on the horizon take advantage of your benefi ts in prep for your next visit to the doctor - a checklist for care

Transcription

1 FALL 2011 on the horizon take advantage of your benefi ts in prep for your next visit to the doctor - a checklist for care one TO one NEWSLETTER FOR MEDICARE ADVANTAGE MEMBERS taking in the fall foliage Y0010_MK11411 Y0010_MK12145 File and Use

2 ONE TO ONE take a step toward a healthier you FOR MANY PEOPLE, THE IDEA OF GETTING HEALTHIER CAN FEEL OVERWHELMING. In truth, though, there are lots of ways to improve your wellness. All it takes is one step to get you started. Then, another step. And another. And all those little steps can add up to a big improvement overall. How about taking your fi rst steps in 2012? We ve compiled ideas to inspire you in this issue of One to One. Spend an afternoon creating your medical album. Read how on page 3. Or, kick off the new year by scheduling a medical checkup, where you can plan your preventive care schedule for Turn to page 5 for more tips to take to your next checkup. Staying informed about your coverage and healthcare costs is another step toward improved health. Be sure to review your 2012 Annual Notice of Changes, and see page 4 to learn about Medicare prescription coverage and how you may be able lower your medication costs. What step will you take today? For a complete list of ideas, turn to page MICHAEL A. KELLER/MEDIA BAKERY (COVER) 2

3 Make Your medical album A three-ring binder is a handy tool for staying on top of your health. Start by creating a summary sheet of key medical info, including your blood type, signifi cant medical conditions (such as diabetes or high blood pressure) and drug or food allergies. List the medications you take, including over-the-counter products like vitamins and aspirin. Next, assign sections of the binder for in-depth information about conditions and surgical procedures. If you have diabetes, for example, compile all of your lab tests and notes from your physician. Use one section of the binder to plan ahead. Insert pages from a calendar that show when you re due for checkups, follow-up tests, screenings and immunizations. Bring this binder with you to every doctor s appointment, and share it with your physician. It s Easy to Change Pharmacies. Looking for a new pharmacy or changing to a preferred pharmacy? Moving your prescriptions is easy. Just do one of the following: # take your prescription bottle to your new pharmacy; they will call your old pharmacy for you. # call your new pharmacy and ask them to call your old pharmacy. # ask your doctor to call your new pharmacy with your prescription information. now available in generic The brand-name drugs below were released in a generic form. For a complete list of medications on our formulary, visit bcidaho.com/ma_formulary. BRAND NAME GENERIC NAME MEDICATION USE nasacort triamcinolone Nasal Spray - Allergies levaquin levofl oxacin Infection entocort ec budesonide EC Crohn s Disease Uroxatral alfuzosin ER Prostate opana er oxymorphone ER Pain Blue Cross of Idaho s formulary may not apply to all healthcare plans. Please refer to your group s contract provisions for more detailed information about the terms and conditions of your prescription drug benefi t. 3

4 Medication Matters How to take charge of your prescriptions. Don t let your prescription coverage leave you bewildered or baffled. Feel confident and knowledgeable and maybe even a little richer with these three tips. - Understand your options. Coverage depends on a few factors: when you signed up for Part D prescription drug coverage and which Medicare Advantage plan you ve chosen. For more information about your prescription coverage, call us at or TTY Get familiar with the formulary. The formulary is a list of drugs believed to be necessary to a quality treatment program. Some drugs on the formulary require additional approvals, called prior authorizations. Other drugs may be limited in the quantity covered. Medications that aren t on the formulary may cost you more. We have more than 3,600 medications on our formulary. Visit and select Part D Prescription Drug Coverage to find out if a medication is on our formulary. - Learn how to save safely. Looking for ways to lower the cost of your prescriptions? You should not skip doses or cut pills in half. You also shouldn t share medication with others. What you can do is check that your medication is on the formulary. If it s not, talk with your doctor about your options. You ll also spend less in 2012 by choosing a preferred pharmacy. When you get your prescriptions at one of Blue Cross of Idaho s preferred pharmacies, you pay a lower copayment and get to the gap later. For a list of these pharmacies, see your 2012 Pharmacy Directory or give us a call. The Bottom Line The safest way to cut your medication spending in 2012 is to buy your prescriptions from one of Blue Cross of Idaho s many preferred pharmacies. Also, make sure the drugs you take are on our formulary. 4 bcidaho.com/medicare

5 Be Smart, Be Healthy Four steps to make the most of your health insurance in visit your doctor for an annual checkup. Quite a few medical problems don t show symptoms until they are very serious. Checking in with your doctor regularly can help you stay ahead of these conditions. Your doctor will check for warning signs like high blood pressure, elevated blood sugar and high cholesterol. Plus, annual exams are available at no cost to members which makes a checkup a smart fi nancial investment. Get your screenings and immunizations. These preventive health services are also covered for Blue Cross of Idaho Medicare Advantage members. Work with your doctor to set the best schedule for your cancer screenings and vaccinations. (By the way, if you haven t gotten your fl u vaccine yet, it s not too late!) have a medication review. The next time you see your doctor, bring along all of your medications and prescriptions including any vitamins and aspirin you take. Ask your doctor to review everything and look for possible interactions or overlaps. Confi rm whether any of your prescribed drugs are available in a generic format, which may save you money. take care of yourself. Manage your long-term medical conditions. Be sure to follow your doctor s instructions and take medication as prescribed. If you notice any changes in your symptoms, let your doctor know. what s your next step? Schedule a checkup with your doctor, where you can plan out your preventive care for the year ahead. five star satisfaction! We are proud to announce True Blue HMO recently received a fi ve star member satisfaction rating!* A heartfelt thank you to all of you for your part in this signifi cant achievement. So please continue providing feedback. Your input allows us to improve the services we provide. And don t forget to take advantage of your preventive benefi ts in 2012! *2012 Idaho Medicare and You Handbook 5

6 Put Your Heart First Do you know your risk factors? You probably know that high cholesterol levels increase your risk for heart disease and heart attacks. But what you may not know about are all the factors that contribute to your cholesterol numbers. Age and Gender: Because cholesterol tends to increase as people get older, everyone s risk for high cholesterol grows with age. Added to this, women and men generally have different cholesterol ranges. Women s LDL, or bad, cholesterol levels rise more quickly than men s as they age. Regardless of age, men tend to have lower HDL, or good, cholesterol levels than women. Lifestyle: Unhealthy habits can increase your chance of developing poor cholesterol numbers. Help your heart by quitting smoking, eating a diet rich in fruits, vegetables and fiber and staying active. Speak honestly with your doctor about your level of activity, your diet and your use of tobacco and alcohol. Discuss realistic goals for improving your lifestyle. And, once you start making changes, celebrate every stage of your progress. Genetics: Cholesterol problems may run in your family. If you inherited a genetic condition called hypercholesterolemia, a healthy diet and exercise might not be enough to improve your cholesterol levels. Talk to your doctor about medications that can help get your numbers under control. What s In a Number? A simple blood test is all it takes to check your cholesterol levels. Call and schedule a screening with your physician today. Discuss what your numbers mean and how you can improve them. Compare your results to these numbers, considered optimal by the American Heart Association: - Total cholesterol: Less than 200 mg/dl - HDL ( good ) cholesterol: 60 mg/dl and above - LDL ( bad ) cholesterol: Less than 100 mg/dl - Triglycerides: Less than 150 mg/dl 6 bcidaho.com/medicare

7 What s Your next step? Make 2012 the year of empowered, healthy action. Hang on to this page and refer to it for ways to make the most of your insurance, improve your overall health and manage your healthcare. plan pointers - REVIEW your 2012 Annual Notice of Changes. How do plan changes for 2012 impact you? - CHECK your 2012 Pharmacy Directory to see if the pharmacy you use is a preferred pharmacy. You could save money by using one of Blue Cross of Idaho s preferred pharmacies. - FIND your medications on the 2012 formulary. If they aren t there, talk with your doctor about drug tier changes and alternative options. - SCHEDULE your 2012 annual wellness appointment and your preventive screenings. (Use the list on this page to work out a schedule with your doctor.) - WATCH your mail in mid- December for your new member ID card. You can start using your new card on Jan. 1, CALL Customer Service with any questions you have. You can reach us at or TTY between 8 a.m. and 8 p.m., seven days a week. $0 copayment preventive screenings Talk with your doctor about which of the following screenings and immunizations are right for you. Then, fi ll in the dates you re due for each. SCREENINGS Annual Wellness Visit: Mammogram: Pap Test: Prostate Test: Bone Mass Measurement: VACCINES Hepatitis B: Flu: Pneumonia: Date Date 7

8 New Preventive Services Now available Medicare announces two new national coverage determinations in October Your no cost, preventive coverage now includes annual depression and alcohol misuse screening. Both screenings must be reasonable and necessary and provided in your primary care provider s office. A national coverage determination means that Medicare (and your plan) covers the services listed below when you receive them anywhere in the U.S. - Alcohol misuse screening and counseling Those who screen positive for alcohol misuse, but are not alcohol dependent, have access to four brief, face-to-face, behavioral counseling visits each year. - Adult depression screening This new coverage includes annual depression screening. Your primary care provider s office should offer depression care support to make sure a diagnosis is accurate, as well as staff to make sure treatment and follow-up are effective. Because other restrictions and limitations may apply, call Customer Service for additional information. You can reach us at or TTY between 8 a.m. and 8 p.m., seven days a week E. Pine Ave. Meridian, ID PRSRT STD U.S. POSTAGE PAID One to One Important plan information. IS Published by McMurry All rights reserved. No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement not take the place of the recommendations of your healthcare provider. Consult your physician before making major changes in your lifestyle or healthcare regimen. McMurry makes no endorsements or warranties regarding any of the products and services included in this publication or its articles.