2019 Plan Benefits

Coverage updates

Cold or Flu? Know the symptoms

Understanding COPD

How to manage it

Preparing for a Healthy Winter SeasonWinter is coming and whether you choose to hibernate or take to the great outdoors, there are some things you can do to prepare for a healthy season and we’re here to help you.

Learn the symptoms of influenza and the common cold, and the differences between them, in our article on page 5. Some vaccines are recommended for certain age groups and health conditions. Read about vaccines for the flu and pneumonia and who should get them on page 6.

Also, keep in mind that the colder air can make some lung disease symptoms worse.

Chronic Obstructive Pulmonary Disease (COPD) is not just one disease, but a group of diseases, all of which cause airflow blockage. These diseases are emphysema, chronic bronchitis, and in some instances, asthma. See the article on page 8 for more information

In many cases, getting COPD is avoidable. In fact, 8 out of 10 COPD-related deaths are caused by smoking. This means you should avoid all smoke, even secondhand smoke. And if you do smoke, we have a program that can help you quit.

Our smoking cessation offers you help in three different ways: one-on-one assistance, an ongoing telephonic program and informational mailings. You can even choose all 3 of these programs.

As the year winds to a close, consider making a new year’s resolution to stop smoking. This one step could be the key to improving your COPD and your overall health. Call your Health Educator at 1-855-813-3102 today to learn more about our smoking cessation program.

Living Healthy | 1

Looking ahead to 2019 With the new year quickly approaching, we thought we’d take a moment to highlight the changes that are coming to your 2019 Medicare Advantage plan. You should have already received your Annual Notice of Change (ANOC) from us which goes into more detail about these changes. But we’re so excited about your 2019 plans, we wanted to highlight them here too.

We have made your 2019 benefits even better! And we did it without changing your monthly plan premium. That is, your premiums are still $0 for Advantage Elite (HMO SNP), $0 for Advantage Gold (HMO) and $29 for Advantage Platinum (HMO).

Also, keep in mind that you do not need to re-enroll with us for 2019. If you are already have Virginia Premier Medicare insurance, there is nothing you need to do. Your plans will roll over to the new year automatically.

What’s new for 2019:

Advantage Elite: ■ We are adding $10 to your quarterly over-the- counter drugs allowance. It’s currently $75 per quarter. So starting in 2019, you will have an $85 quarterly allowance.

Advantage Platinum: ■ We are adding 4 one-way trips for routine medical transportation to your Advantage Platinum coverage. We know this can come in handy and now it’s here for medical appointments and trips to the pharmacy.

Advantage Gold and Platinum: ■ You still have a $0 Primary Care Physician co-pay, but we’ve added an annual physical exam to your coverage. We also improved your dental services by including:

▪ one panoramic and bitewing X-ray

▪ two fluoride treatments

▪ two exams

▪ a comprehensive periodontal evaluation annually ■ We’re increasing the number of annual routine foot care visits from 6 to 8 (Platinum) and from 3 to 4 (Gold).

Advantage Elite/Gold/Platinum:

Our new hearing aid vendor will offer deep discounts for a wide range of hearing aids. You’ll still have a hearing aid allowance once every 3 years and an annual hearing exam.

Also, don’t forget about the extra benefits that are part of your plan like Silver&Fit®. This is a fitness benefit that includes a free membership at participating fitness centers throughout Virginia.

You’ll pay no additional charges for these new services!

As 2018 comes to a close, we want to thank you for being a part of the Virginia Premier family. Here’s to the best of health in 2019.

Rick Gordon Vice President, Federal Programs Virginia Premier

Living Healthy | 3

Medicare enrollment periods made simple

It’s important to know when you can make changes to your health insurance plan. Virginia Premier is here to help you understand the various Medicare enrollment periods and what they mean to you.

The Initial Coverage Enrollment Period (IEP) is when you can first enroll in Medicare. This enrollment period is a 7-month period that runs: ■ 3 months before your 65th birthday ■ The month of your 65th birthday ■ 3 months after your birthday

During your IEP you must enroll in Part A Medicare coverage. However, you can delay enrolling in Part B Medicare coverage if you keep working and have health insurance coverage through your employer.

The Annual Election Period (AEP): ■ Occurs between October 15 to December 7 each year ■ You can switch from one Medicare plan to another Medicare plan ■ Enrollments during this period will be effective January 1, 2019 Dual Eligibility:

If you qualify for both Medicare and Medicaid, you are considered dual eligible. Starting in 2019, you can change your Medicare Dual Special Needs plan (D-SNP) once every quarter during the first nine months of the year.

The Open Enrollment Period (OEP): ■ Runs from January 1 through March 31 ■ You can make a one-time change to your Medicare coverage by moving into a “like plan” ■ Coverage is effective the first day of the month following your change.

For example, you can move from a Medicare Advantage plan with prescription drug coverage (MAPD) to a similar MAPD plan or Original Medicare with a Part D prescription drug plan.

Special Enrollment Period (SEP): ■ Runs year round and covers special circumstances such as:

▪ You lose group medical coverage

▪ You move out of your plan’s service area

▪ You gain eligibility or lose eligibility for “Extra Help” (a low-income subsidy)

▪ You lose eligibility for Medicaid

Staying Engaged at 64 A sense of irrelevancy and invisibility suddenly hits many aging adults, as their life roles shift from hands-on parent to empty nester or from workaholic to retiree. Self-worth and identity may suffer as that feeling that you matter starts to fade.

New research suggests this perception of becoming irrelevant is very real. And that’s why some seniors are determined to stay social, remain relevant and avert the loneliness often linked with aging.

“As people get older, there are fewer and fewer opportunities to feel like they make a difference and matter,” said Markus Schafer, a sociologist and faculty associate at the Institute for Life Course and Aging at the University of Toronto.

Having purpose and meaning forestalls loneliness, which takes an emotional and physical toll. Studies by researchers have found that loneliness is associated with weaker immune systems and poorer physical health.

Volunteering is now seen as an effective way to battle irrelevancy and loneliness. Research studies have found health benefits for older adults who volunteer. One such study led by a Florida State University sociologist showed that volunteering appeared to have the same positive influence on health as exercise and not smoking.

Her study found that “becoming actively engaged in volunteering in later life is related to lower levels of subsequent disability.” Source: Kaiser Health News, khn.org/news/will-we-still-be-relevant-when-were-64

“Volunteering is shown to be, in many ways, a health behavior,” Dawn Carr, Assistant Professor of Sociology, Florida State University

Your Silver&Fit® Benefit The Silver&Fit® program is designed to boost well-being, strength and social activity. You get it at no cost through your Virginia Premier Medicare plan.

View your Silver&Fit® benefits at silverandfit.com. If you have questions, call Silver&Fit® Customer Service toll-free at 1-877-427-4788 (TTY: 711), Monday through Friday, 8:00 am to 8:00 pm.

Flu symptoms can include fever and chills, cough, sore throat, runny or stuffy nose, body aches, headaches and fatigue. Cold symptoms are usually milder than flu symptoms. People with colds are more likely to have a runny or stuffy nose. Although uncomfortable, colds usually do not result in serious health problems.

Here are some tips on how to spot whether you have a cold or the flu.

What is Pneumonia? Pneumonia is a lung infection that can cause mild to severe illness in people of all ages. Common signs of pneumonia include cough, fever, and difficulty breathing. Doctors often treat pneumonia with medications, and vaccines can prevent some forms of pneumonia.

You can help prevent pneumonia and other respiratory infections by washing your hands regularly, disinfecting surfaces that you frequently touch, and taking good care of your health in general.

Consider quitting smoking and remember to get your pneumonia vaccine.

Signs and Symptoms Flu Cold

Symptom onset Abrupt Gradual

Fever Usual Rare

Aches Usual Slight

Chills Fairly common Uncommon

Fatigue, weakness Usual Sometimes

Sneezing Sometimes Common

Stuffy nose Sometimes Common

Sore throat Sometimes Common

Chest discomfort, cough Common Mild to moderate

Headache Common Rare

A cold or the flu?

Living Healthy | 5

Flu and Pneumonia Vaccines

The flu season can start as early as October and go all the way to May. That’s over half the year! This is why it’s so important to get a flu vaccine (flu shot). And if you get it early, the flu shot can help protect you and your family against the virus throughout the flu season.

Those Most at Risk for the Flu

For many, the flu virus will resolve on its own. But for some, the flu virus can be life threatening. Those who are at risk for developing complications from the flu include: ■ Adults older than 65 ■ Residents of nursing homes and other long-term care facilities ■ Pregnant women and women up to two weeks postpartum ■ People with weakened immune systems ■ People who have chronic illnesses, such as asthma, heart disease, kidney disease and diabetes ■ People who are very obese, with a body mass index (BMI) of 40 or higher

Note: If you’re aged 65 or older, it’s recommended you get a higher-dose flu vaccine, called the quadrivalent dose.

Are there any side effects from the flu vaccine?

While you can’t get the flu from the flu vaccine, you can experience side effects from it. These can include a low-grade fever, aches, and soreness or swelling around the vaccine area. It’s also possible to have an allergic reaction to the vaccine, although this is rare. If this occurs though, please contact your doctor and pharmacist. Also, contact your doctor or pharmacist if you have any questions about the flu vaccine.

The Pneumonia Vaccine

Getting a pneumonia vaccine may help protect against lung infection in older adults and persons with chronic health conditions. Those most at risk for pneumonia include: ■ Adults aged 19 and older who:

▪ smoke

▪ have chronic medical conditions such as HIV and Kidney Failure (most at risk) ■ Adults older than age 65 ■ Children younger than age 2 with signs and symptoms ■ People with an underlying health condition or weakened immune system

What are the side effects of the Pneumonia Vaccine?

Side effects of the pneumonia vaccine should only last a few days and include fever, tiredness, headache, chills, and a reaction at the vaccine area such as redness, pain or swelling.

Please contact your doctor or pharmacist with medical questions about the pneumonia vaccines.

Both flu and pneumonia vaccines are covered by your plan under Part B preventative services.

E

Y

S

I

S

F

R

E

V

E

F

F

R

O

U

E

Y

X

L

U

D

R

G

W

X

L

K

W

G

A

P

S

X

P

L

N

N

Y

C

U

S

M

I

G

H

N

J

X

D

O

I

E

D

S

W

U

T

Z

F

X

L

N

P

I

Z

M

E

H

E

U

A

F

N

T

P

C

P

T

E

P

S

I

A

F

F

T

E

H

C

A

D

A

E

H

K

N

T

J

R

N

J

Y

J

I

U

R

N

G

E

G

I

Q

X

F

J

T

F

E

V

D

S

E

D

X

N

Q

S

Q

V

E

S

O

D

Y

L

F

O

N

G

M

Q

K

Q

C

O

U

G

H

L

N

Z

V

F

I

M

I

U

L

F

J

G

E

I

B

Z

L

Y

J

R

F

V

X

U

S

L

D

H

C

E

A

W

E

O

Z

D

U

Z

T

Y

G

C

L

G

O

C

V

Z

H

Z

U

N

O

I

T

S

E

G

N

O

C

Chills

Fever

Fatigue

Sweating

Congestion

Sneezing

Flushing

Dehydration

Cough

Headache

Flu Search

See answers on page 9.

Living Healthy | 7

Understanding COPD Chronic Obstructive Pulmonary Disease, or COPD, is an illness that causes obstructed airflow in the lungs. It does this through two ways: damaging the tissue in the lungs and increasing the amount of fluid in the lungs.

If you have COPD, knowing more about these two causes can help you better understand how to manage your illness.

How COPD affects the lungs

Lung Tissue Damage: COPD causes lung tissue damage, also called emphysema, in the part of your lungs that moves oxygen in and carbon dioxide out. This can be especially problematic because high levels of carbon dioxide can make you feel sick.

Increased Mucus in your Lungs: COPD can also increase the amount of mucus in the lungs and cause a cough that makes it hard to breathe.

If you feel you are experiencing symptoms like these, please call your doctor.

What causes COPD?

The main cause of COPD is smoking and exposure to secondhand smoke. However, there are risk factors that can increase the likelihood of getting the disease. These are: ■ Smoking with a breathing condition, such as asthma ■ Long-term exposure to industrial fumes, chemicals and dust ■ A family history of COPD

How can I reduce symptoms of COPD?

The most important thing you can do to reduce your chance of getting COPD is to avoid any chemicals that damage your lungs. For most people, this means quitting smoking. To learn about our smoking cessation services, call our health educators at 1-855-813-3102.

For more information about COPD, call 1-877-739-1370 and ask to speak to a chronic care nurse. Our trained registered nurses can help you make lasting lifestyles choices that can reduce symptoms of COPD. This service is available Monday through Friday from 8:00 am to 5:00 pm.

Living Healthy | 9

E

Y

S

I

S

F

R

E

V

E

F

F

R

O

U

E

Y

X

L

U

D

R

G

W

X

L

K

W

G

A

P

S

X

P

L

N

N

Y

C

U

S

M

I

G

H

N

J

X

D

O

I

E

D

S

W

U

T

Z

F

X

L

N

P

I

Z

M

E

H

E

U

A

F

N

T

P

C

P

T

E

P

S

I

A

F

F

T

E

H

C

A

D

A

E

H

K

N

T

J

R

N

J

Y

J

I

U

R

N

G

E

G

I

Q

X

F

J

T

F

E

V

D

S

E

D

X

N

Q

S

Q

V

E

S

O

D

Y

L

F

O

N

G

M

Q

K

Q

C

O

U

G

H

L

N

Z

V

F

I

M

I

U

L

F

J

G

E

I

B

Z

L

Y

J

R

F

V

X

U

S

L

D

H

C

E

A

W

E

O

Z

D

U

Z

T

Y

G

C

L

G

O

C

V

Z

H

Z

U

N

O

I

T

S

E

G

N

O

C

Chills

Fever

Fatigue

Sweating

Congestion

Sneezing

Flushing

Dehydration

Cough

Headache

Flu Search Answers

Virginia Premier is an HMO and HMO SNP organization with a Medicare contract. Enrollment in Virginia Premier depends on contract renewal. Benefit information in this newsletter is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments and restrictions may apply. The provider network may change at any time. You will receive notice when necessary. You must continue to pay your Medicare Part B premium. This information is available for free in other languages. ©2018. All rights reserved. Printed in the U.S.A.

Using Your Vision Benefits We are pleased to offer vision benefits to all of our members through our vendor, VSP® Vision Care. These benefits cover eye exams and help with the cost of lenses and eyewear.

Please see below for a list of your plan’s benefits, and instructions on how to use them.

* These benefits are available only if you are a member of both our Elite Plus (CCC+) Plan and our Advantage Elite Plan.

Please note that you must see providers who are in network. You can find an in-network doctor – as well as learn more about your vision benefits – by creating an account with VSP.

Here’s how:

1. Visit vsp.com

2. Click on create an account at the top of the page

3. Enter your SSN or Member ID number

4. Enter your first and last name

5. Enter your date of birth

6. Click continue

7. Then create a user name and password

If you need help, call VSP Member Services at 1-800-877-7195 during the hours below: ■ Monday-Friday, 8 am – 11 pm, ET ■ Saturday, 10 am – 11 pm, ET ■ Sunday, 10 am – 10 pm, ET

Advantage Elite Advantage Gold Advantage Platinum

Exams covered 1 exam every 2 years 1 exam every year 1 exam every year

Purchase allowance

$100 allowance every 2 years toward the purchase of lenses and frames*

$150 allowance every year toward the purchase of lenses and frames

$200 allowance every year toward the purchase of lenses and frames

Virginia PremierP.O. Box 4250Richmond, VA 23220-82501-877-739-1370 (TTY: 711)www.medicare.virginiapremier.com

Follow Us!/virginiapremierhealth

@VAPremierHealth

@vapremierhealth

Contact our Member Services department at 1-877-739-1370 (TTY: 711). From October 1 to March 31, we are open daily from 8 am to 8 pm, 7 days a week. From April 1 through September 30, we are open Monday through Friday, 8 am to 8 pm. On certain holidays and weekends from April 1 through September 30, your call will be handled by our automated phone system.

<First name, Last name><Address Line 1> <Address Line 2> <City, State, Zip>

H9877_0918-18FMNL-500147_M Accepted 11/5/18

Holiday Cranberry Relish Makes: 4 servings

Prep and Cook Time: 10 minutes

Ingredients

1 16-oz. package fresh cranberries

1 medium pear, diced

1 medium apple, diced

1/4 cup honey (or orange juice or maple syrup)

1 tsp grated ginger

1 TBS balsamic vinegar

Directions

1. Blend cranberries in a blender or food processor.

2. In a bowl, combine blended cranberries and rest of ingredients. Source Worlds Healthiest Foods.org, https://tinyurl.com/yat2bp77

Health and wellness or prevention information.