fall winter 2016 comm health styles · 2017. 11. 29. · independenthealth.com fall 2016 winter...

INDEPENDENTHEALTHCOM

FALL 2016 WINTER 2017

Simple ways to save on your health care costs

NEW WAYS TO EAT FALLrsquoS HEALTHIEST FOODS

WHY ITrsquoS IMPORTANT TO VISIT YOUR DOCTOR ANNUALLY

Get rewarded for being healthy

with FitWorks Rewardsreg

See page 2

INSIDE this issue

The cooler fall weather is here and Independent Health is ready to keep your health on track this season See this page to learn about how you can get rewarded for being healthy And see page 4 for tips to keep your health care costs down Herersquos to your health

IN OUR COMMUNITY

5 Teaming up with the Buffalo Bills

7 Healthy Options

PLAN NEWS

9 Internal and external review is available to our members

11 Family Choice plan

TAKE CHARGE

6 Eat healthier with nutrition benefit

10 Take advantage of free preventive care services

Receive our online newsletter HealthStyles Monthly by registering for your own member account at independenthealthcom

Get rewarded for staying healthy with FitWorksreg Rewards program Earlier this year Independent Health introduced FitWorks Rewards an online wellness program that specifically addresses the health and wellness needs of members who are enrolled in a small group or individual plan FitWorks Rewards is designed to keep our members motivated and on track with their health by offering monthly rewards

At the core of this new program is our FitWorks online wellness tool which engages members in meaningful activities that can improve their health and help them build a better relationship with their doctor

How does the program work bull Small group employees (and their

spouses or domestic partners) and individual plan subscribers can create a secure online account with FitWorks Rewards at wwwihfitworks com on or after their 2016 plan effective date

bull Upon activating their FitWorks account participants have the opportunity to earn points by completing claims-verified clinical activities and screenings along with self-reported wellness challenges

bull For the self-reported challenges participants need to keep track of the challenges they complete and record their activity online (paper entry forms will also be accepted from those without computer or internet access)

bull Each challenge is worth points For every 50 points earned the participant will be entered in a monthly reward drawing

Participants can earn monthly rewards Independent Health awards the following on a monthly basis bull 50 $100 Visa reward cards for those who take charge of their

everyday health such as eating fruits and vegetables drinking more water and getting enough sleep

bull 50 $250 Visa reward cards for those who take preventive measures such as seeing their doctor for an annual checkup or getting a colonoscopy mammogram or routine blood work Participants are eligible to receive multiple reward cards throughout

the year The reward cards can be used toward health and wellness services such as a gym membership workout apparel fresh produce healthy cookbooks and more Recipients are selected at random from all eligible entries no later than the 20th of the following month (for example October recipients will be selected no later than November 20)

If you are a small group or individual plan subscriber make sure you create your FitWorks Rewards account so that you have a chance to earn a reward by working on your health and fitness goals

2 HEALTHSTYLES bull FALL 2016WINTER 2017

good to know

Providing you with support so you achieve your health goals Everyone has different reasons for being healthy No matter how simple or unique your goals may be Independent Health is right there with you helping you get and stay healthy Itrsquos why we offer a wide variety of benefits tools and services to get you where you want to be including

bull Nutrition BenefitmdashEating healthier is an important step in meeting your health goals And wersquore here to make it easier with our nutrition benefit For every $2 that you spend on fresh fruits and vegetables at TOPS Friendly Markets yoursquoll earn $1 to use on future grocery purchases which can add up to $1000 each year (See article on page 6)

bull Health ExtrasSMmdashThis benefit will help you lead a healthier lifestyle by giving you the freedom to choose from a wide range of activities Just use our $250 prepaid Health Extras MasterCardreg on health and wellness services including fitness club memberships afterschool activity programs nutritional counseling acupuncture massage therapy vitamins supplements and more

bull FitWorksregmdashThis easy-to-use online wellness tool provides extra motivation through meaningful activities to help you achieve your goals With FitWorks you can set goals take new challenges track your activities earn points and share health tips recipes and personal victories (See article on page 2)

bull MyIH Mobile AppmdashAvailable for Android and iPhone users this free app is just one of the tools we offer to make it easy for you to get the information you need to stay on track with your health goals With MyIH you can review your benefits find a participating doctor or facility track your deductible and access your ID card

bull Member Wellness DiscountsmdashSave money at a variety of organizations and businesses throughout the community Just present your Member ID card and take advantage of special offers on many different services and activities (See article on page 5)

bull Community PartnershipsmdashTo continue improving the health and well-being of the community wersquove established partnerships with a variety of local organizations Together we bring you many different healthy activities programs and events to keep you active throughout the entire year like Reddy bikeshare Fitness in the Parks and the Independent Health and Buffalo Bills Health amp Wellness Challenge (See article on page 5)

To learn more about how wersquore helping you take charge of your health visit RedShirtTreatmentcom

New language tagline requirement for all health plans

Under federal non-discrimination rules set forth by the US Department of Health and Human Services Independent Health and all health plans throughout the nation will soon be required to include information about language access for members whose primary language is not English in all critical plan documents

Health plans will need to include taglines for the top 15 languages spoken in the state in which they are located as determined by the American Community Survey a division of the Census Bureau According to the American Community Survey the top 15 languages spoken in New York State are as follows bull Spanish bull Bengali bull Chinese bull Polish bull Russian bull Arabic bull French bull French

Creole bull Urdu bull Korean bull Tagalog bull Italian bull Greek bull Yiddish bull Albanian

The plan documents that will have the new taglines include applications correspondence containing information about eligibility and participation criteria summary of benefits formulary drug lists provider directories documents that require a signature or response and a subscriberrsquos insurance contract and evidence of coverage

For more information visit wwwcmsgovCCIIOResources Regulations-and-Guidance

INDEPENDENTHEALTHCOM 3

here for you

Simple steps you can take to manage and save on your health care costs Of course everyone wants to get the most value out of their dollars and when it comes to health care costs there are definitely some easy ways you can save money You just need to know how

Independent Health recently launched a new section on our website called ldquoWays to Save on Health Carerdquo which highlights different ways people can minimize their health care expenses such as

Knowing your benefits and finding savings Familiarize yourself with the health care services covered under your plan and their costsmdashincluding free annual wellness visits and other $0 preventive services to help you live a healthy life Your plan may also include additional benefits like money toward a gym membership or fitness classes

Partnering with your doctor Your primary care physician (PCP) is your best partner in managing and coordinating your care and an important resource for managing your health care costs When you have your annual wellness visit with your PCP let him or her know if yoursquore in a deductible plan and ask about lower-cost care or service options that might be appropriate for you

Understanding how to save time and money When you canrsquot reach your PCP you may have options that allow you to seek the appropriate health care you need while also managing your out-of-pocket costs For examples here are some care options offered by Independent Health to its members

Telemedicine benefit bull Connect with a doctor anytime

anywhere using your phone or online video to discuss non-emergency symptoms or conditions (for example allergies common cold ear infections and pinkeye)

bull Either go online to wwwteladoccomih or call 1 (800) TELADOC (1 [800] 835-2362) to request a consult and provide your medical history

bull A prescription can be filled if medically necessary

bull Please refer to your plan benefits to determine whether this option is available to you

24-Hour Medical Help Line bull Whenever you have a health question

or concern you can chat with an experienced registered nurse by calling 1 (800) 501-3439 and asking for the 24-Hour Medical Help Line TTY users can call 1 (800) 855-2881

bull Learn about treatment and procedure options available to you for different health problems or issues

Urgent care bull Immediate care for non-life-threatening

injuries and illnesses (for example sprains cuts and infections)

bull Great alternative for times when you are unable to reach your PCP

bull More cost-effective alternative to the emergency room

Emergency room bull Immediate help for life-threatening

injuries and illnesses such as loss of consciousness difficulty breathing or chest pain

bull Available when you need it 24 hours a day seven days a week

Managing your prescription costs There are many options available to help you save money on prescription costs such as bull Switching to a generic drugmdashGeneric

alternatives are often equally as effective as their brand-name counterparts and less expensive

bull Changing to a 90-day scriptsmdashA 90ndash day supply could save you money on your maintenance prescriptions

bull Comparing drug costsmdashDid you know that prices for the same prescription may vary by pharmacy Use our Prescription Copay tool to estimate the cost before going to your pharmacy

bull Splitting tabletsmdashYou could save on your prescription costs by splitting a higher-dose tablet in half Some commonly prescribed drugs where this savings technique really helps include Januvia Abilify (aripiprazole) and Crestor

Talk with your PCP about these medication options and which make the most sense for you

CHECK OUT OTHER TIPS and additional details on how to save money by visiting the ldquoWays to Save on Health Carerdquo section at independenthealth comwaystosave


in the community

Teaming up with the Buffalo Bills to make our community healthier Itrsquos not too late to sign up for the fifth Independent Health and Buffalo Bills Health amp Wellness Challenge a six-week community-wide fitness and nutrition program designed to help motivate Western New Yorkers to improve their health and well-being Since the launch of the first Health amp Wellness Challenge two years ago more than 13000 individuals have participated in this fun and easy initiative

Get healthy and win prizes By integrating physical activity and good nutrition into their daily lives participants in this fallrsquos Health amp Wellness Challengemdashwhich began on October 3 and runs through November 13mdashhave a chance to win a variety of weekly prizes such as autographed Bills memorabilia and gift cards for workout apparel and sporting goods Plus one lucky participant will be chosen as the grand prize winner of a Buffalo Bills Gameday Experience for the teamrsquos December 18th contest against Cleveland at New Era Field This VIP experience will include bull A game suite for the grand prize winner and 11 guests

(inclusive of food and beverage) bull Visit to the suite by Bills alumnus Thurman Thomas

during the game bull Pregame on-field sideline passes bull Postgame press conference attendance bull A gift certificate to a local restaurant bull Bills merchandise

Earn points by adopting healthy habits Registered participants earn points by meeting three main daily goals 20 minutes of physical activity eat five servings of fruits and vegetables and drink eight glasses of water Individuals can also complete one ldquoextra pointsrdquo challenge each day to gain more chances to win As an added bonus participants who refer their friends family and co-workers receive 10 extra points for each person who registers

Sign up today Go to buffalobillscomthechallenge to register for the latest Challenge and keep track of your progress through November 13 Remember the more points you earn the more chances you have to win

Health and wellness services available to you at a discounted rate

Did you know that being an Independent Health member can save you money on different health and wellness services Wersquove partnered with a number of local businesses and organizations to provide you with special savings on community activities massage therapy healthy cooking sporting equipment and more For example

bull Reddy bikesharemdashIndependent Health has partnered with Shared Mobility Inc to launch this new program and bring 200 GPS-enabled bicycles to the streets of Buffalo The bikes are available to rent for short-term shared use and provide an easy way to get healthy and have fun while commuting to work running errands or exploring downtown And Independent Health members can save 20 percent on an annual membership by using the code ldquoREDDY20IHrdquo when creating an account To learn more visit reddybikesharecom

bull Buffalo RiverWorksmdashIndependent Health is proud to be the official Health and Wellness Partner for Buffalo

RiverWorks As part of this partnership Independent Health members can receive discounts for many of the health and wellness-related activities RiverWorks hosts such as open skate skate and shoot learn to curl paddle boarding kayaking and pickle ball Information about these activities is available at buffaloriverworkscom

bull DrsquoAvolio Olive Oils and VinegarsmdashReceive a 10 discount on all DrsquoAvolio store products including delicious extra virgin olive oils and balsamic vinegars

bull Buffalo Museum of SciencemdashSave 10 on a museum membership which you can use to check out Explore YOU a health science studio presented by Independent Health

JUST SHOW YOUR MEMBER ID CARDS at the time of purchase and enjoy the savings Some discounts can save you 30 percent or more For complete details on all our member discounts visit independenthealthcomdiscounts


eating healthy

New ways to eat 5 of fallrsquos healthiest foods

From Halloween candy to the Thanksgiving feast autumn provides its fair share of opportunities to overdo it Fortunately Mother Nature provides an antidote a bounty of fresh delicious fruits and veggies to keep your taste buds happy your body healthy and your waistline in check Hit the produce aisle and farmers market stat to pick up these seasonal options

Apples Bob for these beauties and yoursquoll come up with a heaping helping of fiber Yoursquoll feel fuller on fewer calories helping you control your weight Plus fiber fights cholesterol and lowers your heart disease risk

Try this Add sliced apples to salads or tortilla wraps dice them into a homemade turkey meatloaf stuff a whole apple with raisins cinnamon and oats and bake for a breakfast or dessert treat

Brussels sprouts The bane of many childrenrsquos dinner plates these small cabbage-shaped veggies now appear on many trendy restaurant menus Low in calories and high in vitamin C fiber and folate brussels sprouts also contain antioxidants that protect your cells Some evidence even suggests they reduce cancer risk

Try this Roast at a high heat steam with lemons mustard and walnut oil

Cauliflower A favorite of low-carb dieters this non-starchy vegetable makes a creamy delicious stand-in for a portion of buttery mashed potatoes And each spoonful serves up plenty of vitamins minerals and plant-based compounds called phytochemicals which help keep arteries clear

Try this Steam then puree with plain Greek yogurt garlic and a bit of Parmesan roast with olive oil and garlic eat raw with your favorite low-fat dressing


Grapes You can find these green and purple globes in grocery stores year-round But as they reach their peak each autumn theyrsquore flavorful and colorful not to mention less expensive These fruits and their juices may contain the very same antioxidants that give red wine its heart-healthy benefits

Try this Pack a small bag for healthy snacking on the go freeze and eat as a dessert treat roast and combine with thyme mustard and cooking wine as a sauce for lean meats

Sweet potatoes Besides filling fiber these bright tubers count as a great source of vitamin A and potassium Vitamin A promotes healthy eyes and skin and boosts your immunity Meanwhile potassium helps control your blood pressure

Try this Mash and stir in wheat germ to make sweet potato pancakes bake in the oven and top with salsa veggies and cheese dice and stir into hearty soups stews and chili

Incentivizing members to eat healthier with our Nutrition Benefit According to a recent study called Healthy Incentives Pilot individuals who were given a financial incentive to buy fruits and vegetables purchased and ate more than those who did not receive the financial incentive Since 2014 Independent Health has been rewarding its members for buying and eating more fruits and vegetables with our innovative nutrition benefit

How our nutrition benefit works bull When members enroll in the

nutrition benefit for every $2 a member spends on fresh fruits and vegetables at Tops Friendly Markets the member will receive a $1 credit for in-store grocery purchases

bull Members can earn up to $1000 on their food purchases each year on a family plan (up to $500 on a single plan)

bull Since fruit and vegetable purchases are tracked right through the Tops BonusPlusreg or BonusCard program it doesnrsquot get much easier to earn reward dollars for purchasing healthy foods

bull If your plan includes the nutrition benefit you can activate it by registering at independenthealth comnutrition

In the first two years of offering the nutrition benefit Independent Health paid out nearly $13 million to members who used this benefit to buy fresh fruits and vegetables at Tops Markets Offering easier access to healthy eating through our nutrition benefit is just one of the many tools we offer to get our members more engaged in their health and develop sustainable healthy lifestyle behaviors

Benefits vary by plan

foundation news

Healthy Options menu items and events continue to be a hit with Western New Yorkers For the past 12 years the Independent Health Foundationrsquos Healthy Options Buffalo Program has been assisting the community in making informed decisions when dining out and cooking at home The Foundation currently works with more than 175 local restaurants and area food trucks to make sure customers are offered heart-healthy food options that are lower in fat saturated fat cholesterol and sodium

Fun facts about the Healthy Options Program bull Healthy Options are once again available at concession stands

throughout New Era Field during Buffalo Bills games Among the healthier items that fans can purchase include smoked turkey wraps chicken tacos yogurt parfaits and fresh fruit cups When ordering fans can identify healthier alternatives by looking for the Healthy Options sticker on menu boards

bull For 10 straight years the Independent Health Foundation has partnered with the Taste of Buffalo to require each restaurant to serve a healthy dish The Taste remains the only festival of its kind in the nation with this requirement The following three restaurants were recognized as 2016 Healthy Options Contest winners for offering the best-tasting healthy dishes

bull First Place Sorbet with Fresh Fruit Topping Sweet Melodyrsquos

bull Second Place Pomegranate Raspberry Sorbet White Rabbit Frozen Yogurt

bull Third Place Chicken in the Grass Sandwich Mineo amp Sapio Street Eats

bull As part of this yearrsquos Taste of Buffalo the Foundation also teamed up with Major League Eating (MLE) the sanctioning body for eating competitions throughout the US to host the first-ever ldquoKale YeahmdashThe Worldrsquos Healthiest Eating Championshiprdquo Gideon ldquoThe Truthrdquo Oji from Marrow Georgia was crowned the inaugural champion as he consumed 255 bowls of kale salad in eight minutes

bull For the past two years all food trucks participating in Food Truck Tuesdays at Larkin Square have been required to serve a Healthy Options menu item

bull New in 2016 Healthy Options were added to the menus at Buffalo RiverWorks and the Erie County Fair

Visit healthyoptionsbuffalocom to view a list of all Healthy Options participating restaurants and food trucks register for Healthy Options cooking classes download healthy recipes and learn tips for making healthier choices when dining out

Ring in the new year at First Night

Welcome 2017 at the ultimate drug- and alcohol-free New Yearrsquos Eve event Independent Health Foundationrsquos First Nightreg Buffalo celebration This yearrsquos event will once again be held at the Buffalo Niagara Convention Center on December 31

First Night Buffalo will be celebrating its 28th year making it one of the longest-running First Night events held in the nation This yearrsquos lineup will feature activities for all ages including bull Rides and amusements bull Music bull Comedy bull Exotic reptiles bull An exciting grand finale

balloon drop

ldquoThe Independent Health Foundation is dedicated to engaging individuals and families in a healthy lifestyle and First Night Buffalo is the perfect place to kick off the new year in a positive wayrdquo said Carrie Meyer Executive Director Independent Health Foundation ldquoAs one of our regionrsquos mainstay events First Night Buffalo provides a fun and healthy way for families to come together and create lasting memoriesrdquo

MARK YOUR CALENDARS For more information about this yearrsquos event and to find out how you can buy tickets please visit wwwfirstnightbuffaloorg or call the Foundation at (716) 635-4959 In addition you can follow the Foundation on Facebook at wwwfacebook comIndependentHealthFoundation


good to knowtake charge

You can do your part to help prevent health care fraud What wersquore doing to

protect your privacy

Independent Health has always put a high priority on protecting our membersrsquo health and financial information This includes your medical treatment and payment for your health care

Here are just some of the administrative physical and technical safeguards that have been put in place to protect your health and financial information bull All our computer systems are

password protected bull We encrypt sensitive company

email and the data on all company laptops

bull We verify our technical security with outside security experts on a regular basis

bull We restrict access to our buildings by requiring our employees to wear photo security cards

bull Our employees are required to use secure trash disposal bins for all paper and electronic materials

bull We require vendors and contractors to sign confidentiality agreements

bull We do not sell your health or financial information for any reason Member trust is a valued principle Selling your information would violate that principle

bull If a security or privacy event does occur we take swift action to limit any potential information disclosure We also let members know if their information has been disclosed

If you have questions about how we use and protect your health and financial information read the Privacy Notice that is included in this issue of HealthStyles You can also call Independent Healthrsquos Information Risk Office at (716) 631-3001 Monday through Friday from 9 am to 5 pm

Independent Health works with government agencies and other health plans to fight health care fraud but we need your assistance

Health care fraud is committed when a dishonest provider or consumer intentionally submits or causes someone else to submit false or misleading information in order to obtain benefits they may not be entitled to Examples of health care fraud include bull Filing claims for services or medications

not received bull Forging or altering bills or receipts bull Using someone elsersquos coverage or

insurance card bull Leaving other dependents on your plan

when they are no longer eligible bull Faking a workerrsquos compensation injury to

receive disability payments

Whether you have employer-sponsored health insurance or you purchase your own insurance policy health care fraud inevitably translates into higher premiums and out-of-pocket expenses for consumers as well as reduced benefits or coverage In fact the National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses

due to health care fraud are in the tens of billions of dollars each year

Here are some simple ways you can avoid being a victim of health care fraud bull Donrsquot provide your personal information

(for example your Social Security or Independent Health member ID number) to anyone except your doctor or health plan

bull Keep a personal health care journal or calendar to record your doctor visits tests and procedures

bull Read the explanation of benefits (EOB) statements you receive from your insurance company Make sure you actually received the treatments for which your insurance was charged and question suspicious expenses

bull Beware of offers for free health care services tests or treatments These offers are often fraud schemes designed to bill you and Independent Health illegally for thousands of dollars of treatments you never received

DO YOU SUSPECT POSSIBLE FRAUD OR ABUSE Call Independent Healthrsquos confidential Fraud and Abuse Hotline at 1 (800) 665-1182 Callers have the option of remaining anonymous


for your benefit

Internal and external review is available to our members Independent Health works hard to help our members get the care they need when they need it Even so there are instances when you may not agree with our decision to deny coverage for a particular health care item or service When you disagree with our coverage decision you have the right to use our internal appeal process at no charge or in rare cases you may ask us to skip our internal review process

In most cases members achieve satisfactory results by using our internal appeal process However if you donrsquot agree with the outcome of our internal appeal process you may use New Yorkrsquos external review process for several types of cases

Under the external review process you or your designated representative (who may be your doctor) have four months to ask for an external review from the New York State Department of Financial Services (DFS) You may use this process if you receive a letter called a final adverse determination from Independent Health which indicates that the health care item or service you or your doctor requested is (1) not medically necessary (2) experimental or investigational (3) an out-of-network service (4) part of a clinical trial or (5) related to the treatment of a rare disease

The DFS will assign an external review panel to review your case The panel will review your medical information along with other data or medical literature your doctorrsquos recommendation and any accepted practice guidelines The panel may ask you or your doctor to provide more information about your appeal The panel will decide your case within 30 days If your doctor verifies that a delay would seriously threaten your health the panel will make its decision within 72 hours The external review panel will not review coverage or claim decisions issues involving choice of provider or services

that are not covered under the terms of your contract with Independent Health

There is a $25 filing fee associated with requesting an external appeal In some cases we may agree to waive the $25 filing fee Also members cannot be charged more than $75 in a single plan year The $25 fee will be refunded to you if the external review panel decides a service should be covered

In addition to your right to ask for an external review your doctor also has an independent right to ask for an external review for cases in which a denial was issued and your health care is ongoing or where health care items or services have already been provided to you If your doctor asks for an external review either your doctor or Independent Health must pay for the costs of the external review You will not be financially responsible for the cost of the external review if your doctor uses his or her independent right to ask for the external appeal

QUESTIONS For more information on Independent Healthrsquos internal review process or external review please call our Member Services Department at (716) 631-8701 or 1 (800) 501-3439

The external review appeals process highlighted above applies to fully insured managed care plans only Self-funded participants should contact their plan administrator to learn more about their external appeal rights

Itrsquos safe and easy to access your plan information online

As an Independent Health member you can keep your membership information up-to-date and have instant access to the information you want and need 24 hours a day seven days a week at independenthealthcom

By registering on our website you will be able to review all your plan benefits check the status of a claim update your personal contact information print your member ID card and more

Enrolling for your own secure account at independenthealthcom is quick and easy Simply click on the ldquoRegisterrdquo button in the Log In box which is located in the upper left-hand corner of our website and then follow the directions You will need your Independent Health member ID number as part of the registration process


your health care

Itrsquos important to visit your doctor every year Independent Health encourages you to schedule your annual wellness visit with your primary care physician (PCP) This annual visit is the ideal time to check in with your doctor about the best ways to take care of your health Plus the visit is covered in full at a $0 copayment

Here are some things you can do to make sure you are prepared when you arrive at the office bull Write down your questions in advance

This ensures that you donrsquot forget to mention something important

bull Bring your health records This is especially important if this is your first visit or if itrsquos been a while since you saw this doctor Let your doctor know about any other health care providers you see You might also want to bring information about the health of your close family members

bull Bring a list of your medications Let your doctor know what medicines you take each day Make sure to include vitamins and supplements Also bring the name and phone number of your pharmacy

bull Talk about any changes yoursquore experiencing Mention any new sensations signs or symptoms that yoursquove been having such as pain in your joints memory problems unsteady balance or difficulty seeing or hearing

bull Ask about your numbers This is a good time to have your blood pressure cholesterol levels blood sugar levels weight body mass index and heart rate checked Ask what you need to do to keep these measurements in healthy ranges

bull Ask about screenings Check with your doctor to see if there are any preventive services or tests you should have

LOOKING FOR A PCP Independent Health has a large network of participating health care providers You can search for participating PCPs who are accepting new patients by visiting the ldquoFind a Doctorrdquo page at independenthealthcom You can also obtain a copy of Independent Healthrsquos Provider Directory by calling our Member Services Department at (716) 631-8701 or 1 (800) 501-3439 Monday through Friday from 8 am to 8 pm TTY users can call 1 (800) 432-1110

Take advantage of free preventive care services

Through preventive services and screenings serious medical conditions can be detected and treated early thus increasing survival rates improving quality of life and lowering long-term costs Thatrsquos why Independent Health is pleased to offer members more than 60 free preventive care services and screenings when performed by an in-networkparticipating health care provider

$0 preventive services include mammograms cholesterol screenings colonoscopies annual physicals and immunizations These services are even excluded from deductibles so those enrolled in a deductible plan can take advantage of these services right from the start

Independent Health wants you to Know Your ZeroSM so that yoursquore aware of all the $0 preventive services offered to help keep you healthy We encourage you to talk with your doctor to make sure you are up-to-date on your preventive care A complete list of preventive services that are covered in full can be accessed on the ldquo$0 Preventive Care Servicesrdquo page of the ldquoMy Healthrdquo section at independenthealthcom

A well visit or preventive service can sometimes turn into a ldquosick visitrdquo in which you will be responsible for paying an office visit copayment or if enrolled in a deductible plan all charges until your deductible level is met There may be other services performed in conjunction with a $0 preventive care service These other services will be subject to any applicable liability as described in your contract


caregiver support

Family Choice plan is designed for residents of nursing homes and assisted living facilities At Independent Health we understand that admitting a family member to a nursing facility can often be a difficult and stressful decision After all itrsquos only natural to be concerned about the type of care and attention a loved one will receive

Thatrsquos why we are pleased to partner with Family Choice of New York to offer the Independent Health Medicare Family Choice HMO-SNP plan which is specifically designed to meet the unique needs of members who permanently reside in nursing homes and assisted living facilities

Members enrolled in Family Choice receive regular visits by specially trained nurse practitioners and physician assistants who are on call 24 hours a day seven days a week to provide care and support as needed Their responsibilities include bull Working in collaboration with the

memberrsquos physicians and the facilityrsquos staff to identify potential problems before they become serious

bull Minimizing unnecessary and disruptive emergency room visits and hospital stays whenever itrsquos safe and appropriate

In addition the Family Choice nurse practitioner keeps in close contact with the memberrsquos family updating them about their loved onersquos condition and making sure that they are involved in the care-planning process As a result Family Choice of New York has consistently received high marks

from families In fact a recent satisfaction survey of people whose loved ones use the programrsquos services indicated that 974 of respondents are satisfied with Family Choice The survey also showed bull 986 of respondents feel their loved

ones have received all the benefits and services they expected them to receive

bull 977 of respondents would recommend Family Choice to another nursing home resident

bull 967 of respondents feel their nurse practitioner provides their loved one with the quality of care they expected them to receive

bull 95 of respondents are satisfied with the communication they have with their nurse practitioner

bull 946 of respondents feel their nurse practitioner helps them and their loved one understand their loved onersquos medical condition

Family Choice is currently available in a network of more than 45 participating facilities in Erie Niagara Genesee Orleans and Wyoming counties Unlike other Medicare Advantage plans individuals are

able to enroll in Family Choice year-round To learn more about this plan visit independenthealthcommedicare or call (716) 635-4900 or 1 (800) 958-4405 (TTY users 1 [888] 357-9167) Monday through Sunday from 8 am to 8 pm

This plan is available to all Medicare eligibles who are entitled to Medicare Part A and enrolled in Part B except those with ESRD unless already enrolled with Independent Health This plan requires the use of participating providers except in the case of emergency care urgent or out-of-area renal dialysis Members must continue to pay Part B premiums if not otherwise paid for under Medicaid or by another third party Survey conducted by Independent Health in July 2016 with 1259 families surveyed and 317 families (252) responding Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO HMO-SNP HMO-POS and PPO plans Enrollment in Independent Health depends on contract renewal H3362_C5647 09042016

Help for our members with special needs

Our member handbook comes in large print and in Spanish versions For a special version of our handbook call our Member Services Department at (716) 631-8701 or 1 (800) 501-3439 (TTY [716] 631-3108) Monday through Friday from 8 am to 8 pm We help non-English speakers through Language Line Services which gives our Member Servicing representatives immediate access to interpreters of more than 150 different languages Whatever our membersrsquo needs are wersquore able to help


medications

Donrsquot forget to follow directions with your medications Taking medication as prescribed is important to properly managing your health an extra missed or wrong dosage can be dangerous Studies have also shown that medication non-compliance costs US consumers some $100 billion to $300 billion annually due to emergency room and hospital admissions extra doctor visits and supplementary medications

Luckily you can personalize your pill-taking routine so that taking the right medication at the right time becomes automatic

Have a system If you have more than two medications to manage consider getting a pill organizermdasha special container marked with the days of the week Besides housing multiple medications a compartmentalized organizer can be useful for keeping track of the medications yoursquove taken

Many people canrsquot remember if they took their pill or if they simply thought about taking it so they skip dosages or take too many pills But by using an organizer you can simply check to see if the pill is missing from that dayrsquos bin Still if you use an organizer be sure to label each bin with the name of the medication and other relevant information so that you consistently load the organizer correctly

Take your cues If you have trouble remembering to take your medications yoursquoll need to develop cues that remind you perhaps in addition to using an organizer For example consider programming your cellphone alarm or investing in a triathlon wristwatch which can be set to sound reminder alarms You can also purchase pill caps that beep or sound an alarm when you need to take the medications After you replace the pill cap the timer is automatically reset for the next time

If your problem is remembering to take your medications in the morning or at night train yourself to remember to do it by placing them in strategic locations If you have orange juice every morning for example put your medications on the breakfast table and consciously try to take your pills every morning when you drink your juice

Be smart Avoid using antibiotics to treat viruses Your head aches your throat burns and your nose runs You might think asking your doctor for an antibiotics prescription will speed your recovery But new advice from two expert groups warns against it After all antibiotics donrsquot work against viruses which cause most respiratory infections Plus overusing them creates supergerms resistant to future treatment

Now the Centers for Disease Control and Prevention (CDC) and the American College of Physicians have joined forces Together they published updated guidelines in the Annals of Internal Medicine that say doctors should never prescribe antibiotics for the common cold a mild illness caused by viruses And you probably donrsquot need them for any other respiratory condition either Exceptions include

bull Bronchitis if your doctor suspects you also have pneumonia

bull Sore throat when you test positive for strep throat bull Sinus infection for symptoms that are severe linger for

more than 10 days or worsen after first getting better These signs mean bacteria are probably involved

Preventing bacterial resistance stands as the biggest reason to steer clear of unnecessary antibiotics But there are also more immediate perks Like any medications antibiotics have risks Side effects range from mildmdashupset stomach or rashmdashto severe and life-threatening The benefits might outweigh the risks if you have a bacterial infection But if antibiotics wonrsquot actually help you therersquos no reason to put yourself in danger


Your essential guide to cancer screenings

preventive care

Detecting cancer earlymdash when itrsquos most treatablemdash should be a key part of your self-care plan

The following screening guidelines from the American Cancer Society (ACS) are for people who have an average risk for cancer If you have an increased riskmdashdue to your family history for instancemdashask your doctor if you should be screened at an earlier age or more often

Some adults depending on their age gender or other risk factors may need periodic exams for other cancers such as those of the skin ovaries or oral cavity Herersquos just one example Fair-skinned people who spend a lot of time outdoors and have a history of sunburns may be at higher risk for skin cancer

Keep in mind that different organizations have different screening recommendations Talk with your doctor to find out which screenings may be right for you It is important to discuss the risks and benefits of each test

Men and women

Colorectal cancer People with an average risk for colorectal cancer should have one of these tests beginning at age 50 Ask your doctor which test you should have bull Flexible sigmoidoscopy every five years bull Colonoscopy every 10 years bull Double-contrast barium enema every

five years bull Guaiac-based fecal occult blood test

annually bull Fecal immunochemical test annually bull Stool DNA test every three years

Women

Breast cancer bull Yearly mammograms are recommended

for women ages 45 to 54 then every other year for women ages 55 and older

bull Women with a heightened breast cancer risk should ask their doctors about the risks and benefits of an annual MRI and mammogram

Cervical cancer bull Women should begin screenings at

age 21 bull Regular Pap tests should be done every

three years bull At age 30 women can choose to

instead have a Pap test once every five years along with a human papillomavirus (HPV) test

bull Women older than age 65 who have had normal screenings and do not have a high risk for cervical cancer do not need Pap tests

Endometrial cancer After menopause women who have bleeding or spotting should tell their doctors who may order screenings

Men

Prostate cancer The US Preventive Services Task Force recommends against PSA screening for all men Their review of two major trials found evidence that the benefits of screening when men do not have symptoms of prostate cancer likely do not outweigh the risks Recommendations from other organizations including the ACS differ slightly However all organizations agree that men with questions or concerns should discuss the potential benefits and risks for prostate cancer screening with their physicians and make an informed decision

WANT MORE INFORMATION Visit the American Cancer Society at wwwcancerorg

Wersquore committed to keeping you safe and healthy

Independent Health has an organization-wide approach to member safety Member safety is improved by creating and maintaining processes and structures whose application reduces the probability of adverse events resulting from exposure to the health care system

Independent Healthrsquos Patient Safety Subcommittee is a clearinghouse for the collection of safety activities across the organization This committee has responsibilities to organize reporting on existing patient safety activities and to screen for and report opportunities initiatives to support members providers and internal staff with member safety efforts

Help you and those you care about stay healthy Visit the ldquoHealthy Living Tips and Guidelinesrdquo section under My Health at independenthealth com to learn how you can protect the health of you and your loved ones


wise choices

Give the flu vaccine a shot this year As you may recall influenza (the flu) hit hard and early last year in spite of many people getting a flu shotmdashmaybe even you So what good does a flu shot do Actually a lot While an annual flu shot doesnrsquot guarantee you will avoid the flu it remains your best defense

Why isnrsquot the flu shot foolproof Months before people start getting sick health professionals attempt to match the vaccine with the most common flu strains they anticipate will be present that winter Even if they are successful flu viruses can change as the months go by making the vaccine less effective

This past flu season of the people who got sick most caught a flu variation slightly different from the one in the vaccine

Benefits of a flu shot While a flu shot wonrsquot make you immune to all strains of the flu you can still benefit Having the shot beforehand can make your symptoms milder even if you do get sick People who got a flu shot last winter were 19 less likely to seek medical care for the flu from a doctor than those who did not Thatrsquos much lower than average

The Centers for Disease Control and Prevention (CDC) estimates that flu shots are 50 to 60 effective when the strain of the flu in the vaccine more closely matches those being circulated

Your flu shotrsquos not just for you A flu shot can also protect those most vulnerable around you older adults and young children If you donrsquot get sick or get a milder case of the flu you are less likely to pass the virus to others

Remember flu season usually peaks between December and February Hit back by getting vaccinated now Itrsquos especially important to get a flu shot if you are age 50 or older have a weakened immune system have certain chronic health problems or will be pregnant during flu season In addition make sure you practice good hygiene to avoid the spread of the flu and other infectious diseases that can be prevalent at this time of year

TALK WITH YOUR PRIMARY CARE PHYSICIAN if you have questions about the flu shot For more information about flu prevention and treatment visit wwwflugov

Our dedication to our members and the community

Independent Health is dedicated to finding solutions to improve the health of our members and the community bull We help members take control of their own health care

by reminding them of the preventive services they need bull We create programs to help them better manage major

medical conditions bull We contact our participating physicians and health care

providers on a regular basis so that they may best help their patients

bull While Independent Health rewards physicians for providing high levels of quality care to patients it does not use incentives to encourage barriers to care and service Independent Health is prohibited from and does not make decisions regarding hiring promoting or

terminating its practitioners or other individuals based upon the likelihood or perceived likelihood that the individual will support or tend to support the denial of benefits Independent Health encourages appropriate utilization and discourages underutilization

Member rights and responsibilities We also provide our members with certain rights and responsibilities that are very important This includes the right to have access to care the right to obtain information and the right to privacy You may request a copy of your rights and responsibilities by calling our Member Services Department at (716) 631-8701 or 1 (800) 501-3439


childrenrsquos health


PRSRT STD US POSTAGE

PA I D Independent

Health The Wellness Magazine for Independent Health Members

511 Farber Lakes Drive Buffalo NY 14221

KEITH PAGE Editor

Material published in HealthStylesreg is not intended to provide personal medical advice Consult your physician before making changes in your health care regimen Benefits discussed in HealthStylesreg may vary by plan Developed by StayWell copy 2016

Printed on Recyclable Paper 530M

For more ways to keep yourself healthy follow us on Facebook or Twitter

Helping to manage the care of our members When our members have complex medical needs they sometimes need extra support and care to prevent their medical problems from getting worse

Thatrsquos why we have our own care management team The care team will work closely with our membersrsquo primary care doctors and other health care providers to help coordinate and arrange care to meet our membersrsquo needs

Independent Healthrsquos Care Management team offers a variety of programs that assist members with education and support with their medical conditions

Case management Case management programs support members who have had a critical medical issue or a serious diagnosis that requires support in proper type of care and services For instance we have a Behavioral Health Case Management Program which is a telephonic program available to help members who are dealing with a mental health andor substance abuse problem or condition Members can contact a case manager to determine the right level of care and to receive education on behavioral health issues including diagnosis treatment levels of care and types of providers

Disease management Disease management programs support members who have a chronic medical

condition such as diabetes and congestive heart failure These programs help members reach personalized care goals improve their health status and reduce the risk for future complications

Hospital alternatives Sometimes members have medical issues that could be treated during a short-term stay at a nursing home or in a memberrsquos home Care team members will help coordinate programs andor services in an outpatient setting doctorrsquos office or home with home care for wound care andor infection rehabilitation and treatment of complications of chronic conditions such as congestive heart failure and pneumonia

Palliative care Palliative care provides services to help individuals and their families by improving independence and comfort during a serious or chronic illness A palliative care team can assist with pain and symptom management support and information on living with chronic illness and setting goals and help with advance care planning

With these programs Independent Health and our membersrsquo doctors work together to help members understand and

better manage their conditions and to ensure they get the right care at the right time in the right location

INSIDE this issue

The cooler fall weather is here and Independent Health is ready to keep your health on track this season See this page to learn about how you can get rewarded for being healthy And see page 4 for tips to keep your health care costs down Herersquos to your health

IN OUR COMMUNITY

5 Teaming up with the Buffalo Bills

7 Healthy Options

PLAN NEWS

9 Internal and external review is available to our members

11 Family Choice plan

TAKE CHARGE

6 Eat healthier with nutrition benefit

10 Take advantage of free preventive care services

Receive our online newsletter HealthStyles Monthly by registering for your own member account at independenthealthcom

Get rewarded for staying healthy with FitWorksreg Rewards program Earlier this year Independent Health introduced FitWorks Rewards an online wellness program that specifically addresses the health and wellness needs of members who are enrolled in a small group or individual plan FitWorks Rewards is designed to keep our members motivated and on track with their health by offering monthly rewards

At the core of this new program is our FitWorks online wellness tool which engages members in meaningful activities that can improve their health and help them build a better relationship with their doctor

How does the program work bull Small group employees (and their

spouses or domestic partners) and individual plan subscribers can create a secure online account with FitWorks Rewards at wwwihfitworks com on or after their 2016 plan effective date

bull Upon activating their FitWorks account participants have the opportunity to earn points by completing claims-verified clinical activities and screenings along with self-reported wellness challenges

bull For the self-reported challenges participants need to keep track of the challenges they complete and record their activity online (paper entry forms will also be accepted from those without computer or internet access)

bull Each challenge is worth points For every 50 points earned the participant will be entered in a monthly reward drawing

Participants can earn monthly rewards Independent Health awards the following on a monthly basis bull 50 $100 Visa reward cards for those who take charge of their

everyday health such as eating fruits and vegetables drinking more water and getting enough sleep

bull 50 $250 Visa reward cards for those who take preventive measures such as seeing their doctor for an annual checkup or getting a colonoscopy mammogram or routine blood work Participants are eligible to receive multiple reward cards throughout

the year The reward cards can be used toward health and wellness services such as a gym membership workout apparel fresh produce healthy cookbooks and more Recipients are selected at random from all eligible entries no later than the 20th of the following month (for example October recipients will be selected no later than November 20)

If you are a small group or individual plan subscriber make sure you create your FitWorks Rewards account so that you have a chance to earn a reward by working on your health and fitness goals


good to know
















here for you





























in the community
















eating healthy






















foundation news















balloon drop

































for your benefit















your health care
















caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














good to know
















here for you





























in the community
















eating healthy






















foundation news















balloon drop

































for your benefit















your health care
















caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














here for you





























in the community
















eating healthy






















foundation news















balloon drop

































for your benefit















your health care
















caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














in the community
















eating healthy






















foundation news















balloon drop

































for your benefit















your health care
















caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














eating healthy






















foundation news















balloon drop

































for your benefit















your health care
















caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














foundation news















balloon drop

































for your benefit















your health care
















caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor











































for your benefit















your health care
















caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














your health care
















caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














caregiver support



















medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














medications















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor















preventive care





Men and women




Women










Men








wise choices





















PA I D Independent



KEITH PAGE Editor














wise choices





















PA I D Independent



KEITH PAGE Editor

















PA I D Independent



KEITH PAGE Editor














fall winter 2016 comm health styles · 2017. 11. 29. · independenthealth.com fall 2016 winter...

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