FIT HEALTH. Get KNOW YOUR NUMBERS. Star Rating Given in Alabama 1. Improve Your. in Winter and stay fit and healthy

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Enjoy Life! Improve Your HEALTH in 2013 Get FIT KNOW YOUR NUMBERS and stay fit and healthy has earned the Highest Medicare Star Rating Given in Alabama 1 FOR THE 3 rd year in a row! Free Healthy Cooking Recipe Inside! 1 Based on overall plan ratings on www.medicare.gov for 2011, 2012, and 2013 plans. Plan performance Star Ratings are assessed each year and may change from one year to the next. Winter 2013 H0154_mcdoc1220A CMS Accepted 02/27/2013

Letter from Dr. Tara Bryant, Medical Director How do you know you re enrolled in a high-quality Medicare Advantage plan? It s in the Stars! Each year the Centers for Medicare & Medicaid Services (CMS) rates the quality of every Medicare Advantage plan in the country. These ratings, called the Star Ratings, assist Medicare beneficiaries in making informed decisions about which Medicare Advantage health plan to choose. The ratings also assure that you are enrolled in a high-quality Viva Medicare Plus plan. For 2013 Viva Medicare Plus scored 3.5 out of 5 Stars, the highest Star quality rating given in the state of Alabama! An important part of the CMS Star ratings is the annual Medicare Satisfaction Survey. These surveys will be mailed to randomly selected Viva Medicare Plus members in March. If you are selected to take this survey, it is important that you complete it. Viva Medicare Plus works hard to make sure our members receive the highest quality care and service possible and we want to hear from you. The Medicare Satisfaction Survey lets us know how satisfied you are with the quality of care and service you receive from our health plan. Plan performance Star Ratings are assessed each year and may change from one year to the next. For more information on plan ratings, please go to www.medicare.gov. Every year, Medicare requires that we send you certain information that relates to your plan benefits and the quality of your health. We understand that may add up to additional mail in your mailbox. We appreciate you taking the time to read your Viva Medicare Plus correspondence and taking any necessary action. We try to make sure what you receive from us is as clear as possible. However, if you have questions, we are here to answer them. You can reach Member Services at 1-800-633-1542 from Monday Friday from 8 a.m. to 8 p.m. (From October 1 to February 14, we are here 7 days a week from 8 a.m. to 8 p.m.) TTY users, please call the Alabama Relay Service at 711. I hope you find this issue of Enjoy Life helpful. Sincerely, Tara M. Bryant, M.D., B.S.N.

NEWS is moving! Over the last three years, Viva Medicare Plus has grown our membership by over 33% 1. To make sure we continue to offer the same great service that we have been providing since 1998 to all of our members, we have added many new employees. We are growing out of our current office space. Viva Medicare Plus is excited to announce that this fall we will be relocating to a larger space in downtown Birmingham. Effective 9/1/2013 our new address will be: 417 20th Street North Birmingham, AL 35203 1 Enrollment data found at http://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/ MCRAdvPartDEnrolData/index.html

Get FIT During his recent wellness visit, Dave s Primary Care Physician (PCP) advised him to have a colon cancer test since he had just turned 50. His PCP explained that colon cancer (or colorectal cancer) is one of the most common forms of cancer in the U.S., and one of the most preventable. Dave s PCP described three types of colon cancer tests. Any of these three tests are covered by Viva Medicare Plus at no cost to you. Colon Cancer Test Frequency DESCRIPTION FIT (Fecal Immunochemical Test) Once every year This test is done at home. You use a small brush to place a small sample of your stool (bowel movement) on a special card and mail it to the lab. The stool is tested for blood. The doctor will ask you to follow up with a colonoscopy if anything unusual is found. Flexible Sigmoidoscopy Every 5 years You use a strong laxative and/or enema to clean out the colon the evening before the test is done. During the test, the doctor uses a special, lighted tube (called a sigmoidoscope) to look inside the rectum and the lower part of the colon. The doctor will ask you to follow up with a colonoscopy if anything unusual is found. Colonoscopy Every 10 years You use a strong laxative and/or enema to clean out the colon the evening before the test is done. During the test, the doctor uses a special, lighted tube (called a colonoscope) to look inside the rectum and the entire colon. Some form of sedation is used in most cases. If polyps (growths found on the colon) are detected, they are removed. Polyps can be cancerous or non-cancerous. Continued on next page C

Since Dave had no family history of colon cancer, his PCP recommended he do the first test called the FIT. Dave did not look forward to cleaning out his colon, so he agreed the FIT would be the ideal test for him. The doctor handed him one of the FIT kits he keeps in his office. At home, Dave followed the easyto-understand instructions and mailed the postage paid card to the lab. Dave s PCP will tell him the results of the test. Ask your PCP if the FIT will work for you. For those who are 50 or older, it s important that you have a colon cancer test done. Your risk for colon cancer increases with age. You should start getting tested earlier if you have a family history of colon cancer or colitis (swelling of the colon). Sources: Centers for Disease Control and Prevention / National Digestive Diseases Information Clearinghouse Signs of Colon Cancer Colon cancer tests are important because there may be no symptoms until the cancer has spread. Contact your PCP if you have any of the following: unexplained weight loss. stomach pain, aches, or cramps that do not go away. blood in or on your stool. change in how your stool looks and/or how many times you have a bowel movement. nausea or vomiting. feeling tired all the time.

IMPROVING YOUR HEALTH IN 2013 We all know the importance of a good diet and exercise, but did you know that even small exercise and diet improvements can improve the health of people who have diseases associated with aging or are frail? Being physically active can also help you stay strong and give you the ability to keep up the lifestyle that you have grown accustomed to. Here are just a few more reasons to stay active and maintain your health along with some suggested exercises: Being inactive can be risky. If you ve ever fallen, or if you are afraid of falling, being inactive will only increase your chances of having another fall. People who are inactive tend to lack the strength and coordination to catch themselves if needed. Exercise will help improve your strength, stamina, balance, and reflexes which combined will help decrease your chances of falling. Prevent or delay diseases. Studies have shown that regular exercise benefits people with chronic conditions such as heart disease, arthritis, diabetes, and high blood pressure. Manage stress and improve your mental health. Starting a routine exercise program has been shown to help manage stress and improve your mood. Regular exercise may also help reduce any feelings of depression you may be having. Simple improvements to your overall health can even have further reaching effects like improving conditions such as bladder control problems. Did you know that almost 1 out of every 11 Americans suffers from an overactive bladder, but only 1 out 5 seek help? If you think you may have an overactive bladder simply track your liquid input and output (how often you drink and what you drink and how often you use the bathroom) for several days, and then take that information to your PCP. If you are having bladder control problems, simple changes to your diet can also help. Avoiding acidic or spicy foods and decreasing your intake of caffeinated or alcoholic drinks will all help prevent urinary leaking. In addition to this, you can take your journal of liquids to your PCP and he or she will be able to help you through a possible combination of medications and bladder training. Now that you re committed to improving all aspects of your health in 2013, what should you do? Before starting any exercise program, Viva Medicare Plus suggests you talk to your PCP first. He or she will be able to assess your current health and let you know if there are any current conditions that may limit your activity. Once you have the green light from your PCP, start in moderation, and most importantly enjoy yourself!

HEALTHY cooking MINI TURKEY LOAVES This super-delicious and incredibly easy recipe is an absolute favorite in my home. I pass it on to everyone I know, and they all rave about it too! -Phyllis Feder Birmingham, Alabama Ingredients 2 cups coarsely chopped zucchini 1 1/2 cups coarsely chopped onions 1 red bell pepper, coarsely chopped 1 pound extra lean ground turkey 1/2 cup uncooked couscous Directions 2 tablespoons Worcestershire sauce 1 tablespoon Dijon mustard 1/2 cup barbecue sauce, or as needed 1 egg 1. Preheat oven to 400 degrees F (200 degrees C). Spray 20 muffin cups with cooking spray. 2. Place zucchini, onions, and red bell pepper into a food processor and pulse several times until finely chopped but not liquefied. Place the vegetables into a bowl and mix in ground turkey, couscous, egg, Worcestershire sauce, and Dijon mustard until thoroughly combined. Fill each prepared muffin cup about 3/4 full. Top each cup with about 1 teaspoon of barbecue sauce. 3. Bake in the preheated oven until juices run clear, about 25 minutes. Internal temperature of a muffin measured by an instant-read meat thermometer should be at least 160 degrees F (70 degrees C). Let stand 5 minutes before serving.

Know Your NUMBERS Do you know your cholesterol, blood pressure, blood sugar and body mass index numbers? According to the Centers for Disease Control and Prevention (CDC), you can lower your chances of developing heart disease, high blood pressure, diabetes, and other illnesses if you know your numbers and take the right steps to keep them in check. KNOW YOUR NUMBER FOR: Cholesterol My number is: Date: / / Blood Pressure My number is: Date: / / Blood Sugar My number is: Date: / / Body Mass Index (BMI) My number is: Date: / / TARGET Less than 200 WHAT YOU SHOULD KNOW Your age, sex, and heredity can increase your risk for high cholesterol. Those things you can t alter, but there are some risk factors you can change: Eating foods that are high in salt and fat Being overweight Not getting enough exercise Drinking too much alcohol You should know your HDL (healthy) and LDL (not so healthy) cholesterol numbers. The normal range for total cholesterol is 200. There are no symptoms for high cholesterol. It s important to have regular cholesterol checks at your Primary Care Physician s (PCP) office. Less According to the Alabama Department of Public Health, over 30% of adults than in Alabama have high blood pressure. High blood pressure, or hypertension, 120/80 increases your risk for stroke and heart disease, which are the leading causes of death in the U.S. They don t call high blood pressure the silent killer for nothing. Many people have high blood pressure and don t realize it. That s why it s vital to have your blood pressure checked at each doctor s visit. 80 to 120 If your blood sugar (glucose) is too high or too low, you might have diabetes. Symptoms may include: Less than 25 Extreme hunger Unexplained weight loss Tiredness that won t go away Blurry vision Frequent urination If diabetes is left untreated, it could cause stroke, blindness, amputation of arms and/or legs, or kidney disease. Have your doctor check your blood sugar on a regular basis. If you ve already been told you have diabetes, it s still important to check your blood sugar often. BMI is defined by your weight and height. It is used to find out your body fatness. A BMI of 25 or more means you re overweight. A BMI of 30 or more means you are obese. Carrying around extra weight can cause high cholesterol, heart disease (including stroke), diabetes, and other illnesses. Have your doctor determine your BMI. If it is 25 or more, become more active. Viva Medicare Plus will pay up to $20 a month toward the cost of membership at a contracted fitness facility. You can call Member Services for more information on this benefit.

Reducing Hospital Admissions Understanding important steps to take and why it is important to you. Nobody wants to be side-tracked by another hospital stay, especially if it is preventable. It is costly to both you (in copays) and Viva. Here are some ways to save money and prevent the unwanted cost of time away from those you love and what you love to do. Start with your Primary Care Physician (PCP) first if your condition is not a medical emergency. A number of conditions can be handled by your PCP. If your PCP s office is closed consider going to a participating urgent care facility like American Family Care or Pri Med. Save the ER for situations where you believe you have medical symptoms that require immediate medical attention to prevent loss of life, loss of a limb, or loss of a function of a limb. When you are discharged from the hospital, keep and understand your post discharge plan of care. This plan of care will be given to you before you leave the hospital. If you have questions, call your physician s office. Be sure to make a follow up appointment to see your physician within 7 days of discharge from a hospital stay. Your chances of going back into the hospital increase without this follow-up care. If you are given new medications or your medication dosages have been changed, know the reasons why you should take your medications and what conditions they are used to treat: 1. If you are given new medications or your medication dosages have been changed, know the name 2. Why you take it 3. How much should you take 4. How often should you take it Below is an example of how you can track this information: Medicine Name & Amount (DOSAGE) Why do i take this? How much do I take? How do i take this medication?

Extra Value Members One Member s Story Inside:» RX Tips»» Filling out your Health Risk Assessment» Maintenance Drug Home Delivery *Person shown here is a model. Names have been changed to protect the identity and health information of the member. Meet Ms. Jane Engel, a Viva Medicare Plus member. After being admitted to the hospital last June, Ms. Engel found out she had diabetes. She began working with Beverly Sasser, a Viva Medicare Plus nurse, after her discharge. Beverly created a care plan just for Ms. Engel. She talked to Ms. Engel about what she needed to do to control her diabetes, like changing her diet and exercise habits. She was open to making changes. My mom died with diabetes. My dad died with diabetes. My sister died with diabetes. So I need to stay on top of it, Ms. Engel said. She has given up soft drinks and white potatoes. Ms. Engel is eating more vegetables and watching the amount of food she puts on her plate. She also walks when the weather is warm enough. Ms. Engel s hard work is paying off. When she was first diagnosed with diabetes, Ms. Engel s A1C levels were very high. (The A1C test tells if your diabetes is out of control.) Ms. Engel took the A1C test again this January. Her A1C levels had been cut almost in half. I m so proud of all the work Ms. Engel has put into controlling her diabetes, Beverly said. Extra Value (HMO SNP) H0154_mcdoc1220A CMS Accepted 02/27/2013

Have Your Maintenance Drugs Delivered to your Home If you have a chronic condition, like diabetes or high blood pressure, it is important that you take your medicine. You should take your medicine just like your doctor tells you. One way to make sure you get your medication filled on time is to set up prescription drug mail order. This convenient service will deliver your maintenance drugs to your doorstep. There is no extra cost to you. Why set up mail order for your maintenance prescription drugs? To save time and money. With mail order, you will no longer need to go to the drugstore to fill your maintenance drug prescription(s); they will be delivered to you. And as someone with extra help, you will get your 3-month supply for the price of one month. For more information on prescription drug mail order, please call Member Services at 1-800-633-1542, Monday Friday from 8 a.m. to 8 p.m. (From October 1 to February 14, we are here 7 days a week from 8 a.m. to 8 p.m.) TTY users, please call the Alabama Relay Service at 711. Your Viva Medicare Plus Rx Extra Value (HMO SNP) Plan Offers Free Transportation If you need transportation to and from your doctor s office or the pharmacy, please call 1-888-318-6362 to reserve your ride with Express Medical Transporters (EMT), our transportation provider. They are available Monday through Friday, 8am to 6pm and Saturday 10am-4pm. TTY users should call the Alabama Relay Service at 711. You are covered for 10 round-trip or 20 one-way rides per year. You can use these rides to go to network doctors to receive non emergency medical care. Want to learn more about this benefit? Please see your plan s Evidence of Coverage.

SNP Members NEWS Every year you will be asked to fill out a Health Risk Assessment (HRA). The three-page form asks a number of questions about your health and lifestyle. The purpose of the Health Risk Assessment is to identify: chronic diseases; injury risks and other risk factors; and any urgent healthcare needs you may have. It s important that you complete and return the form. A Viva Medicare Plus nurse reviews each answer and prepares a care plan that is designed just for you. There is no cost to you for a care plan. Watch your mailbox for the 2013 Health Risk Assessment. Please fill out each page and return in the postagepaid envelope as soon as possible. Please call Member Services if you have any questions about the HRA. Do you have diabetes? What s A1C and why is it important to lower your A1C levels? A1C is a test to measure how well your body controls the amount of sugar in your blood. It is measured over a span of 2 to 3 months. When you lower your A1C levels, even by one point, you greatly reduce your risk of having these diabetes complications: Eye disease Nerve disease Kidney disease Heart attack and stroke Extra Value (HMO SNP)

Prescription Drug Tips The plan you are on covers prescription drugs. These benefits cover both acute and maintenance prescriptions. Acute Medications Acute or short-term medications, like antibiotics, are to be used for a short period of time. A prescription for a short-term medication is written to treat a specific illness or condition. Maintenance Medications Maintenance or long-term prescription drugs are meant to help control chronic conditions, like diabetes and high blood pressure. Did you know you can get three months of many maintenance prescription drugs for the price of only one month? Because you receive extra help with your prescription drug costs (sometimes called the low-income subsidy, or LIS), you pay the same copay, whether you get a one-month or three-month supply. To get 3 months for the price of 1 month 1. Ask your doctor to write a prescription for 90 days for each maintenance drug you use. 2. Tell your pharmacist you want a 90-day supply. 3. Show your Viva Medicare Plus card at the pharmacy each time you visit. Save money and time by following the 3 simple steps above. Feel free to take this article to your next doctor s appointment as a reminder. FOR

FITNESS BENEFITS FOR RESIDENTS OF MOBILE & BALDWIN COUNTIES Throughout this newsletter you have seen information about the importance of improving your health. The best way to do this is simply by being active. Here is a list of fitness facilities in your area that will bill Viva Medicare Plus $20 for every month you are a member with them. You then simply pay any amount over the $20. FACILITY NAME ADDRESS PHONE Snap Fitness 201 Chamber Drive; Bay Minette, AL 36507 251-580-0810 Planet Fitness 308 University Blvd; Mobile, AL 36609 251-414-2700 Anytime Fitness 171 E I-65 South Service Rd; Suite D; Mobile, AL 36606 251-479-0999 Planet Fitness 5363 Hwy 90, Suite B; Mobile, AL 36619 251-660-1700 Planet Fitness 900 Schillinger Rd,; Mobile, AL 36695 251-776-5600 Phoenix Fitness 3055 Dauphin St.; Mobile, AL 36606 251-476-4653 Anytime Fitness - Mobile 3456 Hillcrest Rd.; Mobile, AL 36695 251-662-1320 Rac Health & Fitness 18601 Silverhill; Robertsdale, AL 36567 251-947-7565 Snap Fitness 25 Shelton Beach Rd.; Saraland, AL 36571 251-679-5554 Snap Fitness 6450 Hwy 90; Spanish Fort, AL 36527 251-626-0320 H0154_mcdoc1220A CMS Accepted 02/27/2013

In addition to these facilities, there are also several facilities we have approved for our members to go to that are not directly contracted by the plan. These are: Springhill Hospital Rehab Facility»»» Providence Hospital Rehab Facility» Mobile Infirmary System (including Mobile Infirmary, North Baldwin Infirmary, and Thomas Hospital) rehab facilities. These facilities will not bill Viva Medicare Plus directly so you will have to pay your membership fee up front and then submit your receipts to Viva for reimbursement. Please be sure that the facility name is located on the receipt. When you submit the reimbursement form make sure to tell us your name, your Viva Medicare Plus member number (on your ID card), and what month or months you are requesting reimbursement for. You cannot request reimbursement for future months. To be reimbursed, follow these steps: 1. Call Viva Medicare Plus Member Services Department at 1-800-633-1542 Monday through Friday, 8 a.m. 8 p.m. (From Oct 1 Feb 14, seven days a week, 8 a.m. 8 p.m.). TTY users call 1-800-548-2546. 2. Request that a fitness facility reimbursement form and a business reply envelope be mailed to you. 3. Send the reimbursement form, along with your fitness facility receipt, back to Viva Medicare Plus in the business reply envelope. 4. Be sure to send your reimbursement form within one year of your date of service. Once approved, we will send a check to you. Questions? Please call Member Services at the phone number listed on back.

NOW AVAILABLE In-Person Consultations with Member Services Now Available in Birmingham In order to better serve our Viva Medicare Plus members in the Birmingham area, we now have a Member Service Representative at the Hoover Viva Medicare Café location. This means that if you prefer to speak with a representative in person, rather than over the phone, now you can. The representative can assist you with things like your changing your PCP, talking about claims or a bill, and better understanding your benefits. You don t need an appointment to visit with a representative, just swing by the Viva Medicare Café at 1550-K Montgomery Highway in Hoover in Hoover Monday - Friday, 9 a.m. - 5 p.m. However, if you prefer to schedule your in-person consultation in advance, simply call (205) 978-4911. Over the past four months alone our representatives have assisted over 300 members all in person with the attention and care you deserve. It s just one more way Viva Medicare Plus is helping you to enjoy life without worry! Questions? Call Viva Medicare Plus Member Services at 1-800-633-1542; TTY users call the Alabama Relay Service at 711. 8 AM-8 PM Monday-Friday. Visit our website at www.vivamedicaremember.com

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. 3 7 4 9 7 1 3 5 3 8 4 6 2 4 1 6 5 3 1 5 3 6 9 7 1 9 8 2 3 1 A We want to thank you for your membership in Viva Medicare Plus. We work hard to provide you with great benefits at an affordable price. We hope you have been able to take advantage of valuable services such as the free preventive screenings. Would you recommend Viva Medicare Plus to a Medicare eligible friend or family member? If so, please have him/her complete and mail the attached card. Mail this free postage-paid card to find out more. Yes! Tell me more about 3 2 4 9 7 6 4 5 4 3 8 2 7 2 9 4 9 3 5 2 1 6 8 5 7 1 5 3 8 6 1 8 5 4 9 1 B (Please print, and fill out before mailing) Name (please print) Address City, State, Zip Phone E-mail Address A salesperson may call. H0154_mcdoc1220A CMS Accepted 02/27/2013

1222 14th Avenue South Birmingham, AL 35205 PRSRT STD US POSTAGE PAID BIRMINGHAM, AL PERMIT NO. 2061 Viva Health is a Medicare Advantage organization with a Medicare contract and a contract with the Alabama Medicaid program. H0154_mcdoc1220A CMS Accepted 02/27/2013 VIVA MEDICARE PLUS 1222 14TH AVE S BIRMINGHAM AL 35282-8170 POSTAGE WILL BE PAID BY ADDRESSEE BUSINESS REPLY MAIL FIRST-CLASS MAIL PERMIT NO. 309 BIRMINGHAM, AL SHOP Toll-Free: 1-800-633-1542 TTY users: Alabama Relay Service at 711 Hours: Mon - Fri, 8am - 8pm From Oct 1 - Feb 14, Mon - Sun, 8am - 8pm Visit us online at www.vivamedicaremember.com Go to a Viva Medicare Café: Birmingham Café: 205-978-4911 Mobile Café: 251-380-2222 Montgomery Café: 334-272-8882 NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES