Enjoy Life! Protect yourself from the FLU 8 Simple Steps to Remember YOUR MEDICATIONS Viva Medicare IS COMMITTED TO TRACKING QUALITY HEALTH CARE FOR OUR VETERAN MEMBERS. See back cover for details! Fall 2014 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. H0154_mcdoc1429A CMS Accepted 11/16/2014
Help Us Keep Viva Medicare Healthy Establishing and maintaining a great relationship with your primary care physician (PCP) and getting your preventive screenings is the best way for you to stay healthy and enjoy life. You may not know that there is an extra benefit to making these healthy decisions: You help keep Viva Medicare healthy! Viva Medicare is rated by the Centers for Medicare & Medicaid Services (CMS) every year using a five-star quality rating system. With our members help, Viva Medicare has maintained a 3.5 Star rating for the 2015 rating period. Although a 3.5 Star rating is good, Viva Medicare needs to achieve a 4 Star rating in order to provide you with even more of the health benefits you have come to love as a member of Viva Medicare. We will get to 4 Stars, but only with your help. The CMS Star ratings measure how well we help you get the most out of your Viva Medicare benefits. Ways You Can Help Viva Medicare Stay Healthy:»» Be sure to get your preventive screenings for breast and colon cancer. If a colonoscopy isn t an option for you, ask your doctor if a high-sensitivity fecal occult blood test (FOBT) once a year at home is the right test for you.»» Talk to your primary care physician about treatment for problems like depression, bladder control, weight, and pain.»» If you have diabetes, be sure to get your annual diabetic screenings, including an eye exam.»» Take your cholesterol, blood pressure, and diabetes medications as prescribed.»» Know your numbers. Be sure to get your body mass index (BMI), cholesterol, and blood pressure checked by your doctor.»» Get your flu shot! 2
Flu Season is Coming! Are You Ready? Influenza, commonly called the flu, is a respiratory virus that can lead to serious illness and hospitalization. Flu vaccines provide protection against the illness. Each year, the vaccine protects against the flu virus that research indicates will be most common during the upcoming year. This differs from year to year so it s very important to get vaccinated each year. Flu Symptoms Include: fever cough sore throat runny or stuffy nose body aches chills headache fatigue Less frequent symptoms: vomiting diarrhea Who should get the Flu Shot? The CDC recommends annual influenza vaccinations for everyone age 6 months or older. This means that EVERY Viva Medicare member should get the flu shot. It is especially important for you to get the flu shot if you spend any time during the fall and winter around: Pregnant women Older adults Young children People with chronic health conditions, such as asthma, diabetes, and heart disease Health care workers If you develop flu symptoms, call your doctor. Based on each person s individual needs, you may be asked to come see your doctor. Your doctor may advise you to go to an Emergency or Urgent care facility, or give you instructions for home care. 3
Working Together to Protect Your Personal Information Scams cost Medicare billions of dollars each year. These scams can also have a major impact on Medicare users. Scams can result in higher health care costs, identity theft, and personal loss. Here are a few ways you can help protect your personal information and avoid being a victim of fraud, waste, and abuse: Be aware of anyone calling you to ask for your social security number, Medicare number, Viva Medicare ID number, or banking information. Viva Medicare will not call and ask you for this information. Be aware of anyone coming to your door asking for money or for your personal information. Viva Medicare will not send anyone to your home without asking you first. If someone comes to your door claiming to be from Viva Medicare or Medicare, use extreme caution before allowing them in your home. Plans like Viva Medicare are not allowed to do door-to-door selling. If someone comes to your home asking you to purchase or enroll in another health insurance plan, be very cautious about inviting them into your home. Be cautious of anyone offering you free services or equipment that you do not need. Sometimes criminals will offer free equipment, but then pressure you to give banking or credit card information to pay postage for the equipment. Refuse medical supplies you or your doctor did not order. If you receive supplies you or your doctor did not order, return the supplies to the sender. If you receive a Viva Medicare Explanation of Benefits (EOB), review the EOB to be sure you received the items and/or services billed to Viva Medicare. Keep your Viva Medicare ID card and your Medicare card in a safe place at all times. Protect the card as you would cash or a credit card. Please know that Viva Medicare also takes protecting your personal information very seriously. We understand that your personal information is private and we only use your personal information as allowed by federal and state law. For information on how Viva Medicare uses and shares your personal information, please read the Notice of Health Information Practices (also referred to as a Privacy Notice ) located in your Viva Medicare Evidence of Coverage and available on our website at http://vivahealth.com/privacy/default.aspx. You can also call our Member Services Department. Call 1-800-633-1542, Monday-Friday from 8am to 8pm (from Oct. 1 - Feb. 14: 8am to 8pm, 7 days a week). TTY users should call 711 for a copy of the notice. For more information on preventing fraud, waste, and abuse, please visit the CMS Outreach and Education MEDIC website http://medic-outreach.rainmakerssolutions.com. 4
Getting Screened: Know Your Options More than 90 percent of colorectal cancer diagnoses occur with people age 50 years and older. The American Cancer Society suggests all men and women begin regular screenings for colorectal cancer at age 50. Those with a family history of colorectal cancer, polyps, or inflammatory bowel disease (among other risk factors) should speak with their doctor about undergoing screenings earlier or more often. The US Department of Health claims that if all men and women age 50 and older were screened regularly, six out of ten deaths from colorectal cancer could be prevented. There are often no signs or symptoms for colorectal cancer until it has reached a relatively advanced stage. Early detection greatly improves the chances of a cure. Don t avoid or delay getting screened. Please contact your doctor today! Screening Options There are three expert-approved screening options available: 1. Colonoscopy every 10 years - A procedure that typically requires a trip to a hospital or clinic. Usually involves general anesthesia. 2. Flexible sigmoidoscopy once every 2 to 5 years - Similar to a colonoscopy but involves a shorter tube and generally does not require sedation. 3. High-sensitivity fecal occult blood test (FOBT) once a year at home. Ask your doctor if this is the right test for you. 5
Protect Yourself from the Flu Getting a flu shot is the best way to keep from getting sick, but we also recommend you practice these steps to best protect yourself and others from becoming ill: Wash your hands often with soap and water, especially after you cough or sneeze. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue away immediately after use. Try not to touch your eyes, nose, or mouth. Germs often spread this way. Avoid close contact with people who are sick. If you do get sick, stay home away from others, except to get medical care. Eating healthy foods and getting plenty of exercise can help boost the body s immune system and increase your ability to fight infection. WHERE AND HOW CAN I GET MY FLU VACCINE? Flu vaccinations typically are available each year beginning in early October. For all Viva Medicare plan members except for Viva Medicare Select, just visit a participating pharmacy to get a standard (not high-dose) flu shot at no charge. Viva Medicare members have full coverage for flu shots at no cost at any participating flu vaccination location across the state of Alabama. You may also get your flu shot (including high-dose) at your PCP s office. Some specialists offer them as well. Please visit our Flu Shot Network resource online at VivaMedicareMember.com/ Wellness/ to search and locate a convenient location for you. 6
National Coverage Determinations The Centers for Medicare & Medicaid Services (CMS) can change the coverage rules that apply to an item or service under Medicare. Some changes may include what benefits and services are covered, what benefits and services are changing, and what Medicare will pay for an item or service. When this happens, CMS issues a National Coverage Determination, or NCD. Below is a listing of all NCDs so far for 2014: DATE POSTED COVERAGE DETERMINATION TOPIC 2/6/2014 Positron Emission Tomography (FDG) for Oncologic Conditions 2/6/2014 Cardiac Pacemakers: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers 2/6/2014 Cardiac Pacemakers 3/27/2014 Beta Amyloid Positron Tomography in Dementia and Neurodegenerative Disease 4/15/2014 Aprepitant for Chemotherapy-Induced Emesis 5/16/2014 Percutaneous Image-guided Lumbar Decompression (PILD) for Lumbar Spinal Stenosis (LSS) 7/21/2014 Cardiac Rehabilitation Programs for chronic heart failure 8/29/2014 Artificial Hearts and Related Devices 8/29/2014 Ventricular Assist Devices 9/2014 Screening for Hepatitis C Virus in Adults 10/2014 Intensive Cardiac Rehabilitation Program - Benson-Henry institute Cardiac Wellness Program 10/2014 Colorectal Cancer Screening Tests Further information on each of the above NCDs can be found at www.cms.gov/medicare-coverage-database/reports/national-coverage-annual-report.aspx 7
8 Simple Steps to Remember Your Medication Doctors prescribe medication as part of a treatment plan because they believe the medicine can help ease or manage a particular condition. However, medication non-adherence (not filling or taking a prescription according to the doctor s orders) in the U.S. is above 50%. Not taking your medication as prescribed can lead to prolonged illness, additional doctor visits, unnecessary hospital admissions, and untimely death. The most important step in taking your medicine is to simply remember. It is very common for people to forget to take their daily pills because it is not a set routine for them. People also think they have taken their medication when they have not. There may not be an immediate side effect, but skipping doses could cause problems down the road. Taking your prescribed medicine is extremely important for your health. We have listed 8 simple ways to help you remember your medication: Use a pillbox Put your medicine in a weekly pillbox to help sort your daily medicine. Make sure the pillbox has a section for each day. Make it a priority Make a mental note that you have taken your medicine. Use your smart phone, ipad, or other electronic device to set reminders or alerts to let you know when it s time to take your medicine. Get Family/Friends to help It may be easier if you have another person help you remember to take your medicine. Ask for help if it will make you feel better. Combine with a daily task An easy way to remember your medication is by adding it to your normal routine. Take your medicine first thing in the morning, with your cup of coffee, or with a meal. Keep it visible Keep your medicine in a location you will see every day. Create a routine Take your pills at the same time every day to help remind you. Get 90-day fills- Ask your doctor to write your prescriptions for 90 days at a time so you always have your medicine. These steps will help you remember to take your medicine. Another important thing to remember is to always have your medicine on hand. If you are traveling, don t forget to bring your medicine with you. Also, take note of when your medicine runs out. If your bottle is about to be empty, go ahead and call the pharmacy for a refill. If you are out of refills, the pharmacy can help you contact your doctor to get more refills or a new prescription. 8
Member Website Improvements Coming Soon At Viva Medicare we re all about making Medicare easy. We are constantly working to improve our website. We would like it to become a one-stop-shop for our members to get information about their benefits and plan. Our website now includes ways to access wellness resources and create opportunities to connect and engage with other members in the community. Just some of the new features we are working on or have already released include: An opportunity to start receiving many of your member communications, including newsletters and your annual benefit changes, delivered to your email An all-new wellness directory with resources on everything from managing financial stress to maintaining a healthy lifestyle. This can be found at www.vivahealth.com/wellness More member events at our Viva Medicare Cafés, such as movie matinees and financial seminars, and a way to view and print the event calendar for your nearest Viva Medicare Café at www.vivamedicarecafes.com Added the ability to locate and register for member meetings in your area from our website as well as share your member story Improving our online provider search to give you the most accurate and up-to-date information as possible to find plan providers nearest you A simpler, easier website to navigate at www.vivamedicaremember.com An increased social media presence so you can stay on top of the latest news on Medicare and issues that could impact you including even more information on our blog at MakingMedicareEasy.com All of these updates and more are headed your way soon. Make sure to like us on Facebook at Viva Medicare and follow us on twitter @MedicareEasy so you can be the first to know when these updates are available to you. 9
Diabetes Screening /Control Some diseases, like the flu, go away after a short amount of time. But diabetes is one health problem you ll need to manage your entire life. It may seem difficult or overwhelming at times, but there are simple things you can do every day to feel better, stay healthier, and keep one step ahead of diabetes-related problems. Make wise low-fat and low-salt food choices to help you feel good every day and keep your blood sugar levels under control. Aim for 30 to 60 minutes of physical activity a day. Even small amounts of physical activity help manage diabetes. Examples are things like brisk walking, housework, and gardening. Check your blood sugar every day and learn how to treat low blood sugar quickly. Each time you check, write the numbers in a record book to show your doctor later. Take all medications as directed, including insulin, if prescribed by your doctor. Check your feet each day for cuts, sores, blisters, swelling, or redness and report them to your doctor. Brush and floss your teeth every day. Don t smoke. With diabetes, it s important you see your doctor regularly. He or she will monitor your blood sugar, blood pressure, and cholesterol levels. Your doctor can assist with any changes you may need to feel better. There are many things you can do to help you live a long, healthy life and reduce your chance of developing problems related to diabetes. EXAM CHECKLIST FOR THOSE WITH DIABETES Cholesterol Screening have a doctor perform this blood test to measure your LDL, or bad, cholesterol at least once a year. Blood Pressure during a visit, make sure your physician measures your blood pressure. It takes less than a minute! Eye Exam be sure to get an eye exam at least once a year to check for damage caused by diabetes. Kidney Function Test ask your doctor to perform this simple test at least once a year that monitors kidney disease. HbA1c Blood Sugar Test a hemoglobin A1c test can tell you how well you ve managed your blood sugar during the last three months. It is smart to have an A1c test at least twice a year. Remember to take your diabetes medication regularly and refill any necessary prescriptions before they run out. Maintaining your medication is as important as any exam! HELPFUL QUESTIONS FOR DIABETES PATIENTS TO ASK THEIR DOCTOR: Am I checking my blood sugar enough? How are my levels? We suggest maintaining a record to share with your doctor. How much should I weigh? How are my blood pressure and cholesterol levels? 10 What is the right medication for me? Am I taking the right one(s)? Can you check my feet for any problems related to my diabetes? How can I stay more physically active? If you smoke, ask for help with quitting.
Level: hard Level: easy 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. Help us better serve you! VETERANS Are you a United States Veteran who receives care from a VA medical facility? If so, please fill out the card below or call Member Services and ask to speak to the Quality Improvement Department. It is our mission to continually improve the quality of care our Veteran members receive. We will work with the VA to be sure you get the care you need. NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES Questions? Call Viva Medicare Member Services at 1-800-633-1542; TTY users call the Alabama Relay Service at 711. 8 AM-8 PM Monday-Friday. (From Oct. 1 - Feb. 14: 8am to 8pm, 7 days a week). Visit our website at www.vivamedicaremember.com BUSINESS REPLY MAIL FIRST-CLASS MAIL PERMIT NO. 309 BIRMINGHAM AL POSTAGE WILL BE PAID BY ADDRESSEE VIVA MEDICARE 417 20TH STREET NORTH STE 1100 BIRMINGHAM AL 35282-8170
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. H0154_mcdoc1429A CMS Accepted 11/16/2014 Veterans, return this postage-paid card to help us track the quality of care you receive. I am a United States Veteran who receives care from a VA medical facility. (Please print, and fill out before mailing) Name (please print) Address Are you a United States Veteran who receives care from a VA medical facility? If so, please see the reverse page for information on how we can help improve the quality of health care you receive. 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 City, State, Zip Phone SHOP Stop by a Viva Medicare Café: Hoover Café: 205-978-4911 Grand River Café (Leeds): 205-699-3040 Princeton Cafe (Birmingham): 205-785-5559 Montgomery Café: 334-272-8882 Mobile Café: 251-380-2222