. Blue Shield and the Shield symbol are registered marks of the BlueCross BlueShield Association, an association of independent Blue Cross and Blue Shield plans. Blue Shield of California is an HMO plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium, and/or copayments/coinsurance may change January 1 of each year. You must continue to pay your Medicare Part B premium.

24 Receive Better Living by Would you rather receive this newsletter in your inbox instead of your mail box? It s easy to make that change. Log in to blueshieldca.com and go to My Health Plan. Click on My Profile, then Communications Preferences to manage your paperless delivery and alerts options. Answers from puzzle on pages 4 and 5: scrabble, backgammon, chess, blackjack, poker, checkers, charades, dominoes, monopoly, sudoku, bingo Message: Keep your brain sharp printed on recycled paper 6300 Canoga Ave., Woodland Hills, CA PRSRT STD U.S. POSTAGE PAID Blue Shield of California FPO Health or wellness or prevention information An independent member of the Blue Shield Association MR14070-IMAPD (4/15)