providing you more value through a - independent health · 2017. 11. 29. · fall2016/ winter 2017...
TRANSCRIPT
FALL2016 WINTER 2017
WWWINDEPENDENTHEALTHCOM
Providing you morevalue through a variety of benefits
How to avoid hospital readmission
Things to consider when choosing your plan for 2017
Our commitment
to you never changes
See page 3
Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO HMO-SNP HMO-POS and PPO plans Enrollment in Independent Health depends on contract renewal
Y0042_C5646 Accepted 10152016
INSIDE this issue
The cooler weather is here and Independent Health is ready to help keep you on track this season so that you can achieve your health goals
Itrsquos important to detect and treat serious medical conditions early See this page to learn how wersquore making it easy for you to get preventive care services and screenings
Check out page 4 to find all the ways we provide more value with our Medicare Advantage plans
And if you need help managing all of your medications go to page 8 to see if our Medication Therapy Management (MTM) program may be able to assist you
Herersquos to your health
ALSO IN THIS ISSUE
5 What to consider when selecting your plan
6 Receive your information electronically
9 Is your medication working for you
11 Steps to take to prevent falls
BEN
EFIT
SP
OT
LIG
HT
25+ PREVENTIVE CARE SERVICES AVAILABLE AT A $0 COPAYMENT Staying up-to-date with your preventive care is key to maintaining and improving your health and well-being Thatrsquos why Independent Health covers many key preventive services at no cost to you
More than 25 free preventive care services and screenings are available to our Medicare Advantage plan members when performed by an in-network participating health care provider These services include bull Mammograms bull Bone density (osteoporosis screening) bull Colonoscopies bull Annual well visit bull Immunizations
You can find a complete list of $0 preventive care services on our website Visit the ldquoAdditional Plan Benefitsrdquo section at wwwindependenthealthcommedicare
Check out our preventive care guidelines Talk with your doctor to make sure you are up-to-date on your preventive care Not all of the services listed are things you need every year Independent Health uses the frequency guidelines adopted by CMS and the US Preventive Services Task Force For an overview of preventive care guidelines please visit wwwindependenthealthcom go to the ldquoTools Forms amp Morerdquo section and then visit the ldquoHealthy Living Tips and Guidelinesrdquo page
There may be other services performed in conjunction with the above preventive care services These other services will be subject to any applicable member liability per your contract If an office visit is required for the management of a new or ongoing unrelated condition then applicable office visit copayment would apply
2 HEALTHSTYLES bull FALL 2016 WINTER 2017
here for you
Our commitment to you never changes We have a variety of plan options available to you for 2017
Now that the Medicare open enrollment period is here (running until December 7) our RedShirtsSM will help all of our members understand the four Medicare Advantage plan options and comprehensive benefits that Independent Health will be offering in 2017
Overview of our plans Independent Health will continue to have plans that are designed to meet our membersrsquo individual needs All of our Medicare Advantage plans include bull Premier Wellness Package (valued at $4797) ndash
A group of additional health and wellness benefits such as routine vision preventive dental coverageand a gym membership (see article on page 4) Plus new in 2017 yoursquoll receive a hearing aid benefit (see article on the back cover) and an enhanced annual wellness visit which is a comprehensive annual well visit with your doctor that includes a detailed exam and conversation about your health to create a personalized care plan
bull Access to all WNY hospitals and pharmacies ndash For your convenience all hospitals and pharmacies across the region are included in our network
bull Worldwide emergency room and urgent care coverage ndash If you ever get sick or have an emergency outside of WNY rest assured the care you need is covered with all of our plans
Steps yoursquoll need to take We encourage you to learn more by visiting our website at wwwIndependentHealthcomMedicare where yoursquoll find helpful information about all of our 2017 coverage options If yoursquore happy with your current plan and itrsquos offered in 2017 you donrsquot have to do anything and you will be automatically reenrolled If your plan will not be offered in 2017 you will need to fill out an enrollment form to select a new plan with us
As always our RedShirts are here to support you Call us at (716) 635-4900 or 1-800-958-4405 (TTY users call 1-888-357-9167) Monday through Sunday from 8 am to 8 pm Or speak one-on-one with a RedShirt at a Medicare Information Centerdagger
Applicable copays may apply for these benefits This is the maximum benefit value that a member could receive if they used all of these benefits Maximum benefit value will vary by plan and depends on which services the member uses Member must use EyeMed HealthPlex or TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Member must pay an annual $20 (for group plans) or $30 (for individual plans) activation fee to the gym daggerA sales person will be present with information and applications For accommodations of persons with special needs at sales meetings please call (716) 635-4900 or 1-800-958-4405 (TTY users call 1-888-357-9167) Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
WWWINDEPENDENTHEALTHCOMMEDICARE 3
for your benefit
Providing you more value with our plans
At Independent Health we want to make sure our Medicare Advantage members are getting the most from their plans Thatrsquos why you receive a variety of additional benefits with most of our plans like fitness dental and vision benefits to help you maintain a healthy lifestyle
Fitness benefit Through our Healthy Benefits Fitness program you receive a fitness membership at any of the participating facilities located throughout Western New York This membership is active for a calendar year and gives you access to the various amenities at the fitness facility such as treadmills free weights and fitness classes
To begin using this benefit you simply present your member ID card at the participating facility of your choice and activate your membership You are currently required to pay an annual $20 activation fee when you join a facility or renew with one
Dental benefit Most of our Medicare Advantage plans offer preventive dental coverage As you age good dental care needs to be part of your life Without it yoursquore prone to cavities pain and an inability to eat healthy foods such as fresh fruits and vegetables Our preventive dental benefits include bull Oral examinations (two per
calendar year) bull Routine cleanings (two per
calendar year) bull Bitewing X-rays (two per
calendar year) bull Full-mouth X-rays (once in a
36-month period)
Oral exams routine cleanings and bitewing and full-mouth X-rays are fully covered with no additional cost to you when you visit an in-network dentist in one of Independent Healthrsquos Medicare Advantage plans
When you visit an in-network dentist for covered services the dentist will bill our dental provider Healthplex making it easier and more convenient for you
Vision benefit EyeMed provides routine vision coverage for all of our Medicare Advantage plans and includes bull Routine eye exam bull Routine eyewear bull Post-cataract eyewear bull Post-cataract routine eye exam
In addition there is an eyewear allowance with each of our plans (amount varies by plan)
Need more information To find a participating Healthy Benefits fitness facility dental providers and vision providers please visit the ldquoFind a Medicare Providerrdquo section at wwwindependenthealth commedicare If you have questions about these benefits please call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday
Content to come
through Sunday from 8 am to 8 pm TTY users can call 1 (800) 432-1110
Applicable copays may apply for these benefits Member must use EyeMed and HealthPlex providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits premiums andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
4 HEALTHSTYLES bull FALL 2016 WINTER 2017
wise choices
Do some homework before selecting a Medicare Advantage plan for 2017 The Medicare Annual Election Period is the once-a-year opportunity for most Medicare beneficiaries to select their Medicare coverage for the coming year For some choosing a Medicare Advantage plan can be a confusing and complicated process While on the surface some plans may appear more affordable because of a lower monthly premium they might end up costing more in the long-run or may not meet your individual coverage needs
To help you make the right decision during this yearrsquos enrollment period here are three key things to consider before enrolling in a Medicare Advantage plan for 2017
1 What type of plan best meets your health care needs Many health insurers offer different types of Medicare Advantage plans The two most common are bull Health Maintenance Organization
(HMO) plan ndash With this plan you must use the doctors and hospitals that are in the HMOrsquos network Many HMOs require their members to choose a primary care doctor affiliated with their plan This is the doctor you will see for all your regular office visits and will help determine if you need to see a specialist HMO plans typically have lower costs for doctor office visits than other types of plans
bull Preferred Provider Organization (PPO) plan ndash This plan gives you more flexibility when picking a doctor or hospital but this flexibility typically comes with added cost For example members of PPOs can seek medically necessary care either inside or outside of the network however their member cost share (ie copayments coinsurance and deductibles) may be higher for services they receive outside the network
Itrsquos important to understand how the various Medicare Advantage plans work especially if you travel frequently or are a ldquosnowbirdrdquo with extended periods outside of the planrsquos service area
2 Do your health care providers participate with the plan With some health insurers provider participation varies by plan Check if your health care providers accept your coverage If your providers are not part of a planrsquos network you may still be able to see them if they accept the planrsquos payment terms and original Medicare However you may have to pay much higher costs to see a non-participating provider Therefore make sure you verify that your doctors and hospital
are ldquoin-networkrdquo Ask the health plan for a provider directory that lists all of the doctors and hospitals who participate in its network All plans are also required to post a provider directory to their website
3 Are your medications included on the planrsquos formulary Each plan has its own formulary which is a list of all the drugs that it covers Drugs are typically grouped into tiers on a formulary The tier that your medication is in determines your portion of the drug cost Member cost share can vary significantly by tier Make sure you review the formulary to see if your prescription drugs are covered by the plan and how much you will have to pay for your medications
WWWINDEPENDENTHEALTHCOMMEDICARE 5
good to know
New language tagline requirement for health plans
Under Federal non-discrimination rules set forth by the US Department of Health and Human Services Independent Health and all health plans throughout the nation are now required to include on all critical plan documents information about language access for members whose primary language is not English
Health plans must now include taglines for the top 15 languages spoken in the states in which the plans are located as determined by the American Community Survey a division of the Census Bureau
Among the critical plan documents that will include 15 taglines are applications correspondence containing information about eligibility and participation criteria summary of benefits formulary drug lists provider directories documents that require a signature or response and a subscriberrsquos insurance contract and evidence of coverage
Other plan documents and marketing materials such as our Medicare HealthStyles newsletter may only need to include the following top three language taglines
English ATTENTION If you speak English language assistance services free of charge are available to you Call 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race color national origin age disability or sex
Spanish ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health cumple con las leyes federales de derechos civiles
aplicables y no discrimina por motivos de raza color nacionalidad edad discapacidad o sexo
Chinese注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1 (800) 665-1502 (TTY 1 [800] 432-1110) Independent Health 遵守適用的聯邦民權法律規定不因種族膚色民族血統年齡殘障或性別而歧視任何人
Go paperless Receive plan documents electronically Each September Independent Health is required to provide our Medicare members an Annual Notice of Change (ANOC)Evidence of Coverage (EOC) However you can choose to view this large document electronically rather than receive it in the mail
Itrsquos easy to sign up 1 Log in at wwwindependenthealthcomlogin 2 Click ldquoView Document preferencesrdquo on the
Account Home screen under ldquoDocumentsrdquo 3 Choose the ldquoelectronicrdquo preference then click
ldquoSave preferencesrdquo
Advantages of going paperless include bull You will have access to your document 247 bull If you travel or are temporarily out of the area
you will have access to the document wherever you are
bull You will not have to store the large document each year
bull This option is voluntary and can be changed at any time
If you choose to go paperless when a new version of your document is posted you will receive an email notification with instructions on how to view it
6 HEALTHSTYLES bull FALL 2016 WINTER 2017
plan information
Family Choice plan designed for residents of nursing homes and long-term care facilities
At Independent Health we want the family members of those residing in nursing facilities to take comfort in knowing that their loved onersquos quality of life is being maintained at the highest level possible
Thatrsquos why we are pleased to partner with Family Choice of New York to offer the Independent Health Medicare Family Choice HMO-SNP plan which is specifically designed to meet the unique needs of members who permanently reside in nursing homes and assisted living facilities
Enhanced care provided Members enrolled in Family Choice receive regular visits by specially trained nurse practitioners and physician assistants who are on call 24 hours a day seven days a week to provide care and support as needed Their responsibilities include bull Working in collaboration with the
memberrsquos health care providers and the facilityrsquos staff to identify potential problems before they become serious
bull Minimizing unnecessary and disruptive emergency room visits and hospital stays whenever itrsquos safe and appropriate
bull Keeping in close contact with the memberrsquos family updating them about their loved onersquos condition and making sure they are part of the care-planning process
In addition program social workers are available to assist members and their families with physical issues and help them access necessary resources
Impressive survey results Since first being introduced 10 years ago the Family Choice plan has consistently received high marks from families In fact a recent satisfaction survey of people whose loved ones use the programrsquos services indicates that 974 of respondents are satisfied with Family Choice The survey also shows bull 986 of respondents feel the
loved ones have been receiving all of the benefits and services they expected them to receive
bull 977 of respondents would recommend Family Choice to another nursing home resident
bull 967 of respondents feel their nurse practitioner provides their loved ones with the quality of care they expected them to receive
bull 95 of respondents are satisfied with the communication they have with the nurse practitioner
bull 946 of respondents feel the nurse practitioner helps them and their loved ones understand any medical condition they have
Family Choice currently is available in a network of more than 45 participating facilities in Erie Niagara Genesee Orleans and Wyoming counties Unlike other Medicare Advantage plans individuals are able to enroll in Family Choice year round
To learn more about this plan visit wwwindependenthealthcom medicare or call (716) 635-4900 or 1 (800) 958-4405 Monday through Sunday from 8 am to 8 pm TTY users can call 1 (888) 357-9167
This plan is available to all Medicare eligibles that are entitled to Medicare Part A and enrolled in Part B except those with ESRD unless already enrolled with Independent Health This plan requires the use of participating providers except in the case of emergency care urgent or out-of-area renal dialysis Members must continue to pay Part B premiums if not otherwise paid for under Medicaid or by another third party
Survey conducted by Independent Health in July 2016 with 1259 families surveyed and 317 families (252) responding
WWWINDEPENDENTHEALTHCOMMEDICARE 7
medications
Reduce your prescription drug costs through EPIC
The New York State Department of Health offers the Elderly Pharmaceutical Insurance Coverage (EPIC) program as a way to provide copayment assistance to Medicare Part D plan members for their covered prescription medications
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met
Seniors can apply for EPIC at any time of the year You must be enrolled or eligible to be enrolled in a Medicare Part D drug plan and earn an annual income below $75000 (single) or $100000 (married) to receive EPIC benefits and maintain coverage
For an application or more information visit wwwhealth nygov or call the toll-free EPIC Helpline at 1 (800) 332-3742 Monday through Friday from 830 am to 5 pm TTY users 1 (800) 290-9138
MTM program helps members manage their medications
Independent Health offers a Medication Therapy Management (MTM) program to eligible Medicare Advantage plan members with prescription drug coverage who need to manage multiple medications for chronic conditions This free and voluntary program is designed to help prevent medication-related problems and enhance health outcomes by improving the way our members take their medications
Eligibility requirements To be eligible for this program you must meet the following criteria bull You are likely to meet a specified
annual cost threshold for all your covered prescription drugs For 2016 the annual cost threshold is $3507 For 2017 it will be $3919
bull You have received seven or more distinct prescriptions for chronic conditions
bull You have at least three of the following chronic conditions asthma heart failure chronic kidney disease chronic obstructive pulmonary disease (COPD) coronary artery disease depression diabetes high cholesterol or hypertension
If you meet the eligibility criteria you will be notified by mail andor
by telephone You will then be able to speak with an experienced Independent Health pharmacist who will provide a comprehensive review of all your medications
Why a medication review is important bull It can help keep you safe Our
pharmacist will look at all your medications to check for interactions and make sure nothing yoursquore taking will cause you harm
bull Yoursquoll get answers to your unique questions and concerns about your prescriptionsmdashwith the full attention of the pharmacist you can get the information you need
bull Side effects may be identified You may be experiencing side effects from a medication and not even know it If an issue is discovered the pharmacist can work with your doctor to fix it
How to schedule a review You will need to call to make an appointment with one of our pharmacists Your review can be conducted either over the telephone or in person at our Customer Service center located at 250 Essjay Road in Williamsville
TO LEARN MORE about this program or to schedule an appointment call (716) 250-4436 or 1 (800) 247-1466 ext 4436 (TTY users call 1 [800] 432-1110) Monday through Friday from 830 am to 430 pm or email MTMindependenthealthcom
8 HEALTHSTYLES bull FALL 2016 WINTER 2017
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
INSIDE this issue
The cooler weather is here and Independent Health is ready to help keep you on track this season so that you can achieve your health goals
Itrsquos important to detect and treat serious medical conditions early See this page to learn how wersquore making it easy for you to get preventive care services and screenings
Check out page 4 to find all the ways we provide more value with our Medicare Advantage plans
And if you need help managing all of your medications go to page 8 to see if our Medication Therapy Management (MTM) program may be able to assist you
Herersquos to your health
ALSO IN THIS ISSUE
5 What to consider when selecting your plan
6 Receive your information electronically
9 Is your medication working for you
11 Steps to take to prevent falls
BEN
EFIT
SP
OT
LIG
HT
25+ PREVENTIVE CARE SERVICES AVAILABLE AT A $0 COPAYMENT Staying up-to-date with your preventive care is key to maintaining and improving your health and well-being Thatrsquos why Independent Health covers many key preventive services at no cost to you
More than 25 free preventive care services and screenings are available to our Medicare Advantage plan members when performed by an in-network participating health care provider These services include bull Mammograms bull Bone density (osteoporosis screening) bull Colonoscopies bull Annual well visit bull Immunizations
You can find a complete list of $0 preventive care services on our website Visit the ldquoAdditional Plan Benefitsrdquo section at wwwindependenthealthcommedicare
Check out our preventive care guidelines Talk with your doctor to make sure you are up-to-date on your preventive care Not all of the services listed are things you need every year Independent Health uses the frequency guidelines adopted by CMS and the US Preventive Services Task Force For an overview of preventive care guidelines please visit wwwindependenthealthcom go to the ldquoTools Forms amp Morerdquo section and then visit the ldquoHealthy Living Tips and Guidelinesrdquo page
There may be other services performed in conjunction with the above preventive care services These other services will be subject to any applicable member liability per your contract If an office visit is required for the management of a new or ongoing unrelated condition then applicable office visit copayment would apply
2 HEALTHSTYLES bull FALL 2016 WINTER 2017
here for you
Our commitment to you never changes We have a variety of plan options available to you for 2017
Now that the Medicare open enrollment period is here (running until December 7) our RedShirtsSM will help all of our members understand the four Medicare Advantage plan options and comprehensive benefits that Independent Health will be offering in 2017
Overview of our plans Independent Health will continue to have plans that are designed to meet our membersrsquo individual needs All of our Medicare Advantage plans include bull Premier Wellness Package (valued at $4797) ndash
A group of additional health and wellness benefits such as routine vision preventive dental coverageand a gym membership (see article on page 4) Plus new in 2017 yoursquoll receive a hearing aid benefit (see article on the back cover) and an enhanced annual wellness visit which is a comprehensive annual well visit with your doctor that includes a detailed exam and conversation about your health to create a personalized care plan
bull Access to all WNY hospitals and pharmacies ndash For your convenience all hospitals and pharmacies across the region are included in our network
bull Worldwide emergency room and urgent care coverage ndash If you ever get sick or have an emergency outside of WNY rest assured the care you need is covered with all of our plans
Steps yoursquoll need to take We encourage you to learn more by visiting our website at wwwIndependentHealthcomMedicare where yoursquoll find helpful information about all of our 2017 coverage options If yoursquore happy with your current plan and itrsquos offered in 2017 you donrsquot have to do anything and you will be automatically reenrolled If your plan will not be offered in 2017 you will need to fill out an enrollment form to select a new plan with us
As always our RedShirts are here to support you Call us at (716) 635-4900 or 1-800-958-4405 (TTY users call 1-888-357-9167) Monday through Sunday from 8 am to 8 pm Or speak one-on-one with a RedShirt at a Medicare Information Centerdagger
Applicable copays may apply for these benefits This is the maximum benefit value that a member could receive if they used all of these benefits Maximum benefit value will vary by plan and depends on which services the member uses Member must use EyeMed HealthPlex or TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Member must pay an annual $20 (for group plans) or $30 (for individual plans) activation fee to the gym daggerA sales person will be present with information and applications For accommodations of persons with special needs at sales meetings please call (716) 635-4900 or 1-800-958-4405 (TTY users call 1-888-357-9167) Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
WWWINDEPENDENTHEALTHCOMMEDICARE 3
for your benefit
Providing you more value with our plans
At Independent Health we want to make sure our Medicare Advantage members are getting the most from their plans Thatrsquos why you receive a variety of additional benefits with most of our plans like fitness dental and vision benefits to help you maintain a healthy lifestyle
Fitness benefit Through our Healthy Benefits Fitness program you receive a fitness membership at any of the participating facilities located throughout Western New York This membership is active for a calendar year and gives you access to the various amenities at the fitness facility such as treadmills free weights and fitness classes
To begin using this benefit you simply present your member ID card at the participating facility of your choice and activate your membership You are currently required to pay an annual $20 activation fee when you join a facility or renew with one
Dental benefit Most of our Medicare Advantage plans offer preventive dental coverage As you age good dental care needs to be part of your life Without it yoursquore prone to cavities pain and an inability to eat healthy foods such as fresh fruits and vegetables Our preventive dental benefits include bull Oral examinations (two per
calendar year) bull Routine cleanings (two per
calendar year) bull Bitewing X-rays (two per
calendar year) bull Full-mouth X-rays (once in a
36-month period)
Oral exams routine cleanings and bitewing and full-mouth X-rays are fully covered with no additional cost to you when you visit an in-network dentist in one of Independent Healthrsquos Medicare Advantage plans
When you visit an in-network dentist for covered services the dentist will bill our dental provider Healthplex making it easier and more convenient for you
Vision benefit EyeMed provides routine vision coverage for all of our Medicare Advantage plans and includes bull Routine eye exam bull Routine eyewear bull Post-cataract eyewear bull Post-cataract routine eye exam
In addition there is an eyewear allowance with each of our plans (amount varies by plan)
Need more information To find a participating Healthy Benefits fitness facility dental providers and vision providers please visit the ldquoFind a Medicare Providerrdquo section at wwwindependenthealth commedicare If you have questions about these benefits please call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday
Content to come
through Sunday from 8 am to 8 pm TTY users can call 1 (800) 432-1110
Applicable copays may apply for these benefits Member must use EyeMed and HealthPlex providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits premiums andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
4 HEALTHSTYLES bull FALL 2016 WINTER 2017
wise choices
Do some homework before selecting a Medicare Advantage plan for 2017 The Medicare Annual Election Period is the once-a-year opportunity for most Medicare beneficiaries to select their Medicare coverage for the coming year For some choosing a Medicare Advantage plan can be a confusing and complicated process While on the surface some plans may appear more affordable because of a lower monthly premium they might end up costing more in the long-run or may not meet your individual coverage needs
To help you make the right decision during this yearrsquos enrollment period here are three key things to consider before enrolling in a Medicare Advantage plan for 2017
1 What type of plan best meets your health care needs Many health insurers offer different types of Medicare Advantage plans The two most common are bull Health Maintenance Organization
(HMO) plan ndash With this plan you must use the doctors and hospitals that are in the HMOrsquos network Many HMOs require their members to choose a primary care doctor affiliated with their plan This is the doctor you will see for all your regular office visits and will help determine if you need to see a specialist HMO plans typically have lower costs for doctor office visits than other types of plans
bull Preferred Provider Organization (PPO) plan ndash This plan gives you more flexibility when picking a doctor or hospital but this flexibility typically comes with added cost For example members of PPOs can seek medically necessary care either inside or outside of the network however their member cost share (ie copayments coinsurance and deductibles) may be higher for services they receive outside the network
Itrsquos important to understand how the various Medicare Advantage plans work especially if you travel frequently or are a ldquosnowbirdrdquo with extended periods outside of the planrsquos service area
2 Do your health care providers participate with the plan With some health insurers provider participation varies by plan Check if your health care providers accept your coverage If your providers are not part of a planrsquos network you may still be able to see them if they accept the planrsquos payment terms and original Medicare However you may have to pay much higher costs to see a non-participating provider Therefore make sure you verify that your doctors and hospital
are ldquoin-networkrdquo Ask the health plan for a provider directory that lists all of the doctors and hospitals who participate in its network All plans are also required to post a provider directory to their website
3 Are your medications included on the planrsquos formulary Each plan has its own formulary which is a list of all the drugs that it covers Drugs are typically grouped into tiers on a formulary The tier that your medication is in determines your portion of the drug cost Member cost share can vary significantly by tier Make sure you review the formulary to see if your prescription drugs are covered by the plan and how much you will have to pay for your medications
WWWINDEPENDENTHEALTHCOMMEDICARE 5
good to know
New language tagline requirement for health plans
Under Federal non-discrimination rules set forth by the US Department of Health and Human Services Independent Health and all health plans throughout the nation are now required to include on all critical plan documents information about language access for members whose primary language is not English
Health plans must now include taglines for the top 15 languages spoken in the states in which the plans are located as determined by the American Community Survey a division of the Census Bureau
Among the critical plan documents that will include 15 taglines are applications correspondence containing information about eligibility and participation criteria summary of benefits formulary drug lists provider directories documents that require a signature or response and a subscriberrsquos insurance contract and evidence of coverage
Other plan documents and marketing materials such as our Medicare HealthStyles newsletter may only need to include the following top three language taglines
English ATTENTION If you speak English language assistance services free of charge are available to you Call 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race color national origin age disability or sex
Spanish ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health cumple con las leyes federales de derechos civiles
aplicables y no discrimina por motivos de raza color nacionalidad edad discapacidad o sexo
Chinese注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1 (800) 665-1502 (TTY 1 [800] 432-1110) Independent Health 遵守適用的聯邦民權法律規定不因種族膚色民族血統年齡殘障或性別而歧視任何人
Go paperless Receive plan documents electronically Each September Independent Health is required to provide our Medicare members an Annual Notice of Change (ANOC)Evidence of Coverage (EOC) However you can choose to view this large document electronically rather than receive it in the mail
Itrsquos easy to sign up 1 Log in at wwwindependenthealthcomlogin 2 Click ldquoView Document preferencesrdquo on the
Account Home screen under ldquoDocumentsrdquo 3 Choose the ldquoelectronicrdquo preference then click
ldquoSave preferencesrdquo
Advantages of going paperless include bull You will have access to your document 247 bull If you travel or are temporarily out of the area
you will have access to the document wherever you are
bull You will not have to store the large document each year
bull This option is voluntary and can be changed at any time
If you choose to go paperless when a new version of your document is posted you will receive an email notification with instructions on how to view it
6 HEALTHSTYLES bull FALL 2016 WINTER 2017
plan information
Family Choice plan designed for residents of nursing homes and long-term care facilities
At Independent Health we want the family members of those residing in nursing facilities to take comfort in knowing that their loved onersquos quality of life is being maintained at the highest level possible
Thatrsquos why we are pleased to partner with Family Choice of New York to offer the Independent Health Medicare Family Choice HMO-SNP plan which is specifically designed to meet the unique needs of members who permanently reside in nursing homes and assisted living facilities
Enhanced care provided Members enrolled in Family Choice receive regular visits by specially trained nurse practitioners and physician assistants who are on call 24 hours a day seven days a week to provide care and support as needed Their responsibilities include bull Working in collaboration with the
memberrsquos health care providers and the facilityrsquos staff to identify potential problems before they become serious
bull Minimizing unnecessary and disruptive emergency room visits and hospital stays whenever itrsquos safe and appropriate
bull Keeping in close contact with the memberrsquos family updating them about their loved onersquos condition and making sure they are part of the care-planning process
In addition program social workers are available to assist members and their families with physical issues and help them access necessary resources
Impressive survey results Since first being introduced 10 years ago the Family Choice plan has consistently received high marks from families In fact a recent satisfaction survey of people whose loved ones use the programrsquos services indicates that 974 of respondents are satisfied with Family Choice The survey also shows bull 986 of respondents feel the
loved ones have been receiving all of the benefits and services they expected them to receive
bull 977 of respondents would recommend Family Choice to another nursing home resident
bull 967 of respondents feel their nurse practitioner provides their loved ones with the quality of care they expected them to receive
bull 95 of respondents are satisfied with the communication they have with the nurse practitioner
bull 946 of respondents feel the nurse practitioner helps them and their loved ones understand any medical condition they have
Family Choice currently is available in a network of more than 45 participating facilities in Erie Niagara Genesee Orleans and Wyoming counties Unlike other Medicare Advantage plans individuals are able to enroll in Family Choice year round
To learn more about this plan visit wwwindependenthealthcom medicare or call (716) 635-4900 or 1 (800) 958-4405 Monday through Sunday from 8 am to 8 pm TTY users can call 1 (888) 357-9167
This plan is available to all Medicare eligibles that are entitled to Medicare Part A and enrolled in Part B except those with ESRD unless already enrolled with Independent Health This plan requires the use of participating providers except in the case of emergency care urgent or out-of-area renal dialysis Members must continue to pay Part B premiums if not otherwise paid for under Medicaid or by another third party
Survey conducted by Independent Health in July 2016 with 1259 families surveyed and 317 families (252) responding
WWWINDEPENDENTHEALTHCOMMEDICARE 7
medications
Reduce your prescription drug costs through EPIC
The New York State Department of Health offers the Elderly Pharmaceutical Insurance Coverage (EPIC) program as a way to provide copayment assistance to Medicare Part D plan members for their covered prescription medications
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met
Seniors can apply for EPIC at any time of the year You must be enrolled or eligible to be enrolled in a Medicare Part D drug plan and earn an annual income below $75000 (single) or $100000 (married) to receive EPIC benefits and maintain coverage
For an application or more information visit wwwhealth nygov or call the toll-free EPIC Helpline at 1 (800) 332-3742 Monday through Friday from 830 am to 5 pm TTY users 1 (800) 290-9138
MTM program helps members manage their medications
Independent Health offers a Medication Therapy Management (MTM) program to eligible Medicare Advantage plan members with prescription drug coverage who need to manage multiple medications for chronic conditions This free and voluntary program is designed to help prevent medication-related problems and enhance health outcomes by improving the way our members take their medications
Eligibility requirements To be eligible for this program you must meet the following criteria bull You are likely to meet a specified
annual cost threshold for all your covered prescription drugs For 2016 the annual cost threshold is $3507 For 2017 it will be $3919
bull You have received seven or more distinct prescriptions for chronic conditions
bull You have at least three of the following chronic conditions asthma heart failure chronic kidney disease chronic obstructive pulmonary disease (COPD) coronary artery disease depression diabetes high cholesterol or hypertension
If you meet the eligibility criteria you will be notified by mail andor
by telephone You will then be able to speak with an experienced Independent Health pharmacist who will provide a comprehensive review of all your medications
Why a medication review is important bull It can help keep you safe Our
pharmacist will look at all your medications to check for interactions and make sure nothing yoursquore taking will cause you harm
bull Yoursquoll get answers to your unique questions and concerns about your prescriptionsmdashwith the full attention of the pharmacist you can get the information you need
bull Side effects may be identified You may be experiencing side effects from a medication and not even know it If an issue is discovered the pharmacist can work with your doctor to fix it
How to schedule a review You will need to call to make an appointment with one of our pharmacists Your review can be conducted either over the telephone or in person at our Customer Service center located at 250 Essjay Road in Williamsville
TO LEARN MORE about this program or to schedule an appointment call (716) 250-4436 or 1 (800) 247-1466 ext 4436 (TTY users call 1 [800] 432-1110) Monday through Friday from 830 am to 430 pm or email MTMindependenthealthcom
8 HEALTHSTYLES bull FALL 2016 WINTER 2017
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
here for you
Our commitment to you never changes We have a variety of plan options available to you for 2017
Now that the Medicare open enrollment period is here (running until December 7) our RedShirtsSM will help all of our members understand the four Medicare Advantage plan options and comprehensive benefits that Independent Health will be offering in 2017
Overview of our plans Independent Health will continue to have plans that are designed to meet our membersrsquo individual needs All of our Medicare Advantage plans include bull Premier Wellness Package (valued at $4797) ndash
A group of additional health and wellness benefits such as routine vision preventive dental coverageand a gym membership (see article on page 4) Plus new in 2017 yoursquoll receive a hearing aid benefit (see article on the back cover) and an enhanced annual wellness visit which is a comprehensive annual well visit with your doctor that includes a detailed exam and conversation about your health to create a personalized care plan
bull Access to all WNY hospitals and pharmacies ndash For your convenience all hospitals and pharmacies across the region are included in our network
bull Worldwide emergency room and urgent care coverage ndash If you ever get sick or have an emergency outside of WNY rest assured the care you need is covered with all of our plans
Steps yoursquoll need to take We encourage you to learn more by visiting our website at wwwIndependentHealthcomMedicare where yoursquoll find helpful information about all of our 2017 coverage options If yoursquore happy with your current plan and itrsquos offered in 2017 you donrsquot have to do anything and you will be automatically reenrolled If your plan will not be offered in 2017 you will need to fill out an enrollment form to select a new plan with us
As always our RedShirts are here to support you Call us at (716) 635-4900 or 1-800-958-4405 (TTY users call 1-888-357-9167) Monday through Sunday from 8 am to 8 pm Or speak one-on-one with a RedShirt at a Medicare Information Centerdagger
Applicable copays may apply for these benefits This is the maximum benefit value that a member could receive if they used all of these benefits Maximum benefit value will vary by plan and depends on which services the member uses Member must use EyeMed HealthPlex or TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Member must pay an annual $20 (for group plans) or $30 (for individual plans) activation fee to the gym daggerA sales person will be present with information and applications For accommodations of persons with special needs at sales meetings please call (716) 635-4900 or 1-800-958-4405 (TTY users call 1-888-357-9167) Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
WWWINDEPENDENTHEALTHCOMMEDICARE 3
for your benefit
Providing you more value with our plans
At Independent Health we want to make sure our Medicare Advantage members are getting the most from their plans Thatrsquos why you receive a variety of additional benefits with most of our plans like fitness dental and vision benefits to help you maintain a healthy lifestyle
Fitness benefit Through our Healthy Benefits Fitness program you receive a fitness membership at any of the participating facilities located throughout Western New York This membership is active for a calendar year and gives you access to the various amenities at the fitness facility such as treadmills free weights and fitness classes
To begin using this benefit you simply present your member ID card at the participating facility of your choice and activate your membership You are currently required to pay an annual $20 activation fee when you join a facility or renew with one
Dental benefit Most of our Medicare Advantage plans offer preventive dental coverage As you age good dental care needs to be part of your life Without it yoursquore prone to cavities pain and an inability to eat healthy foods such as fresh fruits and vegetables Our preventive dental benefits include bull Oral examinations (two per
calendar year) bull Routine cleanings (two per
calendar year) bull Bitewing X-rays (two per
calendar year) bull Full-mouth X-rays (once in a
36-month period)
Oral exams routine cleanings and bitewing and full-mouth X-rays are fully covered with no additional cost to you when you visit an in-network dentist in one of Independent Healthrsquos Medicare Advantage plans
When you visit an in-network dentist for covered services the dentist will bill our dental provider Healthplex making it easier and more convenient for you
Vision benefit EyeMed provides routine vision coverage for all of our Medicare Advantage plans and includes bull Routine eye exam bull Routine eyewear bull Post-cataract eyewear bull Post-cataract routine eye exam
In addition there is an eyewear allowance with each of our plans (amount varies by plan)
Need more information To find a participating Healthy Benefits fitness facility dental providers and vision providers please visit the ldquoFind a Medicare Providerrdquo section at wwwindependenthealth commedicare If you have questions about these benefits please call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday
Content to come
through Sunday from 8 am to 8 pm TTY users can call 1 (800) 432-1110
Applicable copays may apply for these benefits Member must use EyeMed and HealthPlex providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits premiums andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
4 HEALTHSTYLES bull FALL 2016 WINTER 2017
wise choices
Do some homework before selecting a Medicare Advantage plan for 2017 The Medicare Annual Election Period is the once-a-year opportunity for most Medicare beneficiaries to select their Medicare coverage for the coming year For some choosing a Medicare Advantage plan can be a confusing and complicated process While on the surface some plans may appear more affordable because of a lower monthly premium they might end up costing more in the long-run or may not meet your individual coverage needs
To help you make the right decision during this yearrsquos enrollment period here are three key things to consider before enrolling in a Medicare Advantage plan for 2017
1 What type of plan best meets your health care needs Many health insurers offer different types of Medicare Advantage plans The two most common are bull Health Maintenance Organization
(HMO) plan ndash With this plan you must use the doctors and hospitals that are in the HMOrsquos network Many HMOs require their members to choose a primary care doctor affiliated with their plan This is the doctor you will see for all your regular office visits and will help determine if you need to see a specialist HMO plans typically have lower costs for doctor office visits than other types of plans
bull Preferred Provider Organization (PPO) plan ndash This plan gives you more flexibility when picking a doctor or hospital but this flexibility typically comes with added cost For example members of PPOs can seek medically necessary care either inside or outside of the network however their member cost share (ie copayments coinsurance and deductibles) may be higher for services they receive outside the network
Itrsquos important to understand how the various Medicare Advantage plans work especially if you travel frequently or are a ldquosnowbirdrdquo with extended periods outside of the planrsquos service area
2 Do your health care providers participate with the plan With some health insurers provider participation varies by plan Check if your health care providers accept your coverage If your providers are not part of a planrsquos network you may still be able to see them if they accept the planrsquos payment terms and original Medicare However you may have to pay much higher costs to see a non-participating provider Therefore make sure you verify that your doctors and hospital
are ldquoin-networkrdquo Ask the health plan for a provider directory that lists all of the doctors and hospitals who participate in its network All plans are also required to post a provider directory to their website
3 Are your medications included on the planrsquos formulary Each plan has its own formulary which is a list of all the drugs that it covers Drugs are typically grouped into tiers on a formulary The tier that your medication is in determines your portion of the drug cost Member cost share can vary significantly by tier Make sure you review the formulary to see if your prescription drugs are covered by the plan and how much you will have to pay for your medications
WWWINDEPENDENTHEALTHCOMMEDICARE 5
good to know
New language tagline requirement for health plans
Under Federal non-discrimination rules set forth by the US Department of Health and Human Services Independent Health and all health plans throughout the nation are now required to include on all critical plan documents information about language access for members whose primary language is not English
Health plans must now include taglines for the top 15 languages spoken in the states in which the plans are located as determined by the American Community Survey a division of the Census Bureau
Among the critical plan documents that will include 15 taglines are applications correspondence containing information about eligibility and participation criteria summary of benefits formulary drug lists provider directories documents that require a signature or response and a subscriberrsquos insurance contract and evidence of coverage
Other plan documents and marketing materials such as our Medicare HealthStyles newsletter may only need to include the following top three language taglines
English ATTENTION If you speak English language assistance services free of charge are available to you Call 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race color national origin age disability or sex
Spanish ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health cumple con las leyes federales de derechos civiles
aplicables y no discrimina por motivos de raza color nacionalidad edad discapacidad o sexo
Chinese注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1 (800) 665-1502 (TTY 1 [800] 432-1110) Independent Health 遵守適用的聯邦民權法律規定不因種族膚色民族血統年齡殘障或性別而歧視任何人
Go paperless Receive plan documents electronically Each September Independent Health is required to provide our Medicare members an Annual Notice of Change (ANOC)Evidence of Coverage (EOC) However you can choose to view this large document electronically rather than receive it in the mail
Itrsquos easy to sign up 1 Log in at wwwindependenthealthcomlogin 2 Click ldquoView Document preferencesrdquo on the
Account Home screen under ldquoDocumentsrdquo 3 Choose the ldquoelectronicrdquo preference then click
ldquoSave preferencesrdquo
Advantages of going paperless include bull You will have access to your document 247 bull If you travel or are temporarily out of the area
you will have access to the document wherever you are
bull You will not have to store the large document each year
bull This option is voluntary and can be changed at any time
If you choose to go paperless when a new version of your document is posted you will receive an email notification with instructions on how to view it
6 HEALTHSTYLES bull FALL 2016 WINTER 2017
plan information
Family Choice plan designed for residents of nursing homes and long-term care facilities
At Independent Health we want the family members of those residing in nursing facilities to take comfort in knowing that their loved onersquos quality of life is being maintained at the highest level possible
Thatrsquos why we are pleased to partner with Family Choice of New York to offer the Independent Health Medicare Family Choice HMO-SNP plan which is specifically designed to meet the unique needs of members who permanently reside in nursing homes and assisted living facilities
Enhanced care provided Members enrolled in Family Choice receive regular visits by specially trained nurse practitioners and physician assistants who are on call 24 hours a day seven days a week to provide care and support as needed Their responsibilities include bull Working in collaboration with the
memberrsquos health care providers and the facilityrsquos staff to identify potential problems before they become serious
bull Minimizing unnecessary and disruptive emergency room visits and hospital stays whenever itrsquos safe and appropriate
bull Keeping in close contact with the memberrsquos family updating them about their loved onersquos condition and making sure they are part of the care-planning process
In addition program social workers are available to assist members and their families with physical issues and help them access necessary resources
Impressive survey results Since first being introduced 10 years ago the Family Choice plan has consistently received high marks from families In fact a recent satisfaction survey of people whose loved ones use the programrsquos services indicates that 974 of respondents are satisfied with Family Choice The survey also shows bull 986 of respondents feel the
loved ones have been receiving all of the benefits and services they expected them to receive
bull 977 of respondents would recommend Family Choice to another nursing home resident
bull 967 of respondents feel their nurse practitioner provides their loved ones with the quality of care they expected them to receive
bull 95 of respondents are satisfied with the communication they have with the nurse practitioner
bull 946 of respondents feel the nurse practitioner helps them and their loved ones understand any medical condition they have
Family Choice currently is available in a network of more than 45 participating facilities in Erie Niagara Genesee Orleans and Wyoming counties Unlike other Medicare Advantage plans individuals are able to enroll in Family Choice year round
To learn more about this plan visit wwwindependenthealthcom medicare or call (716) 635-4900 or 1 (800) 958-4405 Monday through Sunday from 8 am to 8 pm TTY users can call 1 (888) 357-9167
This plan is available to all Medicare eligibles that are entitled to Medicare Part A and enrolled in Part B except those with ESRD unless already enrolled with Independent Health This plan requires the use of participating providers except in the case of emergency care urgent or out-of-area renal dialysis Members must continue to pay Part B premiums if not otherwise paid for under Medicaid or by another third party
Survey conducted by Independent Health in July 2016 with 1259 families surveyed and 317 families (252) responding
WWWINDEPENDENTHEALTHCOMMEDICARE 7
medications
Reduce your prescription drug costs through EPIC
The New York State Department of Health offers the Elderly Pharmaceutical Insurance Coverage (EPIC) program as a way to provide copayment assistance to Medicare Part D plan members for their covered prescription medications
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met
Seniors can apply for EPIC at any time of the year You must be enrolled or eligible to be enrolled in a Medicare Part D drug plan and earn an annual income below $75000 (single) or $100000 (married) to receive EPIC benefits and maintain coverage
For an application or more information visit wwwhealth nygov or call the toll-free EPIC Helpline at 1 (800) 332-3742 Monday through Friday from 830 am to 5 pm TTY users 1 (800) 290-9138
MTM program helps members manage their medications
Independent Health offers a Medication Therapy Management (MTM) program to eligible Medicare Advantage plan members with prescription drug coverage who need to manage multiple medications for chronic conditions This free and voluntary program is designed to help prevent medication-related problems and enhance health outcomes by improving the way our members take their medications
Eligibility requirements To be eligible for this program you must meet the following criteria bull You are likely to meet a specified
annual cost threshold for all your covered prescription drugs For 2016 the annual cost threshold is $3507 For 2017 it will be $3919
bull You have received seven or more distinct prescriptions for chronic conditions
bull You have at least three of the following chronic conditions asthma heart failure chronic kidney disease chronic obstructive pulmonary disease (COPD) coronary artery disease depression diabetes high cholesterol or hypertension
If you meet the eligibility criteria you will be notified by mail andor
by telephone You will then be able to speak with an experienced Independent Health pharmacist who will provide a comprehensive review of all your medications
Why a medication review is important bull It can help keep you safe Our
pharmacist will look at all your medications to check for interactions and make sure nothing yoursquore taking will cause you harm
bull Yoursquoll get answers to your unique questions and concerns about your prescriptionsmdashwith the full attention of the pharmacist you can get the information you need
bull Side effects may be identified You may be experiencing side effects from a medication and not even know it If an issue is discovered the pharmacist can work with your doctor to fix it
How to schedule a review You will need to call to make an appointment with one of our pharmacists Your review can be conducted either over the telephone or in person at our Customer Service center located at 250 Essjay Road in Williamsville
TO LEARN MORE about this program or to schedule an appointment call (716) 250-4436 or 1 (800) 247-1466 ext 4436 (TTY users call 1 [800] 432-1110) Monday through Friday from 830 am to 430 pm or email MTMindependenthealthcom
8 HEALTHSTYLES bull FALL 2016 WINTER 2017
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
for your benefit
Providing you more value with our plans
At Independent Health we want to make sure our Medicare Advantage members are getting the most from their plans Thatrsquos why you receive a variety of additional benefits with most of our plans like fitness dental and vision benefits to help you maintain a healthy lifestyle
Fitness benefit Through our Healthy Benefits Fitness program you receive a fitness membership at any of the participating facilities located throughout Western New York This membership is active for a calendar year and gives you access to the various amenities at the fitness facility such as treadmills free weights and fitness classes
To begin using this benefit you simply present your member ID card at the participating facility of your choice and activate your membership You are currently required to pay an annual $20 activation fee when you join a facility or renew with one
Dental benefit Most of our Medicare Advantage plans offer preventive dental coverage As you age good dental care needs to be part of your life Without it yoursquore prone to cavities pain and an inability to eat healthy foods such as fresh fruits and vegetables Our preventive dental benefits include bull Oral examinations (two per
calendar year) bull Routine cleanings (two per
calendar year) bull Bitewing X-rays (two per
calendar year) bull Full-mouth X-rays (once in a
36-month period)
Oral exams routine cleanings and bitewing and full-mouth X-rays are fully covered with no additional cost to you when you visit an in-network dentist in one of Independent Healthrsquos Medicare Advantage plans
When you visit an in-network dentist for covered services the dentist will bill our dental provider Healthplex making it easier and more convenient for you
Vision benefit EyeMed provides routine vision coverage for all of our Medicare Advantage plans and includes bull Routine eye exam bull Routine eyewear bull Post-cataract eyewear bull Post-cataract routine eye exam
In addition there is an eyewear allowance with each of our plans (amount varies by plan)
Need more information To find a participating Healthy Benefits fitness facility dental providers and vision providers please visit the ldquoFind a Medicare Providerrdquo section at wwwindependenthealth commedicare If you have questions about these benefits please call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday
Content to come
through Sunday from 8 am to 8 pm TTY users can call 1 (800) 432-1110
Applicable copays may apply for these benefits Member must use EyeMed and HealthPlex providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits premiums andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
4 HEALTHSTYLES bull FALL 2016 WINTER 2017
wise choices
Do some homework before selecting a Medicare Advantage plan for 2017 The Medicare Annual Election Period is the once-a-year opportunity for most Medicare beneficiaries to select their Medicare coverage for the coming year For some choosing a Medicare Advantage plan can be a confusing and complicated process While on the surface some plans may appear more affordable because of a lower monthly premium they might end up costing more in the long-run or may not meet your individual coverage needs
To help you make the right decision during this yearrsquos enrollment period here are three key things to consider before enrolling in a Medicare Advantage plan for 2017
1 What type of plan best meets your health care needs Many health insurers offer different types of Medicare Advantage plans The two most common are bull Health Maintenance Organization
(HMO) plan ndash With this plan you must use the doctors and hospitals that are in the HMOrsquos network Many HMOs require their members to choose a primary care doctor affiliated with their plan This is the doctor you will see for all your regular office visits and will help determine if you need to see a specialist HMO plans typically have lower costs for doctor office visits than other types of plans
bull Preferred Provider Organization (PPO) plan ndash This plan gives you more flexibility when picking a doctor or hospital but this flexibility typically comes with added cost For example members of PPOs can seek medically necessary care either inside or outside of the network however their member cost share (ie copayments coinsurance and deductibles) may be higher for services they receive outside the network
Itrsquos important to understand how the various Medicare Advantage plans work especially if you travel frequently or are a ldquosnowbirdrdquo with extended periods outside of the planrsquos service area
2 Do your health care providers participate with the plan With some health insurers provider participation varies by plan Check if your health care providers accept your coverage If your providers are not part of a planrsquos network you may still be able to see them if they accept the planrsquos payment terms and original Medicare However you may have to pay much higher costs to see a non-participating provider Therefore make sure you verify that your doctors and hospital
are ldquoin-networkrdquo Ask the health plan for a provider directory that lists all of the doctors and hospitals who participate in its network All plans are also required to post a provider directory to their website
3 Are your medications included on the planrsquos formulary Each plan has its own formulary which is a list of all the drugs that it covers Drugs are typically grouped into tiers on a formulary The tier that your medication is in determines your portion of the drug cost Member cost share can vary significantly by tier Make sure you review the formulary to see if your prescription drugs are covered by the plan and how much you will have to pay for your medications
WWWINDEPENDENTHEALTHCOMMEDICARE 5
good to know
New language tagline requirement for health plans
Under Federal non-discrimination rules set forth by the US Department of Health and Human Services Independent Health and all health plans throughout the nation are now required to include on all critical plan documents information about language access for members whose primary language is not English
Health plans must now include taglines for the top 15 languages spoken in the states in which the plans are located as determined by the American Community Survey a division of the Census Bureau
Among the critical plan documents that will include 15 taglines are applications correspondence containing information about eligibility and participation criteria summary of benefits formulary drug lists provider directories documents that require a signature or response and a subscriberrsquos insurance contract and evidence of coverage
Other plan documents and marketing materials such as our Medicare HealthStyles newsletter may only need to include the following top three language taglines
English ATTENTION If you speak English language assistance services free of charge are available to you Call 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race color national origin age disability or sex
Spanish ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health cumple con las leyes federales de derechos civiles
aplicables y no discrimina por motivos de raza color nacionalidad edad discapacidad o sexo
Chinese注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1 (800) 665-1502 (TTY 1 [800] 432-1110) Independent Health 遵守適用的聯邦民權法律規定不因種族膚色民族血統年齡殘障或性別而歧視任何人
Go paperless Receive plan documents electronically Each September Independent Health is required to provide our Medicare members an Annual Notice of Change (ANOC)Evidence of Coverage (EOC) However you can choose to view this large document electronically rather than receive it in the mail
Itrsquos easy to sign up 1 Log in at wwwindependenthealthcomlogin 2 Click ldquoView Document preferencesrdquo on the
Account Home screen under ldquoDocumentsrdquo 3 Choose the ldquoelectronicrdquo preference then click
ldquoSave preferencesrdquo
Advantages of going paperless include bull You will have access to your document 247 bull If you travel or are temporarily out of the area
you will have access to the document wherever you are
bull You will not have to store the large document each year
bull This option is voluntary and can be changed at any time
If you choose to go paperless when a new version of your document is posted you will receive an email notification with instructions on how to view it
6 HEALTHSTYLES bull FALL 2016 WINTER 2017
plan information
Family Choice plan designed for residents of nursing homes and long-term care facilities
At Independent Health we want the family members of those residing in nursing facilities to take comfort in knowing that their loved onersquos quality of life is being maintained at the highest level possible
Thatrsquos why we are pleased to partner with Family Choice of New York to offer the Independent Health Medicare Family Choice HMO-SNP plan which is specifically designed to meet the unique needs of members who permanently reside in nursing homes and assisted living facilities
Enhanced care provided Members enrolled in Family Choice receive regular visits by specially trained nurse practitioners and physician assistants who are on call 24 hours a day seven days a week to provide care and support as needed Their responsibilities include bull Working in collaboration with the
memberrsquos health care providers and the facilityrsquos staff to identify potential problems before they become serious
bull Minimizing unnecessary and disruptive emergency room visits and hospital stays whenever itrsquos safe and appropriate
bull Keeping in close contact with the memberrsquos family updating them about their loved onersquos condition and making sure they are part of the care-planning process
In addition program social workers are available to assist members and their families with physical issues and help them access necessary resources
Impressive survey results Since first being introduced 10 years ago the Family Choice plan has consistently received high marks from families In fact a recent satisfaction survey of people whose loved ones use the programrsquos services indicates that 974 of respondents are satisfied with Family Choice The survey also shows bull 986 of respondents feel the
loved ones have been receiving all of the benefits and services they expected them to receive
bull 977 of respondents would recommend Family Choice to another nursing home resident
bull 967 of respondents feel their nurse practitioner provides their loved ones with the quality of care they expected them to receive
bull 95 of respondents are satisfied with the communication they have with the nurse practitioner
bull 946 of respondents feel the nurse practitioner helps them and their loved ones understand any medical condition they have
Family Choice currently is available in a network of more than 45 participating facilities in Erie Niagara Genesee Orleans and Wyoming counties Unlike other Medicare Advantage plans individuals are able to enroll in Family Choice year round
To learn more about this plan visit wwwindependenthealthcom medicare or call (716) 635-4900 or 1 (800) 958-4405 Monday through Sunday from 8 am to 8 pm TTY users can call 1 (888) 357-9167
This plan is available to all Medicare eligibles that are entitled to Medicare Part A and enrolled in Part B except those with ESRD unless already enrolled with Independent Health This plan requires the use of participating providers except in the case of emergency care urgent or out-of-area renal dialysis Members must continue to pay Part B premiums if not otherwise paid for under Medicaid or by another third party
Survey conducted by Independent Health in July 2016 with 1259 families surveyed and 317 families (252) responding
WWWINDEPENDENTHEALTHCOMMEDICARE 7
medications
Reduce your prescription drug costs through EPIC
The New York State Department of Health offers the Elderly Pharmaceutical Insurance Coverage (EPIC) program as a way to provide copayment assistance to Medicare Part D plan members for their covered prescription medications
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met
Seniors can apply for EPIC at any time of the year You must be enrolled or eligible to be enrolled in a Medicare Part D drug plan and earn an annual income below $75000 (single) or $100000 (married) to receive EPIC benefits and maintain coverage
For an application or more information visit wwwhealth nygov or call the toll-free EPIC Helpline at 1 (800) 332-3742 Monday through Friday from 830 am to 5 pm TTY users 1 (800) 290-9138
MTM program helps members manage their medications
Independent Health offers a Medication Therapy Management (MTM) program to eligible Medicare Advantage plan members with prescription drug coverage who need to manage multiple medications for chronic conditions This free and voluntary program is designed to help prevent medication-related problems and enhance health outcomes by improving the way our members take their medications
Eligibility requirements To be eligible for this program you must meet the following criteria bull You are likely to meet a specified
annual cost threshold for all your covered prescription drugs For 2016 the annual cost threshold is $3507 For 2017 it will be $3919
bull You have received seven or more distinct prescriptions for chronic conditions
bull You have at least three of the following chronic conditions asthma heart failure chronic kidney disease chronic obstructive pulmonary disease (COPD) coronary artery disease depression diabetes high cholesterol or hypertension
If you meet the eligibility criteria you will be notified by mail andor
by telephone You will then be able to speak with an experienced Independent Health pharmacist who will provide a comprehensive review of all your medications
Why a medication review is important bull It can help keep you safe Our
pharmacist will look at all your medications to check for interactions and make sure nothing yoursquore taking will cause you harm
bull Yoursquoll get answers to your unique questions and concerns about your prescriptionsmdashwith the full attention of the pharmacist you can get the information you need
bull Side effects may be identified You may be experiencing side effects from a medication and not even know it If an issue is discovered the pharmacist can work with your doctor to fix it
How to schedule a review You will need to call to make an appointment with one of our pharmacists Your review can be conducted either over the telephone or in person at our Customer Service center located at 250 Essjay Road in Williamsville
TO LEARN MORE about this program or to schedule an appointment call (716) 250-4436 or 1 (800) 247-1466 ext 4436 (TTY users call 1 [800] 432-1110) Monday through Friday from 830 am to 430 pm or email MTMindependenthealthcom
8 HEALTHSTYLES bull FALL 2016 WINTER 2017
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
wise choices
Do some homework before selecting a Medicare Advantage plan for 2017 The Medicare Annual Election Period is the once-a-year opportunity for most Medicare beneficiaries to select their Medicare coverage for the coming year For some choosing a Medicare Advantage plan can be a confusing and complicated process While on the surface some plans may appear more affordable because of a lower monthly premium they might end up costing more in the long-run or may not meet your individual coverage needs
To help you make the right decision during this yearrsquos enrollment period here are three key things to consider before enrolling in a Medicare Advantage plan for 2017
1 What type of plan best meets your health care needs Many health insurers offer different types of Medicare Advantage plans The two most common are bull Health Maintenance Organization
(HMO) plan ndash With this plan you must use the doctors and hospitals that are in the HMOrsquos network Many HMOs require their members to choose a primary care doctor affiliated with their plan This is the doctor you will see for all your regular office visits and will help determine if you need to see a specialist HMO plans typically have lower costs for doctor office visits than other types of plans
bull Preferred Provider Organization (PPO) plan ndash This plan gives you more flexibility when picking a doctor or hospital but this flexibility typically comes with added cost For example members of PPOs can seek medically necessary care either inside or outside of the network however their member cost share (ie copayments coinsurance and deductibles) may be higher for services they receive outside the network
Itrsquos important to understand how the various Medicare Advantage plans work especially if you travel frequently or are a ldquosnowbirdrdquo with extended periods outside of the planrsquos service area
2 Do your health care providers participate with the plan With some health insurers provider participation varies by plan Check if your health care providers accept your coverage If your providers are not part of a planrsquos network you may still be able to see them if they accept the planrsquos payment terms and original Medicare However you may have to pay much higher costs to see a non-participating provider Therefore make sure you verify that your doctors and hospital
are ldquoin-networkrdquo Ask the health plan for a provider directory that lists all of the doctors and hospitals who participate in its network All plans are also required to post a provider directory to their website
3 Are your medications included on the planrsquos formulary Each plan has its own formulary which is a list of all the drugs that it covers Drugs are typically grouped into tiers on a formulary The tier that your medication is in determines your portion of the drug cost Member cost share can vary significantly by tier Make sure you review the formulary to see if your prescription drugs are covered by the plan and how much you will have to pay for your medications
WWWINDEPENDENTHEALTHCOMMEDICARE 5
good to know
New language tagline requirement for health plans
Under Federal non-discrimination rules set forth by the US Department of Health and Human Services Independent Health and all health plans throughout the nation are now required to include on all critical plan documents information about language access for members whose primary language is not English
Health plans must now include taglines for the top 15 languages spoken in the states in which the plans are located as determined by the American Community Survey a division of the Census Bureau
Among the critical plan documents that will include 15 taglines are applications correspondence containing information about eligibility and participation criteria summary of benefits formulary drug lists provider directories documents that require a signature or response and a subscriberrsquos insurance contract and evidence of coverage
Other plan documents and marketing materials such as our Medicare HealthStyles newsletter may only need to include the following top three language taglines
English ATTENTION If you speak English language assistance services free of charge are available to you Call 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race color national origin age disability or sex
Spanish ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health cumple con las leyes federales de derechos civiles
aplicables y no discrimina por motivos de raza color nacionalidad edad discapacidad o sexo
Chinese注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1 (800) 665-1502 (TTY 1 [800] 432-1110) Independent Health 遵守適用的聯邦民權法律規定不因種族膚色民族血統年齡殘障或性別而歧視任何人
Go paperless Receive plan documents electronically Each September Independent Health is required to provide our Medicare members an Annual Notice of Change (ANOC)Evidence of Coverage (EOC) However you can choose to view this large document electronically rather than receive it in the mail
Itrsquos easy to sign up 1 Log in at wwwindependenthealthcomlogin 2 Click ldquoView Document preferencesrdquo on the
Account Home screen under ldquoDocumentsrdquo 3 Choose the ldquoelectronicrdquo preference then click
ldquoSave preferencesrdquo
Advantages of going paperless include bull You will have access to your document 247 bull If you travel or are temporarily out of the area
you will have access to the document wherever you are
bull You will not have to store the large document each year
bull This option is voluntary and can be changed at any time
If you choose to go paperless when a new version of your document is posted you will receive an email notification with instructions on how to view it
6 HEALTHSTYLES bull FALL 2016 WINTER 2017
plan information
Family Choice plan designed for residents of nursing homes and long-term care facilities
At Independent Health we want the family members of those residing in nursing facilities to take comfort in knowing that their loved onersquos quality of life is being maintained at the highest level possible
Thatrsquos why we are pleased to partner with Family Choice of New York to offer the Independent Health Medicare Family Choice HMO-SNP plan which is specifically designed to meet the unique needs of members who permanently reside in nursing homes and assisted living facilities
Enhanced care provided Members enrolled in Family Choice receive regular visits by specially trained nurse practitioners and physician assistants who are on call 24 hours a day seven days a week to provide care and support as needed Their responsibilities include bull Working in collaboration with the
memberrsquos health care providers and the facilityrsquos staff to identify potential problems before they become serious
bull Minimizing unnecessary and disruptive emergency room visits and hospital stays whenever itrsquos safe and appropriate
bull Keeping in close contact with the memberrsquos family updating them about their loved onersquos condition and making sure they are part of the care-planning process
In addition program social workers are available to assist members and their families with physical issues and help them access necessary resources
Impressive survey results Since first being introduced 10 years ago the Family Choice plan has consistently received high marks from families In fact a recent satisfaction survey of people whose loved ones use the programrsquos services indicates that 974 of respondents are satisfied with Family Choice The survey also shows bull 986 of respondents feel the
loved ones have been receiving all of the benefits and services they expected them to receive
bull 977 of respondents would recommend Family Choice to another nursing home resident
bull 967 of respondents feel their nurse practitioner provides their loved ones with the quality of care they expected them to receive
bull 95 of respondents are satisfied with the communication they have with the nurse practitioner
bull 946 of respondents feel the nurse practitioner helps them and their loved ones understand any medical condition they have
Family Choice currently is available in a network of more than 45 participating facilities in Erie Niagara Genesee Orleans and Wyoming counties Unlike other Medicare Advantage plans individuals are able to enroll in Family Choice year round
To learn more about this plan visit wwwindependenthealthcom medicare or call (716) 635-4900 or 1 (800) 958-4405 Monday through Sunday from 8 am to 8 pm TTY users can call 1 (888) 357-9167
This plan is available to all Medicare eligibles that are entitled to Medicare Part A and enrolled in Part B except those with ESRD unless already enrolled with Independent Health This plan requires the use of participating providers except in the case of emergency care urgent or out-of-area renal dialysis Members must continue to pay Part B premiums if not otherwise paid for under Medicaid or by another third party
Survey conducted by Independent Health in July 2016 with 1259 families surveyed and 317 families (252) responding
WWWINDEPENDENTHEALTHCOMMEDICARE 7
medications
Reduce your prescription drug costs through EPIC
The New York State Department of Health offers the Elderly Pharmaceutical Insurance Coverage (EPIC) program as a way to provide copayment assistance to Medicare Part D plan members for their covered prescription medications
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met
Seniors can apply for EPIC at any time of the year You must be enrolled or eligible to be enrolled in a Medicare Part D drug plan and earn an annual income below $75000 (single) or $100000 (married) to receive EPIC benefits and maintain coverage
For an application or more information visit wwwhealth nygov or call the toll-free EPIC Helpline at 1 (800) 332-3742 Monday through Friday from 830 am to 5 pm TTY users 1 (800) 290-9138
MTM program helps members manage their medications
Independent Health offers a Medication Therapy Management (MTM) program to eligible Medicare Advantage plan members with prescription drug coverage who need to manage multiple medications for chronic conditions This free and voluntary program is designed to help prevent medication-related problems and enhance health outcomes by improving the way our members take their medications
Eligibility requirements To be eligible for this program you must meet the following criteria bull You are likely to meet a specified
annual cost threshold for all your covered prescription drugs For 2016 the annual cost threshold is $3507 For 2017 it will be $3919
bull You have received seven or more distinct prescriptions for chronic conditions
bull You have at least three of the following chronic conditions asthma heart failure chronic kidney disease chronic obstructive pulmonary disease (COPD) coronary artery disease depression diabetes high cholesterol or hypertension
If you meet the eligibility criteria you will be notified by mail andor
by telephone You will then be able to speak with an experienced Independent Health pharmacist who will provide a comprehensive review of all your medications
Why a medication review is important bull It can help keep you safe Our
pharmacist will look at all your medications to check for interactions and make sure nothing yoursquore taking will cause you harm
bull Yoursquoll get answers to your unique questions and concerns about your prescriptionsmdashwith the full attention of the pharmacist you can get the information you need
bull Side effects may be identified You may be experiencing side effects from a medication and not even know it If an issue is discovered the pharmacist can work with your doctor to fix it
How to schedule a review You will need to call to make an appointment with one of our pharmacists Your review can be conducted either over the telephone or in person at our Customer Service center located at 250 Essjay Road in Williamsville
TO LEARN MORE about this program or to schedule an appointment call (716) 250-4436 or 1 (800) 247-1466 ext 4436 (TTY users call 1 [800] 432-1110) Monday through Friday from 830 am to 430 pm or email MTMindependenthealthcom
8 HEALTHSTYLES bull FALL 2016 WINTER 2017
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
good to know
New language tagline requirement for health plans
Under Federal non-discrimination rules set forth by the US Department of Health and Human Services Independent Health and all health plans throughout the nation are now required to include on all critical plan documents information about language access for members whose primary language is not English
Health plans must now include taglines for the top 15 languages spoken in the states in which the plans are located as determined by the American Community Survey a division of the Census Bureau
Among the critical plan documents that will include 15 taglines are applications correspondence containing information about eligibility and participation criteria summary of benefits formulary drug lists provider directories documents that require a signature or response and a subscriberrsquos insurance contract and evidence of coverage
Other plan documents and marketing materials such as our Medicare HealthStyles newsletter may only need to include the following top three language taglines
English ATTENTION If you speak English language assistance services free of charge are available to you Call 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race color national origin age disability or sex
Spanish ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1 (800) 665-1502 (TTY 1 [800] 432-1110)
Independent Health cumple con las leyes federales de derechos civiles
aplicables y no discrimina por motivos de raza color nacionalidad edad discapacidad o sexo
Chinese注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1 (800) 665-1502 (TTY 1 [800] 432-1110) Independent Health 遵守適用的聯邦民權法律規定不因種族膚色民族血統年齡殘障或性別而歧視任何人
Go paperless Receive plan documents electronically Each September Independent Health is required to provide our Medicare members an Annual Notice of Change (ANOC)Evidence of Coverage (EOC) However you can choose to view this large document electronically rather than receive it in the mail
Itrsquos easy to sign up 1 Log in at wwwindependenthealthcomlogin 2 Click ldquoView Document preferencesrdquo on the
Account Home screen under ldquoDocumentsrdquo 3 Choose the ldquoelectronicrdquo preference then click
ldquoSave preferencesrdquo
Advantages of going paperless include bull You will have access to your document 247 bull If you travel or are temporarily out of the area
you will have access to the document wherever you are
bull You will not have to store the large document each year
bull This option is voluntary and can be changed at any time
If you choose to go paperless when a new version of your document is posted you will receive an email notification with instructions on how to view it
6 HEALTHSTYLES bull FALL 2016 WINTER 2017
plan information
Family Choice plan designed for residents of nursing homes and long-term care facilities
At Independent Health we want the family members of those residing in nursing facilities to take comfort in knowing that their loved onersquos quality of life is being maintained at the highest level possible
Thatrsquos why we are pleased to partner with Family Choice of New York to offer the Independent Health Medicare Family Choice HMO-SNP plan which is specifically designed to meet the unique needs of members who permanently reside in nursing homes and assisted living facilities
Enhanced care provided Members enrolled in Family Choice receive regular visits by specially trained nurse practitioners and physician assistants who are on call 24 hours a day seven days a week to provide care and support as needed Their responsibilities include bull Working in collaboration with the
memberrsquos health care providers and the facilityrsquos staff to identify potential problems before they become serious
bull Minimizing unnecessary and disruptive emergency room visits and hospital stays whenever itrsquos safe and appropriate
bull Keeping in close contact with the memberrsquos family updating them about their loved onersquos condition and making sure they are part of the care-planning process
In addition program social workers are available to assist members and their families with physical issues and help them access necessary resources
Impressive survey results Since first being introduced 10 years ago the Family Choice plan has consistently received high marks from families In fact a recent satisfaction survey of people whose loved ones use the programrsquos services indicates that 974 of respondents are satisfied with Family Choice The survey also shows bull 986 of respondents feel the
loved ones have been receiving all of the benefits and services they expected them to receive
bull 977 of respondents would recommend Family Choice to another nursing home resident
bull 967 of respondents feel their nurse practitioner provides their loved ones with the quality of care they expected them to receive
bull 95 of respondents are satisfied with the communication they have with the nurse practitioner
bull 946 of respondents feel the nurse practitioner helps them and their loved ones understand any medical condition they have
Family Choice currently is available in a network of more than 45 participating facilities in Erie Niagara Genesee Orleans and Wyoming counties Unlike other Medicare Advantage plans individuals are able to enroll in Family Choice year round
To learn more about this plan visit wwwindependenthealthcom medicare or call (716) 635-4900 or 1 (800) 958-4405 Monday through Sunday from 8 am to 8 pm TTY users can call 1 (888) 357-9167
This plan is available to all Medicare eligibles that are entitled to Medicare Part A and enrolled in Part B except those with ESRD unless already enrolled with Independent Health This plan requires the use of participating providers except in the case of emergency care urgent or out-of-area renal dialysis Members must continue to pay Part B premiums if not otherwise paid for under Medicaid or by another third party
Survey conducted by Independent Health in July 2016 with 1259 families surveyed and 317 families (252) responding
WWWINDEPENDENTHEALTHCOMMEDICARE 7
medications
Reduce your prescription drug costs through EPIC
The New York State Department of Health offers the Elderly Pharmaceutical Insurance Coverage (EPIC) program as a way to provide copayment assistance to Medicare Part D plan members for their covered prescription medications
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met
Seniors can apply for EPIC at any time of the year You must be enrolled or eligible to be enrolled in a Medicare Part D drug plan and earn an annual income below $75000 (single) or $100000 (married) to receive EPIC benefits and maintain coverage
For an application or more information visit wwwhealth nygov or call the toll-free EPIC Helpline at 1 (800) 332-3742 Monday through Friday from 830 am to 5 pm TTY users 1 (800) 290-9138
MTM program helps members manage their medications
Independent Health offers a Medication Therapy Management (MTM) program to eligible Medicare Advantage plan members with prescription drug coverage who need to manage multiple medications for chronic conditions This free and voluntary program is designed to help prevent medication-related problems and enhance health outcomes by improving the way our members take their medications
Eligibility requirements To be eligible for this program you must meet the following criteria bull You are likely to meet a specified
annual cost threshold for all your covered prescription drugs For 2016 the annual cost threshold is $3507 For 2017 it will be $3919
bull You have received seven or more distinct prescriptions for chronic conditions
bull You have at least three of the following chronic conditions asthma heart failure chronic kidney disease chronic obstructive pulmonary disease (COPD) coronary artery disease depression diabetes high cholesterol or hypertension
If you meet the eligibility criteria you will be notified by mail andor
by telephone You will then be able to speak with an experienced Independent Health pharmacist who will provide a comprehensive review of all your medications
Why a medication review is important bull It can help keep you safe Our
pharmacist will look at all your medications to check for interactions and make sure nothing yoursquore taking will cause you harm
bull Yoursquoll get answers to your unique questions and concerns about your prescriptionsmdashwith the full attention of the pharmacist you can get the information you need
bull Side effects may be identified You may be experiencing side effects from a medication and not even know it If an issue is discovered the pharmacist can work with your doctor to fix it
How to schedule a review You will need to call to make an appointment with one of our pharmacists Your review can be conducted either over the telephone or in person at our Customer Service center located at 250 Essjay Road in Williamsville
TO LEARN MORE about this program or to schedule an appointment call (716) 250-4436 or 1 (800) 247-1466 ext 4436 (TTY users call 1 [800] 432-1110) Monday through Friday from 830 am to 430 pm or email MTMindependenthealthcom
8 HEALTHSTYLES bull FALL 2016 WINTER 2017
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
plan information
Family Choice plan designed for residents of nursing homes and long-term care facilities
At Independent Health we want the family members of those residing in nursing facilities to take comfort in knowing that their loved onersquos quality of life is being maintained at the highest level possible
Thatrsquos why we are pleased to partner with Family Choice of New York to offer the Independent Health Medicare Family Choice HMO-SNP plan which is specifically designed to meet the unique needs of members who permanently reside in nursing homes and assisted living facilities
Enhanced care provided Members enrolled in Family Choice receive regular visits by specially trained nurse practitioners and physician assistants who are on call 24 hours a day seven days a week to provide care and support as needed Their responsibilities include bull Working in collaboration with the
memberrsquos health care providers and the facilityrsquos staff to identify potential problems before they become serious
bull Minimizing unnecessary and disruptive emergency room visits and hospital stays whenever itrsquos safe and appropriate
bull Keeping in close contact with the memberrsquos family updating them about their loved onersquos condition and making sure they are part of the care-planning process
In addition program social workers are available to assist members and their families with physical issues and help them access necessary resources
Impressive survey results Since first being introduced 10 years ago the Family Choice plan has consistently received high marks from families In fact a recent satisfaction survey of people whose loved ones use the programrsquos services indicates that 974 of respondents are satisfied with Family Choice The survey also shows bull 986 of respondents feel the
loved ones have been receiving all of the benefits and services they expected them to receive
bull 977 of respondents would recommend Family Choice to another nursing home resident
bull 967 of respondents feel their nurse practitioner provides their loved ones with the quality of care they expected them to receive
bull 95 of respondents are satisfied with the communication they have with the nurse practitioner
bull 946 of respondents feel the nurse practitioner helps them and their loved ones understand any medical condition they have
Family Choice currently is available in a network of more than 45 participating facilities in Erie Niagara Genesee Orleans and Wyoming counties Unlike other Medicare Advantage plans individuals are able to enroll in Family Choice year round
To learn more about this plan visit wwwindependenthealthcom medicare or call (716) 635-4900 or 1 (800) 958-4405 Monday through Sunday from 8 am to 8 pm TTY users can call 1 (888) 357-9167
This plan is available to all Medicare eligibles that are entitled to Medicare Part A and enrolled in Part B except those with ESRD unless already enrolled with Independent Health This plan requires the use of participating providers except in the case of emergency care urgent or out-of-area renal dialysis Members must continue to pay Part B premiums if not otherwise paid for under Medicaid or by another third party
Survey conducted by Independent Health in July 2016 with 1259 families surveyed and 317 families (252) responding
WWWINDEPENDENTHEALTHCOMMEDICARE 7
medications
Reduce your prescription drug costs through EPIC
The New York State Department of Health offers the Elderly Pharmaceutical Insurance Coverage (EPIC) program as a way to provide copayment assistance to Medicare Part D plan members for their covered prescription medications
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met
Seniors can apply for EPIC at any time of the year You must be enrolled or eligible to be enrolled in a Medicare Part D drug plan and earn an annual income below $75000 (single) or $100000 (married) to receive EPIC benefits and maintain coverage
For an application or more information visit wwwhealth nygov or call the toll-free EPIC Helpline at 1 (800) 332-3742 Monday through Friday from 830 am to 5 pm TTY users 1 (800) 290-9138
MTM program helps members manage their medications
Independent Health offers a Medication Therapy Management (MTM) program to eligible Medicare Advantage plan members with prescription drug coverage who need to manage multiple medications for chronic conditions This free and voluntary program is designed to help prevent medication-related problems and enhance health outcomes by improving the way our members take their medications
Eligibility requirements To be eligible for this program you must meet the following criteria bull You are likely to meet a specified
annual cost threshold for all your covered prescription drugs For 2016 the annual cost threshold is $3507 For 2017 it will be $3919
bull You have received seven or more distinct prescriptions for chronic conditions
bull You have at least three of the following chronic conditions asthma heart failure chronic kidney disease chronic obstructive pulmonary disease (COPD) coronary artery disease depression diabetes high cholesterol or hypertension
If you meet the eligibility criteria you will be notified by mail andor
by telephone You will then be able to speak with an experienced Independent Health pharmacist who will provide a comprehensive review of all your medications
Why a medication review is important bull It can help keep you safe Our
pharmacist will look at all your medications to check for interactions and make sure nothing yoursquore taking will cause you harm
bull Yoursquoll get answers to your unique questions and concerns about your prescriptionsmdashwith the full attention of the pharmacist you can get the information you need
bull Side effects may be identified You may be experiencing side effects from a medication and not even know it If an issue is discovered the pharmacist can work with your doctor to fix it
How to schedule a review You will need to call to make an appointment with one of our pharmacists Your review can be conducted either over the telephone or in person at our Customer Service center located at 250 Essjay Road in Williamsville
TO LEARN MORE about this program or to schedule an appointment call (716) 250-4436 or 1 (800) 247-1466 ext 4436 (TTY users call 1 [800] 432-1110) Monday through Friday from 830 am to 430 pm or email MTMindependenthealthcom
8 HEALTHSTYLES bull FALL 2016 WINTER 2017
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
medications
Reduce your prescription drug costs through EPIC
The New York State Department of Health offers the Elderly Pharmaceutical Insurance Coverage (EPIC) program as a way to provide copayment assistance to Medicare Part D plan members for their covered prescription medications
EPIC provides secondary coverage for Medicare Part D and EPIC-covered drugs purchased after any Medicare Part D deductible is met
Seniors can apply for EPIC at any time of the year You must be enrolled or eligible to be enrolled in a Medicare Part D drug plan and earn an annual income below $75000 (single) or $100000 (married) to receive EPIC benefits and maintain coverage
For an application or more information visit wwwhealth nygov or call the toll-free EPIC Helpline at 1 (800) 332-3742 Monday through Friday from 830 am to 5 pm TTY users 1 (800) 290-9138
MTM program helps members manage their medications
Independent Health offers a Medication Therapy Management (MTM) program to eligible Medicare Advantage plan members with prescription drug coverage who need to manage multiple medications for chronic conditions This free and voluntary program is designed to help prevent medication-related problems and enhance health outcomes by improving the way our members take their medications
Eligibility requirements To be eligible for this program you must meet the following criteria bull You are likely to meet a specified
annual cost threshold for all your covered prescription drugs For 2016 the annual cost threshold is $3507 For 2017 it will be $3919
bull You have received seven or more distinct prescriptions for chronic conditions
bull You have at least three of the following chronic conditions asthma heart failure chronic kidney disease chronic obstructive pulmonary disease (COPD) coronary artery disease depression diabetes high cholesterol or hypertension
If you meet the eligibility criteria you will be notified by mail andor
by telephone You will then be able to speak with an experienced Independent Health pharmacist who will provide a comprehensive review of all your medications
Why a medication review is important bull It can help keep you safe Our
pharmacist will look at all your medications to check for interactions and make sure nothing yoursquore taking will cause you harm
bull Yoursquoll get answers to your unique questions and concerns about your prescriptionsmdashwith the full attention of the pharmacist you can get the information you need
bull Side effects may be identified You may be experiencing side effects from a medication and not even know it If an issue is discovered the pharmacist can work with your doctor to fix it
How to schedule a review You will need to call to make an appointment with one of our pharmacists Your review can be conducted either over the telephone or in person at our Customer Service center located at 250 Essjay Road in Williamsville
TO LEARN MORE about this program or to schedule an appointment call (716) 250-4436 or 1 (800) 247-1466 ext 4436 (TTY users call 1 [800] 432-1110) Monday through Friday from 830 am to 430 pm or email MTMindependenthealthcom
8 HEALTHSTYLES bull FALL 2016 WINTER 2017
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
medications
Is your medication working for you
Prescription drugs can enhance your life but when not used correctly they may not be effective They may even be dangerous to your health Medications are serious business and should never be taken lightly Ask these questions each time yoursquore prescribed a medication
Q How should I take this drug A large percentage of people donrsquot take their medications correctly according to recent surveys Some stop taking a drug without first getting their health care providerrsquos OK Others donrsquot follow label instructions
Itrsquos one thing to stop taking a prescribed pill for pain or cold-symptom relief when you start to feel better Itrsquos another to take an unsafe dose of that medication or to fail to take a drug that could help prevent a heart attack stroke or diabetes-related blindness or amputation
Q How will I know the drug is working Often a routine test can clearly show if the drug yoursquore taking is doing its job For example a blood sugar test can help show if a diabetes medication is working With pain medications antihistamines and muscle relaxants only the person who takes them can know for sure If your symptoms arenrsquot improving be sure to let your health care provider or pharmacist know so the treatment can be adjusted if necessary
Q If I feel better should I stop taking the medication For some drugs stopping the dose is no problem If allergy symptoms get better you may do just fine
without the antihistamines However some drugs can cause serious problems when you stop taking them too soon including the following medications
bull Antibiotics Bacteria can grow resistant to the medication if you donrsquot take all doses as prescribed no matter how good you start to feel As a result your infection may return with greater intensity Worse the medication may no longer work on that type of infection
Q If I feel worse than before bull Cholesterol diabetes or blood should I keep taking it
pressure medications Often Your health care provider or people taking these medications pharmacist should give you written feel just fine even when they quit information with each prescription taking the drugs However over about side effects That information time this can lead to stroke heart will tell you when itrsquos important to attack heart failure amputations immediately stop taking a drug and blindness or kidney failure contact a health care provider
Reminder about Independent Healthrsquos Medicare Part D drug formularies Learn what medications are covered by Independent Health by viewing our drug formularies online Visit www independenthealthcommedicare go to the ldquoPrescription Coveragerdquo section and then click on ldquoFormularies amp Pharmaciesrdquo You can also request a hard copy of your formulary by calling Member Services at (716) 250-4401 or 1 (800) 665-1502 Monday through Friday from 8 am to 8 pm TTY users 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 9
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
take charge
Avoid hospital readmission by being proactive Once yoursquove left the hospital after an illness the last thing you want to do is end up back there But about 20 of older adults make a repeat visit the month after discharge In fact depending on what sent you to the hospital in the first place the risk for a return trip remains elevated for months or even a year afterward a recent study found
Fortunately doctors and health care professionals can help reduce these risks by providing targeted follow-up care the study said But patients have a role to play too
What you can do You can prevent heading back to the hospital by taking an active role in your health care management You can also enlist family members to help make sure you follow your doctorrsquos advice and keep up with any medications you may need
Before you leave the hospital make sure you askmdashand write down the answers tomdashthese questions bull What should I do to continue
getting better bull What problems should I watch
for And what should I do if I have them
bull What medicines do I need and how do I take them
bull Will I need a walker or other medical equipment
bull Do I need to schedule follow-up visits and tests
In addition request written information you can take with you about your diagnosis and treatment plan If you need further help coping with the transition from hospital to home a social worker may be able to provide advice and support to you or your caregiver
Watch your health closely during the months after a hospital visit If you notice any changes or concerns be sure to notify your doctor right away
Do your part to help prevent health care fraud Independent Health works with government agencies and other health plans to fight health care fraud
Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or
medications not received bull Forging or altering bills or
receipts bull Using someone elsersquos
coverage or insurance card
bull Faking workerrsquos compensation injury to receive disability payments
We need your assistance Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal
information (eg your Social Security or Independent Health member ID number) to anyone except your doctor or health plan
bull Read your Explanation of Benefits (EOB) statements you receive from Independent Health Make sure you actually received the
treatments for which your insurance was charged and question suspicious expenses
bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for treatments you never received
If you suspect possible fraud or abuse call Independent Healthrsquos Fraud amp Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous TTY users 1 (800) 855-2881
10 HEALTHSTYLES bull FALL 2016 WINTER 2017
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
be safe
Take simple steps to prevent falls
Each year nearly 24 million people are treated in the emergency room for falls and 26000 people die as the result of accidental falls The majority of these cases involve a person who is 65 years of age or older
While there is no question that advancing age is a big risk factor for falls researchers have found that specific conditions put some at even greater risk They include the following bull Stroke bull Dementia bull Walking and balance disorders bull Muscle weakness in the legs
and feet bull Use of assistive devices to get
around bull Vision problems
Talk with your doctor The American Academy of Neurology has established guidelines as a way to encourage an open dialogue between doctors and patients about falls If yoursquore at risk of falling your doctor will likely recommend prevention measures Here are some things you can do to avoid a fall bull Get your doctorrsquos permission to
begin a regular exercise program Exercises that improve balance and coordination such as tai chi are very helpful
bull Have your vision checked by an eye doctor at least once a year
bull Ask your doctor or pharmacist to review all of your medicines which may be causing dizziness or confusion
bull Make your home safer For example clear the floor of clutter
improve the lighting around stairs and other hazardous spots and install grab bars in the bathroom
bull Always wear supportive low-heeled shoes
Make sure you discuss your own risk factors whenever you visit with your doctor For example inform your doctor if you have fallen in the past year He or she may want to perform screening tests to evaluate your risk of falling again
Wersquore dedicated to our members and their health care
Independent Health is committed to finding solutions to improve the health of our members For example bull We help members take control
of their own health care by reminding them of the preventive services they need
bull We create programs to help them better manage major medical conditions
bull We contact our participating physicians and health care providers on a regular basis so that they may best help their patients
bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization
Plus whenever you have a question or concern wersquore here to assist Simply call our Member Services Department at (716) 250-4401 or 1 (800) 665-1502 Monday through Sunday from 8 am to 8 pm TTY users call 1 (800) 432-1110
WWWINDEPENDENTHEALTHCOMMEDICARE 11
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary
PRSRT STD US POSTAGE
PA I D Independent
Health 511 Farber Lakes Drive
The Wellness Magazine for Buffalo NY 14221 Independent Health Members
KEITH PAGE Editor
Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell
copy 2016
Health and wellness or prevention information Printed on Recyclable Paper 532M This is an advertisement
For more ways to keep yourself healthy follow us on Facebook and Twitter
Now hear this New advances improve hearing aids About four out of five Americans who could benefit from a hearing aid donrsquot use one If yoursquore among them it may be time to reconsider Beginning in 2017 most of Independent Healthrsquos Medicare Advantage plans will offer a new hearing aid benefit which will include coverage for bull A hearing aid evaluation exam bull Two TruHearing Flyte hearing aids
every year (one per ear) bull Three follow-up visits with an
in-network provider for fitting and adjustment of hearing aids
bull 48 batteries per aid bull Three-year manufacturer warranty
for repairs
Assistive devices have come a long way since the days of vacuum tubes and heavy batteries For example bull Most models are now smaller and
nearly invisible fitting partially or completely within the outer ear or ear canal
bull Many hearing aids have a directional microphone too
Switch it on so that sounds in front of youmdashsay a person speakingmdashwill sound louder than noise behind you These digital hearing aids allow more precise adjustment Programmable models save settings for different listening environments so that you can transition with ease
bull About two-thirds of hearing aids now come equipped with a telecoil which acts like a wireless antenna and allows you to receive sound through the circuits of the hearing aid Some cellphones let you hear clearly using this technology Whatrsquos more many performance halls and other public places now use whatrsquos called an induction loop to broadcast directly to your hearing aid
If yoursquore having trouble hearing check with your doctor or an audiologist He or she can help pinpoint the cause of your problem and choose the hearing aid thatrsquos best for you
Applicable copays may apply for these benefits Member must use TruHearing providers in order to take advantage of these benefits Refer to the Evidence of Coverage for complete details Excludes Independent Healthrsquos Medicare Family Choice HMO-SNP Benefits vary by plan This information is not a complete description of benefits Contact the plan for more information Limitations copayments and restrictions may apply Benefits andor copayments may change on January 1 of each year The provider network may change at any time You will receive notice when necessary