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EXCITING NEW PERKS THAT COME WITH YOUR PLAN
& TIPS
TO KEEP YOUR BLOOD PRESSURE IN CHECK
HEAR FROM
A FELLOW MEMBER AND WWII VETERAN
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Know Your Perks, Old and New Life may speed up going into the holidays, but we want to remind you to slow down and enjoy this season. As you flip the calendar to a new plan year, take the time to reset and go over all your plan has to offer for 2019.
share about a fellow member who served our country during World War II. If you need anything now or going into the new year, call us at the Member Services number on the back of your ID card. We’d love to help you.
In this issue, we’ll highlight some new and exciting benefits. Plus, you’ll learn more about the preauthorization process and our retail site. And we’ll
We hope you have a happy and healthy holiday season and that you enjoy this edition of House Calls.
Inside This Issue 2 The right Care at the Right Time 3 More Perks and Programs for You 5 Member, WWII Vet Honored with Trip
7 Getting your Blood Pressure Under Control 9 Stop in and see us
The Right Care at the Right Time Preauthorization is a process to decide whether a service, medication, treatment or medical equipment is the best and most appropriate option for your individual situation. This can also help keep your out-of-pocket costs down by reducing unnecessary care. How do I know if a service needs preauthorization? You can check which services require preauthorization by: • Reviewing your plan materials
to DC
• Calling the Member Services number on the back of your ID card How do I get preauthorization? Your doctor should request preauthorization on your behalf before you receive a service that requires preauthorization. How long does the preauthorization process take? The turnaround time depends on the type of service and whether it’s a standard or expedited (urgent) request. Medically urgent preauthorization requests are completed within 72 hours and standard outpaient requests are completed within 10-14 business days.
Medicare Advisory Board We want to hear ideas and opinions from members like you, and the Member Advisory Board helps us do just that. The board helps us know the kinds of questions and concerns
members have about their plans and ideas they’re interested in. To join or learn more, call Gregg Mottola 217-902-9228, weekdays from 8 a.m.—4:30 p.m. (TTY 711).
If you have questions about preauthorization, we’re here to help. Just call the Member Services number on the back of your ID card.
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More Perks More Perksand and Programs for You Programs for You in 2019in 2019
We’re always looking for ways to improve our plans, and this year, we’ve done that by giving you some exciting new perks for 2019. Vision We know eye care is important to you and that eye health is key for your vision and overall well-being. This year, you can get a routine vision exam at any in-network eye care provider for a $0 copay. (Eye exams for purposes other than checking vision will still have a copay amount.) Poor vision can affect your ability to function and could lead to falls or other injuries, so we encourage you to use this benefit to help catch any vision issues you’re having. Like in past years, you also have coverage for a glaucoma screening, exams to diagnose and treat eye diseases and conditions, and glasses or contact lenses after each cataract. Virtual Visits Life can be busy, and we know you might feel like you don’t have time to go to the doctor, but getting the right care is still important.
In 2019, you can skip the wait at the doctor’s office with our all-new virtual visit benefit. You can talk to a boardcertified doctor or counselor at any time of day, any day of the week by phone or secure video through MDLive. com or the MD Live app. The cost is the same as a primary care office visit copay. You can be seen for more than 50 common conditions, including these and many more. • Allergies • Behavioral health • Cold/flu • Cough • Ear problems • Insect bites
You also still have access to our Anytime Nurse Line 1-855-802-4612 to get answers to your health-related questions 24/7. If you don’t know whether to see your doctor, go to urgent care, go to the emergency room or stay home for a virtual visit, the Anytime Nurse Line can help direct you to the proper care and offer advice for your situation. Keep Using Your Perks In 2019, you can continue to use many of the perks you’ve had in previous years. Here are just a few of the many we offer. Go to HealthAllianceMedicare.org/Perks or call the Member Services number on the back of your ID card for more information.
• Hearing Benefit Through TruHearing®, you can get one routine hearing exam for a $45 copay and lowered rates on up to two TruHearing Flyte® hearing aids per year when you see a TruHearing provider. • Wellness Rewards You can take steps toward better health while working your way toward a $50 gift card through our pointsbased Wellness Rewards program. Each activity is outlined in our Wellness Rewards checklist, which you can find at HealthAllianceMedicare.org/Perks.
• Be Fit Fitness Benefit Get fit at the fitness center of your choice through our Be Fit benefit. With Be Fit, you choose where you want to work out, and we pay you back up to $360 per year for gym membership or fitness class fees. Visit HealthAllianceMedicare.org/Perks for full details and the reimbursement form.
• Nausea/vomiting • Pink eye • Rash
Check your plan materials or call the Member Services number on the back of your ID card for full details.
Go to HAMP.LifeBalanceProgram.com to learn more and start saving.
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Member, WWII Vet Honored with Trip to DC
After stops in Mississippi, South Carolina and Kentucky, he eventually set sail for Europe on a converted English passenger ship. “I went across in 1943 and passed the Statue of Liberty by boat,” he says. “And I came home the same way, past the Statue of Liberty.” He first landed in England and went through Scotland before crossing the Irish Sea to Northern Ireland. There, he and other Allied troops spent three months preparing for a day that would change history. On June 6, 1944, under the direction of Gen. Dwight D. Eisenhower, about 156,000 Allied troops landed on the beaches of Normandy to begin Operation Overlord, the Allied invasion of Nazi-occupied France. There were thousands of Allied casualties on D-Day, but it paved the way for the liberation of Western Europe from Nazi Germany. Nehring landed at Normandy on a Landing Ship, Tank (LST), a boat built to land tanks, cargo, vehicles and troops right on the beach. He eventually made his way through France, spending some time in a hospital outside of Paris after an injury. He also went through Belgium and finally, Germany. Thinking back to this serious time in his life—and for the world in general—he recalls one moment that makes him laugh a little bit.
Raymond Nehring, a Medicare Advantage member, was drafted into the United States Army in November 1942.
himself saying good-bye to his new wife, home and everything he knew.
He had been married for around one year—about the same amount of time the U.S. had been at war in Europe and the Pacific. It was the day before Thanksgiving, and, like so many other Americans, the then-22-year-old found
His father had served during World War I, but that was before the younger Nehring was born. Now, the world was at war once again, and Raymond was set to report for duty.
“I remember all the land was little borders, like ridges and trees and such,” he says, describing France. “We were in one area there early in the morning before daylight, and we heard a donkey bray. He (a fellow soldier) got under the tank pretty quickly.”
Nehring came home through Southern France and was eventually reunited with his wife.
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“I looked around trying to find my wife, and I couldn’t find her. She finally walked right up. I didn’t think I would even see her. I hadn’t seen her in quite a long time. It was quite emotional.” After the war, Nehring used his military compensation to help him become a pilot and buy a plane. He had three sons and a daughter and spent his time playing with them and flying planes. Two of his sons eventually served during the Vietnam War. The now-98-year-old recently visited the capital of the nation he fought hard to protect all those years ago. In April, Nehring participated in an Honor Flight, a free one-day trip to Washington, D.C., through a nonprofit organization that seeks to honor veterans by helping them see the memorials that were built in their honor, along with other national sites. Nehring was the oldest person on the flight and one of the only WWII veterans, surrounded by veterans of Korea and Vietnam. He raves about how well-organized the event was and how easy the organization made it for the veterans to travel, but he says the part of the visit that stood out most was the Changing of the Guard at the Tomb of the Unknown Soldier in Arlington National Cemetery. “That is really something to see, the way it’s done,” he says. “It’s beautiful.” And the same can be said when veterans get to experience something in person they never thought they would.
Thank you to all our members who served our country. We are forever grateful. To learn more about the Honor Flight Network, go to HonorFlight.org.
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8 Understanding Your Reading Top number = Systolic pressure, or the pressure your heart puts out to pump blood into your bloodstream Bottom number = Diastolic pressure, or the time when your heart is filling and getting ready for its next big pump (relaxation phase) mm Hg = A millimeter of mercury, or a manometric unit of pressure Gaining Control Although some risk factors, like family history and age, are out of your control, taking these healthy steps can help lower your blood pressure. • Take your meds as prescribed. Many people with high blood pressure take one or more medications to help control it. Make sure you understand how and when to take your meds and any side effects to watch out for.
Getting Your Blood Pressure under Control If you have high blood pressure, you’re not alone. About one-third of adults in the U.S. have high blood pressure, also called hypertension. Keeping your blood pressure in check is one of the most important things you can do for your health. Uncontrolled high blood pressure can lead to: • Heart attack—arteries can become blocked and prevent blood from flowing to the tissue in your heart • Heart failure—your heart enlarges and doesn’t supply blood to the body • Kidney disease or failure—arteries around your kidneys become damaged, making it hard to filter blood • Vision loss—your eyes’ blood vessels may be strained or damaged • Stroke—blood vessels in your brain may burst or clog more easily
• Peripheral artery disease—your arteries may narrow in the legs, arms, stomach and head, leading to pain or fatigue • Sexual dysfunction—erectile dysfunction for men or low libido in women Knowing Your Numbers The first step in lowering your blood pressure is to know where you’re at now. Set up a visit with your doctor, and in the meantime check your blood pressure at home and record your results to share with him or her. Talk with your doctor about your blood pressure goal and whether you should call if your at-home readings reach a certain level.
• Get moving. The American Heart Association recommends about 40 minutes of physical activity three or four times a week for people who need to lower their blood pressure. If you can’t do that much now, start small and work your way up. • Eat a balanced diet. Incorporate more fruit, vegetables and low-fat dairy into your diet and eat less saturated fat and total fats. Keep your salt intake to less than 1,500 mg a day.
Normal: Less than 120/80 mm Hg Elevated: Top number (systolic) of 120–129 and bottom number (diastolic) less than 80 mm Hg Stage 1: Systolic of 130–139 or diastolic of 80–89 mm Hg Stage 2: Systolic of 140 or higher or diastolic of 90 mm Hg or higher Uncontrolled high blood pressure: Systolic of 180 or greater and/or diastolic of 120 or greater; see your doctor within 24 hours. If you have severe headache, chest pain, shortness of breath or any vision or movement loss, go to the emergency room.
• Maintain a healthy weight. Losing even 10 pounds can lower your blood pressure. Talk to your doctor about what your weight goal should be and how to get there. • Limit alcohol. This means no more than one drink per day for women and no more than two drinks per day for men. • Don’t use tobacco. If you need help quitting, call the Member Services number on the back of your ID card and ask about our Quit For Life® program. For more info and helpful resources, go to HealthAlliance.org/Disease-Management-Resources and the American Heart Association’s site at Heart.org.
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Stop In to See Us Sometime
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We love meeting with our members in person. If you have questions about your coverage, feel free to stop by your local Health Alliance Northwest office for a face-to-face visit. Our friendly Member Services reps can help you with the following.
316 Fifth St. Wenatchee, WA 98801 1-877-750-3350 (TTY 711)
1701 Creekside Loop #100, Building 11 Yakima, WA 98902 1-877-795-6117 (TTY 711)
Walk-in hours: Weekdays 8 a.m.–5 p.m.
Walk-in hours: Weekdays 9 a.m.– noon and 1–4 p.m.
When you come in, our friendly Member Services reps can help you with the following. • General membership questions • Coverage concerns • Questions about doctors, specialists and facilities • ID cards • Address changes • Questions about our perks • Grievance process • Authorization of care • Premium payment
Our phone numbers have not changed. If you’re a member, you can continue to call us at the number on the back of your ID card, daily 8 a.m. to 8 p.m. local time. Voicemail is used on holidays and weekends from April 1 to September 30. Call us daily 8 a.m. to 8 p.m. local time Voicemail used on holidays and weekends, April 1–September 30 HealthAllianceMedicare.org
DISCRIMINATION IS AGAINST THE LAW Health Alliance complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Health Alliance does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. Health Alliance: • Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information in other formats (large print audio, accessible electronic formats, other formats) • Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages If you need these services, contact customer service. If you believe that Health Alliance has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Health Alliance Medicare, Member Services, 3310 Fields South Drive, Champaign, IL 61822 or 316 Fifth Street, Wenatchee, WA 98801, telephone for members in Illinois, Indiana, Iowa and Ohio: 1-800-965-4022; telephone for members in Washington: 1-877-750-3350 TTY: 711, fax: 217-902-9705, MemberServices@healthalliance.org. You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, Member Services is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, TTY: 1-800-537-7697. Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. ATENCIÓN: Si habla Español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted. IA, IL, IN, OH: Llame 1-800-965-4022, WA Llame: 1-877-750-3350 (TTY: 711). 注意：如果你講中文，語言協助服務，免費的，都可以給你。IA, IL, IN, OH: 呼叫 1-800-965-4022, WA: 呼叫 1-877-750-3350(TTY: 711)。 UWAGA: Jeśli mówić Polskie, usługi pomocy języka, bezpłatnie, są dostępne dla Ciebie. IA, IL, IN, OH: Zadzwoń 1-800-965-4022, WA: Zadzwoń 1-877-750-3350 (TTY: 711). Chú ý: Nếu bạn nói Tiếng Việt, các dịch vụ hỗ trợ ngôn ngữ, miễn phí, có sẵn cho bạn. IA, IL, IN, OH: Gọi 1-800-965-4022, WA: Gọi 1-877-750-3350 (TTY: 711). 주의 : 당신이한국어, 무료 언어 지원 서비스를 말하는 경우 사용할 수 있습니다. 1-800-965-4022 IA, IL, IN, OH: 전화 WA: 1-877-750-3350 전화 (TTY: 711). ВНИМАНИЕ: Если вы говорите русский, вставки услуги языковой помощи, бесплатно, доступны для вас. IA, IL, IN, OH: Вызов 1-800-965-4022, WA: Вызов 1-877-750-3350 (TTY: 711). Pansin: Kung magsalita ka Tagalog, mga serbisyo ng tulong sa wika, nang walang bayad, ay magagamit sa iyo. IA, IL, IN, OH: Tumawag 1-800-965-4022, WA: Tumawag 1-877-750-3350 (TTY: 711). : ﻭﻻﻳﺔ ﻭﺍﺷﻨﻄﻦ،1-800-965-4022 ﺍﺗﺼﻞ ﺑﺎﻟﺮﻗﻢ: ﺃﻭﻫﺎﻳﻮ، ﺇﻧﺪﻳﺎﻧﺎ، ﺇﻳﻠﻴﻨﻮﻱ.ً ﻓﺈﻥ ﺧﺪﻣﺎﺕ ﺍﻟﻤﺴﺎﻋﺪﺓ ﺍﻟﻠﻐﻮﻳﺔ ﻣﺘﻮﻓﺮﺓ ﻟﻚ ﻣﺠﺎﻧﺎ، ﺇﺫﺍ ﻛﻨﺖ ﺗﺘﻜﻠﻢ ﺍﻟﻌﺮﺑﻴﺔ:ﺍﻧﺘﺒﺎﻩ (711 )ﺇﺫﺍ ﻛﻨﺖ ﺗﻌﺎﻧﻲ ﻣﻦ ﺍﻟﺼﻤﻢ ﺃﻭ ﺻﻌﻮﺑﺔ ﻓﻲ ﺍﻟﺴﻤﻊ ﻓﺎﺗﺼﻞ ﻋﻠﻰ ﺍﻟﺮﻗﻢ1-877-750-3350 :ﺍﺗﺼﻞ ﺑﺎﻟﺮﻗﻢ Aufmerksamkeit: Wenn Sie Deutsch sprechen, Sprachassistenzdienste sind kostenlos, zur Verfügung. IA, IL, IN, OH: Anruf 1-800-965-4022, WA: Anruf 1-877-750-3350 (TTY: 711). ATTENTION: Si vous parlez français, les services d'assistance linguistique, gratuitement, sont à votre disposition. IA, IL, IN, OH: Appelez 1-800-965-4022, WA: Appelez 1-877-750-3350 (TTY: 711). ધ્યા: તમે વયત તો �ુજરયતી, ભયષય સહય્ સેવયઓ, મફત, તમયરય મયટ� ઉપલબ્ છે . IA, IL, IN, OH: કૉલ 1-800-965-4022, WA: કૉલ 1-877-750-3350 (TTY: 711). 注意：あなたは、日本語 、無料で言語支援サービスを、話す場合は、あなたに利用可能です。 1-800-965-4022 IA, IL, IN, OH: コール 1-877-750-3350 WA: コール（TTY: 711)。 LET OP: Als je spreekt pennsylvania nederlandse, taalkundige bijstand diensten, gratis voor u beschikbaar zijn. IA, IL, IN, OH: Bel 1-800-965-4022, WA: Bel 1-877-750-3350 (TTY: 711). УВАГА: Якщо ви говорите український, вставки послуги мовної допомоги, безкоштовно, доступні для вас. IA, IL, IN, OH: Виклик 1-800-965-4022, WA: Виклик 1-877-750-3350 (TTY: 711). ATTENZIONE: Se si parla italiano, servizi di assistenza linguistica, a titolo gratuito, sono a vostra disposizione. IA, IL, IN, OH: Chiamare 1-800-965-4022, WA: Chiamare 1-877-750-3350 (TTY: 711). cmp-nondiscrim15MED-0318
PRSRT STD U.S. POSTAGE PAID CHAMPAIGN, IL PERMIT NO. 488
1701 Creekside Loop #100, Building 11 Yakima, WA 98902
Calendar of Events 15th Annual Ice Fishing Festival January 19, 7 a.m. – 3 p.m. Molson Grange Hall 520 Molson Rd. Oroville, WA KPQ Home Expo Friday, March 8, noon – 7 p.m. Saturday March 9, 9 a.m. – 7 p.m. Sunday March 10, 11 a.m. – 4 p.m. Town Toyota Center 1300 Walla Walla Ave Wenatchee, WA
Central Washington Home and Garden Show Friday, March 8, noon – 6 p.m. Saturday, March 9, 10 a.m. – 6 p.m. Sunday, March 10, 10 a.m. – 4 p.m. Yakima Sundome 1301 S. Fair Avenue Yakima, WA
Health Alliance Northwest is a Medicare Advantage Organization with a Medicare contract. Enrollment in Health Alliance Northwest depends on contract renewal. You must continue to pay your Medicare Part B premium. med-NWWinterHC-1018 • H3471_18_72669_C • Approved