Download Out of Your Plan Live Healthy and Be Rewarded For It a Healthy Heart

Volume 2 • 2013
With
Get the Most
Out of
Your Plan
Five Ways You Can
Live Healthy and Be
Rewarded For It
How to
Maintain
a Healthy
Heart
Y0067_MBR NEWS2013_V2_0413 IA 04/22/2013
Member tips, tools
and resources
to support a
healthy lifestyle
TOHMO-MBRNEWSv2 2013
Live Healthy
A Healthy
Collaboration
in action
Our Medicare
Advantage plans share
a promise called A
Healthy Collaboration .
These plans reflect the
commitment we share
with doctors and other
healthcare providers
to help you live healthy
and get the most out
of life. We encourage
our members to find
one trusted healthcare
professional to
coordinate their care,
just like the family
doctor of years past.
®
L
®
iving healthy. It’s what we all aspire to do: Maintain a
healthy diet, stay physically active and get necessary
preventive screenings. Today’s Options HMO wants to
make sure that you have the tools and resources to help you live
a better, healthier life.
In this issue, you will read about symptoms, treatments,
and ways to prevent common diseases such as colon cancer
and osteoporosis.
You will also learn more about free discount programs that
are offered to you as part of your health plan. We encourage you
to get the most out of your health plan by taking advantage of
these discount services.
Participating in the Live Healthy program is another way to
take advantage of services offered by your plan at no cost to you.
You play the biggest part in maintaining your health. Live Healthy
was designed to help you by giving you many opportunities to
participate in improving your health.
Our goal is to ensure that your healthcare needs are
met. If you have questions about your plan or want more
information about Live Healthy please call Member Services at
1-866-802-8571, 8:00 a.m. to 8:00 p.m. in your local time zone
(TTY users call 711) 7 days a week.
Please be sure to see your Primary Care Physician every year
to get important screenings, immunizations, and to discuss any
health concerns.
We hope you find this issue useful and take actions to get
more out of your health plan and more out of life.
®
Sincerely,
Erin Page
President, Medicare Advantage
2 | LIVE HEALTHY WITH TODAY’S OPTIONS HMO
®
In This Issue
Volume 2 • 2013
If you have questions or concerns, contact
Member Services
4
Get the Most Out of Your Plan
6
Today’s Options HMO
MemberLink
7
Five Ways You Can Live Healthy
and Be Rewarded For It!
8
All About Rheumatoid Arthritis
10
How Much do you Know
About Osteoporosis?
11
The Importance of
Mammograms
12
Colorectal Cancer Screenings
Can Save Lives
13
Prostate Cancer
14
Preventive Screenings Checklist
A tool to help you Live Healthy!
15
Save on Prescription Drugs
16
How to Maintain a Healthy Heart
18
Taking Your Medications
as Prescribed
19
CAHPS Survey-Let Your
Voice be Heard
1-866-802-8571, 8:00 a.m. to 8:00 p.m. in your
local time zone (TTY users call 711) 7 days a week.
Your opinion matters to us! If you want to submit
editorial suggestions or give us your feedback,
please contact the Today’s Options HMO
Marketing Department.
®
Editor - Keidra Lewis
[email protected]
Designer - Eric Figueroa
[email protected]
You may also write to us at:
Today’s Options HMO Marketing Department
4888 Loop Central Dr.
Houston, TX 77081
The articles in this publication should not be
considered specific medical advice, as each
individual circumstance is different. Should you
feel the need for medical advice, consult your
Primary Care Physician. Live Healthy provides health
information that supplements the advice of your
doctor. You should consult your doctor for specific
health concerns.
WWW.TODAYSOPTIONSHMO.COM | 3
Get the Most
Out of
Your Plan
As a Today’s Options HMO
member, you have access to
free services and discount
programs that can help you
live healthy while saving
time and money.
®
24/7 HEALTH HOTLINE
We’re here for you 24 hours a day/7 days
a week. With the 24/7 Health Hotline, you can
connect with a trained health professional
anytime to get the help you need.
VISION CARE
EyeMed Vision Care offers discounts on
eye care, with up to 40% off retail prices
on additional pairs of glasses (once benefit
has been exhausted), 20% off non-covered
items and up to 15% off on conventional
contact lenses. Members also save 20% on
non-prescription glasses. You can receive the
EyeMed Vision Care discount at more than
22,000 locations.
HEARING CARE
Save on hearing evaluations and exams
and enjoy a 30% savings on all hearing
aids through HearPO. You can call to
schedule an appointment at any of the 2,500
locations nationwide.
DENTAL SERVICES
Careington offers you a full menu of dental
services available at either a low set fee or a
20% discount.
SERVICES TO KEEP YOU FIT
Careington also provides you with discounts of
10% to 50% at more than 5,000 participating
gyms, exercise facilities, and fitness centers
across the nation. Privileges include all
amenities, programs and services, including
any exercise or recreation program or class.
If you do not want to receive further information
about Today’s Options HMO value-added services,
please call Member Services at 1-866-802-8571,
8:00 a.m. to 8:00 p.m. in your local time zone
(TTY users call 711) 7 days a week.
Simply present your
Today’s Options
member ID card to
enjoy these savings
at participating
locations!
Call Member Services
to learn more about
these services.
Free with no
obligation. v
Today’s Options HMO
®
MemberLink
T
oday’s Options HMO is excited to announce
that members will have access to plan
details at their fingertips this summer.
You will be able to view deductibles, copay
amounts, your maximum out-of-pocket status,
claims information and more.
For additional convenience, you can request
a member ID card replacement online.
All you have to do is visit
https://memberlink.universalamerican.com/
and input the required member
information to take advantage of the
Today’s Options HMO MemberLink.
6 | LIVE HEALTHY WITH TODAY’S OPTIONS HMO
®
While MemberLink will provide online
access at your convenience, if you have any
questions or need further assistance please call
Member Services at 1-866-802-8571, 8:00 a.m.
to 8:00 p.m. in your local time zone (TTY users
call 711) 7 days a week. v
You will be able to view
deductibles, copay amounts, your
maximum out-of-pocket status,
claims information and more.
Five Ways You
Can Live Healthy
and Be
Rewarded
For It!
Coming Soon!
W
e work hard to help our members
get the most out of life, and out of
their healthcare coverage. This is why
we are excited to introduce our Live Healthy
Rewards program.
This exclusive, members-only program is
available as part of your Today’s Options HMO
plan. There is no cost to you. When you take
care of your health, we will Reward you.
It is so easy! You earn Rewards by
scheduling an annual physical exam and other
healthy actions. Complete five different health
actions and earn $50! You can then use your
Live Healthy Rewards card to buy a wide range
of over-the-counter health products, vitamins
and supplements at select national retailers.
Preventive health screenings can identify
health risks and help your doctor provide
information, guidance
®
and support for a healthier lifestyle. The
following are the health actions that earn you
Rewards and help you maintain your health.
3 Annual physical
3 Breast cancer screening
3 Colorectal cancer screening
3 Cholesterol screening
3 Glaucoma test
3 Prostate cancer screening
3 Annual flu shot
You may be closer to earning Rewards
dollars if you have already completed any of the
listed health actions based on eligibility criteria.
As a Today’s Options HMO plan member, your
good health is our first priority. The Rewards
card is just one of many Live Healthy services to
encourage good health and preventive care.
We will mail you an invitation to join the
Live Healthy Rewards program in the
coming months. Be on the lookout for it! v
WWW.TODAYSOPTIONSHMO.COM | 7
All About
Rheumatoid
Arthritis
WHAT IS RHEUMATOID ARTHRITIS
Rheumatoid Arthritis, or RA, is a form of
inflammatory arthritis and an autoimmune
disease. In RA, the immune system, which is
designed to protect our health by attacking
viruses and bacteria, instead attacks the body’s
own tissues.
WHO GETS RA?
An estimated 1.3 million people in the United
States have RA. There are nearly three times
as many women as men with the disease. In
women, RA most commonly begins between the
ages of 30 and 60. It often occurs later in life for
men, but they tend to be more severely affected
by the disease. While RA typically occurs in
middle-age individuals, children can develop it
as well.
WHAT CAUSES RA?
The exact cause of RA is unknown. However,
most scientists believe that a combination
of genetic and environmental factors is
responsible. With RA, something seems to
trigger the immune system to attack the joints.
Researchers are investigating whether certain
bacteria or viruses may trigger the disease to
attack. Research hasn’t completely determined
the role genetics plays in RA, but some people
seem to have a genetic factor that increases
their chance of developing the disease.
Research of the genes and other factors that
may lead to the development of RA is ongoing.
http://www.arthritis.org/what-can-you-do-about-it.php
SIGNS AND SYMPTOMS
The symptoms of RA include joint pain and
swelling, stiffness, and fatigue. RA symptoms
vary from person to person and can change
on a daily basis. RA is symmetrical, meaning if
a joint on one side of the body is affected, the
corresponding joint on the other side of the
body is also involved. In addition to affecting
the joints, RA may occasionally affect the skin,
eyes, lungs, heart, blood, or nerves.
An estimated 1.3 million
people in the United States
have RA.
HOW IS RA DIAGNOSED AND TREATED?
To diagnose RA, your doctor will take a medical
history and perform a physical exam to look for
symptoms of RA and lumps under the skin. Your
doctor may also recommend certain blood tests
to aid in the diagnosis.
There is no cure for RA, but highly-effective
treatments exist. The medications used to treat
RA can be divided into two groups: those that
relieve symptoms and those that can put the
disease in remission. Doctors may recommend
using two or more medications together.
Researchers are continuously studying new
medications to help treat RA. v
WWW.TODAYSOPTIONSHMO.COM | 9
How Much
Do You Know
risk without even realizing it. You can’t feel
your bones becoming weaker. Breaking a
bone is often the first sign that you have
osteoporosis. You may also get shorter or your
upper back will start to curve forward. If you
are experiencing height loss or your spine is
curving, you should talk to a doctor right away
as the disease may be advanced.
About
Osteoporosis
Y
our bones are living, growing tissue made
up of three major components that make
them both flexible and strong:
• Collagen, a protein that gives bones a
flexible framework
• Calcium-phosphate mineral complexes that
make bones hard and strong
• Living bone cells that remove and replace
weakened sections of bone
Osteoporosis is a disease of the bones. It occurs
when you lose too much bone, make too little
bone or both. As a result, bones become weak
and can break from a minor fall or in serious
cases, even from bumping into furniture.
Approximately ten million Americans have
osteoporosis. Estimates suggest that about 50%
of women above age 50 and approximately 25%
of men, will break a bone due to osteoporosis.
Osteoporosis is often called the “silent
disease” because you may have it or be at
www.nof.org.
10 | LIVE HEALTHY WITH TODAY’S OPTIONS HMO
®
What can you do to protect your bones?
• Get enough calcium and vitamin D.
• Eat a well-balanced diet.
• Engage in regular exercise.
• Eat foods that are good for bone health,
such as fruits and vegetables.
• Avoid smoking and limit alcohol intake.
Getting Osteoporosis is not a part of normal
aging. There is a lot you can do to protect your
bones. You’re never too young or too old to
improve the health of your bones. Now is the
time to take action. v
Did you know?
Throughout your
life, you are
constantly losing
old bone and
making new bone?
The Importance of
Mammograms
A
mammogram is a breast examination
that uses specially designed X-ray
equipment to detect tumors that are too
small to be detected through routine exams.
A mammogram examination is recommended
for women who are above 50 years of age,
when the risk of breast cancer is highest.
Mammograms are considered the best
radiographic equipment available today to
detect breast cancer in its early stages.
A mammogram helps in the early detection
and treatment of cancer.
Contrary to popular belief, most breast
disorders are not cancerous. Even in cases
where cancer is detected, the disease is
curable if detected early and treated properly.
A mammogram is the best way to identify
changes in the breast before the obvious
symptoms of cancer surface. Research shows
that mammograms have helped reduce
fatality rates in breast cancer by almost
30 percent.
Mammograms are not painful. Two X-rays
are taken for each breast, and each reveals a
clear structure of the breast and helps experts
understand the readings and accurately
diagnose the condition.
Research shows that mammograms
have helped reduce fatality rates in
breast cancer by almost 30 percent.
Because breast tissues change continuously
during a woman’s lifetime, every new change
may require a mammography test. Changes
in the structure, glandular and fibrous tissues
occur with age. Your doctor will help you decide
whether or not to take a test.
Your doctor may recommend a
mammogram if you are younger than 50 and
preliminary tests show some abnormalities
in your breast structure, or if the disease is
prevalent in your family. v
http://womenshealth.gov/publications/our-publications/fact-sheet/mammograms.cfm
WWW.TODAYSOPTIONSHMO.COM | 11
Colorectal Cancer Screenings
Can Save Lives
As you get older, you become prone to certain diseases.
Colon cancer is one of them.
C
olon cancer is the third most common
cancer in men and women in the United
States. It is also the second leading cancer
killer, but it does not have to be.
It is recommended that everyone age
50 or older be screened for colon cancer
because they are at higher risk of developing
this disorder.
Screening can find precancerous polyps,
abnormal growths in the colon or rectum, which
can be removed before turning into cancer.
Screening also helps find colon cancer at an early
stage, when treatment often leads to a cure.
Your Todays Options HMO plan covers these
colon cancer screenings:
• Barium Enema–is an X-ray examination of
the large intestine (colon and rectum).
• Flexible sigmoidoscopy–This is generally
done every five years. It is a test where the
®
http://www.cdc.gov/cancer/colorectal/basic_info/index.htm
12 | LIVE HEALTHY WITH TODAY’S OPTIONS HMO
®
doctor uses a scope to look for polyps or
cancer in the lower third of the colon.
• Fecal occult blood test–This screening
is done once a year. It is done with a
chemically treated test card provided by
your doctor or lab to check for signs of
cancer in your bowel movements.
• Colonoscopy–This screening is done
every ten years. This test allows the
doctor to look for polyps or cancer while
you are sedated. The doctor is actually
able to remove most polyps
and cancer during the
screening process.
Talk to your doctor to
get more information about
these screenings and to
determine your risks and
the proper test for you. v
Prostate
Cancer
Prostate cancer is the most common cancer in
men. This cancer generally grows very slowly
and if detected early, it can be cured.
In its early stages, prostate cancer usually
does not cause symptoms. As the disease
progresses, symptoms develop such as:
•
•
•
•
•
Fever
Chills
Fatigue
Aching muscles
Chronic pain in the hips, thighs, or
lower back
• Frequent or painful urination
• Blood in the urine or semen
The lack of early symptoms and the
overlap of symptoms with non-cancerous
conditions make prostate cancer difficult to
diagnose. That’s why it’s important to get
screened regularly.
Men should get a prostate check every year
after age 40.
Also to help prevent prostate cancer,
you should:
• Eat right. Studies show that eating
fiber, soy protein, fruits, and cooked
tomatoes help reduce the risk of
developing prostate cancer.
• Watch your weight.
• Exercise regularly.
• Don’t smoke
• Limit alcohol and
avoid caffeine.
• Drink a lot of water.
Talk to your doctor
about other prevention tips,
and to learn more about
prostate exams. v
http://www.prostatehealthguide.com/cancer_about.html
Preventive Screenings
Checklist
A tool to help you Live Healthy!
Y
our health plan covers the important screenings and tests
listed below. Take this checklist to your Primary Care Physician
and ask which preventive screenings are right for you. v
SCREENING • TEST • TREATMENT
RECOMMENDED FREQUENCY
Cardiovascular Screening
Annually
Colorectal Cancer Screening:
Fecal Occult Blood Test
Annually
Diabetes Screening
Annually
Flu Shot
Annually
Glaucoma Test
Annually
Mammogram
Annually
Pap Test and Pelvic Exam
Annually
Prostate Cancer Screening
Annually
Wellness Visit with PCP
Annually
Bone Mass Measurement
Every 2-5 years
Colorectal Cancer Screening:
Barium Enema
Every 2-5 years
Colorectal Cancer Screening:
Flexible Sigmoidoscopy
Every 5-10 years
Colorectal Cancer Screening:
Colonoscopy
Every 5-10 years
Pneumococcal Shot
Once in a lifetime
14 | LIVE HEALTHY WITH TODAY’S OPTIONS HMO
®
DATE RECEIVED
NEXT DUE DATE
at 1-800-875-0867, Monday – Friday, 7:00 a.m.
to 7:00 p.m. Central Standard Time (TTY users
call 1-800-231-4403). Rest assured, your
prescriptions will not be filled by mail unless
you call and give permission to start the home
delivery process.
Don’t miss the opportunity
to save money and avoid
extra trips to the pharmacy
Save on
Prescription
Drugs
T
oday’s Options HMO members with
prescription drug benefits can pay less
for medications by using FastStart , the
CVS Caremark Mail Service offered as part of
your plan.
Through FastStart, you can get a 90-Day
supply of drugs for the price of two copays.
®
®
Along with lower prescription costs,
FastStart Offers:
• Greater convenience: you can enjoy
dependable, regular delivery with no
additional cost for shipping
• Personal service: you can speak with a
registered pharmacist anytime using the
24-hour, toll-free number
To find out if you could save money and to
start using CVS Caremark Mail Service for your
long-term medications, call FastStart toll-free
Before you call, please be sure to have
with you:
• Your Today’s Options HMO member ID
number (on your member ID card)
• Prescription name
• Doctor’s name and phone number
• Mailing address
• Payment information
Don’t miss the opportunity to save money
and avoid extra trips to the pharmacy by
ordering a 90-day supply order of your
medications at a local pharmacy or by mail.
If you have any questions about your plan,
please call Member Services at 1-866-802-8571,
8:00 a.m. to 8:00 p.m. in your local time zone
(TTY users call 711) 7 days a week. v
Ask your pharmacist about auto
refills. You will never
have to worry about
requesting refills
again. Your pharmacy
will automatically place
your refill order and let
you know when
your medications
are ready.
WWW.TODAYSOPTIONSHMO.COM | 15
How to Maintain a
Healthy Heart
T
he heart pumps around 2,000 gallons of
blood as it beats 100,000 times a day. That
is why having a healthy heart is important.
According to the American Heart Association ,
heart disease is the number one cause of death
for Americans.
®
THERE ARE NUMEROUS WAYS TO PREVENT
HEART DISEASE AND LIVE HEALTHY:
•
•
•
•
Monitor your blood pressure regularly
Do not smoke
Manage stress
Stay Active. Here are a few simple things
that one can do every day:
– Take the stairs instead of the elevator
– Drive to the end of the parking lot and
walk to an entrance
– If you ride the bus, try getting off a stop
before your destination and walk the
rest of the way
– Find a hobby outside that requires
some level of physical activity
• Eat foods that help regulate good heart
flow, cholesterol and blood pressure:
– Black Beans
– Salmon and tuna
– Extra Virgin Olive Oil
– Walnuts and almonds
– Oranges
– Sweet Potatoes
– Carrots
To get more information about maintaining
a healthy heart, visit the American Heart
Association website at www.heart.org. v
WWW.TODAYSOPTIONSHMO.COM | 17
Taking Your
Medications as
Prescribed
I
t is easy to forget to take your medicine or
choose to stop taking it once you feel better.
However, not taking your medications as
prescribed by your doctor can prevent the drug
from doing its job and increase your risk for
serious complications.
Medication adherence is a measure of
how well you take your medicines exactly
as prescribed. Below are some common
medications and possible results of not taking
them as advised by your doctor:
• Blood pressure medications: nonadherence can increase your risk for
stroke, kidney problems, and heart failure.
• Cholesterol medications: non-adherence
can increase your risk for heart disease.
• Diabetes medications: non-adherence can
increase complications related to your
kidneys, nerves, feet, and eyes. It can also
increase your risk for heart disease.
It is important that you consult with your
doctor to make sure you are on a medication
18 | LIVE HEALTHY WITH TODAY’S OPTIONS HMO
®
regimen that works for your health condition
and for you.
HERE ARE SOME WAYS TO MAKE TAKING
MEDICATIONS EASIER:
• If your medication requires you to take it
several times each day, ask your doctor if
there is a once-daily substitute that works
for you.
• When possible, use generic drugs to help
lower costs.
• Ask your doctor to prescribe a 90-day
supply when appropriate and in
accordance with your prescription
drug benefits.
• Stay informed about your medications, ask
your doctor why you have to take them,
side effects you may experience, and what
will happen if you do not take them.
If you ever have any questions about your
plan, please call Member Services. v
http://www.yalemedicalgroup.org
CAHPS Survey-
Let Your
Voice
be Heard
Y
our opinion matters to us, and we want
to hear from you! You may receive a
Consumer Assessment of Healthcare
Providers and Systems (CAHPS) survey in the
mail and we ask that you take the time to answer
questions about your Today’s Options HMO
plan and your experience.
The CAHPS survey is a joint effort of the
Agency for Healthcare Research and Quality
(AHRQ) and the Centers for Medicare &
Medicaid Services (CMS). Based on responses
to 70 questions, CAHPS measures members’
satisfaction with their plans and their doctors.
These scores are then posted on the CMS
website so consumers can see how well their
®
plans are doing by a number of different
measures – and compare their plans’ scores
with competitors and national averages.
The questions in the CAHPS survey cover
everything from the amount of respect shown
to you by your doctor to how easy it is to fill
out paperwork from your health plan. The
questions are designed to highlight areas
that are working well and pinpoint those that
need improvement.
Your voice counts and we
want to hear from you.
Surveys are sent out by mail in the early
spring. Members who do not respond get
follow-up contact by phone.
If you receive a CAHPS survey, please be
sure to complete it. Your voice counts and we
want to hear from you. v
WWW.TODAYSOPTIONSHMO.COM | 19
4888 Loop Central Dr.
Houston, TX 77081
Health or wellness or prevention information
NEW MAGAZINE NAME
You may have noticed that the Today’s Options HMO member magazine name has changed
to “Live Healthy.” While our Healthy Collaboration promise to work with your healthcare
providers to help you stay as healthy as possible, is our focus. Live Healthy is a major part
of our Healthy Collaboration as it gives you the opportunity to participate in improving and
maintaining your own health. We find Live Healthy to be a more fitting title for the magazine
as each volume will serve as a great resource and tool to help you on your journey to live
healthy and get the most out of life.
®
®
TALK TO US
We want to make sure that your healthcare needs are met and help you get the most of out of
your plan. If you ever have questions about your plan or any concerns, please don’t hesitate to
call us. We’re always ready to assist you in any way possible.
CALL MEMBER SERVICES
1-866-802-8571, 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call 711) 7 days a week.
Today’s Options HMO is a Health plan with a Medicare contract.
®