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Medicare Advantage Updates: What’s New for 2012

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Enhanced Prescription Drug Benefits:

All Capital Health Plan Medicare Advantage (HMO) plans will offer a 90-day retail supply and a 90-day mail order supply of most prescriptions beginning January 2012.

To take advantage of the 90-day retail supply just ask your physician’s office for a 90-day prescription and fill the prescription at your local pharmacy.

To take advantage of the 90-day mail order service:

Contact your physician’s office and ask for a 90-day prescription with three refills. 

  • Fill out the Mail Service Order Form. 
    • Download the form at caremark.com under “Forms for Print.” 
    • Or, call Member Services at the numbers listed below, and we will mail you a form. 
  • Mail the form to Caremark at the address printed on the form.

Drugs available through mail order are drugs you take on a regular basis, for a chronic or long term medical conditions.  The drugs that are not available through mail order service are marked with a “NM” (not available at mail order) on your Formulary (drug list).   The Formulary is available on line at capitalhealth.com/2012 Medicare. All Medicare Advantage members enrolled in plans that renew between October 1 and January 1 have also received the new 2012 Formulary by mail.  

Medicare-Covered Preventive Services:  

Most preventive services have been covered by Capital Health Plan at no cost to members in the past.  However, in 2012 members will see some additional preventive services covered at no cost.  Please refer to your Evidence of Coverage, Chapter 4, for a list of preventive services.   This is a good time to check and make sure you have completed your annual screenings for 2011.

For other 2012 changes, please refer to your Annual Notices of Changes and Evidence of Coverage.

Questions:  Contact Member Services, 850-523-7441 or 1-877-247-6512 (TTY 850-383-3534 or 1-877-870-8943) 8:00 a.m. to 8:00 p.m., seven days a week.

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Ask Dr. Nancy: Important information about prescription drugs

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Question:How can I improve the benefits of my prescription drugs while reducing the risks?

Answer: In the last 25 years, we’ve seen a major increase in the number of drugs available to us. There are many obvious advantages to that availability, but one negative effect is that we expect there to be an effective pill for every condition. What we may not realize is not all pills are effective for everyone, many carry side effects that can outweigh their advantages, or many may simply control the adverse results of an unhealthy lifestyle rather than address underlying issues with diet and exercise.  To make informed decisions about your medical care, here are some things you should keep in mind about prescription drugs.  

Most medications are tested in young, healthy people who are not on other drugs. The effectiveness and safety of a drug is very different, for example, when taken by an elderly person with tired kidneys who is also taking six other drugs.

The problem is that over time, multiple doctors can continue to prescribe you medications without considering your total health picture. Some may be for symptoms which are bothersome but not life threatening. Those drugs may cause side effects and you may be prescribed more drugs to reduce the side effects.  You may be reluctant to stop any medication once you start it. And that can all add up to a real mess.  

Being proactive and knowledgeable about your prescriptions is very important in the event of a hospital stay. Let’s say you have an emergency and go to the hospital. Hospital

staff will try to find out what medications you are taking. If you or your family members don’t know the names and dosages of your medications, it can be hard for them to give you the best medical care. 

More complications can come when you are released from the hospital. Nurses try to reconcile medications you were taking before you went into the hospital with any new prescriptions from your hospital visit. They will develop a list and give it to you with instructions. You may be overwhelmed by all the new information. Make an appointment to follow up with your primary care physician who knows your medical history best. Be prepared to discuss new medications and any new side effects you may be experiencing. 

There are other simple things you can do to help avoid complications from prescriptions medications. Be honest with your physician about how regularly you take your medications. Let your physician know your goals. Do you want to minimize cost, maximize convenience, or minimize your medications? Working along with your physician, you can experience the advantages to the vast advances in prescription drugs, and avoid the disadvantages. 

Coming Soon for Commercial Members: 90-Day Supply Medications

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Would you like to make fewer trips to the pharmacy?

Effective January 1, 2012, Capital Health Plan Commercial members (who receive their pharmacy benefits through CHP) can obtain a 90-day supply of Tier 1 generic medication for three copayments at participating network pharmacies.  This benefit will allow you to refill your Tier 1 generic medications just four times over the course of a year.  To take advantage of this benefit, simply ask your doctor to write a prescription for a 90-day supply of your Tier 1 generic medication, and then fill it at any CHP network pharmacy.

Why is using a generic drug the best value for your dollar?

Brand name drugs cost an average of six times more than generic drugs—yet according to the U.S. Food and Drug Administration (FDA), generics are just as safe and effective.  To start saving money today, ask your doctor about generic drugs and be sure to present your CHP membership card to receive the most from your pharmacy benefit!

Want to save even more money?

Ask your doctor if one of the generics found on our Low Cost Generics List (available at capitalhealth.com) is right for you. You’ll pay just $9.99 (plus a dispensing fee) for a 90-day supply.  This list offers you the best value on more than 300 generic maintenance medications for chronic conditions. 

November is National Epilepsy Awareness Month

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

It’s Time to Get Seizure Smart!

In recognition of National Epilepsy Awareness Month in November, the Epilepsy Foundation is challenging America to Get Seizure Smart!  The goals of this nationwide public awareness campaign are to educate millions of Americans about epilepsy because epilepsy affects nearly 3 million Americans and nearly 360,000 people in Florida are living with this chronic condition. Yet for many, the biggest problem is not the disorder itself, but society’s knowledge about the condition. That is why awareness—and talking about it—is so important. 

“We want to empower people with epilepsy to dispel myths and encourage the public to better understand the condition,” said Karen Egozi, chief executive officer of the Epilepsy Foundation of Florida. “It is important for people to know what a seizure is, how to recognize one and what to do—and not do-- if someone is having a seizure.”

If you saw someone having a seizure, would you know what to do?  If your answer is no, then it’s time to Get Seizure Smart.

The purpose of National Epilepsy Awareness Month is to:

  • Dispel common myths about epilepsy
  • Promote public awareness, seizure first aid, and an understanding of the condition
  • Inform people with seizure disorders and their families about service programs and informational resources available nationally and in their local areas 
  • Educate the public about the symptoms of epilepsy and seizure disorders to help eliminate the stigma unjustly associated with the condition

Throughout the month, you can visit www.GetSeizureSmart.org to take the interactive online Get Seizure Smart quiz and test your knowledge about seizures. On this site, you will also find a downloadable quiz you can print out and give to everyone you know, or forward to a friend so they will also be seizure smart. There are also downloadable fact sheets, short videos and other resources to arm Americans with tools that will help them recognize a seizure and know how to respond. 

Epilepsy, also known as a seizure disorder, is a medical condition that produces seizures affecting a variety of mental and physical functions. When a person has two or more unprovoked seizures, they are considered to have epilepsy. 

Join us in helping America Get Seizure Smart! Help us spread the word - visit www.GetSeizureSmart.org

Ask Your Local Member Services Department

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Question:

How do I update my personal information at Capital Health Plan?

Answer:

Capital Health Plan strives to keep the most current and updated information for all of our members. If need to change your address or phone number, please use the following steps:

If your home or work number changes:

We can take this information over the phone. Please contact the Member Services Department.

  • Commercial Members: Five days a week 8 a.m. – 5 p.m.850.383.3311 or 800.390.1434
  • Medicare Members: Seven days a week 8 a.m.– 8 p.m.850.523.7441 or 877.247.6512
  • TTY/ TTD: 850.383.3534 or 877.870.8943
If you need to update your address with Capital Health Plan:

We cannot take this information over the phone. Please use the following steps:

  • Commercial  Members: Contact your Employer Group Administrator and ask that they submit your current updated address to us with a “Member Status Change Form.”
  • Medicare Members: Please submit your information to Capital Health Plan through a written request.  
    • Mail to: Capital Health Plan Attention: Enrollment Department PO BOX 15349Tallahassee, Florida, 32317
If you have a Name Change:

We cannot take this information over the phone. Please use the following steps: 

  • Commercial Members: Contact your Employer Group Administrator and ask that they submit your current updated name to us with a “Member Status Change Form.”
  • Medicare Enrolled Members:  Please contact the Medicare Office at 1-800-MEDICARE (1-800-633-4223). They will update your information and forward your name change to Capital Health Plan for prompt updating.

Stay Fit. Stay Balanced. Prevent Falls.

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Each year U.S. hospitals have 300,000 admissions for broken hips. Falling is often the cause of those fractures.

As we age, many physical factors put us at an increased risk of falling such as: hearing loss, vision loss, lack of mobility and loss of muscles mass. The average person will lose about one percent of their muscle mass per year after the age of forty five. The best way to counteract that is to use your muscles by leading an active lifestyle.  Balance exercises can help you stay independent by helping you avoid the often permanent physical disabilities that may result from falling.  And you don’t have to have fancy equipment to strengthen your muscles and improve your balance. There are many easy exercises you can do at home.

Stand on one foot.

  • Stand on one foot behind a sturdy chair, holding on for balance.
  • Hold position for up to 10 seconds.
  • Repeat 10 to 15 times.
  • Repeat with opposite leg

Walk heel to toe.

  • Position the heel of one foot just in front of the toes of the other foot. Your heel and toes should touch or almost touch.
  • Choose a spot ahead of you and focus on it to keep you steady as you walk.
  • Take a step. Put your heel just in front of the toe of your other foot.
  •  Repeat for 20 steps.

Back leg raises  (strengthens buttocks and low back)

  • Stand behind a sturdy chair, holding on for balance.
  • Flex your left foot, then slowly lift left leg straight back without bending your knee.  Try not to lean forward. Hold position for 1 second.
  • Keep your right standing leg slightly bent.
  •  Repeat 10 to 15 times with each leg

Side leg raises (strengthens hips, thighs, and buttocks) 

  • Stand behind a sturdy chair with feet slightly apart, holding on for balance.
  • Flex your left foot and slowly lift your left leg out to the side. Keep your back straight and your toes facing forward.
  • Keep your right standing leg slightly bent and hold position for 1 second.
  • Breathe in as you slowly lower your leg.
  •  Repeat 10 to 15 times with each leg.

How to avoid the holiday spread

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

The holidays are quickly approaching. Holiday traditions and events often center around eating and drinking, making it difficult to maintain weight loss goals. The following tips will keep you focused on your goals while enjoying the season and maintaining your weight.

  • Eat small healthy meals during the day so that you are not “starving” before the event.
  • Fill up on lower calorie dishes such as salads, lean meat (without the skin and visible fat), fruits and vegetables.
  • Don’t skip dessert; just be mindful of the portion.
  • Scope out the food first and decide what you are going to have, rather than loading up a plate and then feeling pressure to finish it.
  • Don’t stand or sit near the food while socializing.
  • SLOW DOWN: it takes 20 minutes for your brain to tell you that you’ve had enough. 
  • Plan a fun activity to take the focus off the food such as playing a board game, cards or taking a family walk.

Being aware of what you are eating and maintaining your exercise will ensure that you avoid the “holiday spread.” Find more dietary and nutrition tips through CHP Health Coaching.

Healthy Mind, Healthy Body

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Do you feel limited by stress or emotional problems?

When you experience stress, your body responds like you are in danger. It makes hormones that speed up your heart, make you breathe faster, and give you a burst of energy. Some stress is normal and even useful. But if stress happens too often or lasts too long, it can have bad effects. Stress can cause headaches, upset stomach, back pain, and trouble sleeping. It can weaken your immune system, and if you already have a health problem, stress may make it worse.

How can you avoid stress?

  • Manage your time. Make a list of tasks to accomplish, think about which things are most important, and do those first.
  • Take care of your body. Get plenty of sleep. Eat well. Don't smoke. Limit alcohol intake.
  • Speak up. Talking about your worries can help alleviate negative emotions, before they cause you stress. Practice calm, assertive communication to help efficiently express how you feel.
  • Ask for help. A strong network of family and friends can help manage stress better.

How can you relieve stress?

  • Exercise. Regular exercise isn’t just good for your body. It’s also one of the best ways to manage stress. (Check out Increase Your Physical Activity to learn how to get started).
  • Let your feelings out. Writing about your feelings can help you work through things that are bothering you. Or, try talking, laughing, crying, and expressing anger with someone you trust.
  • Do something you enjoy. Hobbies, reading or volunteer work can be great stress relievers.
  • Relax your body. Physically relaxing your body through breathing exercises, muscle relaxation exercises, massage, yoga, or meditation can help quiet your mind.

Sometimes stress or emotional problems are just too much to handle alone. Talking to a friend or family member may help, but you may also want to see a medical professional.

Healthy Blood Pressure

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Know your numbers for the New Year!

High blood pressure is the leading cause of heart attack, stroke, heart failure and kidney failure. Lowering high blood pressure helps keep your arteries healthy and is the single best thing you can do for your health. The American Heart Association recommends a blood pressure of less than 120/80 for non-diabetic adults and less than 130/80 for diabetics.

Simple steps to achieve a healthier blood pressure:

  • Monitor your pressure. Measuring your blood pressure is quick and painless. Sit quietly for a few minutes before taking the reading, AND support your arm at the level of your heart during monitoring.
  • Take your blood pressure medication as prescribed. If you cannot afford your medications or if you do not like the side effects of the medications, tell your doctor. Many drugs used to treat high blood pressure are available in generic formulas sold at reduced co-pays.
  • Make these healthy lifestyle changes:
  • Achieve a normal body weight.
  • Participate in some form of physical activity each day (Ask your doctor if you are healthy enough to exercise).
  • Reduce your salt intake to 1500 milligrams a day. Watch out for fast foods, processed and prepackaged foods which are often high in salt.
  • If you smoke- STOP. Visit the Wellness Programs page to find out how we can help.

Making these small changes to achieve a normal blood pressure will help prevent further complications caused by this silent condition. For more information on high blood pressure contact CHP Health Coaching at 850-383-3400.

CHP’s Urgent Care Center: Faster and Less Costly Than the Emergency Room!

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

If you need immediate care for a sickness or injury, consider calling CHP’s expertly staffed Urgent Care Center at 850-383-3382. You will bypass the hectic surroundings and long waits of a hospital Emergency Department—along with the higher copayments. Just telephone our Urgent Care Center and receive an appointment. (If you have a truly life-threatening condition, go to the Emergency Department.)

The CHP Urgent Care Center, located at the Centerville Place Health Center, is staffed by physicians, physician assistants, nurse practitioners, and nurses. Medical problems appropriate for treatment at the Center are:

  • upper respiratory infections, ear infections, and sore throats
  • minor but acute illnesses that include high fever, nausea, or vomiting
  • minor trauma, including ankle sprains or cuts
  • urinary tract infections