Concierge Spring 2021

L I F E , H E A LT H & W E L L N E S S

A P U B L I C AT I O N O F

SPRING 2021

PUTTING Members

FIRST

Questions about the coronavirus vaccine? For Network Health’s latest information about the coronavirus vaccine, please visit networkhealth.com/coronavirus-vaccine. See page 20 for vaccine facts and myths.

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S 8 One-on-One Support When You Need It 9 Why You Need an Annual Wellness Visit

FEATURE 10 2020 – A Year About You 15 Recommend Network Health and Earn Gift Cards

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26 Prevent T2 Diabetes Prevention Program 27 Do You Face Barriers to Getting Care?

BACK COVER Convenient Access to the Care You Need

15 Access to Network Health Care Management Employees and Services 16 Using Your Member Portal

3 Letter from the President and CEO 4 Understanding Your 5 Star Pharmacy Benefit 5 How Do Health Plans Make Decisions?

6 Quality You Can Trust

17 Where Should You Get Care?

Emergency Room, Urgent Care or Virtual Visit 18 Do You Know Your Pharmacist’s Name?

19 The Value of Medication Therapy Management 20 Roll Up Your Sleeve for the Vaccine 22 What You Need to Know About Opioids

7 Updating Your Address 7 Interactive Videos for Healthy Living

EDITORIAL STAFF President and CEO Chief Administrative Officer Strategic Marketing and Communications Manager Strategic Marketing and Communications Coordinator

Visual Design Lead

25 Routine Eye Exam vs. Medical Eye Exam

24 Eat Well, Age Well

Coreen Dicus-Johnson Penny Ransom Romi Norton Becky Pashouwer Debra Sutton

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ASK NETWORK HEALTH If you have questions about anything you read in this issue of Concierge, call member experience at 800-378-5234 (TTY 800-947-3529) Monday–Friday from 8 a.m. to 8 p.m. You can also learn more at networkhealth.com.

Concierge is a biannual publication of Network Health. The health information contained in Concierge is meant to supplement, not replace, the advice of health care professionals. © 2021 Network Health Insurance Corporation. No portion of this newsletter may be reproduced without written permission from Network Health Insurance Corporation.

Out-of-network/non-contracted providers are under no obligation to treat Network Health members, except in emergency situations. Please call our member experience number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Y0108_3367-01-0321_C 2 | C oncierge

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life. health. wellness.

Letter from the President and CEO Thank you for choosing a Network Health Medicare Advantage Plan for 2021.

2020 was challenging for many reasons. Many of us were concerned about our health and the health of our loved ones.

We were cautious when in public settings, we started to collect a variety of masks, kept socially distant and we disinfected and washed our hands constantly. Our communities experienced social isolation in a way society has never experienced before.

Throughout the entire year, Network Health continued to focus and deliver on our mission to create healthy and strong Wisconsin communities. Our feature story reviews 2020 and shares the extra steps Network Health took to give our members the support necessary to keep them healthy and safe. We offered additional benefits and held our member events virtually to provide members an exceptional health insurance experience.

Our members appreciate that we go above and beyond and it shows. Each year, we use the Net Promoter Score to ensure member experiences are positive and that members are satisfied with their Network Health Medicare Advantage Plan. A company’s Net Promoter Score can range from -100 to 100. In 2020, our score was 62, which was up 11 points from our 2019 score. And, it’s well above the health insurance industry average of 43. During a year when we faced so many challenges, having this score increase shows that Network Health is dedicated to doing what is right for our members.

As we mark the one-year anniversary of our offices being closed to the public, health and safety remain our top priority. Through the coronavirus pandemic and beyond, Network Health will continue to support our members.

No matter what, we are here for our members. Continue to stay safe and well.

Sincerely,

Coreen Dicus-Johnson President and Chief Executive Officer

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life. health. wellness.

Understanding Your 5 Star Pharmacy Benefit

By Beth Coopman, PharmD, pharmacist at Network Health

Network Health has an excellent drug plan covering a wide array of medications.

1. Network Health is one of three plans in Wisconsin to achieve a 5 Star Rating from the Centers for Medicare & Medicaid Services for our PPO plan pharmacy benefit. (Our overall PPO plan rating is 4.5 Stars.)* 2. Our formulary—the list of prescription drugs covered by Network Health—is updated regularly to ensure you have accurate information about what we cover and how much it costs.

3. Network Health PPO plans+ have an open formulary that covers about 98 percent of Medicare-eligible drugs. Closed formularies cover around 50 to 60 percent of Medicare-eligible drugs.

4. Important medications for many diseases—including diabetes, high blood pressure and breathing conditions—are tiered, meaning the drugs are broken into groups that represent their cost. This helps keep your drugs affordable.

5. Tier 1, 2 and 3 medications have a $0 deductible, so you can keep more money in your pocket. To find out which tier your medication is in, you can go to networkhealth.com/look-up-medications. Choose 2021 Medicare and select your plan in the Choose a Plan dropdown.

The Network Health Pharmacy Department is homegrown and local.

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1. You have access to local, Network Health Pharmacists. You can call us at 920-720-1287 (TTY 800-947-3529) or email us at pharmacist@networkhealth.com with questions about your medications. No other health plan in Wisconsin offers members direct access to pharmacists.

2. We collaborate with local pharmacies for services such as flu and shingles vaccination clinics.

3. We work with local providers to help you get the medications you need. Our provider partners appreciate our openness, which is one of the reasons they rate us higher than other plans.

4. We work closely with our provider partners to get their input on our formulary and make changes based on their suggestions.

We listen to your feedback and use it to make plan improvements.

1. We meet with member advisory groups to find out what’s going well and where we can improve. We use that feedback to make changes and improve our pharmacy plan every year.

2. We value your input during member events.

Suggestions from these events help us improve our formulary and benefit our members.

3. We personalize the way we communicate to you, based on the preferences you choose in your member portal.

This allows you to receive electronic Explanation of Benefits (EOBs), so you can receive less mail.

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4. New in 2021 – Electronic and mailed EOBs have a new listing of preferred medication alternatives when there is a lower cost option available for a drug you’re taking.

5. New in 2021 – EOBs contain drug price change information, which lets you know if the total cost of each medication you take has stayed the same, increased or decreased throughout the year.

Safety and medication affordability are our focus.

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2.

3.

4.

5.

Medication safety reviews are done routinely using the most up-to-date member information available.

Medication therapy management (MTM) is offered to our eligible Medicare members for no additional cost.

We reach out through phone calls and letters to discuss ways to lower your medication costs.

We work with our pharmacy benefits manager (Express Scripts, Inc.®) to lower medication costs for you.

When asked if they get their needed prescription drugs, 93 percent of our members said yes.

*Every year, Medicare evaluates plans based on a 5-Star rating system. +NetworkCares (D-SNP) plan and Network Health Medicare Explore (HMO) have a closed formulary.

How Do Health Plans Make Decisions?

By Sarah Dencker, vice president of care services

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ecisions made about care by Network Health are based on the appropriateness of care and service. This includes medical procedures, behavioral health procedures, pharmaceuticals and devices. The decisions are based on written criteria founded on sound clinical evidence and on the benefits outlined in the various coverage documents. These written criteria are reviewed and approved annually by actively participating practitioners. Criteria are available to providers, practitioners and/or to you upon request. Requests for criteria can be submitted via telephone, fax, email or mail. Once the request is received, our utilization management team sends the information to the requestor via fax, email or mail.

Network Health does not reward practitioners or other individuals conducting utilization reviews for denying coverage for care or service. We do not prohibit providers from advocating on behalf of members within the utilization management program. In addition, Network Health does not use incentives to encourage barriers to care and service, and we do not make decisions about hiring, promoting or terminating practitioners or other associates based on the likelihood, or the perceived likelihood, that the practitioner or associate supports, or tends to support, denial of benefits.

The medical directors, associates (or designees), care management staff and supervisors of this staff receive no financial incentive to encourage decisions that result in underutilization.

In addition, treating practitioners may discuss medical necessity denial determinations with our physician review medical director by contacting us. Our Medicare team can be reached Monday–Friday from 8 a.m. to 5 p.m. at 920-720-1602 or 866-709-0019 (TTY 800-947-3529). Bilingual language assistance or translation services are also available. Callers can leave a message 24 hours a day, seven days a week. All calls are returned promptly. Calls received after business hours are returned the next business day. Practitioners, providers and/or you may also send inquiries to our Medicare care management department by fax at 920-720-1916 or mail to Network Health, Attn: Utilization Management,1570 Midway Pl., Menasha, WI, 54956.

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life. health. wellness.

Quality You Can Trust

By Anna Rasmussen, quality program coordinator at Network Health Network Health continues to be a top-rated health plan, because we deliver high-quality service that focuses on improving the quality of health care services you receive. The goal of our quality program is to transform the health care industry by collaborating with the highest quality health care providers to deliver innovative solutions that provide exceptional value to you.

Our focus on excellence is reflected in our quality ratings, which are higher than the national average. The Centers for Medicare & Medicaid Services (CMS) gave Network Health a 4.5 Star Rating for our Medicare Advantage PPO plans.* The national average is 4 stars. Plans with higher Star Ratings receive more funding from CMS, which we put back into our plans to offer the benefits that matter most to you.

Due to coronavirus, the National Committee for Quality Assurance (NCQA) did not release 2020–2021 Health Plan Ratings for any product line. NCQA awarded Network Health a 4.5 out of 5 Health Plan Rating for Medicare for 2019-2020. These scores put Network Health in the top 25 Medicare plans nationwide.

Rating of the Health Plan

Rating of Health Care Quality

Network Health

National Average

Getting Needed Care

Getting Appointments and Care Quickly

Customer Service

80.8%

86.6%

89.2%

94.6%

89.2%

97.3%

90.0%

95.0%

82.6%

91.2%

93.6%

97.2%

Medicare

Care Coordination

For more information about Network Health’s quality program, please email the quality health integration department at QI@networkhealth.com. *Every year, Medicare evaluates plans based on a 5-Star rating system.

The source for data contained in this publication is NCQA CAHPS 2020 results and CMS 2019 National Benchmarks. Any analysis, interpretation or conclusion based on this data is solely that of the authors. NCQA and CMS specifically disclaims responsibility for any such analysis, interpretation or conclusion.

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Updating Your Address D

id you know that The Centers for Medicare & Medicaid Services (CMS) notifies Network Health when you make a change to your address? This happens when CMS records do not match our records. When we receive this notification from CMS, we are required to send you a letter.

You may receive one of two letters, depending on your situation.

1. If you’re still in the Network Health service area, but your zip code and/or county has changed, you will receive an address verification letter.

2. If you are a snowbird and provide CMS an out-of-state address (which is outside the Network Health service area), you will receive an out-of-area letter. This notification gives you six months to provide us your new address or confirm your physical address is still in the service area. Please confirm your address with us as quickly as possible, because if you do not, your plan will end after six months.

We care about you and want you to continue receiving Network Health’s local, high-quality service, without plan disruption. When you update your address with CMS, make sure to update it with Network Health, too. By keeping your address current, you will receive your important mailings timely and you won’t risk your plan ending.

You can update your address with Network Health in three ways.

1. Complete the form you receive with one of the letters mentioned above.

2. Log in to your Network Health member portal at login.networkhealth.com. Click your name in the upper right corner. Select Change My Address. You can update your physical or mailing address or both. Once you make this change, your new address won’t appear in the member portal right away. Our system is required to confirm it matches the address CMS has on file before you’ll see the updated address.

3. Call the member experience team at 800-378-5234 (TTY 800-947-3529), Monday–Friday from 8 a.m. to 8 p.m.

Interactive Videos for Healthy Living Emmi® offers free interactive videos on a variety of health topics.

You can view these animated, online programs on your computer, smartphone or tablet as many times as you like.

You can find all the topics for this issue of Concierge at this link

www.my-emmi.com/SelfReg/SCONCIERGE. Note: This URL is case-sensitive.

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life. health. wellness.

Support When You Need It

By Alice Parks, director of population health at Network Health

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etwork Health offers personal wellness, care management and condition management services at no cost to you. Whether you’re dealing with an unexpected medical issue, a complex diagnosis, a chronic disease or just a need a little help maintaining your health, we can help you manage your health to increase your sense of well-being and put you in control.

You can be identified for these services based on specific claims and/or your responses to your health risk assessment. Your doctor may also refer you or you can refer yourself.

These programs begin with a one-on-one conversation between you and one of our health coaches, condition managers or care managers. If you choose to participate, your health coach or care or condition manager will help you manage your health conditions and meet your health goals. You may opt out of these programs at any time by calling the member experience number on your member ID card.

Health Coaching

Our health coaches focus on helping people quit smoking, eat healthy, control blood pressure and learn about ways to exercise. We also help create successful transition plans to go home when you are discharged from the hospital.

Care Management

Our care management program focuses on assisting people with complex medical and behavioral health needs

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which include cancer, end-stage renal disease and other life-threatening conditions.

Condition Management

The condition management program helps people with diabetes, heart disease, heart failure and chronic obstructive pulmonary disease (COPD).

After learning more about you and your health concerns, your coach or care manager can do any of the following.

• Answer any questions you have • Review your medications and treatment plans • Inform you about signs that your health condition is worsening and when to act, including when you should contact your health care provider • Work with your health care providers to ensure they are aware of any health changes • Ensure you and/or your caregivers feel included in your health care decisions • Help you set health care goals to maintain or improve your health • Help you with coordination of care with providers and community services • Provide you with educational resources, specific to your diagnosis • Work with you to meet your health goals You can learn more about our programs at networkhealth.com under Health and Wellness. If you feel you could benefit from health coaching, care or condition management support or would like to know about our programs, call 866-709-0019 (TTY 800-947-3529), Monday–Friday from 8 a.m. to 5 p.m. Callers may leave a message 24 hours a day, seven days a week.

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Why You Need an Annual Wellness Visit

By Devon Lor, MSN, RN, quality health integration clinical supervisor at Network Health

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eeing your personal doctor (also called your primary care practitioner or PCP) for an annual wellness visit early in the year is the first step to managing your health and creating healthy goals. An annual wellness visit primarily focuses on preventive care, health screenings and wellness planning. Because your annual wellness visit is such an important part of your health care, Network Health covers this visit at no charge when you see a doctor within our provider network.

At your annual wellness visit, your personal doctor will review your medical history, discuss medications you are taking, record your height, weight, blood pressure and other routine measurements. This visit allows you to talk with your doctor about your health and goals. He or she will work with you to create a plan to maximize your wellbeing throughout the year. During this visit, it’s important to let your doctor know about any health concerns you may have.* It may help to bring your My Health Journal, which you received in your member guide, to this visit. Using this tool can help you keep track of all your screenings, questions and past health issues that you can share with your doctor.

Preventive vs. Diagnostic Screenings

Preventive and diagnostic screenings are tests doctors can run to help you improve or maintain your health.

Understanding the difference between these two types of tests is beneficial because it explains why you may need certain care, services or screenings.

Your doctor will order preventive screenings when you

have no symptoms and are generally healthy. These screenings are recommended by your personal doctor every year to keep tabs on your health and keep you healthy.

Diagnostic screenings are used when you have symptoms or risk factors, to find and treat the problem. If your doctor finds anything abnormal during your preventive screenings, he or she may order diagnostic screenings to detect any problems.

In addition, preventive screenings are covered at no charge to you. Diagnostic screenings are not considered part of your preventive care and may have a cost associated with them. If your doctor orders tests during your annual wellness visit and you’re not sure if they’re considered preventive—and covered 100 percent by Network Health—or diagnostic—and may have a cost to you—just ask. Your doctor will let you know which screenings are considered preventive and which are diagnostic and why each test is being ordered.

In general, it’s important to have an annual wellness visit each year, because it can help your doctor identify early warnings of health issues. At the beginning of the coronavirus pandemic, routine preventive care was put on hold. Since then, health care providers are taking extra precautions to stop the spread of the virus. If you did not have your annual wellness visit in 2020, call your personal doctor to discuss the best option for you.

*If your doctor feels your conversation about health concerns goes beyond preventive care, he or she may charge you for an office visit.

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COVER STORY

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2020 A Year About ME G N I

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he year 2020 started the same way every year starts. People made resolutions, vowing to be more active, eat better or quit smoking. In addition, the start of a new decade meant a fresh new start. We left the 2010s behind and were looking into the future with 2020 vision.

Early in the year, we began hearing about a disease called COVID-19 or coronavirus. We didn’t know much about it, just that when people were infected, they got really sick. Coronavirus started to spread globally and slowly made its way to Wisconsin. As it got closer to our homes, fear and panic set in.

Then, the entire country shut down. Safer-at-home and shelter-in-place orders began. Hand sanitizer and toilet paper were impossible to find. Seeing family and friends became a thing of the past. We all hoped the virus would be eliminated quickly so everything could get back to normal. When that didn’t happen, we settled in for the long road ahead.

There were some positives to shutting down. People started getting more exercise, spending more time outside and less time driving. Air pollution decreased, children spent more time with their parents and pets rejoiced as their owners stayed home.

At Network Health, we didn’t miss a beat. Without any service interruption, we immediately moved all our employees to work from home to keep serving our highest priority—you.

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COVER STORY

Sharon, a Network Health Medicare member, had a transplant in 2019. To keep herself healthy and safe during the pandemic, she has been in complete isolation. Yvonne, Sharon’s nurse care manager at Network Health, checked in with her regularly to make sure she was doing OK. In a recent call, Sharon said to Yvonne, “I would like to be able to go out, see my family and get a hug. I am alone.

So, it’s hard for me.”

But Sharon isn’t alone. She isn’t the only person who has experienced social isolation. According to a survey done by SurveyMonkey, 70 percent of Wisconsin seniors feel more isolated because of coronavirus. As a result of the pandemic, we all had to adapt to a different way of interacting with our friends, family and Thank you other members of so much for the gifts … our community. To I’m a heart transplant limit our exposure to coronavirus, many of recipient and Network us made significant Health supported me changes to our routines.

all the way. I can’t thank you enough.

At Network Health, we adapted too. For the first time ever, we Network Health held our member events virtually to answer Medicare member member questions and in Appleton get you information about your plan updates for 2021. More than 1,700 people attended, and we received lots of feedback from you, with 93 percent event satisfaction.

One member event attendee said, “I truly appreciated all the presentation planning that went into yesterday’s Zoom gathering. It was concise, clear and easy to understand …

I go to the October meetings every year and this year was equal to being there [in person].”

These events were so successful, we’ll be offering virtual events in 2021, too.

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My husband and mom have been receiving excellent service from Network Health. I will be in new 2021. Keeping it local and personal is important. Thank you for going #aboveandbeyond.

Network Health Medicare member

Normally, our member events are paired with our flu shot clinics. Since we did all our member events virtually, we held 33 outdoor flu shot clinics in 19 different cities throughout our service area. The response was incredible.

We administered a total of 7,850 vaccinations.

A member called to tell us how the flu shot clinic went.

She said, “I attended the Neenah Walgreens flu shot clinic.

Even with the windy conditions, they did an awesome job.

It was a very welcoming experience. I was very pleased.”

During the clinics, we learned that many of you hadn’t received your pneumonia and/or shingles vaccine. To keep you safe and healthy, we were able to get you these vaccines in addition to your annual flu shot.

Volunteering, Special Benefits, Gift Boxes and More

Aligned with our mission to create healthy and strong Wisconsin communities, Network Health encourages employees to get involved in our community. In fact, every year, each employee gets eight hours of paid volunteer time, to give back to the communities where we live and work.

“It’s really cool that Network Health gives us paid time off to volunteer,” said one employee. “Our department usually volunteers together. It’s a fun team-bonding experience and it allows us to contribute to our community in a positive way.”

In 2020, our employees supported several local organizations through donations and volunteering, including Feeding America Eastern Wisconsin, Inc., Alzheimer’s Association, Boys & Girls Club of Greater Milwaukee, Wisconsin Humane Society and many more.

We also partnered with CBS58 and the Annual Hunger Task Force Food Drive to help those in need.

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As a member of a Network Health Medicare Advantage Plan, you always have access to benefits above and beyond Original Medicare. In addition to those benefits, you received additional coronavirus relief benefits in 2020. Depending on plan type, these benefits included transportation to doctor appointments, an expanded hearing aid discount program, meals after an inpatient hospital stay and $0 virtual in-network doctor visits.

In addition, every Network Health Medicare member received a $200 benefits card to be used for Medicarecovered health related services in 2020. One member told us, “Thank you, Network Health, for going above and beyond expectations during this pandemic. The health card with $200 was wonderful and appreciated … we are so impressed and thrilled with your thoughtfulness and concern. So glad we have Network Health.”

We also sent personal protection gift boxes to our 65,754 Medicare members to help you stay safe. We worked with a local Wisconsin vendor to create, pack and send these care packages. Each gift box included these items.

• Hand sanitizer • Alcohol wipes • Digital thermometer • Pen with sanitizer • Two custom face masks • Sherpa blanket As the gift boxes started to hit homes, the feedback really started to flood in from you. Our Network Health Facebook page was inundated with hundreds of comments and messages. Some of you sent letters and others posted pictures of yourself wearing your Network Health mask.

Thank you for this wonderful feedback.

A Network Health member in De Pere said, “Each and every gift speaks loudly of your kindness, your compassion and your thoughtfulness toward all of your members. We have had many insurances over the years, and we have never had one that cares for us in such special ways … Thank you for going above and beyond.”

What’s Next?

First and foremost, we look forward to continuing to serve you as a Network Health member. It’s our

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pleasure to support your health and wellness journey.

As I snuggle under the fleece blanket, I am so thankful for an insurance company that truly puts its customers first. Thank you for the wellness kit.

As 2021 continues, we have a lot more information about the coronavirus.

We know about the symptoms, how and where to get tested, how the virus Network Health Medicare spreads and how to member in Neenah keep ourselves safe.

Most importantly, we’ve taken steps to stop the spread. The biggest contribution to this is the development of the coronavirus vaccine.

For the most up-to-date information about the coronavirus vaccine, visit networkhealth.com/coronavirus-vaccine.

See page 20 for vaccine facts and myths.

Although our local offices remain closed to the public for the time being, know that we’re still here for you when you need us. And, we look forward to seeing you again, in person, as soon as it’s safe.

Thank you, Network Health, for the $200 card that really helped to pay medical visit and prescription refill copayments.

Also, what a nice surprise to receive the #aboveandbeyond box of items … Thank you, Network Health, for looking out for your Medicare Advantage clients during these most difficult, challenging and treacherous times.

Network Health Medicare member

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What a nice surprise Santa (Network Health) left on my front porch today ... I want to thank Network Health for their professional approach to the health care industry … I could not be more pleased with Network Health’s cooperative communications and support during my ongoing health adventure.

Thank you so much for the wonderful gifts you sent. Everything in your gift box is so helpful especially in this terrible pandemic. I have been quarantined since February and besides being so useful, it was wonderful getting a surprise gift in the mail.

Network Health Medicare member

Network Health Medicare member in De Pere

As we reflect on this past Christmas, we have so many things for which to be grateful.

Thank you, Network Health, for sending us our first and one of our favorite, Christmas gifts. We love the beautiful box filled with goodies to help keep us safe and well. We appreciate your thoughtfulness and the reminders to stay safe during the pandemic.

Network Health Medicare member in Appleton

How exciting to find a package from Network Health on my doorstep this afternoon. I never thought I’d say, ‘I love my health insurance company,’ but I do … I truly am grateful this Thanksgiving, especially for my health.

Network Health Medicare member in Green Bay

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I just got home from physical therapy and it was such a nice surprise to find this care package waiting for me. My neighbor is a bit jealous because her insurance carrier hasn’t sent anything.

I told her to switch companies. You are the best.

Network Health Medicare member

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life. health. wellness.

Recommend Network Health and Earn Gift Cards W

hen you recommend Network Health Medicare Advantage Plans, you know your loved ones will have access to the same local, high-quality service you get as a member. As a Wisconsin-based company, we go above and beyond for our customers, because we know we’re helping our neighbors, friends and family.

Our Medicare member referral program gives you the opportunity to earn gift cards for sharing Network Health with your friends and family. You can earn up to four $15 gift cards per year, and you can choose from a variety of stores, like Kohl’s and Home Depot.

How do I earn the gift card?

The people you refer to Network Health must meet these criteria.* • Have Medicare Parts A and B • Live in our service area • Are not already enrolled in a Network Health plan Simply have your friends and family members call our Medicare experts at this special number, 844-850-5284 (TTY 800-947-3529), Monday–Friday from 8 a.m. to 8 p.m.

When they call, our Medicare advisors will ask questions to find out which health insurance benefits are most important to them. Then, they will offer plan options to your referrals’ needs. About a week after we talk to your friend or family member, you’ll get a phone call from a Network Health employee to determine which gift card you want.

Licensed agents who are appointed with Network Health are not eligible for these gift cards.

*

Access to Network Health Care Management Employees and Services Network Health provides access to medical and behavioral health employees for Medicare Advantage members, providers and their office staff who are looking for information about our care or utilization management programs.

If you have questions about these programs, please contact care management at 866-709-0019 (TTY 800-947-3529), Monday–Friday from 8 a.m. to 5 p.m.

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life. health. wellness.

Using Your Member Portal At Network Health, we empower you to get the most out of your Medicare Advantage plan. To do this, you have a great resource right at your fingertips—your member portal. If you haven’t already, access your portal by visiting login.networkhealth.com.

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our member portal was built based on feedback we received from our members, and we continuously make updates based on additional feedback we receive.

Our most recent enhancements include allowing you to easily set up recurring payments, select additional preferences for mail vs. email and to view your newly updated pharmacy Explanation of Benefits (EOB).

be brought to the Express Scripts website to view your documents. In addition to the convenience of seeing them electronically, your EOBs have new features to help you get the most out of your plan.

If you’ve ever had concerns about the cost of your medications, you’ll appreciate the changes to the EOB. Each time you get a pharmacy EOB, there will be an area with a list of medication alternatives, if there is a lower cost option available. This gives you the opportunity to review and discuss potential alternatives with your personal doctor. You may find out that a less expensive medication could be just as effective as the medication you’re currently taking.

The other addition to our pharmacy EOBs is drug price change information. This lets you know if the total cost of each of your medications has stayed the same, increased or decreased throughout the year.

How to Set Up Recurring Payments

If your plan has a monthly premium, you can set up recurring payments in the member portal by selecting Pay Now next to Current Balance Due. (You can still click this link, even if you don’t currently have a balance due.)

You will be brought to a secure page where you can enter a one-time payment or set up a recurring payment.

Simply enter your bank account or credit card information and check the box that says Use same payment source for ongoing monthly payments. This will post to your Credit Card/Bank Account on the 7th of each month.

Click Save Payment Options and your payment will be used for your future premium payments.

Viewing Your Enhanced Pharmacy EOB

You can now view your pharmacy EOBs in your member portal. You can access them by selecting My Claims and choosing Pharmacy EOBs from the dropdown. You will

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Selecting Your Communication Preferences

In the member portal, you can choose which plan information you want to receive in the mail and which information you prefer to receive by email. Typically, when you elect to receive information through email, you will receive it more quickly, so many members choose to receive their EOBs and Annual Notice of Change by email.

To select your preferences, log in to your member portal, click your name in the upper right corner and select Change My Communication Preferences. From here, you can choose email for any or all of these five available categories.

• EOB statements • Medicare Annual Notice of Change • Health and wellness information • Event announcements, reminders and surveys • Member magazine

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Make sure to click Next to save your choices.

Accessing Plan Documents

You can also access many important plan materials and forms within the portal.

While logged in to your portal, click My Materials. From the dropdown, you can select Plan Documents to see your member guide, Evidence of Coverage, Summary of Benefits and more. If you choose Forms, you will find any claim or reimbursement forms applicable to your plan.

To access your important benefits information, click the My Benefits tab in the upper right. The dropdown that appears will contain information about the benefits that are available to you, based on your plan type.

Where Should You Get Care?

Emergency Room, Urgent Care or Virtual Visit

By Alice Parks, director of population health at Network Health

I

f you feel you’re experiencing a life threating medical emergency, it’s important to go to the nearest emergency room or call 911. Options for non-emergency or non-life threatening conditions include an urgent care walk-in clinic, a virtual visit or a visit to your personal doctor’s office. Two questions can help you determine which type of care is right for you.

What’s the difference between emergency care, urgent care and virtual visits?

An emergency is an illness, injury, symptom or condition so serious that immediate medical intervention is needed to avoid serious harm.

Urgent care is appropriate for an unexpected injury or illness that is not life threatening, but still needs attention quickly so it doesn’t develop into a serious problem.

Urgent care is available at your personal doctor’s office, a walk-in clinic or an urgent care facility.

A virtual visit is another option for convenient medical care through a computer, smartphone or tablet. Many local doctors provide virtual visits to their patients as an alternative to urgent care visits for non-emergency medical conditions, so contact your personal doctor to

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find out if he/she offers this type of visit. Network Health also partners with MDLIVE® to provide virtual visits.

What if I’m not sure if it’s an emergency?

Being prepared and knowing what to do before an emergency can help you make the right decision quickly.

For help determining if your situation is an emergency, contact your personal doctor. For more information, go to networkhealth.com and under the Health and Wellness heading, select Getting Care Quickly.

Don’t forget to ask questions Anytime you visit the emergency room, a walk-in clinic, see your personal doctor or use MDLIVE, don’t be afraid to ask questions. If something doesn’t seem right or make sense, ask about it.

Your coverage for each service varies depending on your plan. Visit your member portal at login.networkhealth.com click My Benefits, then Benefits Overview. If you have questions, call the member experience department at 800-378-5234 (TTY 800-947-3529), Monday–Friday from 8 a.m. to 8 p.m.

Whichever form of care you choose, make sure to share information about the visit with your personal doctor.

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life. health. wellness.

Do You Know Your Pharmacist’s Name?

By Anna Peterson Sanders, PharmD, pharmacist at Network Health

T

he American Pharmacists Association coined the phrase, “Know your medicine, know your pharmacist.” The concept is that people who understand their medicine most likely know their pharmacist by name or at least by face. It’s important for you to have the tools you need to make appropriate decisions about your health. This includes being able to locate information, evaluate it for credibility and quality and analyze the risks and benefits. Access to a Network Health pharmacist is another tool in your toolbox to be the healthiest you can be.

Gary Melis Network Health Pharmacist

Pharmacists are viewed as medication experts who focus on safety and cost. They are often considered the most accessible health care provider to the public. Individuals with a close connection to a personal pharmacist are less likely to miss doses, so diseases have better outcomes.

People who trust their pharmacist are more likely to have honest conversations about real life medication challenges. This trust creates honest communication, improves quality of the interaction and often involves shared decision making.

Some people turn to the internet for medication information. While the internet contains a lot of good information, when it comes to medications, it can be hard to determine if that information is accurate, relevant or if key factors are missing.

Sarah Wilczek Network Health Pharmacist

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Recently, the state of Wisconsin discontinued the requirement for pharmacists to provide consults on medication refills. While this saves time for the retail pharmacy, Network Health members may miss an opportunity to ask questions while picking up prescriptions.

To provide you even more access to our clinical pharmacists, we recently added a new pharmacist to our team. As a Network Health member, you have Gary, Anna, Beth and our newest pharmacist, Sarah, to assist with your medication challenges. Now that you know our names, let us get to know yours.

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The Value of Medication Therapy Management

By Tyler Jones, pharmacist intern at Network Health

I

t can be difficult for your personal doctor and retail pharmacist to know everything about your Medicare plan and coverage. Network Health pharmacists are unique because they understand your specific plan benefits.

At Network Health, we offer the Medication Therapy Management (MTM) program, which gives you the opportunity to talk one-on-one with a pharmacist. MTM consists of a comprehensive medication review and can help address financial barriers, identify potential side effects and improve medical outcomes. Best of all, there’s no cost to you.

Your Network Health pharmacist will work with you and your health care team to create an action plan to ensure you are getting the most out of your prescriptions.

You qualify for the MTM program if you take seven or more chronic medications, have three or more qualifying chronic conditions and reach a total drug cost of $4,376 or more in 2021. These are considered qualifying conditions.

• Arthritis • Osteoporosis • Chronic heart failure (CHF) • Diabetes • Dyslipidemia • Hypertension • Depression • Asthma • End-stage renal disease (ESRD) • Chronic obstructive pulmonary disease (COPD) Each year, there are Network Health Medicare Advantage members who qualify for the MTM program who we can’t reach. This is a lost opportunity to connect with a Network Health pharmacist to optimize prescription regimen and potentially save money on medications.

The Network Health pharmacy department minimizes these missed opportunities by reaching out to qualifying members, and partnering with Sinfonia/ MedWiseRX*, an MTM vendor that also makes a portion of the calls.

If you receive an MTM qualification letter, let our local Network Health pharmacists serve you. You can contact Network Health pharmacists in the following ways.

• Call 920-720-1287 or 888-665-1246 (TTY 800-947-3529), Monday–Friday from 8 a.m. to 5 p.m.

• Log in to your member portal at login.networkhealth. com. Select Email Us in the upper left corner, select Pharmacy Benefits, type a message in the text box and click Send to start the conversation. Messages exchanged in your member portal are secure.

• Email pharmacist@networkhealth.com.

Your Network Health pharmacists are here to be a part of your health care team and assist you with medication questions. Our goal is to help you fully understand the reason and importance of your medication(s) and how they are covered by your Network Health Medicare Advantage plan.

Beginning January 1, 2021, our Medication Therapy Management partner, SinfoníaRx, has changed the name of their clinical call centers to MedWiseRxTM. While you may have been familiar with the SinfoníaRx name from years past, you can expect the same exceptional service and care under the new MedWiseRx branding.

*

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Roll Up Your Sleeve for the Vaccine

By Andy Wheaton, manager of pharmacy benefits at Network Health

Immune System 101

When germs, such as bacteria or viruses, enter your body, your immune system recognizes them as foreign invaders and begins creating proteins called antibodies. These antibodies help your body identify and destroy these germs. Antibodies assist with the germ fight when you’re first exposed and protect against future infections. If your body comes in contact with the same germ, even years later, your body uses antibodies to recognize and defend itself against future infection.

diseases like polio, tetanus, measles, diphtheria, whooping cough (pertussis) and chickenpox are no longer a threat.

Getting vaccinated protects you and those around you who are vulnerable to getting the disease.

How Vaccines Work

The Pfizer and Moderna vaccines are mRNA vaccines.

These vaccines give your body’s cells instructions to make a harmless protein called the spike protein (which is found on the surface of the coronavirus).

Vaccines offer a way for your body to begin producing antibodies without coming in direct contact with the germs that make you sick. A vaccine teaches your body to recognize a foreign invader, alarms your immune system to activate and instructs your fighter cells and proteins to go to work against the germ. Vaccines are made using the inactive, weakened or harmless parts of the germ so they prevent disease without making you sick.

Vaccines have been around for hundreds of years and play a major role in fighting disease today. Thanks to vaccines,

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Coronavirus Vaccine*

Three coronavirus vaccines have been authorized for emergency use, including the Pfizer BioNTech, Moderna and Johnson & Johnson Janssen.

The Johnson & Johnson vaccine is a viral vector vaccine.

This type of vaccine uses a common cold virus that has been modified (called an adenovirus) to deliver genetic material for our cells to create the spike protein.

Once your body receives the virus and creates the spike protein, your immune cells start to make antibodies to identify and destroy the virus.

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Coronavirus Vaccine Facts and Mythss Myth 1 – The coronavirus vaccine

is not safe because it was rapidly developed and tested.

The coronavirus (SARS-CoV-2) gene material was sequenced in early January 2020. This allowed the world’s best scientists to understand the importance of the spike protein and that developing antibodies against it might protect us from the disease.

The partnership with the federal government provided nearly unlimited resources and allowed companies to develop vaccines faster than they normally would. For the first time in history, instead of waiting for the first study phase to be completed before starting the second phase and so forth, phases overlapped one another. So, the full duration of each study phase was completed, but in less time. Rest assured, the coronavirus vaccines were properly evaluated without cutting any corners.

Myth 2 – The Pfizer and Moderna

coronavirus vaccines will alter my genes.

This is not true, because mRNA isn’t the same as genetic material (DNA), and it can’t combine with our DNA to change our genetic code. The Centers for Disease Control and Prevention (CDC) says on its website that mRNA vaccines don’t interact with our DNA in any way.

Myth 3 – If I’ve already had

coronavirus, I don’t need the vaccine.

People who have already had the coronavirus may still be at risk for re-infection. Currently, there is not enough information to say if, or for how long, people are protected from getting coronavirus after they have had it.

Myth 4 – The coronavirus vaccine is going to make me sick.

The coronavirus vaccines will not give you coronavirus and do not contain a live virus. These vaccines provide material

for your body to recognize and destroy the virus if you encounter it. As with all vaccines, side effects may occur, but that doesn’t mean they are harmful. The most commonly reported side effects, which typically last several days, are pain at the injection site, tiredness, headache, muscle pain, chills, joint pain and fever. More people experience these side effects after the second dose than after the first dose.

Although these side effects may be mildly unpleasant, this is an indication the vaccine is doing its job and your body is developing antibodies against the coronavirus.

Myth 5 – If you have had the

coronavirus vaccine, you don’t need to wear a mask or social distance.

Even if you received the coronavirus vaccine, you could still pass the virus on to others. We still do not know how the vaccine effects virus transmission, and until we do, the recommendation is to wear a mask and practice social distancing.

Myth 6 – The coronavirus vaccine is

causing widespread allergic reactions.

Anaphylaxis is a severe, life-threatening allergic reaction that occurs rarely after vaccination. The CDC provided an initial analysis on January 22, 2021, which indicated 2.5 anaphylaxis cases per million (1 in 400,000) occurred in the Moderna coronavirus vaccine doses administered (CDC, 2021).

Everyone who gets a coronavirus vaccine should be monitored on site after receiving the vaccine. Anyone who has had severe allergic reactions or any type of immediate allergic reaction to a vaccine or injectable therapy should be monitored for at least 30 minutes after getting the vaccine. All other people should be monitored for at least 15 minutes after getting the vaccine. Your clinic or pharmacy will have the supplies on hand to help you if this very rare reaction occurs.

NOTE: The administration fee for the vaccine will be billed directly to Medicare through the original fee-for-service Medicare program. Make sure to bring your red, white and blue Medicare card to your vaccination appointment. *Information about the coronavirus vaccine is rapidly changing. The information contained in this article is current as the publishing date. For the most up-to-date information, visit our website at networkhealth.com/coronavirus-vaccine.

Centers for Disease Control and Prevention (CDC). (2021, January 22). Allergic Reactions Including Anaphylaxis ... Centers for Disease Control and Prevention. cdc.gov/mmwr/volumes/70/wr/mm7004e1.htm networkhealth.com

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life. health. wellness.

What You Need to Know About Opioids

By Sarah Wilczek, PharmD, pharmacist at Network Health

What are opioid pain medications?

• Tylenol® or ibuprofen for acute pain, such as an injury

Opioid pain medications are used to treat severe pain and include hydrocodone, morphine and oxycodone. These medications are also called narcotic pain medications.

Opioid pain medications can help you manage pain when used correctly. However, there are some risks to them as well.

What are the risks of opioid medications?1

• Cymbalta® (duloxetine) and Neurontin® (gabapentin) are useful for chronic nerve pain • Topical patches such as SalonPas® or lidocaine patches are helpful and available without a prescription • Physical treatments, such as exercise, physical therapy or weight loss, may also be a good option

Common side effects of opioid medications are drowsiness and constipation. You can also become tolerant to the effects of the medication and need more of it to achieve the same pain relief.

•

The most dangerous side effect of opioid medications is a breathing emergency. Breathing emergencies occur when the opioid medication is taken in an amount that decreases your body’s urge to breathe.

• For acute pain, limit use to three to seven days

These are the risk factors for a breathing emergency.

• A high dose of opioids • Ask your doctor or pharmacist about your risk • Combining opioids with these medications • Benzodiazepines (examples include Ativan® [lorazepam], Xanax® [alprazolam]) • Sleeping medications (examples include Ambien® [zolpidem], Lunesta® [eszopiclone]) • Alcohol • Neurontin® (gabapentin) or Lyrica® (pregabalin)

How do I use opioid medications safely?

• Try other pain-relieving strategies first, including these non-opioid medications.2

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If opioid medications are needed, start at the lowest effective dose. This is especially important for people age 65 and older, because the response to opioid medications is less predictable as we age.

• Do not use opioid pain medications at the same time as benzodiazepines, which include Xanax (alprazolam), Valium® (diazepam), Ativan (lorazepam) or sleeping medications such as Ambien (zolpidem) • Ask your pharmacist or doctor about Narcan® (naloxone)

What is Narcan?

Narcan is a medication that can reverse the effects of opioid medications, mainly the breathing emergencies.

The most commonly dispensed form is Narcan nasal spray. Think of Narcan like a fire extinguisher. You hope you never have to use it, but it is there for you in case you need it.

The state of Wisconsin has a standing order that allows pharmacists to dispense Narcan to patients without a prescription from a provider.

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I have left over pain medication. What do I do with it?

After you are no longer using your pain medication, you should not leave it sitting in your cabinet. There are several options to safely dispose of pain medications.

• Drop it off at your local police station—many police stations have drop boxes for unused medications. You may want to call the non-emergency line first to make sure that your local station has a drop box.

• Drop off your unused medication on National Prescription Take Back Day, typically held every April and October. For more information, visit takebackday.dea.gov.

• Some pharmacies offer DisposeRx®, a packet that you add along with water to the unused medication vial—it forms into a biodegradable gel which you can discard. Make sure you remove your personal information from the vial before you throw it away.

If none of these options are accessible to you, place the unused medication in a plastic bag along with coffee grounds or kitty litter and throw it away.

If you have questions or are concerned you may be at risk of opioid abuse, talk with your personal doctor. He or she can provide the resources you need to use your prescribed medication safely.

1 2

Marcum A.Z., Duncan N.A, Makris U.E. Pharmacotherapies in geriatric chronic pain management. Clin Geriatr Med. 2016; 32: 705-724 cdc.gov/drugoverdose/pdf/guidelines_at-a-glance-a.pdf

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life. health. wellness.

F

eeling sluggish, drowsy or down can be your body’s way of telling you to eat more nutrient-rich foods. Good nutrition is important to healthy aging, and spring is the perfect time to develop some good habits. Our bodies and nutritional needs change as we age, making it more important to make healthy choices at every meal. You can educate yourself about healthy aging and adopt lifestyle choices to make you feel better, inside and out.

Benefits of Good Nutrition

Potassium, calcium, vitamin D, vitamin B12 and fiber are micronutrients that become more important with age. They contribute to immune function, brain health and disease prevention. Eating a nutrient-rich diet can also improve your quality of life by helping you feel better overall.1

Need more reasons?

• • • •

Increased energy levels More restful and restorative sleep Enhanced brain function Improved muscle mass and bone density

Eating well and staying active can help you stay strong and healthy so you can keep doing the things you love to do.

By SilverSneakers

®

Sources: 1 U.S. Department of Agriculture, choosemyplate.gov/browse-by-audience/view-allaudiences/adults/older-adults, accessed November 25, 2020 SilverSneakers is a registered trademark of Tivity Health, Inc. SilverSneakers OnDemand is a trademark of Tivity Health, Inc. © 2021 Tivity Health, Inc. All rights reserved. SSFP1072_1220

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Routine Eye Exam vs. Medical Eye Exam

P

eople age 65 and older are more than twice as likely to need glasses or contacts than people in other age groups. There are two types of eye exams. Before scheduling your next eye exam, it’s important to know the difference between each one and what your vision benefits will cover.

Routine Eye Exam – Screens for eye diseases and provides measurements for eyeglasses and/or contacts.

When do you need a routine eye exam?

• • • •

Your vision is blurry You have trouble reading up close You find yourself squinting to see far away Annually, even if you don’t experience issues

Is this type of exam covered by your Network Health Medicare Advantage plan?

Yes. You are covered for a routine eye exam for $10+ and many of our plans* offer up to $40 reimbursement if you visit an out-of-network provider for this service. All members will receive discounts on glasses and contact lenses with an EyeMed provider. You can find an EyeMed provider by visiting networkhealth.com/medicare/ additional-benefits and clicking Find a Vision Provider. The EyeMed network of providers is different from our Network Health medical vision providers.

Medical Eye Exam – Performed to evaluate abnormalities found during your routine eye exam and to monitor

existing medical conditions. If you have an existing eye condition, you receive this type of exam every time you visit your provider. If you have questions about the type of exam you receive, contact your provider.

Why might you need a medical exam instead of a routine exam?

• You have cataracts • You have glaucoma

• You have diabetes • You have macular degeneration

Is this type of exam covered by your Network Health Medicare Advantage Plan?

Yes. This is considered a Medicare-covered exam, and a copayment will apply. To find a Network Health medical vision provider, visit networkhealth.com/find-a-doctor, select your plan type and search for Optometry or Ophthalmology.

You can add your city or zip code under Advanced Search to narrow your search to providers near you. +NetworkCares (D-SNP) members pay $0 for an in-network routine eye exam. *Out-of-network coverage is not available on the Network Health Medicare Explore (HMO) Plan.

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life. health. wellness.

Prevent T2 Diabetes Prevention Program P

revent T2 is a National Diabetes Prevention Program, which was created by the Centers for Disease Control and Prevention in 2010. Network Health began offering this program in 2019 and our participants have learned how to make lifestyle changes and develop healthy habits.

1570 Midway Pl Menasha, WI 54

Health or wellne

Presented by Network Health lifestyle coaches, PreventT2 is part of the National Diabetes Prevention Program, led by the Centers for Disease Control and Prevention (CDC).

This program is designed to help you make small changes that make a big difference to your health.

1570 Midway Pl. Menasha, WI 54952

Health or welln

ess or preventio

n information

Estella Lauter, professor emerita at the University of WisconsinOshkosh, participated in the Prevent T2 program. Estella holds many titles, including mother, wife, professor, writer, traveler, sailor and poet. In her retirement, she continues to use poetry to express her thoughts and feelings, and has published four books with Finishing Line press in Kentucky. Estella wrote this poem and dedicated it to her fellow Prevent T2 classmates.

Prevent T2 invitation 2278-04a-0221.indd 1

Presented by Network Heal th lifestyle coac part of the Nati hes, PreventT onal Diabetes 2 is Prevention Prog Centers for Dise ram, led by the ase Control and Prevention (CDC ).

This program is designed to help a big differenc e to your health. you make small changes that make

Prevent T2 invitation

2278-04a-0221.i

ndd 1

Medicare

2/17/21 9:59 AM

These Are a Few of My Favorite Foods

By Estella Lauter, Network Health Medicare member–For my Prevent T2 classmates Cottage cheese and a juicy pear for breakfast, or an orange red grapes, a Cortland apple, sprouted bread for toast and always coffee, but make it decaf.

Lunch should be a slice, just one, of Provolone or Baby Swiss on a piece of sprouted bread with a ripe tomato or Bibb lettuce, Dijon mustard and maybe a bit of olive oil mayo or homemade pesto.

With dinner comes variety—pork loin or flounder Florentine, chicken Marsala, shrimp curry, roasted turkey, ratatouille, delicious homemade soups, with rice and veggies too many to count.

Desserts of choice are bananas pineapple, applesauce and nonfat frozen yogurt, no sugar added, 26 | C oncierge

a square or two of dark chocolate.

On a hard day, dessert may come first.

In between, crunchy carrots, fig newtons (just two), dried apricots or prunes, popcorn, three crackers with a thin coat of peanut butter (excess oil drained) and always decaf.

For the occasional treat with friends and family, there’s chicken salad, blueberry pancakes, cherry pie, cranberry sauce, zucchini bread, hamburger or steak—more than enough, way more when I think of my parents, their lives on small farms with root cellars for winter storage and blocks of ice from the lake to keep their food fresh in warm weather.

So how can I call this a “diet” when it is really a feast?

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Do You Face Barriers to Getting Care?

By Alice Parks, director of population health at Network Health

You may have heard of social determinants of health, but what are they?

The World Health Organization defines social determinants of health as the conditions in which people are born, live, learn, work, play, worship and age that affect health outcomes and risks, functioning and quality of life. Put simply, it means the factors in your life, outside of health care itself, that can affect your health and wellness. Some of those factors can become barriers or challenges to feeling well and being healthy.

What factors can create these barriers? Here are some examples.

• • • • •

Having enough money to cover basic expenses, like food and clothing A place to live Access to transportation to get to the grocery store, the doctor, a support group or social activities you enjoy People to check in on you and support you, if needed The ability to understand information about your health—medical language can be hard to understand and sometimes we speak and understand different languages • Religious, spiritual or cultural beliefs and values that aren’t understood by your health care team

To determine which barriers you face, ask yourself two questions.

• What barriers to feeling well and being healthy do I face?

• What can I do to break down those barriers?

Then, you can form a plan and take action. For example, if you or a family member has a language barrier, ask for a translator. Or, if a suggested plan of care conflicts with your values, let your health care team know. They can provide alternative care plans that meet your needs and fit your values.

Remember, Network Health is here to support you on your health and wellness journey. We have local nurses and social work care managers to serve you and discuss the challenges you’re experiencing. We’ll help you find resources in your community to break down some of the barriers you face. You can contact our care management department at 866-709-0019 (TTY 800-947-3529), Monday–Friday from 8 a.m. to 5 p.m.

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PRESORT STD US POSTAGE PAID PERMIT 1033 GREEN BAY, WI

1570 Midway Pl. Menasha, WI 54952

Health and wellness or prevention information

PPO, SNP, HMO

Convenient Access to the Care You Need

T

hrough our partnership with Inovalon, Network Health offers convenient health assessments to review your medications and discuss any health concerns you may have. A nurse practitioner will complete a safe and comprehensive visit in the comfort of your home. If you prefer a virtual visit, Inovalon will send you a tablet to complete the visit. Both you and your personal doctor will receive a copy of the results of the assessment.

Who is eligible for an Inovalon health assessment?

All Network Health Medicare Advantage Plan members are eligible for an Inovalon health assessment at no cost.

You may be contacted by mail and phone directly by Inovalon to schedule your appointment. If you aren’t contacted and would like to participate in a health assessment, call our member experience team at 800-378-5234 (TTY 800-947-3529), Monday–Friday from 8 a.m. to 8 p.m.

Why should I complete this health assessment?

The Inovalon health assessment gives you the opportunity to meet with a nurse practitioner at no cost to you. This assessment is not meant to replace your visits with your personal doctor, and it can offer unique insight into your health. During the visit, the nurse practitioner will discuss your health history, perform an exam and answer any questions you may have. He or she may complete a falls assessment and ask questions about daily living activities to ensure you get the care you need, when you need it.

You can earn a $50 reward for completing a visit.

Preventive Screening Kits

Inovalon also offers in-home preventive screenings. If you need a colon cancer screening or certain labs, you may receive kits in the mail to complete on your own or during an in-home visit. To find out if you are eligible or to request a kit, call our member experience team at 800-378-5234 (TTY 800-947-3529) Monday-Friday from 8 a.m. to 8 p.m. You and your personal doctor will receive a copy of your results.

You can also earn a $25 reward for each preventive screening kit you return.