Your Path Starts Here

Transcription

1 spring fall Your Path Starts Here Our Wellness Portal is the perfect place to begin living healthier - Is sleep apnea hurting your health? - Call for 24/7 advice from a nurse - Optional dental coverage in 2015 Y0010_MK14517 Accepted

2 ONE TO ONE Health In Your Hands For almost 70 years, Blue Cross of Idaho has provided more than health insurance. We believe in giving our 700,000 members the tools to help them make informed decisions. Find us online at bcidaho.com/medicare. Or call our Customer Service at Today, those tools look a lot different than they did in Our newly refreshed online wellness portal is a great example. With symptom checkers, food trackers, and a personalized health assessment, it s a convenient and secure way to boost your health and get medical information whether you re on the go or at home. Turn to page 4 to check out all the details. We thank you for being a member and hope you re enjoying all that Blue Cross of Idaho insurance offers. Help us provide quality Medicare coverage by participating in the Medicare Advantage Advisory Panel here at Blue Cross of Idaho. As a panel member, you can comment on proposed changes to benefits before they go into effect. You can also offer your opinion on quality improvement issues brought before the committee. Make your voice heard. Call Customer Service at to learn more. Blue Cross of Idaho is a health plan with a Medicare and Idaho Medicaid contract. Enrollment in Blue Cross of Idaho 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, provider network, premium and/or copayments may change on January 1 of each year. You must continue to pay your part B premium. blue cross of idaho 2 bcidaho.com/medicare

3 24/7 nurse advice line Just the Facts on FLU 1. an annual flu vaccine is the best way to help you avoid getting this year s flu. 2. The flu shot cannot give you the flu though some people will experience mild flu-like symptoms. 3. The flu shot is available to you for free. Call your doctor or visit your pharmacy. 4. The flu vaccine is available as a shot or as a nasal spray in many locations. Call the 24/7 Nurse Advice Line when you are not sure whether you need to see your doctor or when you have questions about symptoms or a medication. Of course, the 24/7 Nurse Advice Line is no substitute for medical attention. If you have an emergency medical condition, call 911. If you want reliable health guidance, try the 24/7 Nurse Advice Line. Just call anytime, day or night! medication update The brand-name drugs below have recently been released in a generic form. Generics are a safe and effective way to lower the cost of your medications. For a complete listing of medications on our drug list, visit bcidaho.com/ma_formulary. Brand Name Generic Name Medication Use Diovan Valsartan High blood pressure (hypertension) Actonel Risedronate Treat or prevent osteoporosis in men and women Lunesta Eszopiclone Insomnia Detrol LA Tolterodine Overactive bladder with symptoms of urinary frequency, urgency, and incontinence. Micardis HCT Telmisartan/ hydrochlorothiazide High blood pressure (hypertension) Blue Cross of Idaho s drug list may not apply to all healthcare plans. Please refer to your group s contract provisions for more detailed information about the terms and conditions of your prescription drug benefit. blue cross of idaho 3 bcidaho.com/medicare

4 Better Health At Your Fingertips We all strive for good health. Having an active mind and body enables us to enjoy a long and productive life. But sometimes we need a little help along the way. And that s where the online wellness portal can help you. Check out three reasons you should head over to bcidaho.com today. Get Started with a Health Assessment 1. Go to bcidaho.com. 2. select Medicare Advantage from the drop-down menu under Members. 3. select log in and enter your username or address and password. If you re not yet registered, follow the prompts to set up your secure account. 4. from your member home page, find Health & Wellness and select Health Assessment under WellConnected Tools in the dropdown menu. You will be securely linked to the WellConnected wellness portal. blue cross of idaho 4 bcidaho.com/medicare

5 WellConnected is personalized. Once you complete a health assessment in the WellConnected wellness portal, you ll get an extensive health summary report as well as a wellness score. You ll even receive personalized recommendations for improving your health. WellConnected is convenient. With a variety of online tools and resources and even a mobile app the wellness portal is easy to incorporate into your daily life. Track your health with logs for blood pressure, blood sugar, and weight. Log your daily activity or food consumption. It s easy to make the portal a habit when you re at home or travelling. WellConnected goes beyond the basics. Even if you already have a good handle on your healthy lifestyle, you ll find resources to help you make informed healthcare decisions. The WellConnected health library includes information on prevention, home treatment and when to call a doctor for thousands of symptoms. You ll also be able to watch health videos and review decision tools about surgeries and medical tests. Optional Dental Coverage In 2015, Blue Cross of Idaho Medicare Advantage members may add dental coverage as an optional benefit. For only $29.50 per month, Healthy Smiles Plus covers preventive and basic dental services. Preventive benefits include: - no waiting period no deductible - Oral examinations one in a six-month period - Emergency oral examination - panoramic X-ray or full mouth series X-ray once in any five consecutive years - Bitewing X-rays once per benefit period - periapical X-rays - Cleanings regular cleaning or periodontal maintenance, once in a six-month period After satisfying a six-month waiting period and a $50 deductible, Healthy Smiles Plus covers the following basic dental services: - Fillings - Extractions blue cross of idaho 5 bcidaho.com/medicare

6 Sleep, Interrupted A chronic sleep disorder might increase your risk for heart disease. Do you awaken during the night with a sensation of choking or gasping? You might be suffering from sleep apnea. Sleep apnea is a common disorder that disrupts sleep. If you have this condition, your breathing pauses or becomes shallow throughout the night. Not only does it leave you feeling tired, but it can also increase your risk for obesity, high blood pressure, stroke, diabetes, and heart attack. The best way to determine if you have sleep apnea is by discussing your symptoms with your doctor, who may recommend a sleep study. A sleep study is a test that measures how well you sleep and how your body responds to changes in your sleep. If your doctor decides a sleep study makes sense, you may be able to have your sleep study at home as long as you don t have a medical condition that requires it be done in a more structured setting like a sleep lab. A home sleep study could help you feel more comfortable and fall asleep more easily. Plus, home sleep studies tend to cost less while still offering quality insights. There are many treatment options for sleep apnea. Work with your doctor to figure out the best option for you based on your lifestyle, the severity of your condition, as well as the risks and benefits of treatment. blue cross of idaho 6 bcidaho.com/medicare

7 Keeping Costs in Check Sleep studies will soon require prior authorization. We are committed giving you access to the highest quality healthcare at the lowest possible cost. A new program, designed to manage testing and therapy services for sleep disorders like sleep apnea, supports this commitment. A sleep study can range in cost from $2,000 at an outpatient clinic to $500 for a home study. Not all sleep studies are necessary, and many members can benefit from convenient and cost-effective home testing instead of a sleep study done in a clinical setting. Starting on Nov. 1, 2014, physicians who order sleep studies must get prior authorization for the services in order to be reimbursed by Blue Cross of Idaho. Services managed under the new sleep testing and therapy program will include: - Home sleep testing (HST) - In-lab sleep study (Polysomnography or PSG) - Positive airway pressure titration study - Initial treatment order automatic positive airway pressure (APAP), continuous positive airway pressure (CPAP), bilevel positive airway pressure (BPAP) - Ongoing treatment order (APAP, CPAP, BPAP) - Oral appliances for sleep therapy Prior authorization is required for both sleep testing and subsequent therapy services. The program also monitors a member s treatment to make sure the equipment prescribed is used correctly so therapy can be safe and effective. The program is administered by AIM Specialty Health, a specialty benefits management company that considers the medical necessity of a sleep study as well as the clinical appropriateness of a facility test or a test done in the home. blue cross of idaho 7 bcidaho.com/medicare

8 Preparing for 2014 Taxes? Get your healthcare details. Blue Cross of Idaho offers online information that summarizes your out-of-pocket expenses. You can also find details on Blue Cross of Idaho s payment to your health care providers. Just login to and run a Claims Itemization Report and a Premium Statement Summary E. Pine Ave. Meridian, ID PRSRT STD U.S. POSTAGE PAID One to One This is an advertisement IS Published by McMurry/TMG, LLC All rights reserved. No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. 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. McMurry/TMG, LLC makes no endorsements or warranties regarding any of the products and services included in this publication or its articles. cover: chad case/idaho stock images