ENJOY Life! LOOK INSIDE FOR GREAT NEWS ABOUT YOUR 2018 BENEFITS! 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, premium, and copayments/coinsurance may change on January 1 of each year. Other providers are available in our network. FALL 2017
GREAT NEWS FOR $400 DENTAL ALLOWANCE! LOWER COPAYS FOR INPATIENT HOSPITAL ADMISSIONS! LOWER COPAYS FOR X-RAYS! LOWER COPAY TO SEE YOUR SPECIALISTS! $0 PER STANDARD- SIZED BOX OF DIABETIC SUPPLIES! UP TO $20 PER MONTH TOWARD DUES AT PARTICIPATING FITNESS CENTERS! 1
As a Viva Medicare Me member, you get some great benefits, discounts, a care team when you need it, and more! CVS Caremark ExtraCare Health Card The ExtraCare Health card gives you a 20% discount on more than 1,300 CVS/pharmacy brand health-related items valued at $1 or more. Viva Medicare Me members are automatically enrolled in this program. Prescription Home Delivery Great convenience and lower cost. Ordering 90-day supplies of your medicine through the mail helps you save money. Call the CVS Caremark Mail Service Pharmacy's FastStart toll-free number at 1-866-788-5146, Monday - Friday, 7 am - 7 pm. Fitness Center Reimbursement Viva Medicare Me includes up to $20 per month toward your membership at a participating fitness center! To find out which fitness centers participate, go to www. vivamedicaremember.com/memberresources/ and click on your plan name, or call Member Services at the number on the back cover of this newsletter. Hearing Care Solutions Annual hearing exams are available for Viva Medicare Me members at no charge at any Hearing Care Solutions location. Additionally, Hearing Care Solutions offers discounted pricing on hearing aids from major manufacturers. To participate, call Hearing Care Solutions at 1-866-344-7756, 7 am - 7 pm, Monday - Friday. Philips Lifeline With Philips Lifeline, you can get connected to their 24/7 Response Center with the press of a button, 24 hours a day, 365 days a year. Viva Medicare Me members get discounts on start-up and monthly fees. For more information about this and other products offered by Philips Lifeline, 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 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 begin to participate in V-Care in a few ways: a physician can refer you, Viva Medicare may contact you if we see you may benefit from V-Care, or you can call 1-855-698-2273, 8 am - 5 pm, Monday - Friday, for more information. 2
MORE GREAT CHANGES FOR 2018! Here's a quick chart that highlights the awesome changes you'll see in 2018: 2018 SERVICE 2017 AMOUNT YOU PAY AMOUNT YOU PAY Specialist $35 $30 Urgently Needed Care Visit $5 PCP $35 Specialist $50 Urgent Care Clinic $5 PCP $30 Specialist $50 Urgent Care Clinic Outpatient Mental Health $35 $30 Annual Hearing Exams $5 PCP $35 Specialist $5 PCP $30 Specialist X-rays $25 per x-ray $10 per x-ray Diagnostic Radiology such as an MRI, PET, or CT Scan $100 per service $75 per service Diabetic Supplies $5 per standard-sized box $0 per standard-sized box Dental Benefits Plan covers up to $100 for preventive & comprehensive dental benefits every year Plan covers up to $400 for preventive & comprehensive dental benefits every year 3
ARE YOU ENROLLED IN THE RIGHT PLAN FOR YOU? Below is quick glance at the other great plans Viva Medicare offers. Please call us if you think another plan may be right for you! See page 5 to find out what plans are offered in your county. SERVICE Monthly Premium 1 $0 Primary Care Physician (PCP) $5 Specialist $40 Inpatient Hospital Outpatient Hospital Medicare Part D Drug Coverage Eyewear Dental SERVICE Monthly Premium 1 Primary Care Physician (PCP) AMOUNT YOU PAY $0 or $28, depending on county. See page 5 for premium by county. $5 Specialist $35 Inpatient Hospital Outpatient Hospital Medicare Part D Drug Coverage Dental Days 1-5: $295 per day; $0 foradditional days $250 Generics starting at $0 2 ; No annual deductible for Tier 1 and 2 drugs $300 annual dental allowance AMOUNT YOU PAY Days 1-6: $250 per day; $0 for additional days $250 No Part D Drug Coverage $100 annual eyewear allowance $100 annual dental allowance SERVICE Monthly Premium 1 $109 Primary Care Physician (PCP) $5 Specialist $20 Inpatient Hospital Outpatient Hospital $175 Medicare Part D Drug Coverage Eyewear Dental SERVICE AMOUNT YOU PAY Days 1-5: $220 per day; $0 for additional days Generics starting at $0 2 ; No annual deductible; Tier 1 generics covered in the Coverage Gap $150 annual eyewear allowance $500 annual dental allowance (You must have Medicare and Medicaid to join) Monthly Premium 1 $0 Primary Care Physician (PCP) AMOUNT YOU PAY $0 Specialist $0 or $10 Inpatient Hospital Outpatient Hospital $0 or $200 Medicare Part D Drug Coverage Eyewear Dental Transportation Benefits Days 1-6: $0 or $245 per day; $0 for additional days No annual deductible; No coverage gap $100 annual eyewear allowance $600 annual dental allowance 20 one-way rides or 10 round-trips 3 1 You must continue to pay your Medicare Part B premium unless the State pays it for you. 2 $0 copay applies only to prescriptions filled at pharmacies offering preferred cost sharing. Please see Viva Medicare s Pharmacy Directory for a complete list of pharmacies. 3 Viva Medicare Extra Value is a Special Needs Plan for anyone who has both Medicare and Medicaid/Medicare Savings Program. Premiums, copayments, coinsurance, and deductibles may vary based on the level of Medicaid and Extra Help you receive. Please contact the plan for further details. 4
Viva Medicare Service Area Viva Medicare is growing! We're excited to welcome Lauderdale, Colbert, and Franklin Counties to the Viva Medicare family! Viva Medicare Premier Premium: $109 Viva Medicare Extra Value Premium: $0 Viva Medicare Plus Premium: $0 Viva Medicare Me Premium: $0 Viva Medicare Plus Premium: $28 Viva Medicare Select Premium: $0 5
WHAT OUR MEMBERS ARE SAYING ABOUT US "The Viva Medicare mail order pharmacy is a game changer. I don t have to remember to pick up my prescriptions. They just come delivered right to my door. It s that easy and convenient!" -Jack, Viva Medicare Member "I believe with all my heart that Viva Medicare wants me to be healthy. I get reminders to go visit my doctor for annual checkups and exams. Viva Medicare is the greatest Medicare Advantage Plan you can use." -Aaron, Viva Medicare Member "What I love about Viva Medicare is how easy it is to get help. When I go to the Viva Health Café, I never feel rushed. The Viva Agent will sit down with me one-on-one and spend all the time in the world with me when I have questions about my plan. I never feel like I m just a number." -Karen, Viva Medicare Member "When I talk to someone at Viva Medicare, I feel like they are a family member. Almost as if we ve met before. They make me feel like they care about my needs. They don t put me on hold or make me wait." -Carolyn, Viva Medicare Member Photos are representations, not the members quoted. 6
Join us for MEMBER APPRECIATION EVENTS We re holding Member Appreciation Days across the state to celebrate YOU! There will be food, prizes 1, and fun! GRAND RIVER MEMBER APPRECIATION 10/09/2017 10 AM 6200 Grand River Blvd. E., Ste. 438 Leeds, AL 35094 205-699-3040 HOOVER MEMBER APPRECIATION 10/10/2017 10 AM 1550-K Montgomery Hwy. Hoover, AL 35216 205-978-4911 MONTGOMERY MEMBER APPRECIATION 10/11/2017 10 AM 2107-B Eastern Blvd. Montgomery, AL 36117 334-272-8882 MOBILE MEMBER APPRECIATION 10/12/2017 10 AM 3071 Dauphin St. Mobile, AL 36606 251-380-2222 FOR Viva Medicare MEMBERS! EVENT OFFERINGS: Blood Pressure Checks Colon Screening Kits Medication Review Retinal Eye Exams Diabetic Blood Testing Bone Mineral Testing 7 1 Eligible for a free drawing and prizes with no obligation. While supplies last.
MEMBER Q&A If I want to stay on my current Viva Medicare plan, what do I need to do during the Annual Enrollment Period? You don t need to do a thing! If you re happy with your Viva Medicare Me plan, you ll automatically stay enrolled with us for the 2018 benefit year. I got a lot of information in the mail from Viva Medicare, including my Annual Notice of Change. What if I have questions about the changes? You can call Member Services at the number on the back of this newsletter or stop by any of the Viva Health Cafés to talk to someone in person. We also have events we d love to see you at in October. See page 7 for details. Does Viva Medicare need to know if my address or phone number changes? Yes, please be sure to call Member Services at the phone number on the back of this newsletter to give us your new address and/or phone number. That way, you ll still get important information from us. I ve been seeing a lot of information about flu shots in my pharmacy and doctor s office. Does Viva Medicare cover these? Yes, it is very important to get a flu shot every year and there is no cost to you. For more information on the importance of flu shots and how your plan covers them, see page 9. 8
FLU SHOT Q&A Below are the most frequently asked questions we get about the Flu Shot at Viva Medicare: Who needs the Flu Shot? Almost everyone 6 months of age or older should get a flu shot, unless you have a history of severe allergic reactions to any part of the vaccine. Why do I need a Flu Shot? A flu shot can protect you from getting sick and also protects your loved ones from catching the flu from you. Getting the flu shot is the best way to protect against the flu. I've heard you can get the flu even with the shot. What's the point? The flu shot will keep you from getting the flu most of the time. Even if you still get the flu, the vaccine reduces the severity of the disease. It also lowers the rate of complications by 50 to 60 percent and death by about 80 percent. Does the Flu Shot give me the flu? No. The flu shot does not have the live virus in it, so it is impossible to get the flu from the flu shot. Side effects from the shot may occur in some people for a day or two, such as mild soreness, redness, or swelling at the injection site, headache, or a low-grade fever. Flu season is not until winter. Why should I get a shot now? It does not have to be cold to be flu season. The flu season, as defined by the Centers for Disease Control and Prevention (CDC), lasts from late fall through early spring. Get your vaccine now so your body is able to fight the virus when you are first exposed. Will my Viva Medicare plan cover the Flu Shot? Yes! With your Viva Medicare coverage, you can get a flu shot every year at no cost to you. Where can I get my Flu Shot? You can visit any network pharmacy or network doctor s office offering flu shots. **Please show your Viva Medicare card wherever you get your flu shot** Is the Pneumonia Shot the same as the Flu Shot? No. The pneumonia shot is different from the flu shot. It can also be called the pneumococcal vaccine, and it's covered, too. If you pay for a flu shot from somewhere like a church or a senior center, we will pay you back up to what Medicare pays. Visit our website or call Member Services to get a Member Reimbursement Form. 9
A QUICK GUIDE TO A POWER OF ATTORNEY & PERSONAL REPRESENTATIVES Many people feel nervous at the thought of a power of attorney. It can be intimidating to consider giving another person the power to make decisions for you. In layman s terms, a power of attorney is a legal document that allows someone to conduct business on your behalf. There are good reasons to consider a power of attorney if the need arises. Durable Power of Attorney: A durable power of attorney is a legal document that can start immediately and allow someone to act on your behalf until the durable power of attorney is either revoked or upon your death. A durable power of attorney may be helpful to individuals who are facing a chronic, debilitating illness or who may be preparing for a future incapacitation (such as a possible nursing home commitment). For health insurance purposes, an appointment of an individual in a durable power of attorney may give that person the power to change your address and enroll, change plans, or disenroll you from our plan. The person appointed may also access your eligibility, enrollment, claims, and authorization information if the document specifically allows the power of attorney to obtain health information. A power of attorney can be revoked in writing at any time. You do not have to use an attorney to prepare a power of attorney. You can get free assistance in preparing a power of attorney by contacting the Alabama Department of Senior Services at 1-800-AGE-LINE (1-800-243-5463). Personal Representative: If you don t have a durable power of attorney, you can appoint a personal representative. This appointment allows the representative to access your eligibility, enrollment, claims, and authorization information. The appointment also allows them to communicate provider changes to Viva Medicare or file a grievance and/or appeal for you. This appointment does not permit your personal representative to change your address or make enrollment or disenrollment decisions for you. Form CMS 1696 can be used to allow an individual to file a grievance and/or appeal for you. The Personal Representative Appointment Form and Form CMS 1696 are available online at www.vivamedicaremember.com/memberresources/#additionalplan. Select your plan, then scroll down to "Appointing a Representative." You can also call Medicare Member Services at 1-800-633-1542 toll free to request a copy of either form. TTY users should call the Alabama Relay Service at 711. Our call center hours are from 8 a.m. to 8 p.m., Monday through Friday (from October 1 to February 14, 8 a.m. to 8 p.m., 7 days a week). If you have filled out a Personal Representative Appointment Form, please mail a copy to the following address so we have it on file when needed: Viva Medicare Enrollment Department 417 20th Street North, Suite 1100 Birmingham, AL 35203 10
CROSSWORD See page 13 for the answers. Across 2 Another word for gathering crops before the winter. 5 What a spider spins. 6 The spooky holiday during the fall. 10 Used to scare birds away from corn. 13 A large orange squash that people carve faces into. 14 A yellow vegetable with kernels. 15 The fruit of the oak, a smooth oval nut in a rough cuplike base. 17 These change color and fall from the trees during the fall. Down 1 A tool used to clean up leaves in the fall. 3 Holiday at the end of fall with lots of turkey and stuffing. 4 Someone may yell this if they want to scare you. 7 Another word for fall. 8 The first month of fall. 9 A sport Alabamians love watching in fall. 11 Flies on a broomstick during Halloween. 12 A crisp red fruit that s fun to pick in the fall. 14 A drink made from crushing apples. 16 Red and yellow make this color. 11
SUDOKU HOW TO PLAY: Each row and column, as well as each block, must contain all of the numbers 1 through 9, and no two numbers in the same row, column, or block can be the same. Level: Medium See page 13 for the answers to these puzzles. Level: Hard 12
PUZZLE ANSWERS The answers below are for the puzzles listed on pages 11 and 12. Level: Medium Level: Hard 13
Thank you for letting us serve you! We know you have a lot of plans to choose from. We are grateful you ve decided to be a Viva Medicare member! Are you happy with your Viva Medicare plan? Tell your family and friends! Have them give us a call at 1-888-830-8482 - TTY 711. Hours: Mon-Fri, 8 am - 8 pm From Oct 1 to Feb 14, 7 days a week, 8 am - 8 pm Thank you for making us who we are! A + Highest Members' Rating of Plan in Alabama 1 4 Stars Highest Medicare Advantage STAR Rating in Alabama 2 1 Based on the 2017 Medicare and You Handbook for Alabama. 2 Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. 14
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. Important plan information. 170495 H0154_mcdoc1880A CMS Accepted 10/03/2017 Toll-Free: Member Services 1-800-633-1542 TTY users: Alabama Relay Service at 711 Hours: Mon - Fri, 8am - 8pm From Oct 1 to 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, 8 am 5 pm Grand River Café (Leeds) 205-699-3040 6200 Grand River Blvd. E. Suite 438 Leeds, AL 35094 Mon - Fri, 8 am 5 pm Sat, 10 am 2 pm Princeton Café (Birmingham) 205-785-5559 833 Princeton Ave. SW. POB III, Suite 110 Birmingham, AL 35211 Mon - Fri, 8 am 5 pm Mobile Café 251-380-2222 3071 Dauphin St. Mobile, AL 36606 Mon - Fri, 8 am 5 pm Montgomery Café 334-272-8882 2107-B Eastern Blvd. Montgomery, AL 36117 Mon - Fri, 8 am 5 pm Viva Health Café at Eliza Coffee Memorial Hospital 256-787-8482 205 S. Marengo St. Florence, AL 35630 Mon - Fri, 8 am 5 pm 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).