Volume 2 2013 With Get the Most Out of Your Plan Five Ways You Can Live Healthy and Be Rewarded For It How to Maintain a Healthy Heart Member tips, tools and resources to support a healthy lifestyle Y0067_MBR NEWS2013_V2_0413 IA 04/22/2013 TXP-SETX-MBRNEWSv2 2013
Live Healthy A Healthy Collaboration in action Our Medicare Advantage plans share a promise called A Healthy Collaboration. These plans reflect the commitment we share with doctors and other healthcare providers to help you live healthy and get the most out of life. We encourage our members to find one trusted healthcare professional to coordinate their care, just like the family doctor of years past. Living healthy. It s what we all aspire to do: Maintain a healthy diet, stay physically active and get necessary preventive screenings. TexanPlus HMO wants to make sure that you have the tools and resources to help you live a better, healthier life. In this issue, you will read about symptoms, treatments, and ways to prevent common diseases such as colon cancer and osteoporosis. You will also learn more about free discount programs that are offered to you as part of your health plan. We encourage you to get the most out of your health plan by taking advantage of these discount services. Participating in the Live Healthy program is another way to take advantage of services offered by your plan at no cost to you. You play the biggest part in maintaining your health. Live Healthy was designed to help you by giving you many opportunities to participate in improving your health. Our goal is to ensure that your healthcare needs are met. If you have questions about your plan or want more information about Live Healthy please call Member Services at 1-866-230-2513, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week. Please be sure to see your Primary Care Physician every year to get important screenings, immunizations, and to discuss any health concerns. We hope you find this issue useful and take actions to get more out of your health plan and more out of life. Sincerely, Erin Page President, Medicare Advantage 2 LIVE HEALTHY WITH TEXANPLUS HMO
In This Issue 4 Get the Most Out of Your Plan Volume 2 2013 If you have questions or concerns, contact Member Services 1-866-230-2513, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week. Your opinion matters to us! If you want to submit editorial suggestions or give us your feedback, please contact the TexanPlus HMO Marketing Department. Editor - Keidra Lewis memberfeedback@universalamerican.com Designer - Eric Figueroa efigueroa@universalamerican.com You may also write to us at: TexanPlus HMO Marketing Department 4888 Loop Central Dr. Houston, TX 77081 The articles in this publication should not be considered specific medical advice, as each individual circumstance is different. Should you feel the need for medical advice, consult your Primary Care Physician. Live Healthy provides health information that supplements the advice of your doctor. You should consult your doctor for specific health concerns. 6 7 8 10 11 12 13 14 15 TexanPlus MemberLink Five Ways You Can Live Healthy and Be Rewarded For It! All About Rheumatoid Arthritis How Much do you Know About Osteoporosis? The Importance of Mammograms Colorectal Cancer Screenings Can Save Lives Prostate Cancer Preventive Screenings Checklist A tool to help you Live Healthy! Save on Prescription Drugs 16 How to Maintain a Healthy Heart 18 Taking Your Medications as Prescribed 19 CAHPS Survey-Let Your Voice be Heard WWW.TEXANPLUS.COM 3
Get the Most Out of Your Plan As a HMO member, you have TexanPlus access to free services and discount programs that can help you live healthy while saving time and money. 24/7 HEALTH HOTLINE We re here for you 24 hours a day/7 days a week. With the 24/7 Health Hotline, you can connect with a trained health professional anytime to get the help you need. VISION CARE EyeMed Vision Care offers discounts on eye care, with up to 40% off retail prices on additional pairs of glasses (once benefit has been exhausted), 20% off non-covered items and up to 15% off on conventional contact lenses. Members also save 20% on non-prescription glasses. You can receive the EyeMed Vision Care discount at more than 22,000 locations. HEARING CARE Save on hearing evaluations and exams and enjoy a 30% savings on all hearing aids through HearPO. You can call to schedule an appointment at any of the 2,500 locations nationwide. DENTAL SERVICES Careington offers you a full menu of dental services available at either a low set fee or a 20% discount. SERVICES TO KEEP YOU FIT Careington also provides you with discounts of 10% to 50% at more than 5,000 participating gyms, exercise facilities, and fitness centers across the nation. Privileges include all amenities, programs and services, including any exercise or recreation program or class. If you do not want to receive further information about TexanPlus value-added services, please call Member Services at 1-866-230-2513, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week. Simply present your TexanPlus member ID card to enjoy these savings at participating locations! Call Member Services to learn more about these services. Free with no obligation. v NIFTY AFTER FIFTYFTY TexanPlus HMO has partnered with Nifty after Fifty to provide our members with access to Nifty after Fifty fitness centers. Nifty after Fifty programs are designed to improve your strength, mobility and general wellness. The program is provided exclusively at no cost with a physician s referral. For more information call us at 1-866-230-2513, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week. WWW.TEXANPLUS.COM 5
TexanPlus MemberLink HMO is excited to announce that TexanPlus members will have access to plan details at their fingertips this summer. You will be able to view deductibles, copay amounts, your maximum out-of-pocket status, claims information and more. For additional convenience, you can request a member ID card replacement online. All you have to do is visit https://memberlink.universalamerican.com/ and input the required member information to take advantage of the TexanPlus MemberLink. While MemberLink will provide online access at your convenience, if you have any questions or need further assistance please call Member Services at 1-866-230-2513, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week. v You will be able to view deductibles, copay amounts, your maximum out-of-pocket status, claims information and more. 6 LIVE HEALTHY WITH TEXANPLUS HMO
Five Ways You Can Live Healthy and Be Rewarded For It! Coming Soon! We work hard to help our members get the most out of life, and out of their healthcare coverage. This is why we are excited to introduce our Live Healthy Rewards program. This exclusive, members-only program is available as part of your TexanPlus HMO plan. There is no cost to you. When you take care of your health, we will Reward you. It is so easy! You earn Rewards by scheduling an annual physical exam and other healthy actions. Complete five different health actions and earn $50! You can then use your Live Healthy Rewards card to buy a wide range of over-the-counter health products, vitamins and supplements at select national retailers. Preventive health screenings can identify health risks and help your doctor provide information, guidance and support for a healthier lifestyle. The following are the health actions that earn you Rewards and help you maintain your health. 3 Annual physical 3 Breast cancer screening 3 Colorectal cancer screening 3 Cholesterol screening 3 Glaucoma test 3 Prostate cancer screening 3 Annual flu shot You may be closer to earning Rewards dollars if you have already completed any of the listed health actions based on eligibility criteria. As a TexanPlus plan member, your good health is our first priority. The Rewards card is just one of many Live Healthy services to encourage good health and preventive care. We will mail you an invitation to join the Live Healthy Rewards program in the coming months. Be on the lookout for it! v WWW.TEXANPLUS.COM 7
All About Rheumatoid Arthritis WHAT IS RHEUMATOID ARTHRITIS Rheumatoid Arthritis, or RA, is a form of inflammatory arthritis and an autoimmune disease. In RA, the immune system, which is designed to protect our health by attacking viruses and bacteria, instead attacks the body s own tissues. WHO GETS RA? An estimated 1.3 million people in the United States have RA. There are nearly three times as many women as men with the disease. In women, RA most commonly begins between the ages of 30 and 60. It often occurs later in life for men, but they tend to be more severely affected by the disease. While RA typically occurs in middle-age individuals, children can develop it as well. WHAT CAUSES RA? The exact cause of RA is unknown. However, most scientists believe that a combination of genetic and environmental factors is responsible. With RA, something seems to trigger the immune system to attack the joints. Researchers are investigating whether certain bacteria or viruses may trigger the disease to attack. Research hasn t completely determined the role genetics plays in RA, but some people seem to have a genetic factor that increases their chance of developing the disease. Research of the genes and other factors that may lead to the development of RA is ongoing. SIGNS AND SYMPTOMS The symptoms of RA include joint pain and swelling, stiffness, and fatigue. RA symptoms vary from person to person and can change on a daily basis. RA is symmetrical, meaning if a joint on one side of the body is affected, the corresponding joint on the other side of the body is also involved. In addition to affecting the joints, RA may occasionally affect the skin, eyes, lungs, heart, blood, or nerves. An estimated 1.3 million people in the United States have RA. HOW IS RA DIAGNOSED AND TREATED? To diagnose RA, your doctor will take a medical history and perform a physical exam to look for symptoms of RA and lumps under the skin. Your doctor may also recommend certain blood tests to aid in the diagnosis. There is no cure for RA, but highly-effective treatments exist. The medications used to treat RA can be divided into two groups: those that relieve symptoms and those that can put the disease in remission. Doctors may recommend using two or more medications together. Researchers are continuously studying new medications to help treat RA. v http://www.arthritis.org/what-can-you-do-about-it.php WWW.TEXANPLUS.COM 9
How Much Do You Know About Osteoporosis Your bones are living, growing tissue made up of three major components that make them both flexible and strong: Collagen, a protein that gives bones a flexible framework Calcium-phosphate mineral complexes that make bones hard and strong Living bone cells that remove and replace weakened sections of bone Osteoporosis is a disease of the bones. It occurs when you lose too much bone, make too little bone or both. As a result, bones become weak and can break from a minor fall or in serious cases, even from bumping into furniture. Approximately ten million Americans have osteoporosis. Estimates suggest that about 50% of women above age 50 and approximately 25% of men, will break a bone due to osteoporosis. Osteoporosis is often called the silent disease because you may have it or be at www.nof.org. 10 LIVE HEALTHY WITH TEXANPLUS HMO risk without even realizing it. You can t feel your bones becoming weaker. Breaking a bone is often the first sign that you have osteoporosis. You may also get shorter or your upper back will start to curve forward. If you are experiencing height loss or your spine is curving, you should talk to a doctor right away as the disease may be advanced. What can you do to protect your bones? Get enough calcium and vitamin D. Eat a well-balanced diet. Engage in regular exercise. Eat foods that are good for bone health, such as fruits and vegetables. Avoid smoking and limit alcohol intake. Getting Osteoporosis is not a part of normal aging. There is a lot you can do to protect your bones. You re never too young or too old to improve the health of your bones. Now is the time to take action. v Did you know? Throughout your life, you are constantly losing old bone and making new bone?
The Importance of Mammograms Amammogram is a breast examination that uses specially designed X-ray equipment to detect tumors that are too small to be detected through routine exams. A mammogram examination is recommended for women who are above 50 years of age, when the risk of breast cancer is highest. Mammograms are considered the best radiographic equipment available today to detect breast cancer in its early stages. A mammogram helps in the early detection and treatment of cancer. Contrary to popular belief, most breast disorders are not cancerous. Even in cases where cancer is detected, the disease is curable if detected early and treated properly. A mammogram is the best way to identify changes in the breast before the obvious symptoms of cancer surface. Research shows that mammograms have helped reduce fatality rates in breast cancer by almost 30 percent. http://womenshealth.gov/publications/our-publications/fact-sheet/mammograms.cfm Mammograms are not painful. Two X-rays are taken for each breast, and each reveals a clear structure of the breast and helps experts understand the readings and accurately diagnose the condition. Research shows that mammograms have helped reduce fatality rates in breast cancer by almost 30 percent. Because breast tissues change continuously during a woman s lifetime, every new change may require a mammography test. Changes in the structure, glandular and fibrous tissues occur with age. Your doctor will help you decide whether or not to take a test. Your doctor may recommend a mammogram if you are younger than 50 and preliminary tests show some abnormalities in your breast structure, or if the disease is prevalent in your family. v WWW.TEXANPLUS.COM 11
Colorectal Cancer Screenings Can Save Lives As you get older, you become prone to certain diseases. Colon cancer is one of them. Colon cancer is the third most common cancer in men and women in the United States. It is also the second leading cancer killer, but it does not have to be. It is recommended that everyone age 50 or older be screened for colon cancer because they are at higher risk of developing this disorder. Screening can find precancerous polyps, abnormal growths in the colon or rectum, which can be removed before turning into cancer. Screening also helps find colon cancer at an early stage, when treatment often leads to a cure. Your TexanPlus HMO plan covers these colon cancer screenings: Barium Enema is an X-ray examination of the large intestine (colon and rectum). Flexible sigmoidoscopy This is generally done every five years. It is a test where the doctor uses a scope to look for polyps or cancer in the lower third of the colon. Fecal occult blood test This screening is done once a year. It is done with a chemically treated test card provided by your doctor or lab to check for signs of cancer in your bowel movements. Colonoscopy This screening is done every ten years. This test allows the doctor to look for polyps or cancer while you are sedated. The doctor is actually able to remove most polyps and cancer during the screening process. Talk to your doctor to get more information about these screenings and to determine your risks and the proper test for you. v http://www.cdc.gov/cancer/colorectal/basic_info/index.htm 12 LIVE HEALTHY WITH TEXANPLUS HMO
Prostate Cancer Prostate cancer is the most common cancer in men. This cancer generally grows very slowly and if detected early, it can be cured. In its early stages, prostate cancer usually does not cause symptoms. As the disease progresses, symptoms develop such as: Fever Chills Fatigue Aching muscles Chronic pain in the hips, thighs, or lower back Frequent or painful urination Blood in the urine or semen The lack of early symptoms and the overlap of symptoms with non-cancerous conditions make prostate cancer difficult to diagnose. That s why it s important to get screened regularly. Men should get a prostate check every year after age 40. Also to help prevent prostate cancer, you should: Eat right. Studies show that eating fiber, soy protein, fruits, and cooked tomatoes help reduce the risk of developing prostate cancer. Watch your weight. Exercise regularly. Don t smoke Limit alcohol and avoid caffeine. Drink a lot of water. Talk to your doctor about other prevention tips, and to learn more about prostate exams. v http://www.prostatehealthguide.com/cancer_about.html
Preventive Screenings Checklist A tool to help you Live Healthy! Your health plan covers the important screenings and tests listed below. Take this checklist to your Primary Care Physician and ask which preventive screenings are right for you. v SCREENING TEST TREATMENT RECOMMENDED FREQUENCY DATE RECEIVED NEXT DUE DATE Cardiovascular Screening Colorectal Cancer Screening: Fecal Occult Blood Test Diabetes Screening Flu Shot Glaucoma Test Mammogram Pap Test and Pelvic Exam Prostate Cancer Screening Wellness Visit with PCP Bone Mass Measurement Colorectal Cancer Screening: Barium Enema Colorectal Cancer Screening: Flexible Sigmoidoscopy Colorectal Cancer Screening: Colonoscopy Pneumococcal Shot Annually Annually Annually Annually Annually Annually Annually Annually Annually Every 2-5 years Every 2-5 years Every 5-10 years Every 5-10 years Once in a lifetime 14 LIVE HEALTHY WITH TEXANPLUS HMO
Save on Prescription Drugs TexanPlus HMO members with prescription drug benefits can pay less for medications by using FastStart, the CVS Caremark Mail Service offered as part of your plan. Through FastStart, you can get a 90-Day supply of drugs for the price of two copays. Along with lower prescription costs, FastStart Offers: Greater convenience: you can enjoy dependable, regular delivery with no additional cost for shipping Personal service: you can speak with a registered pharmacist anytime using the 24-hour, toll-free number To find out if you could save money and to start using CVS Caremark Mail Service for your long-term medications, call FastStart toll-free at 1-800-875-0867, Monday Friday, 7:00 a.m. to 7:00 p.m. Central Standard Time (TTY users call 1-800-231-4403). Rest assured, your prescriptions will not be filled by mail unless you call and give permission to start the home delivery process. Don t miss the opportunity to save money and avoid extra trips to the pharmacy Before you call, please be sure to have with you: Your TexanPlus member ID number (on your member ID card) Prescription name Doctor s name and phone number Mailing address Payment information Don t miss the opportunity to save money and avoid extra trips to the pharmacy by ordering a 90-day supply order of your medications at a local pharmacy or by mail. If you have any questions about your plan, please call Member Services at 1-866-230-2513, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week. v Ask your pharmacist about auto refills. You will never have to worry about requesting refills again. Your pharmacy will automatically ly place your refill order and let you know when your medications are ready. WWW.TEXANPLUS.COM 15
How to Maintain a Healthy Heart The heart pumps around 2,000 gallons of blood as it beats 100,000 times a day. That is why having a healthy heart is important. According to the American Heart Association, heart disease is the number one cause of death for Americans. THERE ARE NUMEROUS WAYS TO PREVENT HEART DISEASE AND LIVE HEALTHY: Monitor your blood pressure regularly Do not smoke Manage stress Stay Active. Here are a few simple things that one can do every day: Take the stairs instead of the elevator Drive to the end of the parking lot and walk to an entrance If you ride the bus, try getting off a stop before your destination and walk the rest of the way Find a hobby outside that requires some level of physical activity Eat foods that help regulate good heart flow, cholesterol and blood pressure: Black Beans Salmon and tuna Extra Virgin Olive Oil Walnuts and almonds Oranges Sweet Potatoes Carrots To get more information about maintaining a healthy heart, visit the American Heart Association website at www.heart.org. v WWW.TEXANPLUS.COM 17
Taking Your Medications as Prescribed It is easy to forget to take your medicine or choose to stop taking it once you feel better. However, not taking your medications as prescribed by your doctor can prevent the drug from doing its job and increase your risk for serious complications. Medication adherence is a measure of how well you take your medicines exactly as prescribed. Below are some common medications and possible results of not taking them as advised by your doctor: Blood pressure medications: nonadherence can increase your risk for stroke, kidney problems, and heart failure. Cholesterol medications: non-adherence can increase your risk for heart disease. Diabetes medications: non-adherence can increase complications related to your kidneys, nerves, feet, and eyes. It can also increase your risk for heart disease. It is important that you consult with your doctor to make sure you are on a medication 18 LIVE HEALTHY WITH TEXANPLUS HMO regimen that works for your health condition and for you. HERE ARE SOME WAYS TO MAKE TAKING MEDICATIONS EASIER: If your medication requires you to take it several times each day, ask your doctor if there is a once-daily substitute that works for you. When possible, use generic drugs to help lower costs. Ask your doctor to prescribe a 90-day supply when appropriate and in accordance with your prescription drug benefits. Stay informed about your medications, ask your doctor why you have to take them, side effects you may experience, and what will happen if you do not take them. If you ever have any questions about your plan, please call Member Services. v http://www.yalemedicalgroup.org
CAHPS Survey- Let Your Voice be Heard Your opinion matters to us, and we want to hear from you! You may receive a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey in the mail and we ask that you take the time to answer questions about your TexanPlus HMO plan and your experience. The CAHPS survey is a joint effort of the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS). Based on responses to 70 questions, CAHPS measures members satisfaction with their plans and their doctors. These scores are then posted on the CMS website so consumers can see how well their plans are doing by a number of different measures and compare their plans scores with competitors and national averages. The questions in the CAHPS survey cover everything from the amount of respect shown to you by your doctor to how easy it is to fill out paperwork from your health plan. The questions are designed to highlight areas that are working well and pinpoint those that need improvement. Your voice counts and we want to hear from you. Surveys are sent out by mail in the early spring. Members who do not respond get follow-up contact by phone. If you receive a CAHPS survey, please be sure to complete it. Your voice counts and we want to hear from you. v WWW.TEXANPLUS.COM 19
4888 Loop Central Dr. Houston, TX 77081 Health or wellness or prevention information NEW MAGAZINE NAME You may have noticed that the TexanPlus HMO member magazine name has changed to Live Healthy. While our Healthy Collaboration promise to work with your healthcare providers to help you stay as healthy as possible, is our focus. Live Healthy is a major part of our Healthy Collaboration as it gives you the opportunity to participate in improving and maintaining your own health. We find Live Healthy to be a more fitting title for the magazine as each volume will serve as a great resource and tool to help you on your journey to live healthy and get the most out of life. TALK TO US We want to make sure that your healthcare needs are met and help you get the most of out of your plan. If you ever have questions about your plan or any concerns, please don t hesitate to call us. We re always ready to assist you in any way possible. CALL MEMBER SERVICES 1-866-230-2513, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week. TexanPlus HMO is a Health plan with a Medicare contract.