Care
Plus
Blue Bulletin
MEMBER NEWSLETTER
F A L L
EDITION
What’s in this issue:
•
Important plan information
coming soon by mail
•
It’s time to get your flu vaccine
•
Review medications with your
doctor after a hospital stay
Health and wellness or prevention information
www.bcidaho.com/medicare
Y0010_MK16221 ACCEPTED
Welcome
One of the things that fall brings in Idaho is the end
to fire season. As you read this though, there may
still be fires burning forests or hills near you. Make
sure you take air quality into account if you plan on
spending an extended amount of time outside in
affected areas – especially if you suffer from asthma
or other chronic conditions affecting the lungs.
If you are traveling and want to know what the
air quality is like in another part of Idaho, visit
Idaho Department of Environmental Quality’s
website at http://airquality.deq.idaho.gov/ to see
the real-time air quality map.
Fall also means there is ‘change’ coming. Changes to
the weather, or colors in the trees. Sometimes there
are changes to health plans to prepare for in the next
calendar year.
In September, we’ll send you some important
documents that will let you know if there are any
changes to your plan in 2017. Turn to page 3 to learn
more.
Finally, as you enjoy Mind Games, make sure to read
the feature on medication adherence tips and tricks.
Is it important to take your medications at the same
time each day? Find out on page 5.
Another thing that fall brings is the the flu season.
The best chance to avoid the flu each year is to
receive an annual flu vaccine. See page 2 to learn
some quick facts about the flu vaccine.
Blue Cross of Idaho Care Plus is a Medicare Advantage health plan with a Medicare
and Idaho Medicaid contract. Enrollment in Blue Cross of Idaho Care Plus depends on
contract renewal. This information is not a complete description of benefits. Contact
the plan for more information. Limitations, copayments and restrictions may apply.
Benefits and/or copayments/coinsurance may change on January 1 of each year.
You must continue to pay your Medicare Part B premium. The formulary, pharmacy
network, and/or provider network may change at any time.
You will receive notice when necessary.
Blue Cross of Idaho Care Plus complies with applicableFederal
civil rights laws and does not discriminate on the basis of
race, color, national origin, age, disability, or sex.
ATENCIÓN: si habla español, tiene a su disposición
servicios gratuitos de asistencia lingüística. Llame al
1-888-494-2583 (TTY: 1-800-377-1363).
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 1-888-494-2583
(TTY: 1-800-377-1363)。
HOUSE
CALLS
Steve Olson is the director of Pharmacy
Management at Blue Cross of Idaho. Steve
and his team work with a team of clinicians
to ensure we remain at the forefront of
changes and innovations that will help
improve health and lower costs.
Biosimilar Medications Offer New
Cost-Saving Possibilities
By Steve Olson
You’ve probably heard a lot of
different terms being thrown
around regarding prescription
drugs. No longer are your
prescriptions just medications,
they’re brand names, or generics,
or biologics, or originator, or
biosimilar – it’s getting hard to
keep all these different definitions
straight.
Recently, there has been a lot of
talk about biologics and biosimilar
medications in various media
outlets. But what are these?
Typical medications, or nonbiologics, have a simple
structure and are easy to copy.
A good example of this type
of medication is the common
pain reliever ibuprofen. But a
biologic medication is made from
living cells and has a structure
of complicated molecules. This
makes them more difficult to
manufacture, harder to copy and
more expensive.
Like typical medications, biologic
medications are protected by
patents. When these patents
expire, competitors are able to
create generic versions of the drug,
which are typically less expensive
and help to lower costs.
But, unlike typical medications,
the complexity of biologics
makes them impossible to copy
exactly. Because of this, the
generic versions of biologics are
called biosimilars because they
are similar to the original – or
originator – but not identical.
Biosimilars are required to undergo
additional tests to ensure safety
and effectiveness before they are
ever sold to the public.
Biosimilars have been approved
and used in Europe for many
years, and have been an important
tool for curbing the rising cost
of prescription drugs. In the
United States, the Federal Drug
Administration has been writing a
policy on biosimilar medications
since 2010.
Many pharmaceutical companies
are anxiously awaiting these
regulations and guidelines so they
can begin introducing these drugs
to the U.S. market. To date, only
two biosimilar products have been
approved, although many more
are in the approval process.
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Blue Cross of Idaho is carefully
watching what happens with
biosimilar regulations in the United
States. These new medications will
bring much needed competition
to a class of medications that has
previously not had any. Without
competition, some pharmaceutical
manufacturers have been raising
drug prices by double-digit
percentages year after year.
It’s estimated that biosimilar
drugs could reduce the amount
Americans spend on prescription
drugs by roughly $44 billion by
2024.
Part of our mission at Blue Cross
of Idaho is to continually help our
members have easy access to
quality healthcare at the best cost
possible, and more competition
in the pharmaceutical industry
could go a long way toward that
goal. Watch for more information
about biosimilar medications in
the future.
1
Simple facts on preventing FLU
An annual flu vaccine is the single best
way to reduce your chances of getting
seasonal flu and spreading it to others.
When more people get vaccinated
against the flu, less flu can spread
through the community.
When it comes to preventing flu, knowledge is
power. Influenza is a serious virus that can lead to
hospitalization and for some people, even death.
Every flu season is different, and influenza affects
people differently. Even healthy people can get
very sick, so your best shot at prevention is to get
vaccinated.
The flu vaccine is available at no cost to
you when you receive it at an in-network
pharmacy.
Ask your doctor about a high-dose
trivalent shot, designed and approved for
people over 65. The high-dose shot has
more antigens and is intended to create
a stronger immune response in those
who receive it.
Want to know more? Visit Centers for Disease Control at http://www.cdc.gov/flu/protect/keyfacts.htm.
Mammograms (Breast Cancer Screening)
Are you putting off a
mammogram? There are lots
of reasons for delaying this
routine breast cancer screening
– you’re nervous, you’re shy,
you’re busy. There’s one great
reason for scheduling one soon –
mammograms save lives.
A woman’s risk for breast cancer is
highest after she reaches 60. Even
as women age, early detection of
breast cancer can lead to more
treatment options, less extensive
surgery and better outcomes. Most
women over 60 need a routine
screening every other year until
age 74, or unless her doctor says
otherwise.
2
Talk to your doctor about
your own risks and the right
schedule for you – especially
if you have an immediate
family member whose
had breast cancer. Blue Cross
of Idaho Medicare Advantage
plans cover mammograms once
every 12 months for all women
ages 40 and older.
BLUE CROSS OF IDAHO CARE PLUS
|
MEDICARE MEMBER NEWSLETTER
Watch for Important
Information in the Mail!
In September, we’ll send you important plan
information so you’ll know if there are any changes to
your 2017 plan. Here’s what to look for:
• Annual Notice of Change (ANOC): This annual
notice provides a summary of any costs or
coverage changes to your plan that go into effect
on January 1, 2017. The ANOC provides a simple
table format allowing you to quickly see if there’s a
change to prepare for.
• Evidence of Coverage (EOC): This booklet lists
benefits and plan costs that will take effect on
January 1, 2017. It also explains what services may
not be covered by your plan. Many simply refer to
the EOC as the plan contract. Keep your EOC handy
and refer to it throughout the year when you have
benefit questions. Chances are good that the
answer you need is in your EOC.
• Formulary (List of Covered Drugs)
and Pharmacy Directory: Quite simply, these
two items are just what they sound like. In these
booklets you will find drugs covered by your plan
and what in-network pharmacies you can use to fill
your prescriptions in 2017.
Discharged from Hospital? Schedule a Medication Review with your PCP
Medications often change during a hospital stay. Old
medications may be stopped, new ones started, or
the strength adjusted. Many patients may resume
old medications after being discharged; not knowing
the hospital has put them on a similar medication or
changes in health may affect the medication they’re
taking. This can lead to increased side-effects and
severe health issues.
Even if the hospital has not added or removed
medications, it is important to review all medications
with your doctor after being discharged.
Your medication follow-up should be with your
primary care physician. If you do not have a primary
care physician, your follow-up may be with the
physician you saw in the hospital. If you would
like assistance finding a primary care physician,
customer service can help.
Items to bring to your follow up appointment:
• Any discharge instructions provided
at the hospital
• A current list of your medications (the
medication bottles may better assist
the doctor)
• A list of any questions regarding medication, your
reason for discharge, and any limits or restrictions.
A follow-up to review medications after your hospital
stay has been shown to reduce the need for a
readmission to the hospital and helps you stay in
control of your health.
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3
Discussing bladder control and treatments
Bladder training: Sets specific times to use the
bathroom, before you get the urge to urinate. Slowly
increasing the time between bathroom trips helps
retrain the bladder.
Discussing bladder control can be embarrassing,
but many of the causes of urinary incontinence are
quite normal and many treatments exist. Bladder
control issues may arise from some medications and
infections, or from previous conditions like childbirth
and menopause for women, or prostate surgery
for men. For these reasons and for information on
treatment, it is very important to discuss bladder
control concerns during your doctor visit.
Muscle exercises: Your physician can review exercises
called Kegel or pelvic floor exercises for men and
women to strengthen muscles used for urinary
retention. This can help with unexpected leakage.
Changing medication: If control issues are the
result of a medication, your doctor may prescribe a
different medication, have you stop a medication, or
change the time of day you take a medication. Your
doctor will always review the risks and benefits of a
medication before making changes.
When speaking with your doctor, he/she may discuss
the following possible treatments, which will depend
on the reason for bladder control issues. As always,
it is very helpful to bring a list of questions to your
appointment and a pen or pencil to write down notes
during the visit.
New medication: In some cases, your physician may
suggest a medication. Several medications exist that
help with a variety of bladder control causes.
Lifestyle changes: Caffeine and alcohol intake can
affect the muscles of the bladder and the amount
of urine produced. Your physician may suggest
reducing the amount of caffeinated and alcoholic
drinks consumed. They may also suggest weight
loss. Excess weight can press on the bladder, making
control difficult. Other lifestyle changes they may
recommend include quitting smoking and increasing
fiber intake.
4
BLUE CROSS OF IDAHO CARE PLUS
For more information on bladder control treatments
log on to Blue Cross of Idaho’s member website and
view our WellConnected resources at
members.bcidaho.com > WellConnected > Health
Library and search for urinary incontinence.
There you’ll find individual resources for men and
women and detailed information regarding specific
treatments.
|
MEDICARE MEMBER NEWSLETTER
Medication Adherence
Tips & Tricks
Mind Games
Keep your mind sharp by exercising your brain.
In order to get the most out of your
medications, it’s important to take them
as directed. Some medications may be
obvious when you miss a dose, others may
not be noticeable. Either way, your health
may depend on the medication you take
regularly.
• Know when to take your medications.
• Your pharmacist can help you
with the best times to take each
medication.
• Some medication should be taken
at specific times of the day, with
or without food, separate from
other medications, or only on
specific days of the week. The time
of day you take your medication
may make it work better or lessen
side effects.
• Take your medications at the same time
every day.
THAT SCRAMBLED WORD GAME
Unscramble these four Jumbles,
one letter to each square,
to form four ordinary words.
RANEA
©2013 Tribune Content Agency, LLC
All Rights Reserved.
DRANG
TIMCER
ABENTE
A:
“
Yesterday’s
Jumble puzzle magazines available at pennydellpuzzles.com/jumblemags
by David L. Hoyt and Jeff Knurek
• Making your medication part of
your daily routine can help you
remember. Placing your pill box next
to regular activities, such as next to
the coffee pot in the morning, puts it
in your field of view as a reminder.
• Fill your medication before you run out.
• You can refill your medication once
you have used at least 75% of it.
This means, for medication you fill
every month, you can refill one week
before you run out.
• Use a pill box and refill it regularly.
Now arrange the circled letters
to form the surprise answer, as
suggested by the above cartoon.
”
(Answers tomorrow)
Jumbles: GUMBO
MINUS
PRETTY
BEHIND
Answer: After years without striking, the picketers
had a — RE-UNION
• Taking the time to use and refill
a pill box ensures you take each
medication every day while saving
time throughout the week. It also
lets you know and compare the
types of pills and amount every day.
If you suspect the medication isn’t
the same when you refill it, contact
your pharmacy.
Answers on back cover.
FA L L 2 0 1 6
5
3000 E. Pine Ave.
Meridian, ID 83642
Published by Blue Cross of Idaho. © 2016 by Blue Cross of Idaho, an independent licensee of the Blue Cross and Blue Shield Association. All rights reserved. No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The
information in this publication is intended to complement – not take the place of – the recommendations of your healthcare provider. Consult your physician before making major changes in your lifestyle or healthcare regimen. Blue Cross of Idaho makes no endorsements or warranties
regarding any of the products and services included in this publication or its articles.
Contact Us
Move recently?
Don’t forget to change your contact information with Blue Cross
of Idaho so you continue receiving important information about
your health insurance coverage. Log on to your account at
members.bcidaho.com or call customer service at the number on
the back of your member ID card.
Have a Question?
Call our Customer Service line at 1-888-494-2583
(TTY 1-888-377-1363). We are available from 8 a.m. to 8 p.m.,
seven days a week.
Jumbles: ARENA GRAND METRIC BEATEN
Answer: The butchers’ convention featured a —
“MEAT” AND GREET
Website: https://members.bcidaho.com
Email: [email protected]
Healthy Recipe
Pumpkin Spice Quinoa Parfait
Nutrient Value: Servings: 4, Total Calories: 314, Protein: 13 g,
Carbohydrates: 52 g, Fiber: 9 g, Sugar: 23 g, Fat: 8 g (1 g saturated), Sodium: 76 g
Ingredients:
1 cup quinoa, well rinsed
1 3/4 cups water
½ tsp cinnamon
2 cups pumpkin puree
2 tbsp brown sugar
½ tsp cinnamon
¼ tsp ginger
¼ tsp nutmeg
1/8 tsp cloves
2 cups vanilla Greek yogurt
2 graham crackers, crushed
½ cup candied pecan halves
Directions: Bring the quinoa, water and cinnamon to a boil, reduce the heat
and simmer, covered, until the water has been absorbed – about 15 minutes
– and set aside to cool. Mix the pumpkin puree with the brown sugar,
cinnamon, ginger, nutmeg, cloves and set aside. Place ¼ cup of yogurt into
four large glasses and top with ¼ cup quinoa, and ¼ cup pumpkin mix.
Repeat layers and top off with pecan halves and crushed graham crackers.