HouseCalls Health or wellness or prevention information
Volume 15 Issue 2
DIABETES and
PREVENTIVE CARE
Issue
med-hcheartdiabetes-0612 Y0034_12_4874 Accepted
1-800-965-4022 TTY/TDD 711 or 1-800-526-0844 (Illinois Relay) HealthAllianceMedicare.org 1-800-526-0844 (Illinois Relay) 8 a.m to 8 p.m. weekdays
What We’re Talking About
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Preventive Care,
Plus Heart Health and
Diabetes
Better ratings equal higher quality.
From the Editor
Our star ratings speak for themselves.
If you have additional questions, please visit our new location: 206 W. Anthony Dr. in Champaign. You’ll find us next to Alexander’s Steakhouse on the access road near Neil St. and I-74.
HMO PPO
F
all is a great time to focus on heart health and diabetes. Taking control now can help lessen the health risks of the upcoming heavy-eating season. To guide your wellness activities this fall, this issue of House Calls focuses on heart and diabetes health, as well as preventive care. You’ll find tips, advice and important information on gaining or maintaining control of these areas of your health. Fall also brings Medicare’s Annual Election Period (AEP). You should have received your Annual Notice of Change packet not long ago. The back page of this issue of House Calls spotlights some changes for 2013. I encourage you to take some time this fall to make sure you understand your Health Alliance Medicare coverage.
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We’re glad you’re a Health Alliance Medicare member. And we’re glad we can share information and good stories in House Calls. You might want to hold onto it and reread when colder days set in.
Taking control now can help lessen the health risks of the upcoming heavy-eating season.
Give Yourself
a Dose of
Laughter
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ccording to the American Heart Association (heart.org), doctors are prescribing an unexpected treatment to help prevent heart disease: laughter. Laughter feels good, and it’s good for you. In fact, a good chuckle not only helps your mind by fending off stress and depression, it’s good for your body, as well. When you laugh, you increase your blood flow and oxygen intake, decrease your blood pressure, speed up your pulse rate and stimulate your muscles. Laughter also releases infection-fighting antibodies (boosting your immune system) and endorphins, which make you feel good and provide natural pain relief.
Prescribe some laughter for yourself with these tips.
Sprinkle humor into your daily routine. Watch a silly movie or flip to your favorite sitcom. Infuse humor into your reading list by turning to the newspaper comics or browsing the comedy section at your local bookstore or library. Share laughs. Because you are more likely to laugh out loud with others, join in on social activities. Host a board game night, plan a trip to a funny play or go bowling. When spending time together, reminisce about funny memories and tell humorous stories. Sharing laughs will also make your relationships stronger. Seek positivity. Stress decreases laughter, so try to get negativity out of your life. Focus on things that make you happy by creating a list. Add to it whenever you find something new you enjoy. You can turn to your list when stress bogs you down.
When you laugh, you increase your blood flow and oxygen intake, decrease your blood pressure, speed up your pulse rate and stimulate your muscles.
Give yourself a natural dose of laughter. Your heart will thank you for it.
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Take Charge of Your Health
T
he 2012 Preventive Care Guidelines are available at HealthAlliance.org. The guidelines, in the Health and Wellness section of our site, highlight which adult screenings need to be done and when, and feature immunization schedules for both children and adults. For now, take note of these areas you can act on this fall.
Get Checked The whole idea of a colonoscopy, let’s face it, can be more than a little awkward. Or not. These days colonoscopies to check for colorectal cancer are commonplace. Most people agree the benefits outweigh any negatives of this screening. According to the Centers for Disease Control and Prevention (CDC), colorectal cancer is the second leading cause of cancer-related deaths. No one wants to be a part of those statistics. Regular colonoscopies can help prevent or catch the cancer in its early stages, possibly leading to more successful treatment.
Break the Silence Urinary Incontinence (UI), or involuntary loss of urine, can take many forms, like frequent bathroom visits, embarrassing leaks or intense feelings of urgency. And, unfortunately, it is a problem often swept under the rug and faced by many with diabetes, especially women. Yet there is no need to suffer in silence. There are many medications and other treatment options available. Talk to your doctor. Together, you can discover the treatment options available to you.
Prevent Falls Falls are the leading cause of injuries for older adults, according to the CDC. Visit vnsny.org and watch a helpful video, which outlines fall prevention tips, like eliminating clutter and clearing paths in your home. Simply hover over the “Home Health Care & You” tab and click “How To Videos” under Education.
Weighing In
I
t’s no surprise, Americans are getting heavier. Americans are weighing in at a whopping 178 pounds, on average, while globally the average is a mere 136 pounds.
Disease Control and Prevention (CDC), your BMI helps determine if your weight should be of concern. It helps your doctor decide if you need further assessment.
America has a (bulging) problem. The great news is each of us can help control it.
You can access an easy-to-use BMI calculator at HealthAlliance.org, on the Health and Wellness tab in the righthand column. If your doctor hasn’t talked to you about your BMI, ask about it at your next visit (even if you think your weight is normal).
Start by knowing your Body Mass Index (BMI). A BMI chart calculates this number from your height and weight. According to the Centers for
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Stop Diabetes Before It Starts Know the Signs of Pre-Diabetes
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ccording the American Diabetes Association (ADA), more than 57 million people in the United States are pre-diabetic. Pre-diabetes means your blood glucose (sugar) levels are higher than normal but are not high enough to be called diabetes. The development of type 2 diabetes becomes very probable, within 10 years, when this condition goes untreated. You could be at risk if you: • are 45 or older. • have a parent, brother or sister with diabetes. • are overweight with a Body Mass Index (BMI) over 25. • don’t get much exercise. • have been diagnosed with high blood pressure. • have low HDL cholesterol and/or high triglycerides.
Online health assessment tools can also help you understand your risks, illnesses, treatment options and medications. WorldDoc is a great place to start, and it’s free for Health Alliance members. WorldDoc offers a free personal health review, along with tools to make challenging health conditions easier to understand and manage. It’s never too early to take action. Find a link to WorldDoc on the Health and Wellness tab at HealthAlliance.org. If you’ve already been diagnosed with diabetes, WorldDoc has an additional assessment specifically for diabetics that will help you determine how well you’re managing your diabetes.
Test Your Progress While it does not replace daily self-testing, glycohemoglobin A1c blood tests, which measure your average blood glucose levels over the past two to three months, help determine if your diabetes plan is working. The American Diabetes Association recommends you receive an A1c blood test at least twice a year. Keeping an eye on your cholesterol levels is also important, so speak to your doctor about lipid panel tests. Both tests are essential for keeping your diabetes plan on track.
Know Your Goals Fasting Blood Sugar
Triglycerides
Blood Pressure
Goal (Normal) Borderline (Pre-diabetic) High (Diabetic)
Goal Borderline High
120/80 or below Goal Borderline 121-139/81-89 140/90 or above High
Below 100 mg/dL 100-125 mg/dL 126 mg/dL or above
Below 150 mg/dL 151-199 mg/dL 200 mg/dL or above
Cholesteral Total
LDL (“bad”)
If you have heart disease or
Goal Borderline High
Below 100 mg/dL 100-159 mg/dL 160 mg/dL or higher
diabetes, your goal levels
Below 200 mg/dL 200-239 mg/dL 240 mg/dL or higher
may be different. Talk to your doctor about what goals are right for you.
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Table Tennis Exercises Mind and Body
Named by Dr. Daniel G. Amen as the World’s Best Brain Sport, Table Tennis has a lot to offer. Mental Health Benefits
During play, you use different parts of your brain to follow the ball, figure out where it will go, plan your counterstrike and carry out the strike. From increasing your speed at performing daily thinking tasks to lowering your risk of developing Alzheimer’s disease, table tennis will give your brain the workout it craves.
Physical Benefits
As we age, getting regular exercise can be difficult due to joint issues and other health factors. With its short, quick movements, which do not strain muscles and joints, table tennis is ideal. It works both the upper and lower body muscle groups to improve balance, lowering a player’s risk of fall and injury.
Prepare Your Body and Stay Hydrated
Although the risk for injury is low, you should still stretch before playing table tennis. Stretching is important to every
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exercise routine. Do this slowly to further decrease your risk of injury. Also remember, when exercising for 30 minutes or more, take a water break every 15 minutes to avoid dehydration.
Getting Started
When beginning any type of exercise program, involve your doctor. Together, develop a plan that is right for you. Next, take it slow. Set a pace you can follow to keep you on track.
Join a Table Tennis Club
For those in the Champaign-Urbana area, the Champaign County Table Tennis Club (CCTTC) welcomes members of all ages and skill levels. You can sign up for monthly or yearly memberships or join a league. CCTTC also welcomes walk-ins and has classes for $5. Visit champaigntabletennis.com for more information.
Stay On
Your Feet S ometimes we do not give our feet enough credit or attention, but if they are not healthy, we can’t move around as we wish. If you have diabetes, foot problems can be common.
High blood glucose levels damage the nerves and blood vessels, decrease the amount of blood and oxygen your feet receive and make it difficult for you to notice foot injuries. Because diabetes also harms your immune system, you are more likely to develop sores and ulcers. If you and your doctor don’t treat these serious conditions, you could even lose your foot or feet. You can prevent foot problems from diabetes. Watch your diabetes by controlling your blood sugar and making healthy choices, like eating right and not smoking. Exercising also helps to improve blood flow, so talk with your doctor about low-intensity exercises.
Having your doctor check your feet at any diabetes checkup is another way to stay on top of your foot health. However, it is also important to schedule annual foot exams. Take this time to discuss ways to care for your feet, like wearing comfortable shoes that provide support and fit well. Also, with your doctor’s advice, come up with a daily foot-care routine. Routines will help you learn how to best care for your feet to prevent problems. The National Institute of Diabetes and Digestive and Kidney Diseases recommends routines include washing, checking for irregularities and applying moisturizer to dry and cracked skin. All of this will help prevent problems, so you can remain on your feet and active.
Read Your Body’s Signs
As with your feet, other parts of your body, like your eyes, are affected by diabetes. Eye problems, like cataracts and glaucoma, can result from high glucose levels. The National Eye Instititute states between 40 and 45 percent of Americans with diabetes have some stage of diabetic retinopathy, the leading cause of blindness in adults. The good news is annual dilated eye exams and glaucoma screenings can help diagnose these eye problems early, when treatment is most successful. Protect your vision. Speak with your optometrist about proper eye care.
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Satisfy Your
Heart’s Cravings
E
ating healthy is one of the best ways to prevent heart disease. Sometimes the foods our stomachs crave aren’t in line with the foods that are good for our hearts. Luckily, you can switch up your eating habits without disappointing your taste buds. Just follow these heart-healthy eating tips from the American Heart Association. Eat fruits and vegetables. Low in calories, high in dietary fiber and packed with vitamins and minerals, fruits and vegetables help lower blood pressure, boost your immune system and control your weight. Eat about 4.5 cups a day. Be careful when buying canned or frozen fruits and vegetables, as many have added sugar or salt. Limit salt. Too much salt can raise your blood pressure. Avoid processed and instant foods, which are often loaded with salt as a preservative. Add flavor to your dishes by swapping in other herbs and spices, like garlic, thyme and oregano. Avoid unhealthy fats and cholesterol. Lower your cholesterol by limiting foods high in saturated and trans fats, like margarine. Many of these foods are dairy products, so choose low-fat options when possible. When eating meat, cut off the fat, and remove the skin from chicken. Add a little fiber and grain. Raise your fiber intake with whole-grain alternatives in foods like bread and pasta. Eating nuts, beans and seeds will bring you more fiber and protein.
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Treat yourself, in moderation. While too much of either could be harmful for your health, small amounts of red wine and dark chocolate can help prevent heart disease. Both contain antioxidants, which help your body in many ways. Talk with your doctor to see if these occassional treats could help you.
Contact Us with Your Compliance Concerns Health Alliance Medicare maintains a reputation for excellence by establishing the highest ethical principles and professional standards and by ensuring compliance with state and federal laws. We apply these to our relationships with members, providers, employer groups, vendors, consultants, regulatory agencies and employees. Health Alliance Medicare established a telephone hotline and an email address for members to report suspected misconduct, violations and compliance issues (including privacy or security of your member information). Call the Compliance Line at 217-383-8304. Or send an email to complianceline@healthalliance.org. Reporting can be anonymous. Health Alliance Medicare does not permit retaliation against anyone who in good faith reports suspected wrongdoing.
Vaccines Question
My doctor has been encouraging me to get certain immunizations, but I thought only children needed to be vaccinated. Do I really need them?
Q&A
Avoid Flu and Pneumonia this Fall
Answer
As we age, our immune system is less able to fight off illness, making it more important to protect ourselves through immunizations. Review the 2012 Preventive Care Guidelines at HealthAlliance.org for a list of recommended vaccines.
Older adults are prone to influenza (respiratory flu) and pneumonia. In fact, the CDC ranks the illnesses as the fifth leading causes of death in the United States for older adults. Receiving vaccinations for the flu and pneumonia will greatly reduce your chances of ending up in the hospital.
Protect Grandchildren with a Whooping Cough Vaccine Vaccines not only help protect you, but your loved ones, as well. Many older people have not received the vaccine for pertussis, or whopping cough, which can be passed along to infants who are too young to receive the vaccine. If an infant contracts whooping cough, treatment is rarely successful. If you have grandchildren, speak with your doctor about this vaccine at your next visit.
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Nurse Practitioner Home-Visit Program
Knowledge
Equals Power
W
hen Linda Reffett had pneumonia for the first time, she said, “It seemed like it came on all at once. I could not get warm. I was just freezing.” Then she woke up in the middle of the night, sweating and running a high fever. She went to the doctor the next day and ended up in the hospital. Before that, Linda had only gotten flu shots. She had no idea there was a pneumonia vaccine, which could have prevented her troubles. In fact, the Centers for Disease Control and Prevention (CDC) say only 59 percent of older adults in the United States have received a pneumonia vaccination. When Nancy Keith, a nurse practitioner for the Health Alliance Medicare home-visit program, visited Linda, she told her to watch for coughing, fever and trouble breathing. Because of Nancy’s advice, Linda knew to contact her doctor when those symptoms began to surface, catching the illness before it got worse. A few weeks later, when Nancy visited Linda’s husband of 35 years, Kenneth, Linda thanked Nancy for her helpful advice. Nancy and Patti Reichard, also a nurse for the Health Alliance Medicare home-visit program, enjoy giving members the health information they need.
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While these visits do not replace seeing your doctor, they do allow a private, casual atmosphere for your questions to be answered. Linda especially enjoys the privacy of these visits, saying, “It makes you feel comfortable.” Linda still keeps her notes from Nancy’s visit as a reminder to check for symptoms. Following Nancy’s advice, “I always check my temperature,” Linda said. “I’m trying to not go through that again.”
The Centers for Disease Control and Prevention say only 59 percent of older adults in the United States have received a pneumonia vaccination.
The Good Old Days
Seem Hazy Looking Back
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Patrick Harness is the Community Representative for Health Alliance Medical Plans, located at Lincoln Square Village in Urbana.
t seems a lot of us boomers wax nostalgic over what things used to cost. I remember when gas cost 45 cents a gallon, you could buy a luxury car for $3,200 and cigarettes cost about 60 cents a pack. Can you believe it? As someone who used to smoke, the nostalgia gets a little hazier. I worked at a hospital, and—believe it or not—even the nursing stations included ashtrays. Smoking was common on airplanes, except during takeoff and landing. I guess that’s when we were the most at risk for a cigarette-inspired explosion. Cigarette butts littered the floors of stores, elevators and movie theaters. Your doctor and dentist provided gigantic glass ashtrays in their waiting rooms for your smoking convenience. Clouds of smoke rose in diners and bathrooms—just about everywhere. I am sure some of you reading this are slack jawed at our collective ignorance. It’s hard to believe that in 1986 about 30 percent of Americans smoked. Now, it’s closer to 20 percent.
Especially helpful to me was a personal health coach, who contacted me by phone for regular check-ins and support. It was nice to have a trained counselor to discuss my options and use as a sounding board when the going got tough. My counselor had a lot of experience with the quitting process and was more than willing to listen and encourage. Maybe you are motivated enough to quit smoking now. What’s the first step? Call your primary care physician and make an appointment. Discuss your options and make a plan to become a non-smoker, one step at time. Health Alliance Medicare Advantage members should ask about I Can Quit. Offered in partnership with Ceridian, I Can Quit can help you become smoke-free for life. The program includes telephone support from a trained health coach and over-the-counter nicotine replacement therapy (NRT), bupropion or Chantix.
Most people who smoke would like to quit or have at least thought about it. Loved ones and friends encourage quitting. Some nag. (A little advice: Don’t do that. It never works, only adds to the stress.) The media bombards us with the grim statistics associated with tobacco use and its rapidly escalating cost.
Forty-five million Americans have succeeded, and you can be one of them. You’re bigger than the habit, and there’s no better time to kick it.
So, what’s a smoker to do?
I really don’t look back on my time as a smoker with nostalgia. I am glad it’s behind me. Sometimes I still pick up a nice ashtray when I see one at a garage sale, but I don’t buy it now. Force of habit, I guess.
Health Alliance Medicare members can take advantage of our I Can Quit program and increase their odds of quitting. A number of approaches exist to help people transition from smoker to non-smoker, including nicotine replacement therapy, such as gum or patches, as well as drugs.
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Find more information on I Can Quit at HealthAlliance.org under Health & Wellness.
Simon Says
An Insider’s Perspective on Pharmaceuticals
With more than 30 years of experience, Health Alliance clinical pharmacist Simon Leung provides insight into understanding your pharmacy benefits.
Take Control of
Your Medication
T
he best way to ensure your medications do their job is by following their directions and taking them as prescribed. Sometimes we forget when or how much of a medication to take, misunderstand instructions or miss refills. But taking medications incorrectly can lead to serious complications, so follow these tips to help manage your medication. Make a list. Write a list of all your medications, including over-the-counter drugs, with their dosage instructions. Bring it to every doctor visit to make sure you are taking them correctly. Or bring in all your pill bottles. Keep them in sight. Simply keeping your medication in an easy-to-see location will give you visual reminders to take your pills. Place them in an open, safe spot you pass by often.
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Stay informed. Take time to study each medication, what it does and how you are supposed to take it. If you feel a medication is making you sick, alert your doctor and find a solution together. Don’t stop taking the medication on your own. Be organized. Use a medication organizer or dispenser if you take multiple medications. You can get these at most pharmacies and ask a pharmacist for directions on how to use them. Use reminders. Set alarms, leave yourself notes or mark a calendar to remind yourself to take your medications on time. Also, make reminders for when you’ll need to call for a refill. Health Alliance Medicare also offers the DailyMed program, which provides delivery of pre-sorted and labeled dosage packets to help you take your medication correctly and safely. Call DailyMed at 1-866-720-9855 or visit DailyMedRx.com to learn more.
Active Angler
Follows Doctor’s Advice About
Generic Drugs
Y
ou won’t find Carl Lane on the couch. This get-up-and-go Health Alliance Medicare member prefers fishing, spending time with his grandchildren and great-grandchildren, gardening at his home and his church, and keeping others people’s lawn mowers in tip-top condition.
“Our members find over and over that they don’t feel any different when they switch to generic drugs,” said Jennifer Jagodzinski, Health Alliance pharmacy director. “Medicare members on generic drugs work with their doctors to make sure they continue to get the results they need.”
His keep-moving spirit thrives even though Carl copes with serious health problems. He has had five heart attacks and two strokes, and recovered from open-heart and back surgery. It hasn’t been easy. He credits his wife, Margaret, with being there for him—for more than 54 years.
Taking the affordable generic drugs Carl needs allows him to keep enjoying one of his favorite pastimes. Living in Lodge, near Monticello, allows Carl to enjoy river fishing, something he’s done his whole life. He doesn’t keep a single catch, though.
“She’s been my angel and my nurse throughout the years,” he said.
“Not even if he’s a big one,” he said, adding, “Fishing is about relaxing, forgetting all your troubles.”
Together, they’ve made keeping track of Carl’s drugs part of their routine. Carl takes generic medications, both to save money and get the results he and his doctor want.
When it comes to his health, Carl knows to follow the advice his doctor gives him. Like drinking coffee, “I haven’t had a cup of coffee since 1990,” said the retired car mechanic. “You just have to keep your eyes open and be aware of your illness.”
“If he tells me we can switch to generics, I say, ‘That’s fine with me,’” Carl said.
What advice does Carl have for others dealing with health problems?
Carl takes multiple cost-saving generic drugs, including carvedilol instead of the brand-name Coreg®, lisinopril instead of Prinivil® or Zestril®, and furosemide instead of a handful of more costly brand-name options.
“Listen to your doctor real well. Don’t just go on the couch and sit there. That’s the worst thing you can do,” he said.
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New Generic Alternatives
Available
Additional generic drugs came to the marketplace this year. This creates some changes to the Health Alliance Medicare formulary for 2013. The table below shows some of those changes, as well as lower-cost alternatives. Consider asking your physician if a lower-cost drug is right for you. Brand-Name Drug
2012 Formulary Status
2013 Formulary Status
Crestor®
Tier 3
Tier 4
Nexium®
Tier 3
Tier 4
Cyclobenzaprine®** Tier 1 Methocarbamol®** Drug 2012 Formulary Status Januvia® Tier 3
Tier 2 2013 Formulary Status Tier 4
Preferred Generic (Tier 1) Alternatives: FREE at Walmart and Sam’s Club, low copayment at other in-network pharmacies. atorvastatin (generic equivalent of Lipitor) lovastatin (generic equivalent of Mevacor) pravastatin (generic equivalent of Pravachol) simvastatin (generic equivalent of Zocor) omeprazole (generic equivalent of Prilosec) pantoprazole (generic equivalent of Protonix) lansoprazole (generic equivalent of Prevacid) baclofen (generic equivalent of Lioresal) tizanidine tablets (generic equivalent of Zanaflex) Preferred Brand (Tier 3) Alternative
Tradjenta®
**Cyclobenzaprine and Methocarbamol are listed by Medicare as medications to be avoided or used with caution in the elderly.
Talk to Your Doctor About Generics
For more information about generic drugs, talk with your doctor or visit AskForGenerics.org. For more about getting FREE Tier 1 generic drugs at Walmart and Sam’s Club, call Health Alliance Medicare or visit HealthAllianceMedicare.org.
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HEALTH ALLIANCE 301 S VINE ST. URBANA IL 61801-3347
2013 Benefit Information—Keep it Handy You should have received your 2013 Annual Notice of Change and Evidence of Coverage mailing recently. This mailing contains details about changes to your plan. Please review the packet carefully and keep it handy.
You can also call Health Alliance Medicare Services at 1-800-965-4022, Monday through Friday, 8 a.m. to 8 p.m. TTY/TDD users should call 711 or 1-800-526-0844 (Illinois Relay).
New HMO Plan Features FREE Medical Coverage! Our HMO Basic (HMO-POS) plan requires no monthly premium for medical coverage. To add drug coverage, the premium is $34 per month. This is an HMO plan with the option to use out-of-network doctors and
Fraud Alerts
hospitals. Members must use a Primary Care Physician and receive referrals for specialty care, just like any other HMO plan. Call us for more information or visit HealthAllianceMedicare.org.
Members to See Premium Decrease in 2013
Be on the Lookout for ‘Government’ Scams
Although we have all heard stories about the threat of scams, many of us think we will never be on the receiving end. But tricky scams pop up every day. Sometime scammers are just a quick phone call away. You may receive a call from a “government official” alerting you to money available to you through the Supreme Court’s ruling on the Affordable Care Act. To get the money, the scammer asks you for personal information, such as Social Security or credit card numbers. Scammers use your information to steal your financial identity.
Plan
New Premium for 2013
Last Year’s Premium
PPO 10 PPO 10Rx
$100 $144
$110 $154
PPO 30 PPO 30Rx
$35 $69
$45 $89
HMO 20 HMO 20Rx
$75 $119
$100 $144
A PUBLICATION OF HEALTH ALLIANCE MEDICARE
HouseCalls
If you get a call like the one described here, hang up the phone. Stay on guard to protect yourself. Chief Executive Officer Jeffrey Ingrum Chief Medical Officer Robert Parker, MD Vice President of Corp. Communications Jane Hayes
Editorial Board James Burke, MD Patrick Harness Jennifer Marquardt Laura Mabry Reba Karr, RN
Becky Aiken Hollie Wilson Lisa Gascoigne Nancy Keith
Editor Katy Hawthorne Assistant Editor Jenna Simon Graphic Design Jason Bentley
HealthAllianceMedicare.org 1-800-965-4022 TTY/TDD 711 or 1-800-526-0844 (Illinois Relay) 8 a.m to 8 p.m. weekdays