WINTER 2014 New Year? New You! Make a resolution for better health - Low-cost fitness - Travel, worry-free - Prescription coverage changes one TO one NEWSLETTER FOR MEDICARE ADVANTAGE MEMBERS Y0010_MK14120 Accepted 11052013
one to one Are you ready for the new year? In the midst of winter, the new year symbolizes the chance for a fresh start. It s a great time to set goals to be happier and healthier in the coming year. Whether you want to exercise more or get smarter about prevention, Blue Cross of Idaho is here for you. Whatever coverage plan you have, your benefi ts can help you with your goals. Plus, healthy steps like counseling for weight loss are covered with no copay, as are many preventive exams, including depression screenings. An ounce of prevention is worth a pound of cure. And, with new lower offi ce visit copays, it s easier than ever to see your doctor. Get ready for the new year. Schedule an appointment to talk to your doctor about your wellness goals, and visit bcidaho.com/medicare to learn more about benefi ts that can help you succeed. Wherever the new year may lead you, we ll be right by your side. Blue Cross of Idaho is a health plan with a Medicare contract. Enrollment depends on contract renewal. The benefi t information provided is a brief summary, not a complete description of benefi ts. For more information contact the plan. You must continue to pay your Medicare Part B premium. Limitations, copayments and restrictions may apply. Benefi ts, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. thinkstock 2 bcidaho.com/medicare
prescription COVErage changes deliver simplicity and savings Simpler pharmacy network Starting in 2014, you will no longer need to worry about whether a pharmacy you re using is preferred or not to get the best price. You ll pay the same copay amount at any participating pharmacy. Cost savings on generics In another change, our members with drug coverage will have two copays for generic drugs during the Medicare Part D Initial Coverage Stage. You ll pay $4 for preferred generics and $7 for non-preferred generics. In 2013, members paid $6 for all generics during the Initial Coverage Stage. Preferred generics are the Tier 1 drugs shown in the 2014 Drug List sent with your Annual Notice of Changes. You can view the most current drug list online at www.bcidaho.com/medicare or call Customer Service for another copy. Mail order prescriptions You may know that our mail order prescriptions have an automatic refill option. If you used this option in the past you automatically got a refill when our records indicated that you were about to run out. Starting in January this year, to prevent waste and unnecessary expense, we need your permission before automatically sending refills. Let us know the best way to reach you by contacting CVS Caremark Mail Order Customer Care at 1-855-479-3661 to update your automatic refill preferences or give Customer Service a call if you have questions. A transition for drug list changes If a medication you take is not on our drug list, you can get one transition fill while you work with your provider to find an alternative. If the alternative drug doesn t meet your needs you can ask for an exception. Your provider will need to complete the exception form found on our website, or they can call Customer Service for help at 1-888-494-2583. TTY users can call 1-800-377-1363. 3 bcidaho.com/medicare
Silver&fit it s never too late to feel great! Could you use a little boost to be more active? Our Silver&Fit Exercise Program could be just what you re looking for. With two choices, you can fi nd a fi tness solution that s right for you. Get a gym membership for only $50 per year! Or, get home exercise kits for $10 per year if you don t live near a facility or prefer to work out at home. gym membership features: - You choose from a variety of participating facilities, full, basic, gender-specific or exercise centers. - Facility memberships may include exercise classes, strength-training equipment, saunas and whirlpools.* - Group fi tness classes are offered exclusively for older adults at full fi tness facilities. home exercise kit features: - Two to three kits annually, depending on your plan coverage. - Your choice of kits like Walking, Pilates, Yoga, Stress Management, Dance, Chair Boxing and more! - Kits usually include a DVD, booklet and a Quick Start guide. all Silver&fit participants get: - Access to healthy-aging learning materials, available online or by mail. - Access to a member-exclusive website at www.silverandfit.com - The Silver Slate newsletter - A toll-free hotline to call if you have questions about the program. ready to get Started? Visit www.silverandfit.com to register, or call Silver&Fit tollfree at 1-877-427-4788 (TTY 4 bcidaho.com/medicare
1-877-710-2746), Monday through Friday, 6 a.m. to 7 p.m. Mountain time. You can also call us at 1-888-494-2583 (TTY 1-800-377-1363), 8 a.m. to 8 p.m., seven days a week. *Services at the fitness facility that call for an added fee are not part of the Silver&Fit program. The Silver&Fit program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). All programs and services are not available in all areas. Silver&Fit, the Silver&Fit logo, and The Silver Slate are federally registered trademarks of ASH. medication update the brand-name drugs below have recently been released in a generic form. generics are a safe and effective way to lower the cost of your medications. For a complete listing of medications on our drug list, visit bcidaho.com/ma-formulary. brand name generic name MeDication Use metrogel 1% Metronidazole rosacea trilipix dr caps Fenofibric acid high cholesterol and high triglyceride levels Soriatane caps acitretin severe psoriasis prandin 0.5 mg tab repaglinide type 2 diabetes 5 bcidaho.com/medicare
True Blue Connected Care hmo-pos Provider Network If you ve switched to our new True Blue Connected Care HMO-POS plan, remember the plan has a select network of providers from the Saint Alphonsus Health Alliance network and their affiliated physicians. Members on this plan should choose a primary care provider from the True Blue Connected Care HMO-POS network. In most cases, your other services such as specialists or hospital care will come from this same network. Your primary care provider will coordinate your care, refer you to specialists and handle your prior authorizations. True Blue Connected Care HMO-POS members will get a special provider directory listing for this plan. Give Customer Service a call for another copy or if you have questions. 6 bcidaho.com/medicare
going Somewhere? when you leave home, you have coverage options that travel with you. Secure blue ppo visitor/travel network Sharing program When you travel with Secure Blue PPO, you can see Medicare Advantage PPO providers in 32 U.S. states and Puerto Rico and pay what you would for covered benefits from in-network providers in Idaho. You have access to more than 380,000 providers in select states and/or counties with Blue Cross and Blue Shield Medicare Advantage PPO plans. Call us for help finding participating providers where you plan to visit. true blue hmo travel benefit Anywhere you travel in the U.S., your True Blue HMO travel benefi t provides coverage for all plan benefi ts at regular in-network cost-sharing amounts up to $3,000 per year. The benefi t applies to the services you receive outside Idaho, within the U.S. You may need approval for some hospitals stays and/or medical procedures. Give us a call to fi nd out which services apply and how to get approval. But it s good to know that urgent or emergency care services don t count toward your annual $3,000 coverage. PREMIUM payment options there are multiple ways to pay your premiums choose the one that s right for you! automatic deductions from your bank account: Choose this option when you enroll, call customer service or use the form on the back of your monthly statement. traditional monthly billing Statement: Each month we mail you a statement with a payment coupon. pay directly from your Social Security check: This option starts when Social Security approves your request, which can take up to two months. You pay your premiums directly to Blue Cross of Idaho until your start date. other payment options: Ask your bank about online bill-paying services they offer or pay in person at our offi ce, 3000 E. Pine Ave, Meridian, ID from 8 a.m. to 5 p.m., Monday through Friday. We accept personal and cashier s checks, money orders and cash. Sorry, we cannot accept credit card payments or online payments. 7 bcidaho.com/medicare
24/7 nurse advice line Call a nurse anytime, day or night! You can talk to a registered nurse anytime, day or night, to help you make informed decisions about your family s health. Call the 24/7 Nurse Advice Line when you: - Wonder whether you need to see your doctor - Need information about medications, medical tests or procedures - Want to learn how to take care of a new or chronic condition - Want to talk more effectively with your healthcare provider - Have questions about your symptoms Of course, the 24/7 Nurse Advice Line is no substitute for medical attention. If you have an emergency medical condition, call 911. But if you want reliable health guidance, try the 24/7 Nurse Advice Line. Just call 1-800-704-0727 anytime, day or night! 3000 E. Pine Ave. Meridian, ID 83642 PRSRT STD U.S. POSTAGE PAID One to One IS Published by McMurry/TMG, LLC. 2013. 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/TMG, LLC makes no endorsements or warranties regarding any of the products and services included in this publication or its articles. cover: larry mckee/media bakery