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Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.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

H5938_DP 267 File & Use 11222011

High Risk Medications for Patients Aged 65 & Older

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

 

Did you know that our bodies begin to respond differently to medications as we get older?

As we age, various changes occur throughout the body. For example, the liver or kidneys may not clear a medication from our system as efficiently as it once did. Likewise, receptors in the body may become more sensitive to certain drugs. These changes have the potential to make us more susceptible to serious and unwanted effects, such as: confusion, depression, falling, and other health consequences. A group of medical experts developed a list of drugs potentially inappropriate for patients aged 65 or older. This list is called the Beer’s Criteria. Some of the drugs are shown below, along with concerns and possible alternatives to these drugs.

Because the risks associated with these medications may outweigh the benefits, talk with your physician about some of the possible alternatives. However, do not stop taking them without first consulting with your doctor.

 

Generic (Brand) Name Concerns Possible Alternatives

Propoxyphene (Darvocet, Darvon)

 

Combination no better than acetaminophen (Tylenol) alone, less effective than ibuprofen (e.g. Motrin, Advil), and may cause narcotic adverse effects. FDA revised labeling includes: Black Box warning concerning risk of overdose, a warning of severe adverse reactions, occurring with concomitant use with CNS depressants (including alcohol), and precautions concerning additional susceptibility of this age group to CNS effects.

Mild Pain: acetaminophen (Tylenol), ibuprofen (e.g. Motrin, Advil)

Moderate or servere pain: hydrocodone/acetaminophen, oxycodone/acetaminophen, oxycodone, fentanyl patch

Note: Sudden discontinuation of chronic therapy can result in withdrawal symptoms. Gradual tapering is recommended.

Cyclobenzaprine (Flexeril) Questionable efficacy at doses tolerated by this age group and efficacy past 2-3 weeks is not proven. Can cause sedation, weakness, confusion, drug mouth, urine retention and may increase the risk of falls in this age group. Spasticity: baclofen (Lioresal), tizanidine (Zanaflex)
Hydroxyzine (Atarax, Vistaril) Can cause sedation, confusion, dry mouth, urinary retention and may increase the risk of falls in this age group.

Allergic conditions: fexofenadine (Allegra), cetirizine (Zyrtec), loratidine (Claritin), desloratadine (Clarinex), azelastine (Astelin)

Anxiety: citalopram (Celexa), paroxetine (Paxil), sertraline (Zoloft), venlafaxine (Effexor), buspirone (Buspar)

Promethazine (Phenergan) Can cause sedation, confusion, dry mouth, urinary retention and may increase the risk of falls in this age group.

Allergic conditions: fexofenadine (Allegra), cetirizine (Zyrtec), loratidine (Claritin), desloratadine (Clarinex), azelastine (Astelin)

Nausea: ondansetron (Zofran), granisetron (Kytril), dolasetron (Anzemet)

Oral Estrogens (Premarin, Prempro) Carcinogenic potential (breast, endometrial cancer), not cardioprotective in this age group. May increase the incidence of dementia in this age group.

Hot flashes: paroxetine (Paxil), gabapentin (Neurontin), venlafaxine (Effexor)

Bone density: calcium, Vitamin D, alendronate (Fosamax), raloxifene (Evista)

 

 

Important Information About Your Medication: Take It!

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

Sounds obvious, doesn’t it? Not to everyone. According to the World Health Organization, almost half of Americans who are prescribed high blood pressure medication do not take it consistently. That equals very risky business—risky for debilitating strokes. Skipping or stopping medicine is an issue in many chronic or serious illnesses that require long-term, daily medication.

Taking medication consistently—sometimes different pills several times a day—can be confusing or hard to remember, but it’s important: medicine cannot work if you don’t take it. Without it, your symptoms will return or worsen, an emergency may result (perhaps irreversible), and you’ll spend more time and money under care. Here are some tips.

1. Get facts: Know exactly at what times and in what dosages to take the medicine, as well as special instructions (such as taking with food) and possible side effects. If you’re unclear, ask your physician or pharmacist.

2. Report all medications: List and report all medications you are taking to every physician and to your pharmacist. This is very important to prevent adverse drug interactions.

3. Organize in advance: Put your pills for the next day or week into a compartmented pill box. Many styles exist, some marked for time of day. You’ll know at a glance what you need to take and whether you have.

4. Remind yourself. Put the pill box where you can’t miss it, for example, by your toothbrush for a morning routine. Or put notes to yourself in obvious places: on the refrigerator, a mirror, or your telephone at work. Some people use a calendar or notebook to keep track of all medications.

5. Refill on time. Make a note to refill a prescription a week before it will run out.