CONNECTIONS CARE. Questions About Your Benefits? We ve Got Answers! MEDICARE 2016 ISSUE II. Refer a Friend

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1 MEDICARE 2016 ISSUE II CARE CONNECTIONS Questions About Your Benefits? We ve Got Answers! When it comes to changes in your health care, Easy Choice is here to help you make sense of it all. A big part of Easy Choice s promise to you is that we ll help you understand your coverage so you can get the most out of your benefits. If you have questions about your benefits, know that you can count on us for answers. In September, you will receive a booklet called the Annual Notice of Changes (ANOC) that will explain how your plan is changing for Along with your ANOC, you ll also receive your Evidence of Coverage (EOC) which provides details on how to use your benefits in the coming year. It explains how to get health care services and prescription drugs if your plan offers part D coverage. Your ANOC and EOC packet includes: Details about your benefits and the cost of your plan, such as how much you can expect to pay at the doctor s office and the pharmacy. Details about extra benefits, such as dental, vision and hearing, if your plan covers these services. So be on the lookout for your packet. And while these documents contain a lot of information, we re here to help you sort through it all. If you have questions or comments, please call us at the number on the back of your member ID card. And remember, if you have Part D, see our list of covered drugs (formulary) to determine which tier your medication is on for If your medication is moving to a higher tier or will not be covered in 2017, talk to your doctor about lower-cost options. Refer a Friend If we ve helped you, then you may know other Medicare-eligible people who could benefit from our services. If so, ask them to give us a call at (TTY ) Monday-Sunday, 8 a.m. to 8 p.m. to discuss what they need in a health plan. H5087_CA034700_WCM_NEW_ENG CMS Accepted WellCare 2016 CA_06_16

2 Mind Your Medications If you re having trouble remembering to take your medications, you re not alone. Keep in mind that your medications are meant to help you be healthier and manage your condition. Here are some tips for taking medications consistently: Use a weekly pillbox. If you take multiple medications daily, get a pillbox with separate sections for the time of day that you need to take your medications. Take your medicine at the same time each day. Pair it with a routine task, such as brushing your teeth. Set a reminder alarm. You could use an reminder, cellphone calendar reminder, or an alarm on your watch or smartphone. Or try using a smartphone app that will alert you to take your medications. Ask your pharmacist about timer caps, which are special caps on pill bottles that remind you when it s time to take your dose. Order a 90-day supply of your medications, if possible, so that you always have them on hand. If you re traveling, pack enough medication to last your entire trip, plus some extra. Keep your pills in your carry-on bag in case your checked baggage gets lost. Source: How Do I Manage My Medicines? American Heart Association. groups/heart-public/@wcm/@hcm/documents/ downloadable/ucm_ pdf. CommUnity Assistance Line CAL NUMBER VIDEO RELAY We offer non-benefit resources such as help with food, rent and utilities. 2 Care Connections

3 Stay on the Path to Mental Health Sometimes you need a hospital stay to fix a health problem. This is true for physical problems. It s also true for behavioral health problems. But what happens after you go home? You need to keep getting better. Or else a behavioral health issue, such as depression or anxiety, may start to get worse again. Take a Step Toward Lasting Recovery What should you do after leaving the hospital? One of the first things is to meet with your health care team. Make an appointment with your doctor. Work with your primary care physician or a psychiatrist. They ll help you keep taking your medication and manage any side effects. This helps you feel better now. It may also reduce your risk of having another behavioral health crisis in the future. Schedule a visit with your therapist. Therapy may help you readjust to life at home and stay on the road to recovery. Try to schedule your first visit within a week after getting home from the hospital. Keep Moving in the Right Direction In your first weeks back home, give yourself time to heal. Ease back slowly into your activities. Follow a routine for eating and sleeping, like you did in the hospital. And if any problems come up, call your health care team. How Case Management Can Help You Case Management helps members with special needs. It pairs a member with a case manager. The case manager is a nurse who can help members with issues such as: Complex medical needs Solid organ and tissue transplants Chronic illnesses such as asthma, diabetes, hypertension and heart disease Children with special health care needs Lead poisoning We re here to help you! Contact us for more information on our program. An Easy Choice staff member will tell you about the program. This no-cost program gives access to a registered nurse (RN) Monday through Friday from 8 a.m. to 5 p.m. Care Connections 3

4 We Want You to Get the Best Quality Care Quality is our most important goal. It is important that you receive the care that you need, the best care, and accurate information. Our Quality Program works to ensure that you are receiving the care you need to optimize your health. For 2015, Easy Choice did many things to improve the quality of your health care, including: Completed assessments on all members who are part of the Easy Choice D-SNP population. Completed individualized care plans for all D-SNP members. Worked with your providers and health plan case manager in inter-disciplinary teams to ensure that quality care was provided. Encouraged you to get your well visits for such things as mammograms, eye exams for people with diabetes, immunizations, and more. Reviewed quality outcome data for the Medicare and the Medicare D-SNP population for chronic illness such as diabetes, congestive heart failure, chronic obstructive pulmonary disease, and mental health diagnoses to ensure providers were providing high quality care. Responded to reported quality of care concerns. Ensured that your language, cultural, and ethnic needs were met. Ensured that you could reach your doctors by phone, get timely appointments, and find a doctor near your home. Ensured your calls to Easy Choice were answered quickly. Ensured claims were paid timely and accurately. In 2016, Easy Choice will continue to: Review and measure the quality of care and services that you receive. Work with you and your doctor(s) to help meet your health care needs. Work with you and your doctor(s) to organize and coordinate your health care so that, together, we can improve the quality of service. Monitor your satisfaction to ensure that you are pleased with Easy Choice and your doctors. To receive a copy of our Quality Improvement Annual Evaluation and/or the D-SNP Model of Care Evaluation, please call Customer Service at the phone number on the back of your member ID card. 4 Care Connections

5 Ask for feedback from your doctor(s) and use it to improve our services. Review and update our guidelines in order to maintain a safe and healthy environment for your care. Complete assessments for all members who are part of the Easy Choice D-SNP population. Implement individualized care plans for all D-SNP members. Review quality outcome data for chronic illnesses to ensure that the plan and providers are providing high quality care. When Your Care is in Transition Getting the care you need is very important to us. That s why we ll work with you to make sure you get your care when: You re leaving another health plan and just starting with us One of your providers leaves our network You leave our health plan to go to another one We want to be sure you continue to see your doctors and get your medications. Please call or have your provider call. We can be reached at the Customer Service number on the back of your member ID Card. Care Connections 5

6 Should You Get a Bone Density Screening? Osteoporosis, or low bone density, causes more than two million fractures every year. Normally, there aren t any warning signs, which is why an osteoporosis screening a painless test similar to an X-ray is so important. Many people aren t getting the osteoporosis screenings they need, though, according to a recent study. And others are having screenings they may not need. Many Fall Short The study involved more than 50,000 women ages 40 to 85 that had not been screened for osteoporosis. The researchers followed the women for four years, on average. The results: About 40% of women ages 60 to 65 who were at high risk for osteoporosis were not screened. But more than 45% of younger women were screened even though they didn t have any risk factors. The study was published in the Journal of General Internal Medicine. Who Needs Screening? The government recommends that all women ages 65 and older be screened for osteoporosis. Younger women at an increased risk for osteoporosis should also undergo screening. Risk factors for osteoporosis include: A family history of osteoporosis or fractures A previous high-risk bone fracture Alcohol abuse Glucocorticoid (steroid) use Low body weight, relative to height Rheumatoid arthritis Smoking Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases. Bone Mass Measurement: What the Numbers Mean. 6 Care Connections

7 A Symptom Checklist for Ovarian Cancer Ovarian cancer is the deadliest cancer of the female reproductive system. That s partly because more than 70 percent of women are not diagnosed until the cancer has spread. The good news: nearly all the cases that are caught early can be cured. Research has shown that women with ovarian cancer most frequently experienced the following symptoms more than 12 times monthly, but for less than one year prior to being diagnosed: Pain in the pelvis or abdomen A need or urge to urinate often Swollen stomach Feeling full quickly and finding it hard to eat Tell your doctor if you experience any of these symptoms. The presence and frequency of these symptoms may help detect ovarian cancer early. Ovarian cancer is also detected through various tests, including a pelvic exam, which is covered once every 24 months at no charge to you. Read your Evidence of Coverage (EOC) or call Customer Service at the number on the back of your member ID card to get the details you need to schedule your exam. Sources: American Cancer Society. Signs and Symptoms of Ovarian Cancer. cancer/ovariancancer/detailedguide/ovariancancer-signs-and-symptoms National Cancer Institute. A Snapshot of Ovarian Cancer. snapshots/ovarian Our Disease Management Program Can Help You Easy Choice s Disease Management program gives support to members with health problems that may include, but are not limited to, the following: Asthma Diabetes Hypertension Heart disease If you have any of the above conditions and are interested in this program, please call us to learn more at , 8 a.m. to 5 p.m. Eastern. Members in this program get educational materials. In some cases, they get coaching from a registered nurse. Care Connections 7

8 P.O. Box 6025 Cypress, CA PRSRT STD U.S. POSTAGE PAID WELLCARE HEALTH PLANS This is an advertisement. Easy Choice Health Plan (HMO), a WellCare company, is a Medicare Advantage organization with a Medicare contract. Enrollment in Easy Choice (HMO) depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments and restrictions may apply. Benefits, premiums and/or co-payments/coinsurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Easy Choice uses a formulary. Please contact Easy Choice for details This information is available for free in other languages. Please call our Customer Service number at , Monday Friday, 8 a.m. to 8 p.m. Between October 1 and February 14, representatives are available Monday Sunday, 8 a.m. to 8 p.m. TTY users should call Esta información está disponible gratis en otros idiomas. Por favor llame a nuestro número de Servicio al Cliente al , de lunes a viernes, de 8 a.m. a 8 p.m. Entre el 1 de octubre y el 14 de febrero, los representantes están disponibles de lunes a domingo de 8 a.m. a 8 p.m. Los usuarios de TTY deben llamar al MD