CARECONNECTIONS

H5087_CA028544_WCM_NEW_ENG CMS Accepted 01122015 ©WellCare 2014 CA_12_14_CA

MEDICARE | 2015 | ISSUE I

CAHPS® Wants Your Opinion on Health Care Quality

What is CAHPS? It stands for Consumer Assessment of Health Care Providers and Systems. It’s a program that asks members what they think about the quality of care they get. In February, you may get a CAHPS survey by mail or over the phone. If you are selected, we encourage you to complete and return it in the envelope provided. If you do not respond by mail, you will be contacted by phone. Your answers will be kept private.

You do make a difference! The survey asks about your personal experiences with providers and your health plan. Your feedback will help us make improvements that are important to you.

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). To learn more about the CAHPS® program and its products and services, visit www.cahps.ahrq.gov.

We know that choosing a health plan is an important decision for you, and we appreciate the trust that you have placed in us to help manage your health care needs. To those of you who recently joined Easy Choice, and those of you who have been with us for years, thank you for giving us the opportunity to serve you.

At Easy Choice, our mission is to serve our members by helping them lead better and healthier lives. Because of this, our services are designed specifically to meet your needs. Our Medicare Advantage plans offer you more benefits than the traditional Medicare plans offered by the federal government such as fitness/gym membership and healthy lifestyle discounts. In addition, our skilled service associates are just a phone call away, and are dedicated to helping you get access to the right care, when you need it most.

We provide coverage you can count on, but that’s only part of your health care picture. Now it’s time to team up with doctors who can give you the services you need. An important part of your team is your primary care physician (PCP). Schedule a visit with your PCP in the next few months – it’s a great way to start a healthy partnership.

At Easy Choice, we strive to make a positive impact on the quality of our members’ lives, and we are glad that you’ve chosen us as your health plan. We wish you good health, and we look forward to continuing to serve you.

Refer a Friend

If we’ve helped you, then you may know other Medicare-eligible people who could benefit from our services. If so, ask them to give us a call at 1-866-999-3945 (TTY 1-800-735-2929) Monday-Friday, 8 a.m. to 8 p.m. to discuss what they need in a health plan.

A Warm Welcome and Wishes for Good Health

Learn How to Control AsthmaAsthma is a disease that affects your lungs. Asthma causes wheezing, breathlessness, chest tightness and coughing at night or early in the morning. If you have asthma, you can control it by staying away from things that cause an attack, and following your doctor’s advice.

What Causes an Asthma Attack?An asthma attack can happen when you are exposed to “asthma triggers.” Know your triggers and learn how to avoid them. Watch out for an attack when you can’t avoid the triggers. Some of the most common triggers are:

Source: Centers for Disease Control and Prevention; retrieved from http://www.cdc.gov/asthma/faqs.htm

•Tobacco Smoke – Tobacco smoke and “secondhand smoke” are unhealthy for everyone, especially people with asthma. If you have asthma and you smoke, quit smoking. People should avoid smoking near you as well.

•Dust Mites – These are tiny bugs that are in almost every home. Use mattress covers and pillowcase covers to make a barrier between dust mites and yourself. Wash sheets and blankets weekly.

•Outdoor Air Pollution – This pollution can come from factories, automobiles and other sources.

•Pets – Furry pets can trigger an asthma attack. Bathe pets every week and keep them outside as much as you can. If you have a furry pet, vacuum often. If your floors have a hard surface, such as wood or tile, damp mop them every week.

•Mold – Breathing in mold can cause an asthma attack. Get rid of mold in your home to help control your attacks. Humidity – the amount of moisture in the air – can make mold grow. An air conditioner or dehumidifier will help you keep the humidity level low. Fix water leaks, which let mold grow behind walls and under floors.

•Other Triggers – Infections linked to influenza (flu), colds and respiratory syncytial virus (RSV) can trigger an asthma attack. Sinus infections, allergies, breathing in some chemicals, and acid reflux can also cause attacks. Physical exercise; some medicines; bad weather, such as thunderstorms or high humidity; breathing in cold, dry air; and some foods, food additives and fragrances can also bring on an asthma attack.

2 Care Connections

Although anyone can get colorectal cancer, it is most often found in people age 50 or older. If you’re 50 or older, getting a colorectal cancer screening test could save your life. Early-stage colorectal cancer doesn’t always cause symptoms, especially at first. This means that someone could have polyps or colorectal cancer and not know it. That is why having a screening test is so important.

Screening tests for colorectal cancer include:

•Once a year high-sensitivity fecal occult blood test (stool test) •Flexible sigmoidoscopy every five years•Colonoscopy every 10 years

Talk with your doctor about getting screened.

Although all women are at risk for cervical cancer, it occurs most often in women over age 30. There are ways to detect cervical cancer in its early stages. There are two tests that can either help prevent cervical cancer or find it early:

•The Pap test (or Pap smear) looks for pre-cancers – cell changes – on the cervix that can be treated, so that cervical cancer is prevented.•The HPV test looks for HPV – the virus that

can cause precancerous cell changes and cervical cancer.

You should start getting regular Pap tests at age 21. If your Pap test results are normal, your doctor may say that you will not need another Pap test for three years.

The HPV test can be used to screen for cervical cancer along with the Pap test in women age 30 and older. If you are age 30 or older, you may choose to have an HPV test along with the Pap test. For women ages 21-65, it is important to continue getting a Pap test as directed by your doctor.

Women’s Corner: Cervical Cancer at a Glance

Men’s Corner: Colorectal (Colon) Cancer at a Glance

Sources: Centers for Disease Control and Prevention; http://www.cdc.gov/cancer/cervical/pdf/cervical_facts.pdf and http://www.cdc.gov/cancer/colorectal/pdf/Basic_FS_Eng_Color.pdf

We’re here for you! Easy Choice covers these preventive cancer screenings at no charge to you. And, you may not need a prior authorization from us. For more information, check your Evidence of Coverage (EOC) or call the Customer Service number on the back of your member ID card.

Care Connections 3

Hospital to Home: Plan for a Smooth Transition

Nobody likes having to go into the hospital. But if you do need to, it is a good idea to be prepared. Below are some tips to help with a smooth transition from the hospital back to your home:

•Make a list of the names and dosages of all your medications. Besides prescription drugs, include vitamins, herbals, laxatives and other over-the- counter products.•Carry important information with you about your

condition, and your doctor and pharmacy contact information. •Make sure you or your family caregiver talks to a discharge

planner – someone at the hospital who helps plan a smooth transition home.•Bring your hospital discharge plan, along with a list of

any new medications you are taking, to your follow-up appointment with your doctor.•Make a follow-up appointment with your doctor within

seven days. •Ask questions about anything you don’t understand

regarding any new medications you are given, such as, should these medications be taken with meals, or at certain times each day? Do they have any side effects?•Ask your doctor if there are any signs or symptoms that

you should report to your doctor right away, such as fever, intense pain or shortness of breath.

Source: Eldercare Locator; http://www.eldercare.gov/eldercare.net/public/Resources/Brochures/docs/HospitaltoHome.pdf

Don’t Forget to Take Your Meds!

Are you having trouble remembering to take your medication regularly? You’re not alone. We know taking medications isn’t fun, but not taking them properly – or not taking them at all – can be dangerous. Here are some ways to help you remember to take your medications:

•Put a sticky note on your bathroom mirror or on your refrigerator. •Use a pillbox to help

organize your daily doses. •Use the buddy system

– have a close friend or relative call to remind you each day.•Set an alarm on your watch

or a kitchen timer.•Mark off on your calendar

when you’ve taken your medication.

A great way to stay healthy is to take your medications exactly as your doctor prescribes. Try using some of these tips to help keep you on track to healthy living!

Source: Healthcare Intelligence Network; www.hin.com/library/PreviewMedicationAdherence Benchmarks.pdf

4 Care Connections

Save Money on Your Prescriptions with Network Pharmacies that Offer Preferred Cost-Sharing

To save money on your prescription drugs in 2015, we teamed up with select network pharmacies to offer our members preferred cost-sharing. When you use our network pharmacies that offer preferred cost-sharing, your co-pay may be lower. Please note that some of our network pharmacies offer preferred cost-sharing while others offer standard cost-sharing. You can fill your prescription at any of our more than 60,000 network pharmacies. See the example to the left.

What if I don’t have a preferred cost-sharing network pharmacy in my area?Remember you can get great savings with a network mail-service pharmacy that offers preferred cost-sharing. Check your Pharmacy or Provider/Pharmacy Directory, or call us at the customer service number on the back of your member ID card.

†Other pharmacies are available in our network.

Save with Network Pharmacies that Offer Preferred Cost-Sharing

Network Preferred vs. Standard Cost-Sharing Pharmacies (Example only)

Jill gets her prescription

filled at an Easy Choice network pharmacy that

offers preferred cost-sharing.

Jill’s co-pay is $0

Jill gets her prescription

filled at an Easy Choice network pharmacy that offers standard

cost-sharing.

Jill’s co-pay is $9

Jill’s doctor gives her a prescription for a generic

(Tier 1) medication.

Network Retail Pharmacies† with Preferred Cost-Sharing

Care Connections 5

You deserve quality health care, value for your money and someone on your side when you need help getting the most from your benefits. We’re here to help you find the right plan for you with the quality care you deserve.

You may be eligible for a plan that offers more without the additional premiums. An integrated Dual Eligible Special Needs Plan (D-SNP) is a plan that combines your Medicare and Medicaid benefits. You may qualify for a D-SNP plan if you’re 18 or older, live in a geographic area where we offer a D-SNP plan, and are eligible for both Medicare and Medicaid benefits.

What does a D-SNP plan cover? •Additional benefits. Like all Medicare health

plans, we cover everything that Original Medicare covers – and more. And, there won’t be any additional monthly premiums even though you receive extra benefits. We also cover Part D drugs. In addition, we cover Part B drugs such as chemotherapy and some drugs administered by your provider. Your out-of-pocket costs for prescription drugs can be as low as $0. •A provider network that meets your needs.

We built our network to give you access to the providers you need. Whether you’re looking for your specific physician or a new primary care provider, a specialist or a pharmacy, you’ll find a selection of qualified professionals.•Service you can count on. Our Customer

Service team is here for you to answer questions about your coverage. You can also find answers anytime at our website, www.easychoicehealthplan.com. When

you have a question about your health, our Nurse Advice Line is available 24 hours a day, seven days a week. Just call 1-800-581-9952 (TTY 1-877-247-6272).

Choosing a health plan is an important decision. Our experience allows us to design plans and services to specifically meet your needs. If you have any questions, feel free to call us at the number on the back of your member ID card. We’re here for you.

You must continue to pay your Medicare Part B premium. If you meet certain eligibility requirements for both Medicare and Medicaid, your Part B premiums may be covered in full. Some plans are available to those who have medical assistance from both the state and Medicare. Premiums, co-payments, coinsurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

Do You Qualify for Medicaid?

6 Care Connections

Easy Choice’s Commitment to Quality

Quality is one of our most important goals. Our Quality Program works to ensure that you are receiving the right care to optimize your health. In 2014, the Quality Program did many things to improve the quality of your health care, such as:

•Responded to reported quality concerns;•Encouraged you to get your well visits.

For example, mammograms, eye exams for individuals with diabetes, immunizations, and more; •Ensured that your language, cultural and

ethnic needs were met; •Checked your doctors to ensure that

you can reach doctors by phone, get a timely appointment, and find a doctor near your home; •Ensured that your calls to Easy Choice were

answered quickly; and•Ensured that claims are paid accurately.

Our goals for 2015 include:•Continue to review and measure the quality

of care and services that you receive;•Continue working with you and your doctor(s)

to help meet your health care needs;•Continue to work with you and your doctor(s)

to organize care so that together we can coordinate your health care and improve the quality of service; •Continue to monitor your satisfaction to

ensure that you are pleased with Easy Choice and your doctors; •Easy Choice will also ask what your doctor(s)

think of our service and use that feedback to improve our services; and•Continue to review and update our guidelines

to ensure that a safe and healthy environment for your care is maintained.

To receive a copy of our Quality Improvement Program Description, please call Customer Service at the number on the back of your member ID card.

Click or Call for the Latest Drug Coverage Updates

Want to find the latest information about the drugs we cover? Visit our website to find the most up-to-date formulary. Just go to www.easychoicehealthplan.com/formulary.php and click on “Search a Drug.” You can also:

•Learn about medications we’ve recently added; and•Find changes to drug requirements or

coverage limits to drugs.

You’ll also notice that many of the brand-name medications have recently been replaced on the formulary with their generic version.

If you don’t have a computer, feel free to call us at the number on the back of your member ID card.

Care Connections 7

6412

7

Easy Choice Health Plan (HMO), a WellCare company, is a Medicare Advantage organization with a Medicare contract.Enrollment in Easy Choice (HMO) depends on contract renewal.

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, co-payments and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/coinsurance may change on January 1 of each year. Easy Choice uses a formulary.

PRSRT STDU.S. POSTAGEPaid

WELLCARE HEALTH PLANS

10866MD

In This Issue

Hello, and welcome to the first issue of Care Connections of 2015. In this issue, you’ll find information about what’s ahead in 2015, more affordable ways to take care of your health, and tips for improving your health. We will also tell you about important preventive cancer screenings. Please take a moment to explore what’s inside, and as always, we wish you good health.

Visit Our Website to Stay Informed!Did you know you can find a wealth of information about our plans and benefits at www.easychoicehealthplan.com/evedence_coverage.php? Download an updated copy of the Evidence of Coverage (EOC), which details what’s covered in our plans, find guidelines for getting care, see the rights and responsibilities for members, and more.

P.O. Box 31531Tampa, FL 33631-3531

This is an advertisement