VitalityFALL Be sure to check inside for upcoming Viva Medicare Plus Fall Health Fair dates! Your 2012 Viva Medicare Plus Benefits

Transcription

1 VitalityFALL 2011 Viva A newsletter for Viva Medicare Plus members. Your 2012 Viva Medicare Plus Benefits Viva Medicare Plus, a Medicare Advantage plan, has a yearly contract with the Centers for Medicare & Medicaid Services (CMS). Every year we renew our contract with CMS and submit benefits for the upcoming year. During the month of September, Viva Medicare Plus members will receive the following 2012 documents to let you know about your 2012 benefits: 1. Annual Notice of Change This document gives you a summary of changes to your benefits and costs for Evidence of Coverage This document is the legal, detailed description of your benefits for Formulary If your plan includes prescription drug coverage you will also receive a formulary. The formulary tells you what Part D prescription drugs are covered by Viva Medicare Plus. It also lets you know if there are any rules that restrict coverage for a drug. Viva Medicare Plus members who receive extra help paying for prescription drugs or are covered by the Alabama Medicaid Agency will receive additional information that describes what you pay for prescription drugs. When you receive your packet please take the time to thoroughly review all changes. If you have questions, we re here to help. Please call Member Services at in Birmingham or (TTY users should call the Alabama Relay Service at ). Hours are 8 a.m. to 8 p.m., Monday through Friday (from October 15 to February 14, available 8 a.m. to 8 p.m., 7 days a week). Calls to these numbers are free. Be sure to check inside for upcoming Viva Medicare Plus Fall Health Fair dates! H0154_mcdoc1049A File and Use 09/19/2011

2 viva medicare plus Fall Health Fairs Viva Medicare Plus is committed to helping you get the preventive health screens you need. Preventive health screens can identify health risks. This lets your doctor provide you information, guidance, and support for a healthier lifestyle. These tests can play a major part in reducing future health problems and lead to a healthier you. Starting in October, come join us as we kick off our health fair events in each of our Viva Medicare Cafés. A representative will be available at the Health Fairs to discuss any questions you may have about your 2012 benefit changes. All events will be held on the dates and locations listed below. Hours will be from 10 a.m. - 2 p.m. Birmingham Montgomery mobile 1550J Montgomery Highway 2107B Eastern Boulevard 907 Hillcrest Road Birmingham, AL Montgomery, AL Mobile, AL (205) (334) (251) (next to Ellis Piano in Hoover) (next to Starbucks) (between Airport Blvd & Grelot Rd) 10/4/ /6/ /7/ /11/ /13/ /18/ /20/ /25/ /27/ /1/ /3/ /8/2011 Gardendale Bessemer Pell City Gardendale Civic Center YMCA Pell City Civic Center 857 Main Street th Avenue SW 2801 Stemley Bridge Road Gardendale, AL Bessemer, AL Pell City, AL (across from Gardendale High School) (next to Little Red Barn) Our licensed nurses will be conducting various tests ranging from checking your blood sugar to cholesterol screening (for LDL or bad cholesterol). We can also conduct spirometry tests if you are having breathing problems to assess any underlying conditions like asthma or Chronic Obstructive Pulmonary Disease (COPD). We will also have other health professionals and information on hand that may help you. DOOR PRIZES AVAILABLE WHILE SUPPLIES LAST!

3 Diabetes Diabetes is a lifelong disease. Alabama has the highest rate of diabetes in the nation according to a recently released study from the Robert Woods Johnson Foundation. In this report, Alabama is among the worst states in the U.S. for at-risk health conditions such as diabetes that are linked to obesity. The report states that 12.2% of Alabamians are considered at-risk for diabetes. Worse yet, many people with diabetes don t even know they have it! Currently there is no cure for diabetes and people with the disease need to manage their condition to stay healthy. Diabetes means that your blood sugar is too high. The medical term for sugar in the body is glucose. Your blood always has some glucose in it because that is what the body uses for energy. But too much glucose in the blood is bad for your health and can cause many problems such as kidney disease, loss of sight and circulatory problems. No one knows exactly what causes diabetes, but lifestyle, diet and genetics appear to play a role. Types of Diabetes Pre-Diabetes Before people develop type 2 diabetes they usually have pre-diabetes where their blood glucose levels are higher than normal, but not yet high enough to diagnose diabetes. These higher than normal blood glucose levels begin to damage the heart and circulatory system. Many times a pre-diabetes condition can be reversed with lifestyle changes such as obtaining a normal weight, eating a healthy diet and getting regular exercise. Type 2 Diabetes In type 2 diabetes, the pancreas still makes some insulin, but the body can t use it very well. Most people with type 2 diabetes manage their disease with pills or shots depending on how severely the disease has progressed. Diabetes is better managed by staying at a healthy weight, eating healthy and participating in regular physical exercise. Type 1 Diabetes In type 1 diabetes, the pancreas stops making insulin. This type of diabetes used to be called juvenile diabetes. People with type 1 diabetes need to get insulin through a shot or pump several times a day. Type 1 diabetes usually starts in childhood or young adulthood. Warning Signs of Diabetes Many of the symptoms of diabetes seem so harmless, or may be so slight, that many people miss the beginning signs and symptoms. Don t wait until problems are severe to see your doctor. The earlier that diabetes is detected the earlier treatment can begin to avoid complications.

4 Commons Symptoms of Diabetes: Frequent urination Excessive thirst Extreme hunger Unusual weight loss Increased fatigue or tiredness Irritability Blurry vision Fall Fun H C A O C A E S L G S A S E E P T L H G H O E N C L E P A I N N O E N S F C L F L E F H A L L O W E E N O O P F E S W T D R W L C T O O P U G N I V I G S K N A H T A I H O D D N I L T W L C B I F W I N Z G A H P O A S A A H A P A N O L E T D B N L B R L M P O A N L B H A L L T I I A L E A V E S C M O I L A I H M L N R U B U A O G T O N C T T K I C K O F F A U Z B Y L I M A F E T A C K L E Alabama apples Auburn blitz championship coach endzone fall family football Georgia halloween If you think you may have holding kickoff leaves some of these symptoms or be at-risk for diabetes, it is very important that you talk penalty thanksgiving school touchdown tackle UAB to your Personal Care Physician (PCP) and get screened for this disease. Here in Alabama, diabetes is under diagnosed. With our obesity rate of over 32%, many people are living with a disease that is damaging their bodies and are unaware. The good news is that some complications of diabetes can be prevented if the disease is caught early. Changes such as eating a healthy diet and exercise can become a part of your everyday lifestyle. Senior Medicare Member Services Representative, Fred Martinear Fred has been in Medicare Member Services for over five years. He cares deeply about our members, and he takes ownership for any issues that come his way. Fred enjoys helping others. He believes that each member deserves the care and respect that he would wish for a member of his own family. Fred is a graduate of Birmingham Southern College and makes Birmingham his home. He enjoys basketball, football, and swimming. Fred loves working with kids, and spends much of his free time coaching and mentoring young people.

5 viva medicare plus Doing More to Help Members Stay Healthy In our last newsletter, we introduced you to our care management program called VCare. VCare is a FREE program for members with certain complex or on-going medical conditions. Our care coordinators, nurses, and social workers currently serve over 600 members. Through phone calls and home visits, we help these members stay healthy and on course with their doctor s plan of care. Under a new program, when you come home from the hospital the VCare Transitions Team will work with you to make sure your condition is improving and that you are getting the care you need. We may also help you schedule a follow-up visit with your Personal Care Physician (PCP). Already this program is making a difference from helping members understand how and when to take their medicines to teaching them signs and symptoms to watch for so the doctor can be called right away. Home visits viva Medicare Plus is working with two companies that perform in-home health assessments. An in-home assessment may be offered to members who have not had a recent doctor s visit or who may need certain tests or services. The assessments are typically performed by a doctor, nurse practitioner, or physician s assistant. If you are invited to have an assessment, we hope you will take advantage of the offer. The results of an assessment do not impact your coverage with viva Medicare Plus in any way, but they do provide important information that viva Medicare Plus can use to help your Personal Care Physician, our V-Care team, and our quality improvement department take better care of you. Quality Improvement Projects The viva Medicare Plus quality improvement team wants to be sure every member gets the services needed to stay as healthy as possible. To meet this goal, we are calling members who we show need certain tests or services to get them scheduled. We are also offering health fairs to help members get the care they need (see article viva Medicare Plus Fall Health Fairs ). Please help us by being sure to see your Personal Care Physician for your annual physical covered at no charge to you. The name and phone number of your Personal Care Physician are printed on your viva Medicare Plus member ID card.

6 Viva Vitality th Ave S Birmingham, AL PRSRT STD It s Time to Get Your Flu Shot viva Medicare Plus urges you to think seriously about getting a flu shot this year. The flu is the 7th leading cause of death in the U.S. The flu shot is the most effective method for preventing the flu. You may want to get your flu shot early in case there are shortages. To make it as simple as possible, viva Medicare Plus will let you get your flu shot in any of the following ways: From any viva Medicare Plus participating provider including your PCP, a specialist, or any other provider who accepts viva Medicare Plus. Participating providers bill viva Medicare Plus directly with no charge to you. From any other flu shot provider including any drug store that offers flu shots. If you get your flu shot from a non-participating provider or at a drug store, they will probably ask you to pay. viva Medicare Plus will pay you up to the Medicare allowable rate (currently $33.08), if you send your receipt to us within a year along with your first and last name, member number, and date of birth to: viva Medicare Plus, P. O. Box 55209, Birmingham, AL To make sure you are giving us all the information we need, you can fill out our claim form to make your request for payment. Either download a copy of the form from our website ( or call Member Services and ask for the form.