Concierge 0913

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Nancy Beresford

Doing What You Love at Any Age

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Nancy didn’t mind the moving, she always looked at it as a new adventure. And, no matter where she lived, she could always work on her craft. When her youngest daughter Diane enrolled in college, Nancy decided she would join her.

Nancy started taking a few art classes each semester while living in Colorado. She studied at Mesa University and eventually got her two-year associates degree. She quickly made up for lost time, becoming a prolific artist.

Nancy enjoys painting, printmaking, batik and collage. Her house is largely decorated with her own work as well as some of her son Dan’s, who must have inherited his creative talent from Nancy. Her different projects keep her active and busy.

“I don’t consider myself retired,” and looking around her home, you’d have to agree with her.

Nancy and Bob moved back to Wisconsin continued on page 2 »

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ou’ve probably heard the saying “do what you love” countless times. It’s good advice, the only problem is some of us don’t realize what we love until we’ve matured a bit. This was certainly the case for Nancy Beresford, Network Health Medicare Advantage (PPO) member.

When raising her five children, Nancy wasn’t able to spend nearly as much time developing her interest in art as she would have liked. Although she had always been passionate about art, being a full-time, stayat-home mom didn’t leave her a lot of time for herself.

Plus, the Beresfords were often on the move. Nancy and her husband Bob are Wisconsin natives–this is made clear by their love of cheese curds and Friday night fish fries. But, unlike a lot of Badger-state residents, the Beresfords have also called plenty of other states home through the years.

I don’t consider myself retired,

and looking around her home, you’d have to agree with her.

H5215_MbrNewsV6 Accepted 09172013

Nancy in her studio

Volume 2 | Number 2 | 2013

LIFE, HEALTH & WELLNESS

life don’t have to worry When you

about things like health insurance coverage, you have to do whatever it is you love.

more time

The happy couple—Nancy and Bob first met in Wisconsin while working for the same phone company, Wisconsin Bell. In 1955, if you wanted to make a call, you would need to give a switchboard operator, like Nancy your number, so she could complete your call.

Nancy did this for a year before moving into quality assurance. Bob was working in business development, so the two didn’t cross paths until the company picnic. It was a short courtship. The couple started dating in the fall of 1957 and married in July of 1958.

continued from page 1 » seven years ago. It was important to Nancy to be closer to her mother, who had fallen ill. Nancy was ready to come home. “I always knew I would move back to Wisconsin eventually,” she says.

After moving back, one of Nancy’s family members recommended she look into a local health insurance plan. Joan Merwin (Nancy’s niece) knew a Network Health Medicare Advantage plan would be a good fit for Nancy because of the world-wide travel benefit.

Since all of Nancy and Bob’s children and grandchildren live out of state, they do a fair amount of traveling. With their Network Health Medicare Advantage plan, they never have to worry about paying out-of-network costs when visiting.

Nancy is very pleased with her coverage since switching, “I have nothing but good things to say about Network Health—Bob and I haven’t had any problems. Our services have always been covered.”

And because all Network Health Medicare Advantage plans are PPOs, Nancy and Bob have the freedom to see any doctor or specialist they’d like. They pay less by visiting providers that are in-network, but it’s good to know they have the flexibility they need to receive the very best care. And, when you don’t have to worry about things like health insurance, you have more time to do whatever it is you love.

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EDITORIAL STAFF

President Chief Administrative Officer

Publications Coordinator

Graphic Designer

Sheila Jenkins Penny Ransom Cassie Goodman Debra Sutton

EDITORIAL BOARD Marcia Broeren, Joan Merwin, Angie Keenan, Jeanne Skinner, Melanie Draheim, Dawn Rady, Deborah Anderson, Renee Corral, Barb Gore, Chuck Rynearson Concierge is published quarterly by Network Health. The health information contained in Concierge is meant to supplement, not replace, the advice of health care professionals. © 2013 Network Health Insurance Corporation.

No portion of this newsletter may be reproduced without written permission from Network Health Insurance Corporation.

Network Health Medicare Advantage Plans are PPO plans with a Medicare contract.

NetworkCares is a Coordinated Care Plan with a Medicare contract and a contract with the Forward Health Wisconsin Medicaid Program.

Enrollment in Network Health Medicare Advantage plans depends on contract renewal.

TELL US WHAT YOU THINK Thank you for your comments about the last issue of Concierge. Please continue to email your feedback to concierge@networkhealth.com.

YOU CAN ALSO WRITE TO US Network Health, Attention: Cassie Goodman 1570 Midway Pl., Menasha, WI 54952 NetworkHealthMedicare.com

96

%

of our members stay with us year after year* *Network Health Medicare Advantage PPO plans received an overall rating of 4 out of 5 stars in 2013 from the Federal Medicare program. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.

2014

Y O U R

A Special

STEP 1

2 0 1 to Medicare 4 e e r F s s Stre

Stress free guide to Medicare Sim

GUIDE I

t’s almost that time of year again. Soon, your mailbox will be overflowing with advertisements from different health insurance companies each claiming to be the best for you.

Message

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Janua rage all

ple step to be sure s you’re in the right plan for 2014

800-3785234 (TTY 800947-3529 ) Monday Frid NetworkH ay, 8 a.m. - 8 p.m. ealthMed icare.com

Review Yo u

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Marcia Bro eren, RN , BSN Vice Preside nt, Medic are

Hospital Sta

STEP 2

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Know You

r Needs

DEDUCT

The amoun IBLE t before an you must pay insurance company will help pay expens es.

All the pla ns to the left have a $0 deduct ible.

NetworkC

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Did you kno w we also needs? If offer a pla you n for Medic plan includ receive both Medic are memb ers are and Me es medical your own dicaid, you with special and drug coverage, health car may be elig plu e team. To (TTY 800 learn more, s eye and dental ben ible. This -947-3529 ), Monda contact 800 efits and y through -983-7587 Friday, 8 a.m. to 8 p.m.

All of this information can be overwhelming—but it doesn’t need to be. We can walk you through any questions you might have and make sure you’re getting the right coverage for the right price.

health care concierge with any questions. If you’d like to change your plan, he or she can help you through the process. To stay in the same plan, you don’t have to do anything.

The 2014 Annual Enrollment Period for Medicare begins October 15 and runs to December 7. Make sure to read your plan materials and call your

In this special edition of Concierge, you’ll find a simple guide. By following the steps outlined in the guide, you can be sure you’re in right plan for 2014.

Keep an Eye on Vision Loss

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id you know once your vision is lost due to glaucoma, it can’t be regained? That’s why early detection is so important. Older adults are at an increased risk for developing glaucoma, which can lead to blindness or vision loss. Pay careful attention to your eye health and review the warning signs below.

What are the warning signs?

The Centers for Disease Control and Prevention (CDC) recommends you see an eye care professional if you have the following symptoms.

• Blurred vision • Decreased vision • Eye pain • Drainage or redness of the eyes • Double vision • You see halos or circles around light sources

Can eye conditions be prevented?

While some risk factors are out of your control (such as age and family history), the CDC makes the following recommendations to keep your eyes healthy.

• Get an annual eye exam. Having a comprehensive exam every year can help find problems, and a dilated eye exam is the only way to detect glaucoma in its early stages.

• Eat foods good for your eyes. Have you heard about carrots being good for your eyesight? It’s true, because carrots contain a natural antioxidant that can help protect your eyes. This little-known substance is also found in greens, corn, paprika and spinach.

• Wear sunglasses. Protect your eyes from harmful UVA and UVB rays. Make sure to always wear your shades on sunny days, regardless of temperature.

• Avoid touching your eyes. To help stop infection from spreading, fight the urge to rub your eyes. And, always wash your hands thoroughly.

For more tips and information about glaucoma and eye health, visit www.cdc.gov/visionhealth.

NetworkHealthMedicare.com

A Great Day at the Y W

e’d like to thank everyone who attended our first Network Health Medicare Ambassador event on May 29. We were glad to have the opportunity to meet and get to know so many members.

We had over 200 people come to the Heart of the Valley YMCA in Kimberly to participate in the day’s events. We were pleased to see our members and their guests working to get active.

Several members signed up for a YMCA membership that same day. We all know how important the benefits of exercise can be— good health requires physical activity. So we gave away helpful tools, like pedometers, to help members set and achieve their exercise goals. We also had some of our nurses on-site to answer questions and take blood pressure readings.

We’re looking forward to future events to promote good physical, mental and social health in our communities. We’d love for you to help with future events. If you’re interested in joining the Network Health Medicare Ambassadors, call Anne Rappert at 920-720-1348.

Other health club providers are available in our network.

Denise Balboa, RN and Sharon Kennedy, Network Health Medicare Advantage Member C oncierge • F all 2013 | 3

health

Want to Learn More about Falls Prevention?

Attend a Stepping On workshop. Helpful instructors can teach you proven techniques to reduce your risk of falling. Call Sue Srnka at 920-720-1655, Monday - Friday, 8 a.m. - 5 p.m., to find classes in your area.

5 Easy Steps to

Better Bone Health

S

lips, falls and fractures don’t have to keep you from doing the things you enjoy. Unfortunately, every year millions of older Americans suffer from painful injuries due to falls. And for people with osteoporosis, these falls can cause serious damage.

Reduce your risk for falls and broken bones with these simple steps.

1 2

GET AND STAY ACTIVE. Stretching and flexibility can help you avoid injury. You can improve your muscle strength and reaction time by exercising and being active, which decreases your risk of falling.

Doctors often recommend weight bearing, low-impact exercises like walking to help keep bones strong.

TALK TO YOUR DOCTOR. Osteoporosis is a common disease that weakens the bones, and it can often be prevented. As you age, it is important to take steps to limit bone thinning, which increases your risk for fractures. Talk to your doctor about how exercise and diet affect bone health. Ask if he or she recommends taking dietary supplements for calcium and vitamin D. You should also talk to your doctor if a medication is making you dizzy or lightheaded. Side effects from prescription drugs are often the culprit behind serious falls. And, if you’ve recently fallen, make sure to discuss it.

Your doctor may need to evaluate your strength and balance.

3

GET A BONE MINERAL DENSITY (BMD) TEST. Make sure to get a BMD test, especially if you’ve broken a bone and/or if you’re a woman over 65. This quick and painless test will measure how strong (or dense) your bones are and determine if you have osteoporosis. Keep

a record of your test and ask your doctor about follow-up care. He or she may prescribe a medication to preserve your bone density or recommend another BMD test in the future.

If you experience a fracture, and you’re a woman over age 66, it’s important to talk to your doctor about a BMD test or start a medication for osteoporosis within six months. Your doctor can prescribe the best medication for building bone density and you can take it safely under his or her supervision. Working with your doctor to develop a personal treatment plan is the best way to prevent future injuries.

4 5

TAKE PRECAUTIONS. When it’s wet or icy outside, slow down and take small steps. Be careful getting in and out of your car and make sure paths and walkways are clear. Take alternative routes if necessary.

AVOID ALCOHOL AND TOBACCO. Drinking two or more alcoholic drinks per day can interfere with your body’s ability to absorb calcium. And, research has shown a direct relationship between tobacco use and decreased bone density. To keep your bones strong and healthy, it’s important to limit alcohol and stay away from all forms of tobacco.

KNOW YOUR NUMBERS BLOOD PRESSURE Near or above goal

120/80

Prehypertension

121-139/81-89

or below

120 100

High blood pressure

140/90

Near or above goal Less than 150 mg/dL

or above

140 160 180

80

200 220

Borderline High 150-199

Very High 500 or above

High 200-499

240 260

60 40 20

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TRIGLYCERIDES

300

280

0

100

200

300

400

500

600

CHOLESTEROL Type of Cholesterol

Goal

Borderline High

High

Total

Below 200

200 -239

240 or higher

LDL (“bad”)

Below 100

100 -159

160 or higher

HDL (“good”)

Women: 50 or higher Men: 40 or higher

Women: below 50 Men: below 40

N/A

NetworkHealthMedicare.com

Get Cholesterol Under Control

H

ave you heard the phrase, “It’s the job that’s never started that takes the longest to accomplish?” That’s especially true when it comes to managing your cholesterol. Instead of putting off healthy choices until next week, month or year, why not start today?

Check out the tips below to see what changes you can make.

LIMIT SATURATED FATS. This type of fat is found mostly in foods from animals (and some plants). Saturated fats can raise your cholesterol and low-density lipoprotein (LDL) levels, which can increase your risk of cardiovascular disease.

Limit saturated fats found in bacon, ribs, cheese, pizza, sausages and beef.

AVOID TRANS FATS. Although they occur naturally in some foods, most trans fats are made during food processing through hydrogenation of unsaturated fats. These synthetic trans fats can increase unhealthy LDL levels and raise your risk for heart attacks and stroke. Examples of trans fats include margarine, french fries, cake mixes, doughnuts, potato chips and cookies.

EAT HEART-HEALTHY FOODS. Give yourself a realistic goal, such as eating one or two more servings of fruits and vegetables each day.

Apples, bananas and berries are all great choices because they are high in fiber and can help lower your cholesterol.

LOSE WEIGHT. If you are overweight or obese, it is important to monitor your weight and actively seek to shed the extra pounds. Decreasing your weight can give you more energy and also decrease your risk for heart disease.

GET MOVING. Once you cut back on junk food and add more fruits and vegetables to your diet, you’ll notice you have more energy. Put this new-found energy to good use by taking walks, going for a swim or bike ride. Getting active is one of the best things you can do for your heart.

ASK YOUR DOCTOR ABOUT MEDS. Some people may already live a healthy lifestyle, but due to their family history, they need medication to maintain their cholesterol levels. Talk to your doctor to see if a cholesterol medication is right for you. If he or she writes a prescription, make sure to follow it carefully. You’ll need to take the medication as prescribed to see results.

WHAT’S THAT?

Low-density lipoprotein (LDL)

A type of cholesterol that can lead to buildup in the inner walls of blood vessels that supply blood to the heart and brain.

How Do Health Plans Make Their Decisions?

D

id you know that decisions made about your care by Network Health are based on the appropriateness of care and service?

Care and service include medical procedures, behavioral health procedures, pharmaceuticals and devices. Decisions are based on written criteria founded on sound clinical evidence and on the benefits outlined in your plan policy, called your Evidence of Coverage.

Network Health does not in any way reward any practitioners or other individuals conducting utilization review for denying coverage for care or service. Network Health allows providers to advocate on behalf of members within the utilization management program. In addition, the medical director, associates (or designees), care management staff and supervisors of Network Health’s staff receive no financial incentive to encourage decisions that result in underutilization.

If you have any questions about Network Health’s utilization management process, decision or criteria, call our utilization management department Monday - Friday, 8 a.m. to 5 p.m. at 920-720-1602. Bilingual language assistance or translation services are available for members to discuss utilization management issues.

Network Health also offers TTY services for deaf, hard of hearing or speech-impaired members. For questions specific to behavioral health utilization, call 920-720-1602. TTY users call 800-947-3529.

NetworkHealthMedicare.com

T

Coverage That Travels With You

raveling can be one of the great joys of retirement. Checking out new places and meeting new people is exciting. But, trips can also be stressful—especially if you need medical care.

When you’re traveling outside the Badger state (but still in the United States), you can rest easy knowing your’re covered. Medical services will cost the same as if you were in Wisconsin. Just make sure to show your Network Health Medicare Advantage member ID card. This will help with the billing process.

And when you’re outside the United States, you’re always covered for emergency care. If you have questions about your travel benefit, simply call your health care concierge or 800-378-5234, Monday - Friday, 8 a.m. to 8 p.m. (TTY 800-947-3529). We’re available every day, 8 a.m. – 8 p.m. from October 1 – February 14.

C oncierge • F all 2013 | 5

wellness

Need Help Quitting? Network Health covers smoking cessation counseling sessions for two attempts per calendar year. To learn more, call your health care concierge.

Can E-Cigarettes Help You Quit Smoking?

I

ntroduced to the U.S. market in 2007, electronic cigarettes have ignited a However, little is known national debate between health officials and consumers over the long-term about the possible side effects of the products. effects of inhaling nicotine vapor, as well While electronic cigarettes make up just a fraction of the $80 billion-a-year as other health risks e-cigarettes U.S. market for smoking products, their popularity has grown over the last few could pose to users and the public. The years. In 2011 (the latest year for available data) more than 20 percent of adult Food and Drug Administration (FDA) and some health experts are smokers said they tried e-cigarettes. That’s double the rate in 2010, according concerned that because the side effects of inhaling pure nicotine have yet to to the Centers for Disease Control and Prevention. be adequately studied, they remain unknown. The FDA is also concerned about quality control, worried some manufacturers may not properly So you may wonder, are electronic cigarettes a safe alternative to traditional cigarettes and should they be used as a tool to wean off of cigarettes? Here are disclose all the chemical ingredients and the actual amount of nicotine in their e-cigarettes. some answers.

How do electronic cigarettes work?

Electronic cigarettes, also known as e-cigarettes, are battery-powered devices that deliver vaporized nicotine, but they don’t contain tobacco or produce smoke. The device activates a mechanism that heats up liquid nicotine, which turns into a vapor that smokers inhale and exhale.

Are they a safe alternative to cigarettes?

E-cigarettes contain potentially harmful substances, but are not typically as concentrated as traditional cigarettes, nor do they contain the additives.

Manufacturers and satisfied customers say that nicotine vapor offers many advantages over traditional cigarette smoke.

Can they help you quit?

E-cigarettes might help certain people quit or cut down on real cigarettes, but clinical trials are needed to determine whether this is true. The FDA hasn’t endorsed e-cigarettes as aides for quitting smoking, and in 2010, the agency sent warning letters to companies who marketed e-cigarettes that way.

The truth is, it’s too early to know for sure if e-cigarettes are a safe alternative to traditional cigarettes. And until more clinical evidence is gathered, it will be difficult to assess their benefits and risks. Until then, it’s always best to ask your doctor for a more proven method to help you quit smoking.

Know Where to Get Care I f you get hurt or you become very ill, panic and confusion can make it difficult to know what to do. If you feel it’s an emergency, it’s important to get to the nearest emergency room or call 911. But sometimes, you might not be sure if it’s an emergency. If it’s not, many times your primary doctor or a walk-in clinic can help.

Here are the answers to the two most common questions we get.

What’s the difference between emergency care and urgent care?

First of all, emergency care and urgent care are not the same. An emergency is an illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe

harm. Urgent care is for an unexpected injury or illness that is not life threatening, but still needs attention quickly so you don’t develop a serious problem.

You typically receive emergency care at the emergency room. You may get urgent care at your primary doctor’s office or at a walk-in clinic or urgent care facility.

What if I’m not sure if it’s an emergency?

Knowing what to do before an emergency can help you make the right decisions quickly. If you are not sure whether you should go to the emergency room, call your doctor.

Several health systems also have 24-hour hotlines you can call to speak to a nurse or health professional for health advice. Ask your doctor for this number ahead of time.

Here are some of those hotlines.

6 | C oncierge

w Affinity NurseDirect at 800-362-9900 w Bellin Health On-Call at 888-758-7373 w Prevea On-Call at 888-277-3832 w ThedaCare On-Call at 800-236-2236

NetworkHealthMedicare.com

New Hearing Aid Offer– All Network Health Medicare Advantage members are eligible for an exclusive discount on digital, reprogrammable hearing aids from Pickart Hearing. Call Pickart Hearing at 920-926-1288 to learn more.

Should You Get a Flu Shot?

A

s the season changes from summer to fall, it also moves us closer to Can the Flu Shot Give You the Flu? another flu season. Although you don’t want to think about it now, No. The flu vaccine can’t give you the flu, but you might develop symptoms getting infected with the flu can leave you feeling miserable, and despite getting the shot. These symptoms might develop because of a bad even put you in the hospital. reaction to the vaccine, getting sick in the two-week window before the antibodies build up, getting sick with a different illness that has flu-like An annual flu vaccine is the best way to reduce your chances for getting symptoms or getting a flu virus that doesn’t match one in the vaccine . the flu and will prevent you from spreading it to others. Although many are skeptical of the flu shot, the more people get vaccinated the less it can spread through our communities.

When should you get vaccinated?

Still not sure if you need a flu shot this year? Here is some information to help you decide.

Flu season can start as early as October, so get vaccinated as soon as the shot becomes available in your community. See the next page for more information about where to get your flu shot.

How Does the Vaccine Work?

The flu vaccine causes the body to develop antibodies about two weeks after vaccination. The antibodies protect you from getting infected by viruses that are in the vaccine.

The seasonal flu vaccine works to protect you from the three most common viruses. Each year, one flu virus of each kind is used to produce the vaccine.

Who Should Get Vaccinated?

The CDC recommends that everyone over the age of six get a flu shot. Vaccination is especially important for people with a high risk of developing complications due to the flu, including: • Pregnant women • Young children • Older adults Certain chronic conditions can also increase your risk of flu complications.

Talk to your doctor to find out if you’re at risk.

Should Anyone Not Get Vaccinated?

If you are severely allergic to eggs–some flu vaccines contain a small amount of egg proteins. If you have an egg allergy, talk to your doctor about special precautions to take before receiving the vaccine.

If you’ve had a severe reaction to a past flu shot, check with your doctor.

The flu shot will offer you

better protection

than going without a vaccine.

MEMBER SATISFACTION

A

t Network Health, we make every effort to ensure our members are receiving the service they need and deserve. We believe that’s a big part of the reason 96 percent of our members stay with us year after year.* But, if concerns arise, we want to make sure you understand all your options. If you do not agree with Network Health’s decisions about your care or what’s covered, you have the right to file an appeal, if you believe the following.

• Network Health will not approve or give you care it should cover.

• Network Health is stopping care you still need.

• Network Health has denied payment for services or items you received that are not covered, and you think they should be covered.

You must file your appeal in writing within 60 calendar days after the date of the denial. Although, if you have a good reason for missing the deadline, we can give you more time.

Who may file an appeal?

You or someone you name to act for you (called your authorized representative) may file an appeal. You can name a relative, friend, advocate, attorney, doctor or

NetworkHealthMedicare.com

someone else to act for you. To do this, you and the person you choose must sign, date and send us a statement naming that person to act for you. To learn how to name your authorized representative, call your health care concierge or 800-378-5234.

How do I file an appeal?

You can send us your appeal by faxing it to 920-720-1908 or writing to Network Health Medicare Advantage Plans C/O Appeals and Grievances, P.O. Box 120, Menasha, WI 54952.

What happens after I file an appeal?

If you appeal, we will review our decision. After we review our decision, if payment for any of your claims is still denied, we will automatically forward your appeal request to the CMS Contractor (MAXIMUS Federal Services) for an independent review. This is provided

by Medicare for a new and impartial review of your case outside of your Medicare Advantage organization. If you disagree with that decision, you will have further appeal rights and you’ll be notified of those rights if this happens.

How can I file a complaint?

If you’re dissatisfied with the service or quality provided by your plan, we’re here to work with you through any issues. You have the right to file a grievance (a formal complaint) about how Network Health provided services.

Examples of situations appropriate for a grievance include: • Difficulty getting through on the phone • Concerns about the quality of care of services provided • Interpersonal aspects of care (for example, rudeness of a provider or staff) • Failure to respect your rights You can submit your grievance over the phone or in writing within 60 calendar days from the date of the event. Call us at 800-378-5234 (TTY 800 947-3529), Monday - Friday, 8 a.m. to 8 p.m., or write to Network Health Medicare Advantage Plans C/O Appeals and Grievances, P.O. Box 120, Menasha, WI 54952 We will complete a full investigation as quickly as your case requires and let you know the results no later than 30 calendar days from the date we received your request. If we need more time to make a determination, we’ll let you know about that extension within 24 hours.

C oncierge • F all 2013 | 7

Ask the Experts B

eing a Network Health Medicare Advantage member means having a partner to help you get your questions answered. Our talented health care concierges work with you to make sure you’re receiving the most out of your plan. We recently asked four concierges to provide answers to the most common questions members ask.

Q: W hat if I need a wheelchair, scooter or diabetes supplies--where should I go?

A: We’ll help you with that. Call your concierge directly or customer service. We’ll find you an in-network provider close to where you live. Television ads for companies providing these items are typically out-of-network. When you order from these companies, it will often cost more.

Q: How is the shingles shot (Zostavax) covered?

A: It is only covered if you have Part D (prescription drug coverage). If you are not in the donut hole, you will pay $40 if you get the shot at a preferred pharmacy or $45 at a non-preferred pharmacy.

If you get the shot at a doctor’s office, you’ll need to pay the full cost up front—then, contact your health care concierge for a reimbursement packet.

We will reimburse you for everything but the copayment. Remember, the shot is not covered if your plan does not include drug coverage.*

Q: A:

Q: How long will it take to get my fitness reimbursement?

A: Gym membership reimbursements take a minimum of 45 days to process from the time we receive them.

Q:

A:

What is the Benefit Accumulator on my Explanation of Benefits?

This is an explanation of what you paid toward your out-of-pocket maximum. Your out-of-pocket maximum is the plan-specific amount which is the most you could pay for medical services in a calendar year. The amount listed by Benefit Accumulator is the amount you’ve paid in copayments up until that Explanation of Benefits was printed.

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Where can I get a flu shot?

There are several ways to get your flu shot. If you get it at your doctor’s office, you’ll pay the copayment for the visit. If you get a flu shot at a pharmacy, you will need to pay for it in full and then send a receipt to Network Health for reimbursement.

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*The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Benefits, formulary, pharmacy network, premium and/ or copayments/coinsurance may change January 1 of each year.

Limitations, copayments and restrictions may apply.

1570 Midway Place, Menasha, WI 54952

SHANNON LENIUS

Exclusive Reduced Rate

A Christmas Carol

Wednesday, December 4 at 7:30 p.m.

Cost is $17 To see this Christmas classic at the special discounted rate, log on to eventusher.com, and type Medicare in the password field. Then, purchase your ticket by following the simple instructions that appear. This offer is only valid for Network Health Medicare Advantage members and their families. Not valid on previously purchased tickets. Valid while supplies last. Offer expires October 20, 2013, at midnight.

HEALTH OR WELLNESS OR PREVENTION INFORMATION

WHAT’S THAT? Health Care Concierge Your personal Network Health customer service representative.

You can always call this person directly.