HOPnews. Health Options Program. Not All SUNSCREENS Are Alike For Retirees Eligible for Premium Assistance Spring 2013

Transcription

1 Pennsylvania Public School Employees Retirement System (PSERS) Health Options Program HOPnews For Retirees Eligible for Premium Assistance Spring Not All SUNSCREENS Are Alike With each passing year, your skin grows thinner, more delicate and less capable of self-protection and rejuvenation. Sun damage is the greatest threat to skin of any age, but seniors are advised to take extra care to avoid sun exposure. Health specialists recommend wearing sunscreen whenever you go outside. However, not all sunscreens are created equal. To help consumers identify better levels of protection, the Food and Drug Administration (FDA) has set standards for product testing and labeling. Under the FDA rules (which became effective last summer), if a product protects against both ultraviolet B radiation (UVB) and ultraviolet A radiation (UVA), it is labeled Broad Spectrum and SPF 15 (or higher). If it is less effective, the label may state that the product helps prevent sunburn, but it must also include the following: This product has been shown only to help prevent sunburn, not skin cancer or early skin aging. The FDA also requires that sunscreen labels provide information about how long the protection will last if you go in the water or perspire. For simplicity, manufacturers are allowed only two options: 40 minutes or 80 minutes. What s more, because the effectiveness of all sunscreens is fleeting, manufacturers cannot claim that their product is either waterproof or sweatproof, nor can they call it a sunblock. Besides mandating requirements for sunscreen makers, the FDA offers these sun protection measures for everyone: Use sunscreens with broad spectrum SPF values of 15 or higher regularly and as directed. Limit time in the sun, especially between the hours of 10 a.m. and 2 p.m., when the sun s rays are most intense. Wear clothing to cover skin exposed to the sun; for example, long-sleeved shirts, pants, sunglasses, and broad-brimmed hats. Reapply sunscreen at least every two hours, more often if you re sweating or jumping in and out of the water.

2 2 WHY JOIN HOP There are many reasons to join HOP. Consider these: If you are eligible for Premium Assistance, you ll save up to $100 a month in premiums. Unlike other retiree medical programs, HOP is designed exclusively for PSERS retirees and their dependents. HOP offers a choice of medical and prescription drug options for both Medicare-eligible and non- Medicare-eligible participants. HOP is committed to keeping premium rates as low as possible. In most cases, your monthly premium can be deducted automatically from your retirement benefit. If you enroll in the HOP Medical Plan or the HOP Pre-65 Medical Plan, you can join the SilverSneakers Fitness Program at no additional cost. You can change from one option to another each fall during the Option Selection Period. The change becomes effective the following January 1. If you or a dependent experiences a Qualifying Event (as described in If You re NOT Turning 65 on page 4), you can enroll, add dependents, or change your option at any time during the year, within 180 days of the Qualifying Event. HOP wants you to have the health care resources you need. Customer service representatives are available to answer your questions. We also send newsletters, personalized statements, and booklets about HOP and maintain a Web site for online access to program information. Sign Up Early for HOP AND SAVE If you enroll in the HOP Medical Plan at age 65, you will be entitled to a special, discounted premium. If you have no coverage or are in a different plan at age 65 and enroll in the HOP Medical Plan at a later date, you will pay the standard nondiscounted premium in effect when you join even if you are enrolling in HOP for the first time. You have 180 days after your 65th birthday to enroll and qualify for the lower rate. Don t delay. Review your materials carefully when they arrive and call the HOP Administration Unit at if you have questions. You have 180 days after your 65th birthday to enroll in the HOP Medical Plan and qualify for a lower rate.

3 3 The Highs and Lows of Blood Pressure As blood pumps through your body, it creates pressure on the walls of your arteries. The pressure constantly changes depending on such things as your level of activity, diet, emotional state, posture, and use of medications. A consistently high pressure reading can damage your heart and blood vessels. A simple blood pressure test provides two different measures of pressure. The first, called systolic blood pressure, is the maximum pressure in your arteries when your heart contracts, or beats. The other, diastolic blood pressure, is the minimum pressure when the heart is at rest between beats. Both pressures are measured in millimeters of mercury and are reported together as a top number and a bottom number for example, 110 over 70 (written as 110/70). In adults, the top number (systolic pressure) should be no more than 120, and the bottom number (diastolic pressure) should be no more than 80. If either or both of these numbers are above these levels, you may have or be developing high blood pressure, also known as hypertension. While we frequently hear about cases of high blood pressure, some people have low blood pressure (hypotension), which refers to readings of 90/60 or below. Low blood pressure can be caused by a sudden change in body position, certain medications, or health conditions such as advanced diabetes or heart failure. Symptoms may include blurry vision, confusion, fainting, sleepiness, or weakness. The need for and type of treatment for low blood pressure depend on its cause. Fast Facts about Avoiding unhealthy fats helps keep your heart healthy. Most foods contain several types of fats both healthy and unhealthy. Saturated fats and trans fats raise your risk for heart disease. Unsaturated fats (monounsaturated and polyunsaturated) can lower your risk for heart disease. Omega-3 fatty acids (a polyunsaturated fat) may be especially beneficial to your heart. Healthy Fats Olive oil Avocados Walnuts Salmon Kitchen Tips Unhealthy Fats French fries Eggs Poultry Margarine Try to limit the fat in your diet. (The U.S. Department of Agriculture and Department of Health and Human Services advise that no more than 35% of your daily calories should come from fat.) To help increase the percentage of healthy fats, the Mayo Clinic offers these suggestions: Saute with olive oil not butter. FATS Use olive oil in salad dressings and marinades. Sprinkle nuts or sunflower seeds on salads not bacon bits. Snack on nuts or spread peanut butter on celery, bananas, or rice cakes. Add avocado not cheese to a sandwich. Once or twice a week, replace meat with salmon, mackerel, or other fish with healthy fats.

4 4 Are You Almost 65? If you re a PSERS retiree about to turn age 65, we re eager to tell you about the benefits of joining HOP. We ll take a number of steps to make sure you understand how the program works. First, we ll send you a package of information from four to nine months before your 65th birthday. We mail these twice a year in the fall for people turning age 65 during the first six months of the following year and in the spring for people turning age 65 in the second half of the year. The package contains a description of the medical and prescription drug benefits available under HOP plus a personalized statement that has information specific to you including your monthly premiums for all your coverage options. In addition, we conduct face-to-face meetings twice a year at locations throughout the Commonwealth for retirees approaching age 65. Look for the meeting schedule in the package you receive in the mail. Our latest method for reaching our soon-tobe-65 audience is via the HOP Web site ( Besides all the regular features available on the Web site, if you register, you ll find a personalized statement with all the same information as the printed statement you receive in the mail. Plus, if you misplace or want another copy of your statement, a printer-friendly version is available. If You re NOT Turning 65 YOU MAY STILL BE ELIGIBLE TO JOIN HOP Becoming eligible for Medicare is only one of a number of events that make you eligible for HOP. Here are others, all of which are known as Qualifying Events: You lose health care coverage under your school employer s health plan (including any COBRA coverage you may have elected under that plan). Your loss of coverage could be due to retirement or any other event that results in an involuntary loss of coverage. You lose health care coverage under your spouse s employer plan or another nonschool employer plan. Your loss of coverage could be due to retirement or any other event that results in an involuntary loss of coverage. A change in legislation makes you eligible for Premium Assistance. Another plan approved for Premium Assistance in which you are enrolled terminates, or you move out of the plan s service area. Qualifying Events apply to you, your spouse, and/or your dependents. If one member of your family has a Qualifying Event, all members may enroll in HOP, within 180 days of the Qualifying Event. For example, if your spouse becomes eligible for Medicare, all eligible family members have 180 days from your spouse s 65th birthday to join HOP. If you are also eligible for Medicare, you can join the same plan as your spouse. If you are younger than your spouse, you can join a HOP option designed especially for non-medicare-eligible members.

5 5 UNDERSTANDING PRESCRIPTION SHORTHAND Doctors use prescription abbreviations (based on Latin words) that tell your pharmacist which medication to give you and directions on how to use that medication. If you learn to understand the medical shorthand used by your doctor, you can read your own prescription immediately after it is written. This will help make sure that you know what medication you are getting and make it less likely that you will have a medical error. For example, your pharmacist may make a mistake reading your doctor s handwriting. If your doctor s writing is not clear and easily read, your prescription may take longer to fill or you may be given the wrong dose or the wrong directions. 1. sig a. as needed 2. bid b. capsule Try matching these commonly used prescription abbreviations with their meanings. (Answers below.) 3. prn c. apply topically 4. q4h d. after meals 5. qd e. write on label 6. pc f. every day 7. po g. 3 times a day 8. tid h. twice a day 9. caps i. every 4 hours 10. top j. by mouth If the DAW Is Left Open If a box labeled DAW on your prescription is left blank, the pharmacist may choose to fill it with a less expensive generic medication even if your doctor prescribed a brand name. However, if your doctor initials the box or writes DAW (which means dispense as written ) on your prescription, the pharmacist cannot legally substitute a generic alternative for the brand name. Be sure to talk to your doctor about a generic alternative especially for a drug you are taking long term. If an appropriate alternative is available, you will likely pay less each time you fill your prescription. Reaching Out to Nonmember Retirees In 2012, almost 13,000 PSERS retirees turned 65 and became eligible to enroll in the HOP Medical Plan for Medicare-eligible members or a Medicare Advantage Plan. We recognize that PSERS retirees have access to coverage other than HOP, so we re pleased that each year more than half sign up with us. However, because we want to meet the needs of as many PSERS retirees as possible, we want to understand why someone would choose another plan over ours (especially since ours is the only one that offers Premium Assistance). So every six months or so, we ask some retirees why they declined coverage with HOP. Mostly, it s because they have coverage with another employer often a spouse s. But if that coverage ends, almost all said they would consider joining HOP. 1. e 2. h 3. a 4. i 5. f 6. d 7. j 8. g 9. b 10.c

6 6 Premium Assistance Annual Verification of Payments Premium Assistance is a reimbursement of a premium paid by an eligible retiree to an approved health plan. It is added to a retiree s retirement benefit and is not subject to federal or state income tax. In order to preserve this tax-favored treatment, PSERS is required to obtain verification that retirees who receive Premium Assistance actually have out-of-pocket premium expenses from approved plans. Don t know if you re eligible for Premium Assistance? Call for help. Each year, PSERS asks school employers to verify that Premium Assistance recipients have paid premiums each month that equal or exceed the amount of the Premium Assistance benefit. If the school employer is unable to do so, PSERS must collect unverified benefits from the retiree. PSERS sends a letter to all retirees who have received overpayments. The letter advises them of the amount of Premium Assistance they will receive in the future, if any, and requests that overpayments be returned. The amount due can be paid in a lump sum or deducted in $100 increments each month from the retiree s retirement benefit until the overpayment is recouped. If a retiree has been receiving $100 in Premium Assistance with no out-of-pocket expense from an approved plan, this will result in a $200 reduction in the retiree s monthly benefit ($100 for the loss of the Premium Assistance and $100 to repay the debt). No interest is charged on the balance of the debt while the monthly deductions are being made. Remember to Call PSERS If you are receiving Premium Assistance and your out-of-pocket premium expense changes or stops, it is your responsibility to notify PSERS. You must also notify PSERS if you have terminated your health coverage with your former school employer and have not enrolled in the PSERS Health Options Program (HOP). About 30,000 PSERS retirees receive Premium Assistance for the premiums paid to former school employers. In most cases, overpayments result when a retiree terminates coverage and fails to notify PSERS. Each year, the verification process identifies about 500 retirees who have received Premium Assistance to which they were not entitled. If you are unsure about your eligibility for Premium Assistance, call the Premium Assistance Unit at and ask a customer service representative to check your retirement benefit records.

7 7 Recipe: Berry Healthy Muffins A store-bought blueberry muffin is likely to be made with refined flour and lots of sugar and contain 450 calories. It may satisfy your hunger for a while, but chances are you ll be hungry again soon after eating it. A muffin from this recipe, provided by The Culinary Institute of America, is made with whole wheat, white, and almond flour and contains only 130 calories. The healthier ingredients will provide more energy and satisfy your hunger longer than the store-bought variety. Ingredients 1 cup whole wheat pastry flour ¾ cup all-purpose flour ¼ cup almond flour 1 teaspoon baking powder ½ teaspoon baking soda ½ teaspoon salt 1 teaspoon orange zest 2 cups fresh blueberries 2 eggs, large 1-¼ cups low-fat (1%) buttermilk ½ cup brown sugar 6 tablespoons canola oil 1 tablespoon orange juice ½ teaspoon vanilla Preparation Place the rack in the top third of the oven and preheat the oven to 400 F. Line muffin tins with 18 paper liners. In a large mixing bowl, combine the flours, baking powder, salt, baking soda, and orange zest. Add the fresh blueberries and toss gently to coat the blueberries in flour. This will help keep the blueberries suspended in the batter versus falling to the bottom. In a medium mixing bowl, lightly beat the eggs, then whisk in the buttermilk, brown sugar, canola oil, orange juice, and vanilla. Don t be concerned if the mixture looks curdled or lumpy. Pour the wet ingredients into the dry ingredients and stir until most of the flour is incorporated. The mixture can be slightly lumpy; don t over mix. Divide the batter among the 18 prepared muffin cups. Bake 12 to 14 minutes, until the muffins are golden brown around the edges. Yield: 18 muffins. Each muffin provides 130 calories; 3 g protein; 16 g carbohydrate; 1.5 g fiber; 140 mg sodium; 1 g saturated fat; 2 g polyunsaturated fat; 3 g monounsaturated fat; 0 g trans fat; 21 mg cholesterol.

8 HOP Administration Unit P.O. Box 1764 Lancaster, PA How To Read SUNSCREEN Product Labels Have a Question? If You Have a Question About Please Call Or Go Online HOP enrollment or HOP in general HOP Administration Unit PSERS25 ( ) 8 a.m. to 5 p.m. eastern time, weekdays HOP Website Premium Assistance Premium Assistance Office a.m. to 4:30 p.m. eastern time, weekdays Retirement PSERS PSERS4U ( ) 7:30 a.m. to 5 p.m. eastern time, weekdays PSERS Website Medicare Medicare MEDICARE ( ) Medicare Website