Member News. VNSNY CHOICE MLTC Member Newsletter Fall 2012

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1 Member News VNSNY CHOICE MLTC Member Newsletter Fall 2012 Tips to Prevent a Fall A ccording to the Centers for Disease Control and Prevention, each year, one in every three adults, age 65 and older, suffers a fall. Falls can cause moderate to severe injuries, such as hip fractures and head injuries, and even increase the risk of early death. At VNSNY CHOICE, we want to help you reduce the risk of a fall, or if you have already fallen, get you back on your feet as soon as possible. These simple tips can help prevent a fall: Install non-slip mats: Put non-slip mats in the bathtub and on the shower floor. Remove small rugs: Remove small throw rugs or use doublesided tape to keep the rugs from slipping. Install grab bars: Have grab bars put in next to your toilet, tub or shower. Wear proper footwear: Make sure shoes and slippers have good support and non-slip soles. Reorganize cabinets: Keep the items you use most often on shelves that are easy to reach, so you can avoid using a step stool. Discuss prior falls, if any: Tell your Care Manager and doctor if IN THIS ISSUE CHOICE Expansion 5 Reasons to Get a Flu Shot Health Care Proxy Help with Heating Costs you have fallen and describe how the fall(s) happened. Discuss ALL medications: Be sure to tell your Care Manager and doctor about every medication that you are taking, including over-thecounter medications, vitamins and herbal remedies. By making your home safer and communicating with your VNSNY CHOICE health care professionals, you can easily lower your chance of a fall.

2 How to Contact Us If you have any questions about your benefits, need assistance in scheduling an appointment or need any additional information please call Member Services at toll free, Monday through Friday, from 9:00 a.m. until 5:00 p.m. (TTY users should call 711). You can visit us online at: 2013.vnsnychoice.org. Click on the Long Term Care heading for the most up to date: Member Handbook Drug Formulary 2 Fall 2012 T Original Service Area: 5 Boroughs MLTC Expansion: Phase 1; Medicare Expansion MLTC Expansion Phase 2; currently operational MLTC Expansion Phase 2; not yet operational CHOICE Expansion his year, VNSNY CHOICE has grown quickly and now serves more members in the New York metropolitan area than ever before. Our growth includes the addition of a new Medicaid special needs plan, the addition of thousands of new members to our Medicare and Managed Long Term Care plans, and the addition of new counties to our service area. MLTC Expansion: Phase 1 On May 1, 2012, VNSNY CHOICE received approval from the State of New York to expand its MLTC health plan to Nassau, Suffolk and Westchester Counties. This monumental move the first expansion for CHOICE Health Plans outside of New York City is good news for seniors in Westchester and Long Island who have chronic illnesses and disabilities and are unable to live on their own but wish to remain at home instead of moving into a nursing home. MLTC Expansion: Phase 2 The second phase includes plans to expand to 23 additional counties in New York, which was approved as of October 1, To date, we ve opened an office in the city of Fishkill and have begun enrolling and serving members in Dutchess, Orange, Putnam, Rockland, Sullivan and Ulster Counties. The expansion of our MLTC plan will continue next year. VNSNY CHOICE hopes and expects to be part of the Department of Health's plans to bring managed long term care to all corners of the Empire State. Medicare Expands to Nassau, Suffolk and Westchester Another exciting development, VNSNY CHOICE Medicare is expanding its service area too. Since 2007, we have offered comprehensive Medicare benefits and prescription drug coverage to residents across the five boroughs of New York City. As of January 2013, we will offer our Medicare plan in Nassau, Suffolk and Westchester. People who live in these areas will be able to enroll in one of the same four plan options that we have today. With these additions, VNSNY CHOICE can serve more New Yorkers than ever before. Mary Ann Christopher, President and Chief Executive Officer, of the Visiting Nurse Service of New York explains, This growth is driven by the goal to touch even more patients and to improve their quality of life.

3 1 5 2 Reasons to Get a Flu Shot Today Certain people have a high risk for developing serious complications if they get sick with the flu, including: People who have certain medical conditions, such as: Asthma and other respiratory conditions Heart, lung or kidney disease A weakened immune system from illness or medication Pregnant women People aged 65 and older The flu season can begin as early as October; it takes 2 weeks for the flu vaccine to offer protection. The Centers for Disease Control and Prevention recommends that individuals receive their flu shot as soon as the vaccine becomes available in their community. 3 Strains of the flu viruses can change each year. A flu vaccine is needed each year because flu viruses are constantly changing. It s not unusual for new flu viruses to appear each year and the flu vaccine is specifically formulated each year to fight off the viruses as they change. It s important to get a flu shot annually, even if you were vaccinated the year before. 4 The flu shot will not cause the flu. The viruses contained in the flu shots are inactivated (dead), which means they cannot cause infection. The most common side effect of the flu vaccine in adults is soreness at the injection site, usually lasting less than two days. 5 The flu shot is available now, from your Doctor or Nurse Consultant free of charge. Call your Doctor or Nurse Consultant to request the flu shot. If you have a prescription drug plan through VNSNY CHOICE, you can bring your prescription card and a valid photo ID to any participating CVS pharmacy and ask the pharmacist behind the counter for your free flu vaccination. For a list of participating CVS pharmacies near you, call Member Services at , Monday Friday, 9:00 AM 5:00 PM. (TTY users call 711). Content adapted from CDC.gov/flu Your Benefits A Smooth Ride Easy Steps to Arrange Transportation Ordering Transportation Please call for a ride at least hours in advance, Monday-Friday, 8 AM-6 PM. Have the address and phone number of your doctor handy. About Pick-Up One person may travel with you: either a home health aide, caregiver or family member. About the Return Trip Call the transportation phone line when you are finished with your appointment. Provide the transportation representative with a working telephone number, so he or she can call you when your ride is outside. Questions, Cancellations & Issues Please call to cancel 24 hours prior to your appointment. Our staff is available to assist you, please call Member Services at or your local regional office. (TTY users call 711). SelectHealth 3

4 Community Resources Artwork created by an MLTC CHOICE member Need Help With Heating Costs This Winter? The Home Energy Assistance Program (HEAP) is a federally funded program to supplement a household s annual energy cost. There are 3 types of HEAP Benefits: Regular Benefit: Assists low-income New Yorkers with the cost of heating their homes. Applications for regular HEAP benefits will be accepted beginning November 19, 2012 through at least March15, Emergency Benefit: Assists qualifying low-income New Yorkers who are facing a heat or heat-related energy emergency and do not have resources above the established limits. Applications for heat or heat-related emergency benefits will be accepted beginning January 2, Heating Equipment Repair or Replacement: Available to help eligible low-income home owners repair or replace furnaces, boilers and other direct heating components necessary to keep the home's primary heating source functional. Applications for heating equipment repair or replacement benefits will be accepted beginning October 1, If you would like more information about applying for HEAP benefits, or have a heat or heat-related energy emergency this winter call: NYC (Brooklyn, Bronx, Manhattan, Staten Island, Queens): HEAP Local District: (800) After Hours Emergency Contact: 911 Dutchess County Dutchess County Department of Social Services: (845) After Hours Emergency Contact: Community Action (845) Nassau County Nassau County Department of Social Services: (516) After Hours Emergency Contact: DSS (516) Fall 2012 Orange County Orange County Department of Social Services: (845) After Hours Emergency Contact: 211 Putnam County Putnam County Department of Social Services: (845) After Hours Emergency Contact: Sheriff s Department (845) Rockland County Rockland County Department of Social Services: (845) After Hours Emergency Contact: Sheriff s Department (845) Suffolk County Suffolk County Department of Social Services: (631) After Hours Emergency Contact: DSS (631) Sullivan County Sullivan County Division of Health & Family Services: (845) After Hours Emergency Contacts: DSS Pager: (845) Sheriff s Department: (845) Ulster County Ulster County Department of Social Services: (845) After Hours Emergency Contact: Sheriff s Department (845) Westchester County Westchester County Department of Social Services: (914) After Hours Emergency Contact: DSS Emergency Services (914) The general NYS HEAP Hotline is If you have any questions about what you should do in the event of an emergency, call Member Services at (TTY users call 711).

5 T Who Will Speak For You? Answers to questions about the NY Health Care Proxy Form T he New York Health Care Proxy Law allows you to appoint someone you trust, such as a family member or close friend, as a health care agent who can make health care decisions for you, in the event that you lose your ability to make decisions. Frequently Asked Questions Why should I choose a health care agent? An unexpected or drastic change in your health status, such as becoming comatose from a terminal illness, being in a persistent vegetative state, or suffering from dementia or Alzheimer s, can compromise your ability to communicate. Is having a health care proxy the same thing as having a living will? No. A living will is a document that provides specific instructions about health care decisions and requires that you know in advance all the decisions that may arise. While you may put such instructions on your health care proxy form, the health care proxy is a person appointed by you to make health care decisions on your behalf and interpret your wishes as medical circumstances change. How do I appoint a health care agent? All competent adults, 18 years of age or older, can appoint a health care agent by signing a form called a health care proxy. You do not need a lawyer or a notary, just two adult witnesses. Note: your health care agent cannot sign as a witness. What if my health care agent is not available when decisions must be made? You may appoint an alternate agent, or secondary health care agent, to make decisions for you if your primary health care agent is unavailable, unable or unwilling to act when decisions must be made. Otherwise, health care providers will make health care decisions that follow the instructions you gave while you were still able to do so. Any instructions that you write on your Health Care Proxy form will guide health care providers under these circumstances. Hence, it is recommended that you name two individuals, a primary and a secondary health care agent. In the event that the primary health care agent is unavailable or unwilling to make decisions when they must be made, you and/or your family will not have to worry about naming a new agent or completing a new health care proxy form. Where should I keep my health care proxy form after it is signed? Give a copy of the form to your health care agent, your doctor, your attorney and any other family members or close friends who you choose. Keep a copy in your wallet or purse or with other important papers, but not in a location where no one can access it, such as a safe deposit box. To obtain a health care proxy form go to health.ny.gov/forms/ and scroll down to Health Care Proxy. Adapted from the New York State Department of Health: SelectHealth 5

6 VNSNY CHOICE 1250 Broadway, 11th Floor New York, NY Member Services: Monday through Friday from 9:00 AM to 5:00 PM Calendar of Events November American Diabetes Month Is your sugar under good control? Always ask your doctor about your A1C level. This is a simple blood test of diabetes control. If it isn t 9.0 or lower, be sure to ask your doctor what he or she recommends. Controlling your cholesterol and blood pressure are also very important to prevent or delay complications of diabetes. Bladder Health Awareness Month Many people experience problems with urine leakage and may be embarrassed to talk to their doctor about it. Doctors want to help, but can t if you don t let them know. They can suggest many ways to treat urinary incontinence including bladder training, exercises, medication and/or surgery. December Happy and healthy holidays to you and your loved ones from VNSNY CHOICE Health Plans! 6 Fall 2012