Be On the Lookout Important plan news is coming your way

Transcription

1 SUMMER/FALL 2013 SUMMER/FALL 2013 Be On the Lookout Important plan news is coming your way - Your privacy matters - Discounted services and free screenings - Our provider networks one TO one NEWSLETTER FOR MEDICARE ADVANTAGE MEMBERS Y0010_MK13221 Accepted

2 ONE TO ONE Fall is the season for harvest Autumn in Idaho offers plenty of opportunities for exercise. Consider making a change in your fi tness routine get outside and try something new! Raking leaves or a gentle walk with a friend are good reasons to get outdoors and breathe the fresh autumn air. What will you focus on harvesting this season? Increased physical activity? More time with family and friends? How about greater knowledge about your health coverage? This fall, rediscover your healthcare benefi ts, commit yourself to important screenings and share your thoughts on your health coverage. And be sure to like us on Facebook at facebook.com/ BlueCrossofIdaho to watch the Blue Cross of Idaho community garden grow. We want your opinions! Join Blue Cross of Idaho s online opinion panel today. Registered members login to /medicare and look for Member Opinion Center on the members home page. Blue Cross of Idaho is a health plan with a Medicare contract. 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 BLUE CROSS OF IDAHO 2 BCIDAHO.COM

3 SAVINGS IN THE COVERAGE GAP, Or DONUT HOlE T he 2013 coverage gap begins after you and your drug plan spend a combined $2,970 on covered drugs. Not everyone reaches this gap, and those who qualify for extra help with their Part D costs won t reach the gap either. If you do reach the gap in 2013 or 2014, you ll pay 47.5 percent of your plan s cost for covered brand-name prescriptions. If your plan has coverage in the gap, you may get an additional discount beyond what your plan pays. This discount will apply to the cost your plan agrees to pay the pharmacy. Year Percentage you pay for brandname drugs in the gap Percentage you pay for generic drugs in the gap % 79% % 72% If you think you ve reached the gap but didn t get your discount, contact us to make sure we have current and accurate information about your prescription expenses. Protection Pointers Follow these tips to protect your identity and benefi ts: - Never give out your insurance, Social Security or Medicare numbers or banking information to someone you don t know. - remember that free services should not require you to give your insurance or Medicare information. - Carefully review your paid claims to make sure all the information is correct. Medicare does not sell or mail medical supplies. If you receive medical supplies that you or your doctor did not order, you might be the target of fraud. - refuse any medical supplies you did not order. - return unordered medical supplies that are shipped to you. - report companies that send you these items. Have questions or concerns about potential fraud? Call our Fraud Hotline at 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 /ma_formulary. BrAND NAME GENErIC NAME MEDICATION USE Subozone SL Tablets Buprenorphine/Naloxone Opiate dependence Luvox CR Capsules Fluvoxamine Obsessive compulsive disorder/depression Zovirax 5% Ointment Acyclovir Herpes ocular infection Atacand Tablets Candesartan Control blood pressure 3

4 Watch for This Important Information! We mail your ANOC and EOC in late September each year. We send you important plan information every year in the fall. - ANNUAL NOTICE OF CHANGE (ANOC): This notice gives a summary of any changes to your plan s current costs and coverage. Any listed changes will take effect January 1 of the next year. - EVIDENCE OF COVERAGE (EOC): This is our contract with you. The EOC includes your plan s costs and benefits that are effective on January 1. Your Benefi ts at a Glance! look for your new pocket-sized benefi ts at a glance, in the mail soon. This handy reference guide includes a wealth of plan information and folds neatly into a pocket-sized card. Tuck it inside your wallet or purse so that you always have your benefi t information and our contact details with you. You can also use it to compare plans to see if another one of our plans may be a better fi t. - DRUG LIST AND PHARMACY DIRECTORY: The Drug List contains your plan s covered drugs. The Pharmacy Directory contains information on the over 65,000 local and national chain pharmacies that participate in our network. 4

5 HOW WE PROTECT YOUR PERSONAL INFORMATION Blue Cross of Idaho takes your privacy seriously. Your privacy matters so we work hard to protect your fi nancial and health information. This includes what you give us when you apply for insurance like your name, address, birth date and Medicare number. We have strict privacy policies and follow all state and federal laws. We also never sell or share your information with any one that would use it to sell to you. - All your information is confi dential. - We protect the information of current, past and future members. - Our employees and partners can see your information only as needed to serve you or to do business. - We train our staff on privacy and security, they can face disciplinary action if they violate our policies. - We won t share your information unless the law requires it or we have approval from you or your personal representative. - We work to keep our buildings and systems secure. For more on our privacy practices and your rights, visit / about_us/privacy_policy.asp. You can also call our information privacy offi cer at to learn more. Save Money With Our Discounts THINkSTOCk Blue Cross of Idaho offers savings on services, programs and products to help you achieve your personal health and wellness goals. Our members can get discounts on: - Acupuncture and massage - Vision services, including exams and glasses - Hearing services, including exams and hearing aids - Medical alert systems Get more details on other discounts and ways to save money. View the list of participating vendors by visiting /medicare. 5

6 FIGHT THE FLU Your best shot at staying healthy this season is the fl u vaccine. You can count on it: Every year, the fl u bug rears its head. And with it comes those chills, fever and aches. Do your part to stop the fl u in your household and your neighborhood by getting the fl u shot. Anyone over age 65 and anyone with a chronic illness should get the vaccine. Take Note: Flu shots are covered with $0 cost share for all Blue Cross of Idaho Medicare Advantage plans. Ask your pharmacist or visit one of our participating network pharmacies to get your fl u shot. Did you get all your FREE preventive services this year? If not, schedule an appointment with your doctor today to make the most of the $0 copay screenings and preventive services below. - Abdominal aortic aneurysm screening - Alcohol misuse screenings and counseling - Bone mass measurements (bone density) - Cardiovascular disease screenings - Cardiovascular disease (behavioral therapy) - Cervical and vaginal cancer screening - Colorectal cancer screening - Depression screening - Diabetes screening - Diabetes self-management training - Glaucoma testing - HIV screening - Mammogram - Nutrition therapy services - Obesity screening and counseling - Prostate cancer screening - STD screening and counseling - Flu shots - Hepatitis B shots - Pneumonia shots - Tobacco use cessation counseling - Yearly wellness visit 6

7 Our Provider Networks TRUE BLUE HMO NETWORK: True Blue HMO has an extensive statewide network of participating doctors, specialists and hospitals. With many doctors and Idaho hospitals in our network, members have a choice from over 2,200 contracting providers for their care. SECURE BLUE PPO NETWORK: The Secure Blue PPO network also includes more than 2,200 Idaho providers, plus our Visitor/ Travel program provides access to over 300,000 Blue Cross Blue Shield doctors, specialists and hospitals in 30 states and one territory. Members pay the same amount for care from these providers as they would pay when seeing in-network providers in Idaho. TRUE BLUE CONNECTED CARE HMO-POS NETWORK: The True Blue Connected Care HMO-POS network brings members and providers together in a unique way. Members choose a primary care provider from a hospital affiliated network. In most cases, members get other services such as specialists or hospital care from this same group of network providers. Watch for more information on this innovative network in your 2014 plan information. What Is a Provider Directory? Our provider directory is a booklet listing the doctors, hospitals and others who contract with us to provide member care. To prevent waste and save on mailing costs, we send out provider directories upon request. Need a new one? Give us a call. You can also visit /medicare for the most up-to-date provider information. 7

8 What to Look for By October 1 We re excited to share news about your 2014 coverage. look for information in your mail about the following updates: - Exciting fitness and exercise opportunities - Drug list tier changes - Simpler pharmacy network - Affordable copays MEMbEr MEETINGS, coming SooN! Give us a call at (TTy users call ) or register online at /medicare for a member meeting in your area! 3000 E. Pine Ave. Meridian, ID PRSRT STD U.S. POSTAGE PAID One to One IS Published by McMurry/TMG, LLC 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