PDF Important Plan 4 Have you had your Information Coming This Fall

  • Pdf File 1,303.67KByte

´╗┐Issue 3|2019

Exclusively for MVP Medicare Advantage Members

In This Issue

4 Have you had your Annual Wellness Visit?

5 Save Money on Your Prescription Drugs

5 Take a Stand to Prevent Falls

6 Traveling? We've got you covered!

7 Get the flu shot, not the flu!

8 MVP Offers Personalized Support

9 MVP's Quality Improvement Program

10 Manage Diabetes 11 Look for the Matrix

Mobile Health Clinic 11 MVP Member Online

Account Updates 12 The MVP Health Care

Cobb's Hill Fitness Court 13 15 Facts About

SilverSneakers? 15 Living Well Health,

Wellness, and Fitness Classes

Every year, Medicare evaluates plans based on a 5-star rating system.

Y0051_4363_C_W Accepted

Important Plan Information Coming This Fall

Be on the lookout in the coming months for important information about your MVP Medicare Advantage plan coverage for 2020.

The Annual Notice of Changes (ANOC) This document explains the changes to your health plan monthly premium, copays, and benefits for the upcoming year. Be sure to review this document. If you pay MVP directly for your health plan: ? You will receive this document by

September 30. ? You can switch to another MVP

Medicare Advantage plan during the Annual Enrollment Period, October 15? December 7, but you don't have to

(Continued on page 3)

Contact MVP

Call the MVP Medicare Customer Care Center

1-800-665-7924

TTY: 1-800-662-1220 Representatives are available Monday?Friday 8am?8pm Eastern Time Web:

We Welcome Your Comments

Write to us at: MVP Health Care Marketing & Communications 220 Alexander Street Rochester, NY 14607 Email: memberservices@

To receive this newsletter and other general communications from MVP by email instead of postal mail, Sign In/Register for an online account at and select Communication Preferences to opt in. You can update your preferences at any time via your online account. MVP will continue to send documents about your health plan contract and benefits by mail.

We are committed to protecting your personal information. Your email address will not be shared with anyone else.

MVPMCR0042(07/2019) ?2019 MVP Health Care?

2|Living Well

Women's health

includes anything that affects a woman's physical, mental, and emotional well-being. While women face many of the same health challenges as men, their symptoms and treatments may not always be the same. MVP Health Care works with our provider partners to champion women's health through access to quality care and reliable information--to benefit all the amazing women in our lives, and in yours!

Bruce Himelstein, MD Chief Medical Officer MVP Health Care

Material presented in this newsletter is not intended to replace medical advice, which should be obtained from a qualified physician. If any information in the Living Well newsletter conflicts with provisions of your Evidence of Coverage (your contract), the provisions of your contract take precedence over Living Well articles and information.

MVP Health Plan, Inc. is an HMOPOS/PPO/MSA organization with a Medicare contract. Enrollment in MVP Health Plan depends on contract renewal.

(Continued from page 1)

change plans each year. If you want to keep your current plan with the changes noted in your ANOC for 2020, you don't need to do anything. You will automatically stay enrolled in the same plan for next year.

If your MVP coverage is provided by a former employer or union group:

? This document will be sent to you in November.

? You may receive additional benefit information directly from your group.

Need more information? Directions on how to get a copy of your full Evidence of Coverage

(contract), will be included in the mailing.

A new MVP Member ID card. You may receive a new member ID card if the cost for services listed on the card (primary care, emergency, urgent care, or specialist co-pay) is changing for 2020. Specific benefit changes will be listed in your ANOC. If you choose to change plans during the Annual Enrollment Period, you will receive a new member ID card. New Member ID cards will be mailed by the end of December.

Questions? Call the MVP Medicare Customer Care Center at 1-800-665-7924 (TTY: 1-800-662-1220).

One-Per-Household Mailings

MVP is required to send you certain documents explaining your benefits and coverage. Due to regulations, we must send separate copies to you and other members of your household. But we understand that you receive a lot of mail from us. For non-required communications, such as this Living Well newsletter, we mail one copy per household. This helps us reduce our costs and the amount of mail you receive.

Prefer electronic delivery? You can receive your Living Well newsletter via email each quarter. Sign In/Register for an MVP online account at and select Communication Preferences to opt in. You can update your preferences at any time.

MVP Health Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCI?N: Si habla espa?ol, tiene a su disposici?n servicios gratuitos de asistencia lingu?stica. Llame al 1-844-946-8010 (TTY: 1-800-662-1220). 1-844-946-8010 (TTY: 1-800-662-1220).

Fall 2019 |3

Have you had your Annual Wellness Visit this year?

As an MVP Medicare Advantage Plan member, you are encouraged to visit your Primary Care Physician (PCP) for an Annual Wellness Visit. This is your time to talk with your doctor about your health and create or update a personalized prevention plan. Plus the Annual Wellness Visit is the first step to earning your $75 Wellness Reward incentive!

During your Annual Wellness Visit, you should:

? Complete a Health Risk Assessment to find out what health problems you're most at risk of developing.

? Review your medical and family history. ? Update the list of medications you take. ? Have your routine measurements taken, such as weight and height. ? Discuss preventive services that are covered in full with your health

plan, including mammograms, prostate exams, immunizations, and bone density measurement. ? Talk about what physical activity is best for you, how to remain active and safe, and how to avoid falls.

Don't forget to bring the Wellness Reward screening form included in this newsletter. Ask your doctor to complete the form, then send it to MVP to receive your $75 Wellness Reward gift card!

4 | Living Well

Save Money on Your Prescription Drugs-- Find Out if You Qualify for State Assistance

New York State offers a program that can help pay for prescription drug coverage. To qualify, you must meet age and income requirements.

The EPIC (Elderly Pharmaceutical Insurance Coverage) program is available to residents 65 or older who have an annual income below $75,000 if single or $100,000 if married, and don't receive full Medicaid benefits. If you qualify, EPIC provides secondary coverage for Medicare Part D and EPIC covered drugs purchased after you meet your Part D deductible. It can also cover many Part D excluded drugs. Co-payments are $3, $7, $15,

or $20, depending on the cost of the drug. You can apply at any point in the year.

For more information or to find out if you're eligible, call 1-800-332-3742 or visit health.health_care/epic.

Visit partD to learn more about your prescription drug coverage.

Take a Stand to Prevent Falls

September 23, the first day of fall, marks the 10th annual National Falls Prevention Awareness Day.

Falls are serious, but you can take actions and make decisions to stop slips, trips, and falls. Talk about your fall risk with your doctor, remove hazards around your home, and build confidence with smart daily decisions and increased physical activity.

Get moving with the SilverSneakers? fitness program or a Living Well class in the community, starting on page 13. Or join us for the "Stop Slips, Trips, and Falls" fall prevention presentation. See page 17 for more information.

Fall 2019 |5

Traveling? We've got you covered!

Whether you're taking a day trip or heading to a warmer destination for the winter, your MVP Medicare Advantage plan includes coverage away from home.

Emergency and urgently needed care are covered worldwide. When seen in the U.S. for an emergency situation or urgently needed care service, you simply pay your co-pay. When traveling outside of the U.S., you may need to pay up-front for the services and submit your bills to MVP when you return home.

All plans include coverage for nonemergency care from providers who do not contract with MVP. You can choose to see a doctor anywhere in the U.S. who may or may not have a contract with MVP for services such as allergy shots, physical therapy, or maintenance lab work. You may pay more for care received from providers who do not have a contract with MVP. Not all services from non-contracted providers are covered--see your Evidence of Coverage for more information.

doctor to send a prescription to the pharmacy where you are traveling, or take your medication bottle to the pharmacy and ask if they will transfer a refill for you.

See a doctor when and where it's convenient for you with $0 myVisitNow?--24/7 Online Doctor Visits. Use your smartphone, tablet, or computer with a webcam to see board-certified urgent care doctors face-to-face. Providers can give you a diagnosis, treatment options, and order prescriptions, if needed. Learn more or Sign Up/Log In at and download the free myVisitNow mobile app.

Always carry your MVP Member ID card with you and show it any time you need medical services or prescription drugs.

You can refill prescriptions away from home. If your plan includes Part D, prescription drug coverage is available at any MVP-contracted pharmacy, including national chains such as CVS, Rite Aid, Walgreens, and Walmart. Ask your

6 | Living Well

Get the flu shot, not the flu!

The flu season occurs in late fall and winter every year. Most people who catch the flu get better in a few weeks, but in some cases, it can lead to serious health problems and hospitalization. Adults over age 65 are at higher risk of having worse flu symptoms and developing complications.

When it comes to the flu, prevention is the best medicine. The best way to avoid the flu is to get your annual flu shot, available to you at no cost with your MVP Medicare Advantage plan.

To get your annual flu shot, you can:

? Visit your doctor. Your Primary Care Physician (PCP) can give you the vaccine at no cost (note: a copay may apply if the shot is given during an office visit).

? Call your local county Health Department to find locations of clinics, pharmacies, or grocery stores that offer the flu vaccine.

? Go to your pharmacy.

Flu vaccines are safe and effective at preventing the flu. Check with

your doctor to see if you should receive the vaccine. It may not be safe for people who are allergic to eggs, have had severe reactions to the vaccine in the past, or have chronic illnesses that weaken the immune system.

Getting your annual flu shot is the best way to prevent catching and spreading the flu. It is especially important for people with medical conditions such as asthma, diabetes, and chronic lung disease, who are at risk of developing pneumonia. Most adults should also consider getting a shot to prevent pneumonia. The pneumococcal shot is free to you as an MVP member.

My Flu Shot Reminder

An annual flu shot is the best way to prevent the flu. Talk to your doctor or call your local Health Department to find out how to get your shot.

I will get my flu shot on (date/time)

|

I got my flu shot and told my doctor on (date)

Fall 2019 |7

MVP Offers Personalized Support

Sometimes, living well takes a helping hand.

Care Management Program

The Care Management Program helps members who have high-risk medical conditions or complicated, life-threatening illnesses, providing support to you and your family when it's needed most. Your case manager will work closely with you, your family, doctors, and other members of your health care team to help answer questions and create a plan for your ongoing care.

Your case manager may ask you to verify personal or account information when working with you over the phone. We ask these questions for your security, and you may call us back using the phone number listed on the back of your MVP Member ID card before providing the information if you would like to verify that the caller is from MVP.

Transition of Care Program

If you have had a recent hospital stay you may be eligible for this program. A case manager will contact you after a hospital stay and may arrange for a home visit. Your case manager will work with you to help you understand your discharge instructions, review your medications, help to schedule your follow-up appointments with your doctor(s), and reduce the chance that you may need to be admitted back into the hospital due to a complication. This program is available at no cost to you.

Health Management Programs

Additionally, help is available to you if you have Asthma, Chronic Obstructive Pulmonary Disorder (COPD), Diabetes, Cardiac Issues, Heart Failure, or Back Pain. If you need help to work through any health concerns, a health coach can answer your questions and help you find resources and health care solutions. These programs are designed to supplement your doctor's care--we will work with you, your family, doctors, and other members of your health care team to help you set and reach goals that are important to the treatment plan from your doctor.

Free for MVP Members

Care Management and Health Management programs are available at no cost to you and you are under no obligation to participate. MVP may call you if you qualify, or your doctor may refer you to us.

For more information about these programs, you can call MVP at 1-866-942-7966, 8:30am?5pm, Monday?Friday.

8 | Living Well

MVP's Quality Improvement Program

MVP is dedicated to providing quality health care and services to our members.

Our Quality Improvement (QI) program sets standards for the care and services that are provided to our members by MVP and by participating providers. MVP reports on its progress toward achieving the QI program goals in an annual Quality Improvement Evaluation report.

You are welcome to take part in the development, implementation, or evaluation of the quality improvement system, and/or you may comment on the MVP QI process.

If you are interested in taking part, commenting, or receiving a summary of the program description document and the Executive Summary of the Annual Evaluation, call the MVP Quality Improvement Department at 1-800-777-4793, ext. 42588.

MVP HIPAA Privacy Notice

"HIPAA" refers to the Health Insurance Portability and Accountability Act of 1996. The HIPAA Privacy Notice describes how MVP uses, discloses, and safeguards your health information. It also explains your rights with regard to your health information. To obtain a copy of our HIPAA Privacy Notice, visit and select Notice of Privacy Practices & Compliance at the bottom of the page, then Privacy Notices.

Medicare Member Rights

MVP encourages members to learn about and exercise their rights and responsibilities, including timely access to covered services, privacy protections, and your right to make decisions about your health care. Visit and select Notice of Privacy Practices & Compliance, then Member Rights and Responsibilities, or refer to Chapter 8 of your plan Evidence of Coverage.

You can also call the MVP Customer Care Center at 1-800-665-7924 (TTY: 1-800-662-1220) to request copies of these documents.

A Note About Financial Incentives Related to Utilization Management

It is the policy of all of the operating subsidiaries of MVP Health Care, Inc. (MVP) to facilitate the delivery of appropriate health care to our members, and to monitor the impact of the plan's Utilization Management Program to ensure appropriate use of services. MVP's Utilization Management Program does not provide financial incentives to employees, providers, or practitioners who make utilization management decisions that would encourage carriers to care and services.

The MVP utilization management decisions are based only on

(Continued on page 11)

Fall 2019 |9

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Online Preview   Download