House Calls - Midwest Fall 2016

Winter MW

Health and Wellness or

Know Your Plan

Call us 8 a.m. to 8 p.m. weekdays • Toll-free 1-800-965-4022 • TTY/TDD 711 Voicemail is used on holidays and weekends from February 15 to September 30.

HealthAllianceMedicare.org Med-MWfallHC-1116 • Y0034_15_31264

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HealthAllianceMedicare.org ▼

From the Editor: Get to Know Your Health Plan

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s you go into the holiday season and prepare for 2017, it’s also important to know how your health plan will work for the new year.

In this issue, we’ll walk you through some changes and additions that will help make your life easier. We’ll also give you an inside look at our Member Advisory Board, share tips and reminders for being prepared this winter and give you other helpful details along the way

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Remember, we’re always just a phone call away. If you need help now or throughout the year, call the Member Services number on the back of your ID card. We also have a local office in Central Illinois. We love seeing our members in person.

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206 W. Anthony Dr. Champaign, IL 61822 (weekdays from 8 a.m. to 5 p.m.)

HealthAllianceMedicare.org

Controlling Diabetes Is Key for Your Kidneys

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hile you’re checking out your new benefits and thinking about your healthcare coverage, it’s also a great time to focus on your health. Diabetes can raise your risk for some other diseases, so it’s always important to keep your blood sugar and blood pressure in check.

Help with your Health If you have a chronic health problem like diabetes, high blood pressure or asthma, we have extra help and resources for you. We also have nurses to help with these conditions and more complex conditions. Call the Member Services number on the back of your ID card and ask about our nurse case managers and disease management programs if you think you could benefit from extra help with your health.

High blood sugar levels can lead to kidney damage.

Kidneys filter waste out of your blood, but uncontrolled sugar makes the kidneys filter too much blood, putting extra pressure on the filtering system.

Quit For Life® If you need help to stop using tobacco, try the Quit For Life® program that comes with your plan. It includes one-on-one coaching, a personalized quit plan and lots more. Call the Member Services number on the back of your ID card to learn more.

Damaged kidneys can eventually lead to kidney failure, meaning they can no longer filter blood and will allow waste to build up in the bloodstream. At that point, the only treatment options are dialysis and transplant.

Fortunately, there are steps you can take to help reduce your risk of kidney problems.

Protect Yourself and Others This Flu Season

• Control your blood sugar.

• Keep your blood pressure in check (under 140/90 mmHg).

Get a flu shot to help you avoid getting the flu and spreading it to others. Your plan covers the flu shot as part of your wellness benefits at no cost to you.

To find an in-network doctor or facility where you can get the shot, call the Member Services number on the back of your ID card.

• Don’t smoke.

You should also get the following screenings yearly.

• Urinary albumin test • Estimated glomerular filtration rate test People with moderate to severe kidney disease may not have symptoms, so regular checkups and testing are key.

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Exciting Changes Coming to Your Plan

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e introduced some exciting changes to your coverage this fall for the 2017 plan year. From a brand-new fitness benefit to a new preferred costsharing network pharmacy, we’re cutting back on hassle and making your plan more convenient.

Wellness Be Fit Starting in January, we’re making our fitness benefit less restrictive and letting you go to any gym of your choice. We’ll reimburse you for your gym membership or fitness class fees up to $30 per month for a possible total of $360 per year.

You can submit receipts monthly, quarterly or at the end of the year. We included a flier with more details and our reimbursement form in your 2017 materials.

Rally® Rally*, our easy-to-use digital health experience, is another helpful fitness tool that’s now included in your plan. Rally uses personalized missions, group challenges, support and rewards to help you with your health in these areas and more.

• Exercise • Sleep • Nutrition • Stress management Go to HealthAlliance.org to learn more and get started.

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HealthAllianceMedicare.org

Pharmacy Walgreens as a Preferred Cost-Sharing Pharmacy You spoke, and we listened. For 2017, we’ve made Walgreens a preferred cost-sharing pharmacy, which means you can get your Tier 1 generic drugs for $0 when you fill your prescriptions there. You can also take advantage of its convenient drive-thru. We have other preferred cost-sharing pharmacies, too. Check your pharmacy directory to learn more.

Walmart and Sam’s Club are still in-network and will be considered standard cost-sharing pharmacies for 2017.

Retail 90 Along with $0 Tier 1 generics, you can also get a 90-day supply of your drugs for a two-month copay at Walgreens and other preferred cost-sharing pharmacies.

And this year, we have even more exciting pharmacy discounts coming your way. You can get a 90-day supply of your drugs for a 2.5-month copay at our standard cost-sharing network pharmacies. In the past, this would have been a three-month copay.

No Deductible for Tier 2 Drugs In 2017, you will no longer need to meet a pharmacy deductible for Tier 2 drugs. Last year, you had a deductible for Tiers 2–5, but starting in January, your deductible will apply to only Tiers 3–5.

To learn more, read your Annual Notice of Change and go to HealthAllianceMedicare.org. You can also give us a call at the Member Services number on the back of your ID card. *If you don’t have internet access, health surveys, self-management tools and rewards are also available by mail or phone. To participate, call the Member Services number on the back of your ID card.

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Member Advisory Board Helps Shape Health Alliance Medicare

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n healthcare coverage, change happens often and comes from many different directions—the government, hospitals, pharmacies.

The list goes on and on. But at Health Alliance Medicare, some of the most exciting changes come from the most important stakeholders, the members.

Health Alliance Medicare’s member advisory board meets four times a year to discuss topics that affect coverage, quality, extra benefits and more. The current board boasts 12 members from various towns in the service area. They talk about ways to make healthcare coverage as easy and useful as possible for themselves and their fellow members.

“Our advisory board members do a really good job of thinking beyond themselves to how our changes and our plans affect their peers and others within the community,” says Jennifer Marquardt, director of consumer product service at Health Alliance Medicare. “They are great at thinking about needs beyond their own.”

Marquardt, an Oakland, IL, native who now lives in Monticello, IL, has worked at Health Alliance for 15 years.

She started as a manager of marketing administration for employer group health plans and made the move to a Medicare role in 2007. At that time, she became the chairperson of the member advisory board and has been ever since.

As someone born and raised in Central Illinois, Marquardt likes helping people in her community and other counties in the Midwest.

“I really enjoy having a confidence that someone is taking care of our members,” she says. “I feel like that’s my role, and I like doing that. And I work with a team of people who feel the same way.”

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She also likes seeing the member advisory board help make fellow members’ lives a little easier. This year, the board members helped change how Health Alliance Medicare approaches member renewals.

During the Annual Enrollment Period in past years, Health Alliance Medicare sent renewal notices and not much else to current members. This year, member advisory board feedback changed that.

Jennifer says that this year members got information about other plans Health Alliance Medicare offers in case a member’s needs or financial situation had changed. That way, members could make sure they were getting the most from their plans, which is one of Health Alliance Medicare’s biggest goals.

Jennifer appreciates the board members’ dedication in their voluntary role. She is also glad they are willing to be honest even when their opinions disagree with other board members or what Health Alliance Medicare is currently doing. She welcomes change, especially when it comes from members wanting to help other members.

“We’re looking for someone who doesn’t have a personal agenda but is a respectful listener and not shy to speak up or to share their opinion even if it’s contrary,” she says.

“We’re not looking for people to just agree with what we’re doing on every issue.”

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If you’d like to learn more about becoming a board member, call the Member Services number on the back of your ID card and ask to speak to Jennifer Marquardt.

Current Member Advisory Board • Nancy Apperson • MaryLou Beggs • Rich Frankenfeld • Dan Harmon • Arlene Jaynes • Hermann Kreidl • Nancy Merz • Roger Rheeling • Philip Robinson • Lucille Symmonds • Jim Turpin • David Wiegand

HealthAllianceMedicare.org

Be Prepared for Winter Weather

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inter weather can be dangerous and hard to predict, but planning ahead can help. Here are some tips to stay as safe and warm as possible at home and on the road.

Power Outages Winter storms can knock out your home’s electricity, so have a battery-powered space heater, flashlights, a batterypowered radio, extra blankets and three days’ worth of nonperishable food and water on hand. These are good things to have ready in case you get snowed in, too.

Learn about your area’s emergency plans and locate the nearest shelter by visiting your state’s or city’s website or calling your local Red Cross chapter.

Bad Road Conditions Try to avoid driving when the roads are bad. If you must go out, make sure you have at least half a tank of gas and an emergency kit in your car with these items.

• Shovel • Windshield scraper • Flashlight with extra batteries • Battery-powered radio • Bottled water • Snacks, like energy bars and raisins • Extra hats, socks and gloves • Blankets or sleeping bag • First aid kit with pocket knife • Necessary medications • Emergency flares and reflectors • Car-compatible phone charger

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Before heading out, check your state’s Department of Transportation website or watch the local news to learn about road conditions. Drive with extra caution—go slowly, don’t stop suddenly and leave

plenty of room between you and the car ahead of you. Also, make sure you have your brakes, tires and antifreeze level checked.

Slippery Outdoor Surfaces.

People 65 and older have a higher risk of fractures caused by falls, and adding snow and ice to the mix doesn’t help. But following these tips can help you avoid slips and falls this winter.

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Keep your sidewalks and driveway clear.

These surfaces can be dangerous when covered in ice and snow. Have a family member or neighbor shovel snow (or use a snow blower), then use salt or sand to help make those areas less slippery.

Be careful on stairs. If you have outdoor stairs leading up to your house, consider having handrails installed to keep you from slipping. Also, check that your stairs are sturdy. Weak or wobbly stairs could raise your chances of a fall.

Ask for help getting to your car. If you park outside and the path to your car is slippery, have a family member or neighbor help you get from your house to your car safely.

Avoid going outside at night or in bad weather. It’s hard to see where you’re walking in the dark or during a snowstorm, and that can raise your risk of a fall. If you do have to go out, have someone walk with you.

Wear shoes with non-skid soles. Having the right winter footwear can go a long way toward avoiding a fall. Check your shoes and boots before the weather gets bad to make sure the soles aren’t too worn down to give you good traction.

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For more tips and info, search for “winter” at ready.gov or cdc.gov.

HealthAllianceMedicare.org

Heading South for the Winter?

You’re Connected to Care Anywhere

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One of the great things about being retired is having the freedom to travel. After decades of hard work, many people find they now have the time and resources to migrate to warmer climates and escape the dreary winter months of the Midwest.

Whether you go south of the border or just far enough to leave your winter coat behind, your Assist America benefit connects you to care when you’re more than 100 miles from home. It’s one of the valuable perks that come with your Medicare Advantage plan at no extra cost to you.

Here are just some of the many services you can get through Assist America.

• Prescription assistance • Compassionate visit • Return of mortal remains • Help returning home if you’re hurt or ill • Prompt medical attention • Medical referrals • Immediate hospital admission • Emergency medical evacuation • Lost luggage assistance • Interpreter and legal referrals • Help recovering essential travel documents • Pre-trip information You can reach Assist America 24 hours a day, 365 days a year from anywhere in the world. Keep these important numbers with you while traveling.

Reference number: 01-AA-HAM-031003 Within the U.S.: 1-800-872-1414 Outside the U.S.: +1-609-986-1234

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Here is some more good-to-know info.

• Your Assist America benefit takes effect when you are more than 100 miles from home for less than 90 days.

• Assist America pays for all the services it provides.

This winter, when you pack your bags and hit the road, you can leave your worries behind. You’ll have peace of mind knowing that Assist America connects you to care while you’re away from home.

To learn more, see your plan materials or call the Member Services number on the back of your ID card.

• There is no financial cap on any services.

• There are no exclusions for preexisting conditions or for participating in extreme sports.

If you have an HMO plan, all Assist America benefits apply when you’re out-of-network. But remember, while traveling, Health Alliance Medicare only covers your emergency care.

Assist America will not pay you back for ambulance and other services you arrange on your own. But in a life-threatening emergency, always call the ambulance right away.

There is no added cost for the service itself, but there could still be a cost with any medical care. Other conditions and exclusions may apply.

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HEALTH ALLIANCE 301 S VINE ST. URBANA IL 61801-3347

PRSRT STD U.S. POSTAGE PAID CHAMPAIGN,IL PERMIT NO. 488

Give a Gold Star

Have you had a great experience with somebody at Health Alliance Medicare? If so, you can give that person a Gold Star as a special way to say thanks. We’ll share your story with that person and his or her manager and peers. And we might even use it in ongoing employee recognitions. You can thank someone today at HealthAlliance.org/GoldStar.

Calendar of Events: Jazz Vespers Sundays • 4 p.m.

Westminster Presbyterian Church 1420 W. Moss Ave. Peoria, IL Westminsterpeoria.com

ABCs of Medicare March 1 • 5:30–7 p.m.

Heartland Community College 211 E. Madison Ave. Pontiac, IL

Urbana Park District Free Fitness Week January 3–January 6 Try the fitness classes at the Phillips Recreation Center, the Urbana Indoor Aquatics Center, the Anita Purves Nature Center or Brookens Gym free for this week.

UrbanaParks.org/events

2017 CBS 2 Your Health Expo April 2 • 11 a.m.–3 p.m.

Doubletree by Hilton Convention Complex 350 1st Avenue NE Cedar Rapids, IA

Health Alliance Medicare is a Medicare Advantage Organization with a Medicare contract.

Enrollment in Health Alliance Medicare depends on contract renewal.

The formulary, pharmacy network and/or provider network may change at any time. You will receive notice when necessary.

You must continue to pay your Medicare Part B Premium.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments and restrictions may apply.

Benefits and co-payments/co-insurance may change on January 1 of each year.

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