ENJOY Life! for a Colonoscopy WELL NOURISHED FREE AND FUN EDUCATIONAL EVENTS. Join us for our HOW TO PREPARE. Keeping Your Mind & Body

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ENJOY Life! Join us for our FREE AND FUN EDUCATIONAL EVENTS PAGE 2 HOW TO PREPARE for a Colonoscopy PAGE 4-5 Keeping Your Mind & Body WELL NOURISHED PAGE 6 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 copayments may change on January 1 of each year. WINTER 2017

CAFÉ EVENTS Grand River (LEEDS) 6200 Grand River Blvd. E, Suite 438 Leeds, AL 35094 205-699-3040 Mobile 3071 Dauphin Street Mobile, AL 36606 251-380-2222 Ask The Expert: Gastroenterology 3/6/17 10 AM BINGO! 3/14/17 10 AM Movie Day 3/23/17 1 PM Ask The Expert: Diabetes Academy 4/10/17 10 AM Healthy Cooking Class 4/20/17 11 AM Member Appreciation Event 5/15/17 10 AM Ask The Expert: Gastroenterology 3/9/17 10 AM BINGO! 3/14/17 10 AM Ask The Expert: Diabetes Academy 4/13/17 10 AM Healthy Cooking Class 4/20/17 2 PM Member Appreciation Event 5/18/17 10 AM Hoover 1550-K Montgomery Hwy Hoover, AL 35216 205-978-4911 Montgomery 2107-B Eastern Blvd Montgomery, AL 36117 334-272-8882 Ask The Expert: Gastroenterology 3/7/17 10 AM BINGO! 3/14/17 10 AM Ask The Expert: Diabetes Academy 4/11/17 10 AM Healthy Cooking Class 4/20/17 2 PM Member Appreciation Event 5/16/17 10 AM Ask The Expert: Gastroenterology 3/8/17 10 AM BINGO! 3/14/17 2 PM Healthy Cooking Class 3/22/17 1 PM Ask The Expert: Diabetes Academy 4/12/17 10 AM Healthy Cooking Class 4/20/17 2 PM Member Appreciation Event 5/17/17 10 AM 2

ARE YOU GETTING THE MOST OUT OF YOUR BENEFITS? Did you know as a Viva Medicare member these extra benefits and services are available to you? CVS Caremark ExtraCare Health Card The ExtraCare Health card provides a 20% discount on more than 1,300 CVS/pharmacy brand health-related items valued at $1 or more. Viva Medicare members are automatically enrolled to receive this cost saving benefits. Mail Order Pharmacy Great convenience and lower cost. Ordering 90-day supplies of your medicine through the mail may help you save time and money. Available on most drugs covered under our plans with Part D. Call the FastStart toll-free number at 1-800-875-0867, Monday- Friday, 7 AM - 7 PM. Gym Reimbursement Viva Medicare includes $20 per month toward your fitness center membership at participating gyms! To find out which gyms participate call Member Services at 1-800-633-1542 or go to www.vivamedicaremember.com. Hearing Care Solutions Viva Medicare offers annual hearing exams at no charge at any Hearing Care Solutions location. In addition, there is fixed discounted pricing on hearing aids from major manufacturers. To participate call 1-866-344-7756, 7 AM - 7 PM, Monday-Friday. Philips Lifeline Philips Lifeline medical alert services can call for help with the press of a button 24 hours a day, 365 days a year. They also have an automated medication dispenser with continuous monitoring and timely caregiver alerts. Viva Medicare members receive discounts on start-up and monthly fees. For more information call 1-800-242-1306 EXT 4535 or visit www.offer.lifelinesys.com/vivahealth. V Care V-Care is a wellness program designed to help our members with complex and/or chronic conditions stay as healthy as possible. Our specially trained team looks for opportunities to help keep you well. You can participate in V-Care in a few ways: A physician can refer you to V-Care, we may contact you if we identify a possible need for V-Care, or you can call 1-855-698-2273 for more information. 3

HOW TO PREPARE for a Colonoscopy If your doctor recommends you have a colonoscopy, don t worry. You may think it s going to be a terrible procedure, but it likely won't be. A colonoscopy is an exam by your doctor to look inside your large intestine for possible causes of things like abdominal pain, rectal bleeding, or changes in bowel habits. Colonoscopies are also used to check for colorectal cancer when you re over age 50. Because of the sedatives most people get, you may sleep during the test or at least be very relaxed and unaware. The colonoscope is a long black flexible tube, approximately the diameter of the index finger. The doctor will gently pump air and sterile water or saline through the scope into the colon to inflate it and allow the doctor to see the entire lining. During the procedure, the doctor might take a biopsy (small pieces of tissue) or remove polyps. A colonoscopy is not just to find out if you have cancer, it can actually prevent it as some polyps may turn cancerous if they are not removed. More information about how to prepare and what to expect after the exam from the Mayo Clinic website is included below (www.mayoclinic.org). How you Prepare: Before a colonoscopy, you'll need to clean out (empty) your colon. Any residue in your colon may obscure the view during the exam. 4 To empty your colon, your doctor may ask you to: 1. Follow a special diet the day before the exam. Typically, you won't be able to eat solid food the day before the exam. Drinks may be limited to clear liquids plain water, tea and coffee without milk or cream, broth, and carbonated beverages. Avoid red liquids, which can be confused with blood during the colonoscopy. You may not be able to eat or drink anything after midnight the night before the exam.

2. Take a laxative. Your doctor may suggest taking a laxative, in either pill form or liquid form. You may be instructed to take the laxative the night before your colonoscopy, or you may be asked to use the laxative both the night before and the morning of the procedure. 3. Use an enema kit. In some cases, you may need to use an over-thecounter enema kit either the night before the exam or a few hours before the exam to empty your colon. 4. Adjust your medications. Remind your doctor of your medications at least a week before the exam especially if you have diabetes, high blood pressure or heart problems or if you take medications or supplements that contain iron. Also tell your doctor if you take aspirin or other medications that thin the blood, such as warfarin (Coumadin); newer anticoagulants, such as dabigatran (Pradaxa), apixaban (Eliquis), or rivaroxaban (Xarelto), used to reduce the risk of blot clots or stroke; or clopidogrel (Plavix). You may need to adjust your dosages or stop taking the medications temporarily. After the exam After the exam, it takes about an hour to begin to recover from the sedative. You'll need someone to take you home because it can take up to a day for the full effects of the sedative to wear off. Don't drive or go back to work for the rest of the day. If your doctor removed a polyp during your colonoscopy, you may be advised to eat a special diet temporarily. You may feel bloated or pass gas for a few hours after the exam, as you clear the air from your colon. Walking may help relieve any discomfort. You may also notice a small amount of blood with your first bowel movement after the exam. Usually this isn't cause for alarm. Consult your doctor if you continue to pass blood or blood clots or if you have persistent abdominal pain or a fever of 100 F (37.8 C) or higher. Source: www.mayoclinic.org 5

Keeping Your Mind & Body WELL NOURISHED Malnutrition can occur due to lack of calories or nutrients consumed. Common causes of malnutrition include:unbalanced diet, eating too few calories, excreting too much of a nutrient, some medications, malabsorption of nutrients, and a variety of medical conditions. Some life stage groups, such as infancy, childhood, adolescence, pregnancy, and old age might be at a higher risk for malnutrition due to higher demand of certain nutrients. Surgery, trauma, infections, burns, and chronic diseases also can affect nutritional needs and increase the chance of malnutrition. Symptoms of malnutrition can include: weight loss, fatigue, dizziness, brittle nails, chronic diarrhea, slow wound healing, bone or joint pain, and confusion. Children can become extremely thin, have stunted growth, or a swollen gut. Treatment for malnutrition includes replacing any missing nutrients or calories; follow these key steps: CONSUME A WELL-BALANCED DIET. Choose foods that are full of nutrients, such as fruits, vegetables, whole grains, and lean meats. Limit intakes of solid fats, sugars, alcoholic beverages and salt. Snacking on healthy foods is a good way to get extra nutrients and calories between meals, especially for older adults who may fill up quickly at mealtimes. Use herbs and spices to help restore flavor to bland foods. Gradually increase the number of calories consumed through several small meals at regular intervals during the day. Nutritional supplements may be needed depending on the severity of the malnutrition. ENCOURAGE PHYSICAL ACTIVITY. Even just a small amount of physical activity can help improve appetite while keeping bones and muscles strong. MAKE IT SOCIAL. Eat meals together as a family, or you can meet a friend or group for lunch. Many restaurants offer lunch specials, and some have discounts for seniors. ASK FOR HELP. Your doctor can talk to you about your risk for malnutrition and treat any underlying medical conditions to prevent ongoing loss of nutrients. Community resources may be available as well. 6 References: MedlinePlus: Malnutrition Merck Manual: Undernutrition Nutrition and the Cancer Patient by Abby S. Broch and Joyce Daly Margie

Fruity Protein Shake INGREDIENTS 8 oz. milk ½ Cup cottage cheese or 2 Tablespoons peanut butter 1 Cup chopped apple, banana, or berries 3 Tablespoons quick oats 1 Tablespoon olive oil INSTRUCTIONS In blender pulse oats until powdery, then add remaining ingredients. Blend on low for 1 minute. Provides about: 600 calories, 25 g protein High Protein Smoothie INGREDIENTS 1 cup cottage cheese 1 cup yogurt 1 teaspoon vanilla or honey INSTRUCTIONS Blend until smooth. Provides about: 475 calories, 30 g protein 7

SUDOKU HOW TO PLAY: Each row as well as each block must contain all of the numbers 1 through 9, and no two numbers in the same row can be the same. Viva Medicare MONTHLY MEMBER FAQ: SECTION 1557 You may have noticed additional information in multiple languages on some of the material you re receiving from Viva Medicare. Here are some questions and answers that will help explain extra information: WHAT IS SECTION 1557? Level: medium It is the nondiscrimination provision of the Affordable Care Act (ACA). The law prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in health programs like Viva Medicare that receive Federal financial assistance or are administered by an Federal executive agency. WHAT DOES IT MEAN TO Viva Medicare AND ITS MEMBERS? Level: hard We are required by the Federal government to provide information to our members and prospective members about their rights. This includes information for people with limited English proficiency (LEP) know their right to receive communication assistance. To do this, Viva Medicare must post taglines in some of our material in the top languages spoken in Alabama about the availability of free language assistance services. 8 See pg 11 for the answers to these puzzles.

BRAIN GAMES See pg 11 for the answers. Across Down 2 Drink plenty of this to stay hydrated and happy. 3 A diet full of fruits and is healthy. 7 Visit this professional to make sure your teeth are strong and healthy. 8 It is important to visit your every year for a wellness visit. 9 A yellow fruit that s a great source of potassium. 10 The tomato is not a vegetable, it is a health. 14 Eating nutritious food and getting regular are key to being healthy. 15 A healthy sandwich can be made with two slices of whole bread. 16 Almonds, dried fruit, or granola are great to eat in between meals. 17 Come to your local café for a Cooking Class to learn how to cook delicious, nutritious meals. 1 An orange root vegetable rich in many vitamins. 4 A meal eaten in the morning, the first meal of the day. 5 This is a great exercise done in the water. 6 These fruit are a great source of Vitamin C and make delicious juice. 11 Calcium helps to build strong teeth and. 12 This is used as a great base for most salads. 13 Always your hands thoroughly before eating or cooking. 9

Yearly Healthy Living Checklist Getting regular screenings helps Viva Medicare achieve a higher star rating and helps keep your out-of-pocket costs low! Yearly Wellness Exam Colon Cancer Screening (50+) Screening Mammogram Yearly Eye Exam Lab tests for 3 Month Blood Sugar Levels (Hemoglobin A1C Test for diabetics) Take medications as directed Flu and other recommended vaccines Talk to your PCP about a healthy exercise plan Call Viva and ask how we can help with your wellness screenings! 10

PUZZLE ANSWERS The answers below are for the puzzles listed on pages 8 and 9 Level: medium Level: hard 11

417 20th Street North Suite 1100 Birmingham, Alabama 35203 PRSRT STD US POSTAGE PAID BIRMINGHAM, AL PERMIT NO. 2061 Viva Medicare is an HMO plan with a Medicare contract and a contract with the Alabama Medicaid Agency. Enrollment in Viva Medicare depends on contract renewal. Health and Wellness or prevention information. H0154_mcdoc1797A CMS Accepted 2/20/2017 Toll-Free: Member Services 1-800-633-1542 TTY users: Alabama Relay Service at 711 Hours: Mon - Fri, 8am - 8pm From Oct 1 - Feb 14, 7 days a week, 8am - 8pm Visit us online at www.vivamedicaremember.com www.vivahealthcafes.com SHOP Stop by a Viva Health Café: Hoover Café 205-978-4911 1550-K Montgomery Hwy Hoover, AL 35216 Mon - Fri, 9am - 5pm Grand River Café (Leeds) 205-699-3040 6200 Grand River Blvd. E, Suite 438 Leeds, AL 35094 Mon - Fri, 10am - 6pm Saturday, 12pm - 4pm Mobile Café 251-380-2222 3071 Dauphin Street Mobile, AL 36606 Mon - Fri, 8am - 4pm Princeton Cafe (Birmingham) 205-785-5559 833 Princeton Ave SW POB III, Suite 110 Birmingham, AL 35211 Mon - Fri, 8am - 4pm Montgomery Café 334-272-8882 2107-B Eastern Blvd Montgomery, AL 36117 Mon - Fri, 9am - 5pm Viva Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-294-7780 (TTY: 711). 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務. 請致電 1-800-294-7780 (TTY: 711).