Healthy Life - Fall 2025

healthylife OCTOBER 2025

Plan Changes in 2026

FALL NE VACCI IST KL CHEC 2 See p.

SE N IORCARE CE LE BRATION 2025

WHO N E E DS TO TAKE A STATI N?

PHARMACY U PDATE

Quick Start 

Changing Leaves Fall Vaccine Checklist Fall is a notorious time for respiratory illnesses. Your best defense?

Vaccination. Be sure to get these shots checked off your list.

Flu Among older adults and individuals with compromised health, flu vaccination greatly reduces the risk of hospitalization and intensive care admissions. Remember to get your flu shot once every year.

Pneumococcal Pneumococcal vaccines protect against pneumococcal diseases, like pneumonia. Adults ages 50 and older may need one or more shots.

RSV (Respiratory Syncytial Virus) Every year, between 6,000 and 10,000 older adults die from RSV in the U.S. Everyone over age 75 should get the vaccine.

It’s also recommended for anyone ages 60 to 74 with heart or lung problems, and nursing home patients. You only need one dose.

To schedule your flu, pneumococcal, and RSV vaccines, call your doctor or visit any participating pharmacy.

Healthy Life is published by Baylor Scott & White Health Plan.

The information is intended to educate readers about subjects pertinent to their health, not as a substitute for consultation with a personal physician. Developed by WebMD Ignite. © 2025 Printed in U.S.A.

2 | Healthy Life | OCTOBER 2025

Fall is a time for change. Changing leaves. Changing weather. Changing schedules as children go back to school. Change can be a good thing, and at Baylor Scott & White Health Plan, we’re constantly thinking of changes that will make your healthcare experience better.

In August, our mail-order and specialty pharmacy changed to Costco Pharmacy. We made this change to enhance your customer experience and to keep your prescription prices competitive. Don’t worry—you don’t need a Costco membership to use this service. Turn to page 7 to learn more.

Your Annual Notice of Change should also be coming in the mail, if it hasn’t arrived already.

Our plans have many exciting changes coming in 2026. Turn to page 4 for a quick overview of what to expect.

One thing you shouldn’t change?

Making healthy choices like scheduling your annual wellness visit. Also, remember to get your flu shot to protect yourself as well as your loved ones. And, of course, be sure to continue habits like making healthy food choices, staying active, and keeping track of your doctor's appointments.

Remember, you have the power to finish the year strong.

Robert Waterhouse, MD, MBA, HSM Chief Medical Officer/ Senior Vice President Baylor Scott & White Value-Based Care and Baylor Scott & White Health Plan

SeniorCare

 Members Matter

Celebration 2025 We can’t help but reminisce about our annual SeniorCare Celebration that took place this past May. Shout out to everyone who came to the Mayborn Convention Center in Temple, Texas, and thank you to the volunteers who made this event possible. 

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A Closer Look 

WHAT’S NEW FOR 2026?

Your Annual Notice of Change will be arriving in your mailbox soon. If you’re considering changing plans, here are some highlights to look out for.

For complete benefit details, see your Annual Notice of Change.

exams, as well as hearing aid fitting and evaluation. You may use your hearing aid allowance at any provider, too.

Over-the-Counter Benefit Now Available for All Plans No matter what plan you choose in 2026, you’ll get a quarterly allowance that you can use to purchase select over-the-counter items at retail stores.

Two plans will have increased allowances next year:  West Texas PPO: $130 per quarter  Central Texas HMO-POS Select Rx: $80 per quarter  NEW! Central Texas PPO Platinum: $30 per quarter

Vision Changes For all plans, you may visit any provider—in or out of network—for routine vision exams and eyewear.

Dental Changes for Central Texas Plans  Central Texas HMO-POS Premium Rx: Plan maximum allowance reduced to $3,000  Central Texas PPO Basic: Plan maximum allowance reduced to $3,000 Hearing Changes For all plans, you may use your hearing aid allowance to purchase hearing aids over the counter. You may also visit any provider—in or out of network—for routine hearing

4 | Healthy Life | OCTOBER 2025

Annual Physical Exams for PPO Plans All PPO plans now include an annual physical exam for a $0 copay.  Need help understanding your 2026 Medicare Advantage plan options?

Call our Customer Engagement team for a one-on-one opportunity to ask about 2026 plan changes or to get assistance in selecting a new plan. 877.845.3901 (TTY: 711), Monday through Friday, 8:00 AM to 5:00 PM

Out-of-network/non-contracted providers are under no obligation to treat BSW SeniorCareAdvantage members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Join Us! Learn more about plan changes at one of these events.

October 1, 2025 10:00 AM, 11:30 AM, 2:00 PM BSW Medical Office Building 810 State Hwy 71 Marble Falls, TX 78654 October 2, 2025 10:00 AM, 11:30 AM, 2:00 PM Williamson County Advocacy Center 1811 SE Inner Loop Georgetown, TX 78626 October 3, 2025 9:00 AM, 11:00 AM, 1:00 PM, 3:00 PM Killeen Civic Center 3601 S WS Young Dr. Killeen, TX 76542

October 6, 2025 10:00 AM, 11:30 AM, 2:00 PM BSW Medical Center 5252 W University Dr. McKinney, TX 75071

October 10, 2025 10:00 AM, 11:30 AM Knipling Education Center 3514 21st St. Lubbock, TX 79410

October 7, 2025 9:00 AM, 11:00 AM, 1:00 PM, 3:00 PM Mayborn Center 3303 N 3rd St. Temple, TX 76502

October 13, 2025 10:00 AM, 11:30 AM, 2:00 PM BSW Medical Office Building Hillcrest 100 Hillcrest Medical Blvd.

Waco, TX 76712

October 8, 2025 10:00 AM, 11:30 AM, 2:00 PM BSW Plaza, Alamo Auditorium B 900 Scott & White Dr. College Station, TX 77845 October 9, 2025 10:00 AM, 11:30 AM BSW Medical Office Building 2400 N Interstate 35 E Rd. Waxahachie, TX 75165

October 14, 2025 10:00 AM, 11:30 AM BSW Medical Office Building 1650 W College St. Grapevine, TX 76502 Scan the QR Code to RSVP. You may also RSVP and request accommodations for special needs by calling 877.845.3901 (TTY: 711), Monday through Friday, 8:00 AM to 5:00 PM.

A recorded presentation is available at BSWHealthPlan.com/Medicare.

Take Advantage of Your Supplemental Benefits in 2026 

Hearing. All plans include hearing services that are not covered by Original Medicare, like a routine hearing exam and an allowance every three years toward the purchase of hearing aids. You may use any provider, in or out of network.

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Vision. All plans include a routine annual exam, plus an annual allowance toward the purchase of contacts, frames, and lenses. You may use any provider, in or out of network.

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Dental. All plans feature dental benefits through MetLife at no additional premium. MetLife’s Preferred Dentist Program is a dental PPO plan.

You can visit any licensed dentist—in or out of the MetLife PDP Plus network—and receive benefits.

Find a participating dentist at MetLife.com.

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Fitness membership. All plans include fitness benefits with the Silver&Fit® program. This program helps you to improve your health with fitness options, digital tools, and healthy aging resources.

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OTC allowance. All plans feature a quarterly purchase allowance from participating retailers for eligible over-the-counter items, such as bandages, cold and allergy medicines, pain relievers, and more.

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Routine transportation. BSW SeniorCare Advantage HMO-POS plans include routine transportation to approved locations, such as medical appointments, physical therapy visits, labs, grocery stores, and drug stores.

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In-home meals. BSW SeniorCare Advantage HMO-POS plans include a meal benefit to ease your recovery when you return home from the hospital.

The Silver&Fit program is provided by ASH Fitness, a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit, Living Boldly, FitnessCoach, Silver&Fit Connected!, and the Silver&Fit logo are trademarks of ASH. Limitations and restrictions may apply. Fitness center participation may vary by location and is subject to change. Kits are based on availability and subject to change.

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Pharmacy Benefits 

STATINS:

More Than a Cholesterol-Lowering Drug Statins are the most common medication used to lower high cholesterol in the blood. But they have other important benefits, too. In fact, they may be prescribed for people with diabetes even when their cholesterol level is normal.

The names of these medications are easy to recognize: They all end with “-statin.” Examples include atorvastatin (Lipitor), pravastatin (Pravachol), rosuvastatin calcium (Crestor), and simvastatin (Zocor).

Here’s a look at how statins work and why you might need one.

What Statins Do in the Body Cholesterol is a fat-like substance in the blood that can build up inside blood vessels and cause problems. Statins help keep the liver from producing cholesterol.

This reduces the amount of LDL

(“bad”) cholesterol in the blood.

To a lesser extent, statins also help lower triglycerides (blood fats) and raise HDL (“good”) cholesterol levels.

But there’s more. Statins may also help:  Lessen infl ammation in blood vessels, which works against the buildup of fatty deposits  Reduce the risk of having a heart attack or stroke  Decrease the chance that people with heart disease will need a cardiac procedure

Who Needs to Take a Statin?

For certain adults up to age 75, experts recommend statins as the first-choice drug treatment to:  Lower high LDL cholesterol  Prevent cardiovascular disease in people with diabetes, regardless of their cholesterol level Discuss possible side effects with your provider, as well. Most side effects are mild and go away as your body gets used to the medication. Some people report bothersome muscle pain. If that happens, your provider may switch you to a lower dose or a different statin.

For people who need a statin, research shows that the pros far outweigh any cons. Statins may be helpful for many people older than age 75, too. Talk with your provider about whether a statin could be beneficial for you. 

6 | Healthy Life | OCTOBER 2025

Pharmacy Update An upgraded mail-order and specialty pharmacy experience is here.

Effective August 1, 2025, prescriptions formerly filled by Optum Home Delivery or Optum Specialty Pharmacy are now handled by Costco Pharmacy (some exceptions may apply). You do NOT need a Costco membership to use this pharmacy. You will, however, need to set up a Costco Pharmacy account. This account is available at no cost.

You should have received a letter in the mail if this change applies to you. If you pick up your prescription(s) in person from a retail pharmacy, you are NOT impacted by this change.

Questions? Visit BSWHealthPlan.com/CapitalRx or call 833.502.3340.

Scan the QR code to learn how to set up your Costco account and find answers to frequently asked questions.

Budget Tip Consider three-month supplies of your prescriptions to save money.

Many medications are available for a 90-day supply at a lower copay. This saves you money—and extra trips to the pharmacy. There are two ways you can take advantage of this benefit: 

Preferred Retail Pharmacy: Most Tier 1 medications are available for $0 for a 90day supply at preferred retail pharmacies. In addition, most medications in Tiers 2 through 4 are available for two copays for a 90-day supply.



Mail-Order Pharmacy: Mail-order service is also available through Costco Mail Order Pharmacy. Most Tier 1 and Tier 2 medications are available for $0 for a 90-day supply when using mail order. In addition, most Tier 3 and Tier 4 medications are available for two copays for a 90-day supply. If you are not taking advantage of this benefit, talk with your doctor to see if a 90-day supply of your prescriptions is right for you.

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Call for Nominations 1206 West Campus Drive Temple, TX 76502

The Medicare Member Advisory Committee is accepting nominations for additional members. Nominees should be current members with insight into Medicare and available to meet quarterly at our Temple office to discuss how to make the Health Plan better. To nominate someone or learn more, email Customer Engagement Manager Larry Wilson at lawrence.wilson@ bswhealth.org.

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Recipe 

Multigrain Chicken Soup There’s nothing like warm, cozy soup on a chilly fall day. This twist on the classic chicken soup includes brown rice, barley, lentils, and split peas—all great sources of iron.

Ingredients ¹/2 cup raw brown rice ¹/3 cup medium barley ¹/3 cup red lentils ¹/3 cup yellow split peas 2 ribs celery, sliced 4 carrots, sliced 2 garlic cloves, crushed 2 tbsp. dried parsley 1 tbsp. dried thyme

1 tsp. powdered ginger 1 tsp. marjoram ½ to 1 tsp. salt, depending on taste ½ tsp. ground black pepper 1 lb. b oneless, skinless chicken breasts, cut into bite-sized pieces 12 cups water

Directions 1. Put all ingredients in a large pot.

Bring to a boil.

2. Cover the pot and turn the heat down to simmer. Cook for about one hour, until all grains are tender.

3. Check seasonings. Soup will be thick.

Per Serving Serves eight. Each 1 ½ cup serving contains approximately 236 calories, 22 grams protein, 3 grams fat, 30 grams carbohydrate. 

TIP: You can thin the soup, if you like, by adding water or low-sodium chicken stock.