SUMMER IS HERE Get Your Medicine Ready!

MAY IS HEALTHY VISION MONTH

ARE YOU AT RISK FOR A BONE FRACTURE?

TIME TO CHECK YOUR BLOOD PRESSURE

PrimeTimeYOUR GUIDE TO HEALTHY LIVING SUMMER 2013

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PRIMETIME SUMMER 2013

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MAY IS HEALTHY

VISION MONTH

DO YOU HAVE

HIGH BLOOD PRESSURE?

HURRICANE SEASON

WILL BE HERE

SOON

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7

SUMMER2013

EDITION

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REPORT FRAUD,

WASTE AND ABUSE

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Dear Valued Members,Welcome to another edition of PrimeTime. This issue is packed with information designed to help you live well.

May is Healthy Vision Month. Preferred Care Partners wants you to protect your vision with a comprehensive dilated eye exam. This is especially important for those of you who may be at risk for developing glaucoma – which is the second leading cause of blindness globally, according to the World Health Organization.

Here in Florida, May also means that hurricane season is right around the corner. The 2013 hurricane season begins June 1st and runs through November 30th. This issue of PrimeTime includes timely information on how to make a medication preparedness plan now to avoid the possibility of disruption to any medication regimen you may be following.

According to the National Osteoporosis Foundation, 44 million Americans have low bone density or osteoporosis. As a Preferred Care Partners member, we want to arm you with information to maintain strong bones. This issue’s article entitled “Are You at Risk for a Bone Fracture?” is packed with important tips on how to keep your bones at optimal density levels – and reduce the risk of bone fracture.

And finally, I’d like to ask all of you to take the CAHPS® Survey if asked. Each spring, Medicare beneficiaries are given an opportunity to let the Centers for Medicare and Medicaid Services know how they feel about their health plan. Your response will play an important role in determining our 2014 CMS Star Rating and help us continue to drive quality improvement.

Here’s to a safe and healthy summer for all of you from Preferred Care Partners!

Yours truly,

Orlando Lopez-Fernandez, M.D.Chief Medical Officer, Preferred Care Partners

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

ARE YOU AT RISK FOR

A BONE FRACTURE?

HEALTH LITERACY

IS THE ABILITY TO READ AND UNDERSTAND

HEALTH INFORMATION

3www.MyPreferredCare.com

GOOD NUTRITION PLAYS A VITAL ROLE IN MAINTAINING STRONG BONES. IT’S ESPECIALLY IMPORTANT THAT YOU GET ENOUGH CALCIUM. ONE WAY YOU CAN GET CALCIUM IS THROUGH SUPPLEMENTS.

Calcium supplements are available without a prescription. According to the National Osteoporosis Foundation, here are some things to keep in mind when choosing a supplement:

• Choose supplements with proven reliability. Look for labels that state “purified” or have the USP (United States Pharmacopeia) symbol.

• Take calcium supplements with food. Eating food produces stomach acid that helps your body absorb most calcium supplements.

• When starting a calcium supplement, start with a smaller amount. For example, start with 200-300 mg of calcium every day for a week, and drink an extra 6-8 ounces of water with it. Then gradually add more calcium each week.

If you are thinking about adding a calcium supplement to your diet, speak with your physician first to discuss possible interactions between any medications you may be taking.

OSTEOPOROSIS IS A DISEASE OF THE SKELETAL SYSTEM. OSTEOPOROSIS CAN MAKE BONES WEAK AND BREAK EASILY. OFTEN PEOPLE DON’T KNOW THAT THEY HAVE OSTEOPOROSIS UNTIL A BONE ACTUALLY BREAKS OR FRACTURES.

One way to detect osteoporosis is with a bone density test. A bone density test uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. Doctors use bone density testing to: • Identify changes in bone density • Determine your risk of breaking a bone • Confirm a diagnosis of osteoporosis if you’ve experienced broken bones • Monitor osteoporosis treatment

Your doctor may recommend a bone density test if you’ve recently lost height, fractured a bone, take certain long-term medications, have received an organ or bone marrow transplant or experienced a drop in hormone levels as a result of menopause or cancer treatments.

Are You at Risk for A Bone

ATTENTION MEMBERS:You still may be able to participate in the 2013 Consumer Assessment Health Plan Survey® (CAHPS) or the Medicare Health Outcomes Survey (HOS). If you receive the CAHPS Survey, you can respond telephonically until May 29th. The HOS Survey will be mailed to more than 1,000 health plan members between April 1st and July 8th. CAHPS® is a registered trademark for the Agency for Healthcare Research and Quality (AHRQ).

SEE PAGE 6 FOR MORE INFORMATION!

4 PRIMETIME | SUMMER 2013

PROTECT YOUR VISION WITH A COMPREHENSIVE DILATED EYE EXAM.Getting a comprehensive dilated eye exam can protect your vision. It is especially important if you are at risk for glaucoma. Left untreated, glaucoma can result in vision loss or blindness.

May is Healthy Vision Month.

Glaucoma results when the optic nerve gets damaged. A comprehensive dilated eye exam can help your eye care professional determine if there is damage to your optic nerve. During a comprehensive dilated eye exam, your physician will examine your eyes to look for vision problems. This exam includes:• Dilation – your physician will place drops in your eyes to widen the pupils then examine your retina to look for signs of damage to the optic nerve. • Tonometry – helps detect glaucoma by measuring eye pressure. Your physician will direct a quick “puff” of air onto the eye or apply a pressure-sensitive tip near or against the eye.• Visual field test – This test can help your physician determine if you have lost peripheral (side) vision. This can be a sign of glaucoma.• Visual acuity test – measures how well you see at different distances.

You can find a network vision provider by calling Advantica toll free at 1-877-488-5131. Network providers are listed by zip code, specialty or language preference.

IMPORTANT PREFERRED CARE PARTNERS PHONE NUMBERS

For information about your health plan, call the areas listed below to speak with our staff. These phone numbers are toll free.

Member Services* 1-866-231-7201 (Including Pharmacy Member Services)

File an Appeal 1-888-291-5721

Social Services Unit 1-877-698-7008

Fraud, Waste and Abuse 1-866-678-8822

Medical Management 1-800-995-0480

Advantica Vision Provider 1-877-488-5131

Psychcare Mental Health Services 1-800-221-5487

Monday-Friday 8am to 8pm/TTY 711 toll free *7 days a week, 8am to 8pm/TTY 711 toll free

DO YOU HAVE HIGH

BLOOD PRESSURE?

If your blood pressure is high or pre-high, tell your doctor. He or she can help you lower your blood pressure. High blood pressure is also called “the silent disease.” This is because many times people don’t feel it or know they have it.

To avoid high blood pressure, watch your weight, exercise often and avoid foods high in salt. If you have high blood pressure, doing these things can lower it.

Follow your doctor’s orders about medicine you should take and the diet you should have. The most important thing you can do to keep high blood pressure low is have your blood pressure checked often.

Get it in checkHIGH BLOOD PRESSURE IS WHEN YOUR BLOOD PRESSURE STAYS HIGH OVER TIME. A NORMAL BLOOD PRESSURE IS LESS THAN 120/80. A HIGH BLOOD PRESSURE IS 140/90 OR HIGHER. READINGS THAT FALL IN BETWEEN ARE KNOWN AS “PRE-HIGH BLOOD PRESSURE.”

Did you know? Medicare does not sell or mail medical supplies. If you receive medical supplies that you or your doctor did not order, you might be the target of a fraud scheme.

5www.MyPreferredCare.com

To discuss benefit, coverage or claims payment concerns, contact Member Services at 1-866-231-7201/TTY 711 toll free. To report suspected fraud, call 1-877-7SAFERX (1-877-772-3379).

Do Your PartYou can protect your identity

and your benefits

v Never give out your Social Security, Medicare, health plan numbers, or banking information to someone you don’t know.

v Carefully review your Plan Statement to ensure all the information is correct.

v Know that free services DO NOT require you give your plan or Medicare number to anyone.

v Share this information with your friends.

If you suspect fraud, report it immediately. Call 1-877-7SAFERX

(1-877-772-3379)

DO YOUR PART. You can protect your identity and your benefits:• Never give out your Social Security, Medicare, health plan numbers, or banking information to someone you don’t know• Carefully review your plan statement to ensure all the information is correct• Know that free services DO NOT require you to give your plan or Medicare number to anyone• Share this information with your friends

TAKE ACTION TO PROTECT YOUR MEDICARE BENEFITS: • Refuse medical supplies you did not order • Return unordered medical supplies that are shipped to your home • Report companies that send you these items

6 PRIMETIME | SUMMER 2013

HURRICANE SEASON WILL BEHERE SOON. MAKE YOUR MEDICATION PREPAREDNESS PLAN NOW.

AS FLORIDIANS,

WE ALL KNOW HOW

DISRUPTIVE

HURRICANES CAN BE.

SEVERE WEATHER

CONDITIONS CAN

EASILY UPSET

ROUTINE

ACTIVITIES –

INCLUDING

MANAGING DAILY

MAINTENANCE

MEDICATIONS.

Preferred Care Partners encourages all health plan members to have at least a two-week supply of maintenance medications on hand during hurricane season. If this is not possible, Preferred Care Partners will honor thirty-day supply refills of maintenance medications if there is a hurricane threat.

If you find yourself needing to obtain prescription refills during an emergency:• Have appropriate identification – name, address, phone number and a photo identification• Have the written prescription if it is available• Have the prescription bottle available• Have the prescribing doctor or health care professional’s contact information• Have your Preferred Care Partners member identification card available

If you have questions about your prescriptions and emergency refills, call our Member Services Department at 1-866-231-7201/TTY 711 toll free, 7 days a week, from 8am to 8pm. A Member Services representative will be happy to answer any questions you may have.

Each spring, Medicare beneficiaries just like you are given an opportunity to share their opinion about their health plan by participating in the CAHPS Survey. Help us improve your experience with Preferred Care Partners. If you receive a CAHPS Survey from Preferred Care Partners in the mail, please complete it. Your opinion can help us better serve you.

Preferred Care Partners will not know the names of the members included in the survey. All answers are confidential. We use an outside company to do this confidential survey. This company receives all responses and provides us with only the final scores and comments.

Please call our Member Services Department toll free if you have any questions: 1-866-231-7201/TTY 711 toll free, 7 days a week, 8:00a.m. to 8:00p.m.CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

THANK YOU TO ALL OF OUR MEMBERS WHO HAVE ALREADY COMPLETED AND RETURNED YOUR CAHPS SURVEY. YOUR PARTICIPATION IS GREATLY APPRECIATED.

HELP US BETTER SERVE YOU. TAKE THE CAHPS® SURVEY IF ASKED.

THANK YOU TO OUR PCP MEMBERS!

7www.MyPreferredCare.com

READ THE FORMS FIRST. Then gather all of the information you will need before you begin to fill them out.

BRING YOUR PREFERRED CARE PARTNERS MEMBER IDENTIFICATION CARD WITH YOU TO YOUR DOCTOR’S VISIT. If you cannot fill out your medical forms before your visit, be prepared to fill out forms at your physician’s office or the hospital.

GATHER A LIST OF ALL MEDICATIONS YOU ARE CURRENTLY TAKING – including names, dosages and how many times a day you take each medication. This includes prescription and over-the-counter medication, nutritional or herbal supplements.

KNOW YOUR HEALTH HISTORY. This includes any allergies you have to medications, health conditions that you have been diagnosed with and what tests you’ve recently had.

AFTER YOU’VE FILLED OUT YOUR FORM, REVIEW IT CAREFULLY. Then sign it. By signing it, you verify that the information is true and accurate to the best of your knowledge.

Health literacy is the ability to read and understand health information.

This includes being able to fill out medical forms. Here are some simple tips

on how to fill out medical forms.

Do you have limited financial

resources? IF SO, YOU COULD BE ELIGIBLE TO SAVE HUNDREDS OF DOLLARS A YEAR IN HEALTHCARE AND PRESCRIPTION DRUG COSTS. PREFERRED CARE PARTNERS TAKES GREAT PRIDE IN SERVING OUR MEMBERS.

If you have limited financial resources, call the Preferred Care Partners Social Services Unit at 1-877-698-7008/TTY 711 toll free, Monday – Friday from 8:30am to 5:30pm to see if you qualify for public assistance.

THANK YOU TO ALL OF OUR MEMBERS WHO HAVE ALREADY COMPLETED AND RETURNED YOUR CAHPS SURVEY. YOUR PARTICIPATION IS GREATLY APPRECIATED.

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This includes helping members apply for any of the followingstate and federal public assistance programs. • MEDICARE SAVINGS PROGRAMS – including Extra Help withprescription drug costs, monthly Medicare Part B premium deductions of up to $104.90 and cost-sharing to pay all or part of co-payments or deductibles on Medicare-covered services. • FOOD ASSISTANCE - through the Supplemental Nutritional Assistance Program (food stamps). • TELEPHONIC ASSISTANCE – through the Lifeline Assistance Program including free wireless phones and a $12.75 credit per month on local phone bills. • MEDICAL ASSISTANCE THROUGH MEDICAID – for Medicare members who qualify for dual eligibility.

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PO BOX 56-5748, MIAMI, FL 33256-5748

PRESORT STD

US POSTAGE PAID

MIAMI, FL

PERMIT NO.869

H1045_PCPMK1288 CMS Accepted

PrimeTime contains educational health information of general interest. All material in the newsletter is for educational purposes only and should not be taken as medical advice or instruction. No publication can replace the advice of medical professionals. This newsletter may also contain general information about plan benefits. Plan benefits vary; for information about your benefit plan, please refer to your Evidence of Coverage.

If you suspect fraud, waste, or abuse, you can contact Preferred Care Partners’ Special Investigations Unit at:

PHONE: 1-866-678-8822 TTY 711 toll free or FAX: 1-888-659-0617

EMAIL: reportfraud@mypreferredcare.com

ONLINE: http://www.mypreferredcare.com/en/contact-us/report-fraud-waste-or-abuse.aspx

MAIL: P.O. Box 56-5748, Miami, FL 33256-5748

You may remain anonymous and you are protected from retaliation.

You can also contact the Centers for Medicare and Medicaid Services (CMS),Office of the Inspector General at:

PHONE: 1-800-447-8477 (TTY) 1-800-377-4950 FAX: 1-800-223-8164

EMAIL: HHSTips@oig.hhs.gov

MAIL: Office of the Inspector GeneralDepartment of Health and Human ServicesAttn: HOTLINE, P.O. Box 23489Washington, DC 20026

ONLINE: http://oig.hhs.gov/fraud/report-fraud/index.asp

To contact the Preferred Care Partners Member Services Department, call 1-866-231-7201/TTY 711 toll free, 7 days a week, 8 am to 8pm.

REPORT FRAUD, WASTE AND ABUSE

HEALTH AND WELLNESS OR PREVENTION INFORMATION ENCLOSED

WE WOULD LIKE TO THANK OUR MEMBERSPreferred Care Partners received a 5-Star Rating for Customer Service for 2013. Preferred Care Partners received a 4-Star Overall Plan Rating for 2013. Plan performance Star Ratings are assessed each year and may change from one year to the next.