Flu season is quickly approaching and your friends

Transcription

1 A Newsletter For Members of Vi va Medicare Plus Fall 2010 Make Plans to get a Flu Shot this Year! Flu season is quickly approaching and your friends at Vi va Medicare Plus want to make sure you are fully prepared to combat the flu bug this season. While we would like all members to be vaccinated, it is extremely important for the following groups of people to get a shot because they are at a higher risk of having complications from the flu: People aged 50 years or older Residents of nursing homes and other long-term care facilities housing anyone of any age with chronic medical conditions People with chronic disorders of the lungs or heart, such as asthma, emphysema, chronic bronchitis, or cystic fibrosis People who are less able to fight infections because of a disease they are born with; infection with the Human Immunodeficiency Virus (HIV), treatment with drugs such as long term steroids, and/or treatment for cancer with x-rays or drugs People who have required regular medical follow up or hospitalization during the preceding year because of chronic metabolic diseases (including diabetes mellitus), kidney diseases, and blood cell diseases such as sickle cell anemia The benefits of the flu shot go beyond just your own health. The health of loved ones and friends around you can also be affected. The flu affects approximately 5-20% of the population every year and more than 200,000 people are hospitalized due to flu like complications. By avoiding getting the flu, you are also preventing passing the virus on to loved ones around you who may be in a high risk group. There is another great reason for receiving the flu shot every year besides protecting your health - It is absolutely free to members of Vi va Medicare Plus! No matter what Vi va Medicare Plus plan you are on, your annual flu shot is covered 100% at our network providers. Don t let common misconceptions about the flu vaccine keep you from getting it: 1. The flu vaccine CANNOT cause the flu in people who receive the vaccine. The vaccine contains viruses that have been inactivated so they will not cause infection. The reason why your arm may feel sore after you receive the vaccine is because your body has already started making antibodies towards the inactivated virus. 2. Some believe that it is possible for immunity to go away if you get vaccinated too early in the season. That is also false. Although the optimal time for vaccination is in October or November, no matter when you receive it your vaccination will last for the entire flu season. Also, there are NO benefits in receiving multiple immunizations in the same season. see Flu Shot page 2 H0154_mcdoc946A File and Use 09/28/2010

2 Page 2 A Newsletter for Members of VIVA MEDICARE Plus Options for Receiving Your Plan Documents During October, Vi va Medicare Plus will be sending all of its 33,000 members their plan documents for the 2011 plan year in a packet via traditional mail. To meet member demands and reduce paper usage in the future, we are working to give our Medicare members the opportunity to receive plan documents via starting next year. If you would like to receive your documents electronically simply go to and fill out the form. All you need is your member number (on your member identification card) and one or two free minutes. You will then receive a confirmation that will confirm your choice and give you the ability to opt out at any time. You can also call member services to opt out of this service. The default method for receiving plan documents is via traditional mail so if you don t act then nothing will change. Thank you for helping us make a difference! Flu Shot continued from page 1 So often in the elderly, the flu can lead to pneumonia. According to the Department of Health and Human Services, seniors age 65 and older are two to three times more likely to get an infection caused by pneumonia. Fortunately, recent studies suggest that the pneumonia vaccine prevents most cases of bacterial pneumonia which is the more serious form of the illness. No matter what plan you are on, Vi va Medicare Plus covers the pneumonia vaccine at no cost to you at all of our network providers. If you received the vaccine before you turned 65, ask your physician if a booster is right for you. As with the influenza vaccination, this is inactive so it will not cause the illness in those that receive it. Other ways to prevent pneumonia are: Get the flu shot Thoroughly wash your hands Avoid smoking and inhaling dust or mold particles Stay healthy and be active, get appropriate rest, and eat a healthy diet. Vi va Medicare Plus is working with different companies to provide our members access to flu shots. Remember that you can always go to your own providers to receive the immunization. A list of these clinics, as of the time of this printing, is enclosed. You may also get information about these at our website, If you get your flu shot at a local grocery or drug store chain, you will be required to pay for the shot and be reimbursed by Vi va Medicare Plus. To be reimbursed, simply send us a request for payment along with your bill and documentation of any payment you have made. You can also fill out our claim form to make your request for payment. This can be found on or you can call Members Services to request the form. Once completed, send your request for payment of medical claims together with any bills or receipts to us at: Viva Medicare Plus P.O. Box Birmingham, AL If you have any questions regarding the influenza or pneumonia vaccination benefit under your plan or where you can receive your vaccinations, please do not hesitate to call our Member Services Department at (800) or locally at (205) We can be reached Monday Friday from 8 a.m. to 8 p.m. TTY users should call

3 A Newsletter for Members of VIVA MEDICARE Plus Page 3 $250 Medicare Rebate for Drug Coverage Gap In June, Medicare issued the first $250 rebate checks to beneficiaries who entered the coverage gap for Medicare prescription drug coverage (sometimes referred to as the doughnut hole ). As a Medicare beneficiary, you enter the prescription drug coverage gap after you and Vi va Medicare Plus have paid a certain amount of money (in 2010 it is $2,830) toward the cost of Medicarecovered prescription drugs. As part of the healthcare reform efforts, Medicare will issue a $250 check to beneficiaries that enter the coverage gap during If you receive Medicare prescription drug coverage (Part D) through Vi va Medicare Plus, here are some important facts you should know about the rebate: Not everyone receiving Medicare prescription drug coverage will receive a $250 rebate check. Only those beneficiaries whose drug costs put them into the prescription drug coverage gap will receive a check. Beneficiaries receiving Medicare Extra Help are not eligible to receive a rebate because your prescription drug benefit does not include a coverage gap. Medicare sends rebate checks directly to beneficiaries, not Viva Medicare Plus. Beneficiaries do not have to call Medicare to request rebate checks. Medicare issues rebate checks automatically. No one should call or write beneficiaries asking for identifying information in order to receive a rebate! If this happens to you, please call MEDICARE ( ) and report it! TTY users should call Rebate checks are mailed to beneficiaries at the address Medicare has on file. Beneficiaries may change their address with Medicare by calling Social Security at or visiting a local Social Security Office. TTY users should call Medicare mails rebate checks to beneficiaries within days after the beneficiary enters the prescription drug coverage gap. The rebate check is a one-time payment. Beneficiaries will not receive more than one $250 rebate. Rebate checks go away at the end of Beginning in 2011, beneficiaries in the coverage gap will receive discounts on Part D prescription drugs. The rebate check is tax-free. If you have Medicare prescription drug coverage with Vi va Medicare Plus, you can find out how much you have spent on covered prescription drugs by reviewing the Explanation of Benefits you receive from Caremark each month. If you have any further questions, please call Vi va Medicare Plus Member Services toll-free at or in Birmingham at TTY users should call the Alabama Relay Service at Our office hours are Monday through Friday, from 8:00 a.m. to 8:00 p.m.

4 Page 4 A Newsletter for Members of VIVA MEDICARE Plus 2010 Flu Shot Clinics County Date Time Location Address Autauga 10/21/2010 9a-11a Gillespie Senior Center 332 Doster Road Prattville, AL Chilton 10/16/2010 8a-11a Chilton Medical Center 1010 Lay Dam Road Clanton, AL Cullman 10/6/ :15p-1:30p West Point Senior Center at Town Hall Cullman 10/7/ p-2p Cullman Senior Center on Sportsman Lake Cullman 10/14/2010 9a-12p Cullman Civic Center at Cullman Country Health Fair 3990 County Road 1141 Vinemont, AL Sportsman Lake Rd. NW Cullman, AL th Street SW Cullman, AL (256) Dekalb 10/13/2010 9a-11a Chamber of Commerce 300 Gault Ave. North Fort Payne, AL Elmore 10/22/2010 9a-11a Wetumpka Senior Center 120 Cotton Street Wetumpka, AL Etowah 10/7/2010 9a-11a YMCA of Coosa Valley 100 Walnut Street Gadsden, AL Jefferson 10/5/2010 9a-11a Iron Works Fitness 2801 Allison Bonnett Mem Dr. Hueytown, AL Jefferson 10/6/2010 9a-11a Northeast Family Branch YMCA 628 Red Lane Road Birmingham, AL Jefferson 10/13/2010 9a-11a Lakeshore Foundation 4000 Ridgeway Drive Birmingham, AL Jefferson 10/18/2010 9a-11a Tri-Star Fitness 438 Decatur Highway Gardendale, AL Montgomery 10/21/2010 1p-3p Gold s Gym 2300 Berryhill Road Montgomery, AL Shelby 10/8/2010 9a-11a Shelby County YMCA 2610 Pelham Parkway Pelham, AL Walker 10/4/2010 9a-11a Fitness Factory & Spa Highway 78 East Jasper, AL 35501

5 A Newsletter for Members of VIVA MEDICARE Plus Page 5 Advance Directives You have the right to ask someone such as a family member or friend to help you with decisions about your health care. Sometimes, people become unable to make health care decisions for themselves due to accidents or serious illness. If you want to, you can use a special form to give someone the legal authority to make decisions for you if you ever become unable to make decisions for yourself. You also have the right to give your doctors written instructions about how you want them to handle your medical care if you become unable to make decisions for yourself. The legal documents that you can use to give your directions in advance in these situations are called advance directives. One type of advance directive document is an advance directive for health care (or living will). Member Services can send you a copy of this form for your use. It is important to sign this form and keep a copy at home. There s no need to send a copy of your completed form to Vi va Medicare Plus, but you should give a copy of the form to your doctor and to the person you name on the form as the one to make decisions for you if you can t. You may want to give copies to close friends or family members as well. We encourage Vi va Medicare Plus members to fill out advance directives. But remember, it is your choice (including whether you want to sign one if you are in the hospital). If you would like the advance directive for health care form, simply call Member Services at (205) in Birmingham or toll free. TTY users should call the Alabama Relay Service at toll free. Our office hours are from 8:00 a.m. to 8:00 p.m., Monday through Friday. You may also visit our website at under Forms and Resources to download a copy. Spotlight on Member Services Your Member Services team is just a phone call away and is available for help about anything related to your Medicare health plan. Please feel free to give us a call whenever you need us. Our spotlight in this issue is on the Team Leader for Member Services, Cynthia. Cynthia enjoys assisting the Member Services Representatives. Her responsibilities include making sure they have all the resources they need in order to give the best possible service to our members. She also enjoys speaking with our members and helping them understand their benefits. Her mission is to ensure you are happy being a member of Vi va Medicare Plus. On a personal note, Cynthia enjoys watching old American Classic movies, spending time with her family and friends, and organizing events. Calling Member Services is easy. You won t have to listen to endless menus or push any buttons to reach a friendly, helpful representative. We can be reached at (205) in Birmingham or toll free. TTY users should call the Alabama Relay Service at toll free. Our office hours are from 8:00 a.m. to 8:00 p.m., Monday through Friday.

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 H0154_mcdoc946A File and Use 09/28/2010