HMSA s Medicare News Live the life you imagine. HMSA Akamai Advantage newsletter Fall 2017 What s Inside 7 Benefits for Good Health Get Vaccinated Crock-pot Chili Recipe LIVING WELL Achoo! Prevent the flu. Flu season starts now. It typically begins in October and can continue into the new year. Adults age 65 and older are at high risk for the flu, which can lead to hospitalization. It s worth a shot The best way to prevent the flu is to get a flu shot. It s part of your health plan benefits. You can get a flu shot from your primary care provider (PCP) or at a pharmacy. Also, check to see if flu shots are available at a community health fair near you. You can also prevent the flu with these good health habits: Wash your hands for 15 seconds with soap and warm water before eating, cooking, or handling food. Clean surfaces of your home, including computer keyboards, phones, and door handles. Cover your mouth with tissue or your sleeve when coughing or sneezing. Stay healthy this fall. Take preventive steps to fight the flu. H3832_4009_8750_9273 Approved
ALOHA Happy Anniversary Island Scene! For the past 25 years, it s been our privilege sharing stories, recipes, and news to help you engage in your health and well-being. From cover to cover, Island Scene is a source of inspiration for and information on leading a healthy lifestyle. It s just one of the many benefits of being an HMSA Akamai Advantage member. Thanks for reading! Look for the special Big Island edition of Island Scene in your mailbox this fall! Got a comment or suggestion? Email us at feedback@islandscene.com. Read the magazine online. Visit our Well-Being Hawaii blog at wellbeinghi.com. Dear Members, HMSA Akamai Advantage is here for you when you need us. You have enough to worry about when you get sick or if an accident occurs. You shouldn t have to worry about how you re going to pay for your care. That s why we re here. You have peace of mind knowing that we ve got you covered. But we re not just a health plan during bad times. We re a health care organization that looks out for the health and well-being of you and your family year-round. Health care isn t just about going to the doctor when you re sick. It s about taking preventive steps to keep you healthy and active every day. That s why your health plan includes programs, services, and tools to keep you on top of your health at little or no additional cost. You can learn more in 7 Benefits for Good Health on page 3. You ll find information on special member discounts, health workshops, and more. Make your health plan work for you. To take advantage of your health plan benefits, make an appointment with your doctor for an annual wellness visit and health screenings. And for the flu season, read our cover article about how you can protect yourself from getting sick. Thank you for choosing HMSA and putting your trust in us for your health care needs. It s a privilege having you in the HMSA family of members. We ll continue to improve HMSA Akamai Advantage and the services we provide you to keep you healthy and happy this fall and throughout the year. Mahalo, Wendy C. Nakasone Vice President Medicare Programs 2
1. HEALTH 7 Benefits for Good Health Best of all, these services are part of your health plan benefits available to you at little or no cost. 1. Annual wellness visit. See your doctor every year at no cost to check on your health and review your medications. 2. Screenings and vaccines. Your benefits include services to help prevent heart disease, colorectal cancer, breast cancer, osteoporosis, the flu, and other health issues. 3. Get care any time. Speak to doctors online or on the phone with HMSA s Online Care or see a nurse practitioner at a walk-in CVS/ minuteclinic at selected Longs Drugs stores. No appointment needed. 4. Benefits when you travel. Enjoy visiting places near and far because your health plan travels with you for urgent and emergency care. 5. Medications. Get prescription drugs at your nearest pharmacy or mailed to your home. Review your medications with a pharmacist to make sure that you re taking them safely. 6. Discounts. With HMSA365, you ll save money on health and well-being products and services like exercise classes, transportation for medical appointments, hearings aids, dental and vision services, and more. 7. Health education workshops. Learn how to sleep better, make healthy food choices, maintain balance, and more. For a workshop schedule, visit hmsa.com. From the Well-being tab, click Health Education Workshops. Or see the latest issue of Island Scene. Get Vaccinated Vaccines and immunizations help protect you from many illnesses. Talk to your primary care provider (PCP) to see which vaccines are right for you. Where you get your vaccines and how your health plan pays for it depends on the vaccine. Vaccines under your medical benefits. See your doctor or network pharmacy. Vaccines under your Medicare prescription drug benefits. Check your health plan s formulary, or list of covered drugs. Go to a network pharmacy. Flu Pneumonia Hepatitis B (if you re at medium to high risk) Other vaccines as needed (for example, tetanus shot if you step on a rusty nail) Find a pharmacy Go to a pharmacy in the HMSA Akamai Advantage network: Check your Provider Directory. View the Provider Directory at hmsa.com/advantage. Call CVS Caremark at 1 (855) 479-3659 toll-free 24 hours a day, seven days a week. For TTY, call 711. Hepatitis A Shingles (herpes zoster) If you have questions about whether a vaccine is a health plan benefit, call us Monday through Friday, 8 a.m.-8 p.m.: Oahu: 948-6000 Neighbor Islands: 1 (800) 660-4672 TTY: 711 AmericanWell is an independent company providing hosting and software services for HMSA s Online Care platform on behalf of HMSA. CVS Caremark is an independent company providing pharmacy benefit management services on behalf of HMSA. 3
4 KAU KAU CORNER Healthy Crock-pot Chili If slow and steady wins the race, the crock-pot is the champion. This fall, put your slow cooker to work and try this healthy, hearty chili recipe from HMSA s Well-Being Hawaii blog. 1 medium onion, diced 15-oz. can black beans, drained and rinsed 15-oz. can kidney beans, drained and rinsed 8-oz. can tomato sauce 10-oz. package frozen corn 2 14.5-oz cans diced tomatoes with chilies 1 packet taco seasoning 1 Tbsp. cumin 1 Tbsp. chili powder 3 boneless skinless chicken breasts Place diced onion, black and kidney beans, tomato sauce, corn, diced tomatoes, taco seasoning, cumin, and chili powder in the crock-pot. Mix well. Place chicken breasts on top. Cover and cook on high for 6 hours. After 5-1/2 hours, shred the cooked chicken and stir into chili. Cover and cook for 30 minutes. Serve with brown rice and a leafy green salad for an easy and nutritious meal. Get more recipes on wellbeinghi.com. You ll find photos, step-by-step instructions, videos, and more. MEDICATION CORNER Save Money at Network Pharmacies To save the most money on your prescription drugs, get your medications from a pharmacy in the HMSA Akamai Advantage network. We have an agreement with these pharmacies to provide you with medications on your health plan s drug list at the best possible cost. In some situations, your health plan will pay for medications you buy from a pharmacy that s not in your health plan s network. These situations include emergency or urgent care when a network provider isn t available, such as when you re traveling outside the U.S. In these cases, you may have to pay for the full price of the medications out of pocket. It s important that you save the receipts so you can get reimbursed. Getting reimbursed For the quickest way to receive your reimbursements for medications that you get from out-of-network pharmacies, please complete the Prescription Reimbursement Claim Form. Download the form from My Account on hmsa.com. From the homepage, click Member Login. If you re not registered for My Account, take a few minutes to do so. 1. Log onto My Account. 2. Hover over Drugs and click Order Drugs Online. You ll be directed to a CVS Caremark webpage. 3. From Plans & Benefits, click Print Plan Forms. Select the appropriate link under Paper Claims Reimbursement Forms. If you want us to mail you a claim form, call us 8 a.m. to 8 p.m., seven days a week at 948-6000 on Oahu or 1 (800) 660-4672 from the Neighbor Islands. For TTY, call 711. Send the completed form with any bills and receipts to: Caremark, Inc. Medicare Part D Claims P.O. Box 52066 Phoenix, AZ 85072-2066 Make a copy of your bill and receipts for your records. To get reimbursed, you must submit your claim within a year from the date you received the medication. Need Help Paying for Medications? If you have limited resources and income, you may qualify for Extra Help. This program can help pay for your out-of-pocket prescription drug plan costs, including monthly premiums, annual deductibles, and copayments. Find out if you qualify Online. Visit socialsecurity.gov/extrahelp. Phone. Call the Social Security Administration at 1 (800) 772-1213 toll-free. For TTY, call 1 (800) 325-0778.
Important Information About Your Health Plan HMSA doesn t discriminate We comply with applicable federal civil rights laws. We don t discriminate, exclude people, or treat people differently because of things like: Race. Color. National origin. Age. Disability. Sex. Services that HMSA provides To better communicate with people who have disabilities or whose primary language isn t English, HMSA provides services at no cost when reasonable, such as: Language services and translations. Text relay services. Information written in other languages or formats. If you need these services, please call 1 (800) 776-4672 toll-free. TTY 711. How to file a discrimination-related grievance or complaint If you believe that we ve failed to provide these services or discriminated against you in some way, you can file a grievance in any of the following ways: Phone: 1 (800) 776-4672 toll-free TTY: 711 Email: Compliance_Ethics@hmsa.com Fax: (808) 948-6414 on Oahu Mail: 818 Keeaumoku St., Honolulu, HI 96814 You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, in any of the following ways: Online: ocrportal.hhs.gov/ocr/portal/lobby.jsf Phone: 1 (800) 368-1019 toll-free; TDD users, call 1 (800) 537-7697 toll-free Mail: U.S. Department of Health and Human Services, 200 Independence Ave. S.W., Room 509F, HHH Building, Washington, DC 20201 For complaint forms, please go to hhs.gov/ocr/office/file/index.html. Federal law requires HMSA to provide you with this notice. H3832_4036_2025_1157_v4 Accepted H7317_4036_2025_1157 Accepted 5
6
7
P.O. Box 860 Honolulu, HI 96808-0860 PRESORTED STANDARD U.S. POSTAGE PAID HONOLULU, HI PERMIT NO. 6 Important plan information. Here for You We re happy to provide you with personalized service: Over the phone Seven days a week 8 a.m.-8 p.m. 948-6000 on Oahu. 1 (800) 660-4672 toll-free on the Neighbor Islands or Mainland. TTY users, call 711. In person Visit one of our HMSA Centers with convenient evening and Saturday hours: HMSA Center @ Honolulu 818 Keeaumoku St. Monday-Friday, 8 a.m.-6 p.m. Saturday, 9 a.m.-2 p.m. HMSA Center @ Pearl City Pearl City Gateway 1132 Kuala St., Suite 400 Monday-Friday, 9 a.m.-7 p.m. Saturday, 9 a.m.-2 p.m. HMSA Center @ Hilo Waiakea Center 303A E. Makaala St. Monday-Friday, 9 a.m.-7 p.m. Saturday, 9 a.m.-2 p.m. You can also visit us at our offices Monday through Friday, 8 a.m.-4 p.m.: Kailua-Kona office 75-1029 Henry St., Suite 301 Kahului office 33 Lono Ave., Suite 350 Lihue office 4366 Kukui Grove St., Suite 103 Visit hmsa.com for our holiday schedule. HMSA Akamai Advantage is a PPO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits or copayments may change on January 1 of each year. HMSA365 and other special discounts are available only to HMSA Akamai Advantage members and are not considered a plan benefit. (03) 8750-9273 9.17 fn