PrimeTimeSEPTEMBER

Is Healthy Living Month!

CHOLESTEROL KEEPING IT

IN CHECK

YOUR GUIDE TO HEALTHY LIVING FALL 2012

SCREENINGS AND IMMUNIZATIONS

CAN KEEP YOU WELL

GOOD HEALTH IS A

LIFE-LONG PROCESS.

THIS SEASON, GET

YOUR FLU

SHOT.

2 PrimeTime | FALL 2012

PrimeTime contains educational health information of general interest. All material

in the newsletter is for educational purposes only and should not be taken as medical advice or instruction. No publication can replace

the advice of medical professionals. This newsletter

may also contain general information about plan

benefits. Plan benefits vary; for information about your benefit plan, please refer to your Evidence of Coverage.

DEAR MEMBERS,

Fall is almost here. It is a good time to refocus on our health now and be aware of how our actions can have long term effects on our wellbeing.

If you are a diabetic, it is important to discuss your blood glucose levels with your physician and track how well your care plan is working. If you do not have diabetes, it is important to know the risk factors and to check if you may be at risk. Risk factors include: obesity or being overweight, exercising fewer than 3 times a week, high blood pressure, cholesterol or a family history of diabetes.

If you are at risk, you can lower your chances of getting Type II diabetes by maintaining a healthy lifestyle, watching what you eat, controlling your weight, being active and managing your blood pressure & cholesterol levels. Diabetes, if not controlled, can lead to other serious health conditions such as blindness, heart disease and stroke.

The start of fall also means the beginning of flu season. Older adults are among those at greatest risk of suffering complications from the flu. Those with chronic illness such as diabetes, heart disease or asthma are at even greater risk. Preferred Care Partners encourages all members to protect themselves from the harmful effects of the flu by getting vaccinated.

As a member of Preferred Care Partners your flu vaccine is available at no cost. Speak to your physician today about getting your annual vaccination.

At Preferred Care Partners your health and wellbeing matters. Yours sincerely, Orlando Lopez-Fernandez, M.D. Chief Medical Officer

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The FALL 2012 ISSUE

SEPTEMBER is LIVE HEALTHY MONTH Celebrate!

KEEPING YOUR Cholesterol in check for a Healthy Heart

STAY WELL WITH The 5 W’s! And SCREENINGS + IMMUNIZATIONS

REPORT Fraud, Waste And Abuse

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SEPTEMBER isHEALTHY LIVING MONTH

www.myPreferredCare.com

Our new Healthy Living portal will be available beginning October 1 st. Just go to our landing page to find the link at www.mypreferredcare.com/en/healthy-living/. It will contain relevant and useful information on a variety of health topics that affect us all. Website visitors can find healthy living information on:• Fitness and exercise, including strength training, cardiovascular exercise and the importance of stretching for flexibility.• Nutrition and diet, including recommended dietary guidelines, healthy grocery shopping tips and how to manage your weight.• Wellness, including health plan discounts on programs and services.• Injury prevention, including home injury prevention and how to reduce the risk of falling.• Behavioral and mental health, including resources for caregivers and common emotional conditions among older adults.• Managing chronic conditions, how to reduce risk factors and adopt healthy habits.• Health literacy, including information on how to talk with your physician & understand better how to take medications. This information is not intended to replace the advice of a healthcare professional. Speak with your physician before beginning any new program. Preferred Care Partners wants to be sure our members are getting the care that they need.

WHETHER YOU ARE NEW TO PREFERRED CARE PARTNERS FAMILY OR HAVE BEEN WITH US FOR A WHILE, WE WANT TO HELP YOU LIVE AN INDEPENDENT AND REWARDING A

LIFE AS POSSIBLE. THAT’S WHY WE’VE GATHERED INFORMATION ON HEALTH, WELLNESS AND HEALTHY LIVING ISSUES AND PLACED IT ON OUR WEBSITE.

Celebrate All Year Long!

We have specially trained teams of nurses, social workers and case managers to help members living with special needs. These healthcare professionals can arrange for services included in the member’s benefits – including transportation or the delivery of medical equipment.Our healthcare professionals can also provide important telephonic services, including making appointments for physician visits and arranging for diagnostic testing.To learn more, please call our Complex Case Management department at 1-800-995-0480 from 9:00am to 5:00pm Monday through Friday.

We are very pleased to let you know that your routine vision benefits are now provided through the Advantica network of ophthalmologists and optometrists. To see if your routine vision care provider is part of their network, call Advantica toll free at: 1-877-488-5131 Monday through Friday from 8am to 8pm.

4 PrimeTime | FALL 2012

CH LESTEROLKEEPING YOUR

IN CHECK FOR A HEALTHY HEART

What Factors Affect Cholesterol Levels? There are several factors that can be controlled. These include:DIET- Saturated fat can raise blood cholesterol levels. By reducing the amount of saturated fat in your diet, youcan lower your blood cholesterol levels. Saturated fats are found in meat and poultry, butter, lard and shortening.WEIGHT- Being overweight increases one’s risk for heart disease and elevated cholesterol levels.PHYSICAL ACTIVITY- Not being physically active can increase your risk for heart disease. Regular exercise can help lower LDL (low-density lipoprotein) bad cholesterol levels and raise HDL (high-density lipoprotein) good cholesterol levels. Being active can also help you lose weight. Always speak with your physician before beginning any exercise or physical activity program.

There are also factors that affect cholesterol levels that can’t be controlled. These include:AGE & GENDER- As women and men get older, their cholesterol levels typically rise.HEREDITY- High blood cholesterol can run in families. If high blood cholesterol runs in your family, make sure to let your physician know this.

TREATING HIGH COLESTEROL The main goal of any cholesterol-lowering treatment is to lower LDL levels. According to the National Institutes of Health, risk factors that can delay lowering LDL cholesterol levels include:

• Cigarette smoking• High blood pressure (140/90mmHg or higher on blood pressure medication)• Low HDL cholesterol (less than 40mg/dL. If your HDL cholesterol is 60mg/dL or higher, subtract 1 from your total count.)• A family history of heart disease -- heart disease in your father or brother before they turned age 55 or in your mother or sister before they turned age 65.• Age. Men 45 years or older; women 55 years or older.

Cholesterol is found in the fats (lipids) in your blood. Although your body needs cholesterol to build healthy cells, having high cholesterol can increase your risk of heart disease.

High cholesterol is defined as 240 mg/dL and above. People with high total cholesterol have approximately twice the risk of developing heart disease as people with ideal levels. This is

especially true for adults who are at high risk. Adults who are at high risk include those who have a family history of early heart disease, have high blood pressure or smoke cigarettes.

5www.myPreferredCare.com

CH LESTEROLIN CHECK FOR A HEALTHY HEART

ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION,

APPROXIMATELY ONE IN EVERY SIX ADULTS HAS HIGH TOTAL CHOLESTEROL.

ALTHOUGH HIGH CHOLESTEROL CAN BE INHERITED, IT IS OFTEN PREVENTABLE &

CAN BE SUCCESSFULLY MANAGED BY DIET, EXERCISE & SOMETIMES MEDICATION.

SEPTEMBER IS NATIONAL CHOLESTEROL EDUCATION MONTH!

LOWERING CHOLESTEROL LEVELS WITH PRESCRIPTION MEDICATION.There are several drug treatment options to lower or manage cholesterol levels. These include statins, bile acid sequestrants, nicotinic acid, fibric acids and cholesterol absorption inhibitors. All of these should be used in conjunction with a therapeutic life change treatment plan to help you lower your LDL.• Statin drugs are very effective in lowering LDL levels. They are safe for most people.• Bile acid sequestrants also lower LDL levels. They can be used alone or in combination with statin drugs.• Nicotinic acid lowers LDL and triglycerides. It also raises HDL.• Fibric acids lower LDL, but they are primarily used to treat high triglyceride and low HDL levels.• Cholesterol absorption inhibitors lower LDL. They can be used alone or in combination with statin drugs.

If your physician determines that medication can help you lower cholesterol levels, he or she will put you on a program that’s right for you based on your particular blood chemistry.

Reduce Your Saturated Fat Intake to Lower CholesterolThe American Heart Association recommends eating no more than six ounces of cooked lean meat, poultry, fish or seafood a day for people who need 2,000 calories. The amount of saturated fat in meats can vary widely, depending on the cut and how it’s prepared. Here are some ways to reduce saturated fat:• Select lean cuts of meat with minimal visible fat. Lean beef cuts include the round, chuck, sirloin or loin. Lean pork cuts include the tenderloin or loin chop, while lean lamb cuts come from the leg, arm and loin.• Buy “choice” or “select” grades rather than “prime.” Select lean or extra lean ground beef.• Trim all visible fat from meat before cooking.• Broil rather than pan-fry hamburgers, lamb chops, pork chops or steaks.• Use a rack to drain off fat when broiling, roasting or baking. Instead of basting with drippings, keep meat moist with fruit juices or an oil-based marinade.• Cook a day ahead of time. Stews, boiled meat, soup stock or other dishes in which fat cooks into the liquid can be refrigerated. Then the hardened fat can be removed from the top.• When a recipe calls for browning the meat first, try browning it under the broiler instead of in a pan.• Eat chicken and turkey rather than duck and goose. These have a higher fat content.• Remove the skin from chicken or turkey before cooking. If your poultry dries out too much, leave the skin on for cooking but remove before eating.• Limit processed meats such as sausage, bologna, salami and hot dogs. Many processed meats — even those with “reduced fat” labels — are high in calories and saturated fat. They are often high in sodium as well. Read labels carefully and choose such meats only now and then.• Meats that come from animal organs - liver, sweetbreads, kidney and brain -- are very high in cholesterol. If you’re on a cholesterol-lowering diet, eat them only occasionally.

6 PrimeTime | FALL 2012

Flu viruses can spread from person to person when an infected person coughs, sneezes or speaks. Viruses can also spread when people touch something with the flu virus on it, and then touch their mouth, eyes or nose. Everyday preventive actions can help slow the spread of germs that can cause the flu.

• Seek medical advice quickly if you develop flu symptoms! Flu symptoms can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills or fatigue. Some people may also havevomiting or diarrhea. People may also have respiratory symptoms without a fever.

• Cover your nose and mouth with a tissue when you cough or sneeze to avoid the spread of germs.• Wash your hands often with soap and water. • Try to avoid close contact with people who are sick.

this Fall with the

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FightINFLUENZA

As you age, your immune system weakens. This can make adults 65 years and older more susceptible to the flu. This can be very serious for older adults.

Flu shots. The best way to prevent the flu is with a flu vaccine. Vaccination is especially important for people 65 years and older because they are at increased risk for complications from the flu. This year’s flu vaccine is available at the following locations:IN MIAMI-DADE AND BROWARD COUNTIES Costco, CVS, Kmart, Navarro, Publix, Sam’s Club, Target, Walgreens, and Winn-Dixie.IN CENTRAL FLORIDA, GREATER ORLANDO AND GREATER TAMPA Albertson’s, Costco, CVS, Kmart, Publix, Sam’s Club, Sweet Bay, Target, Walgreens, and Winn-Dixie.

Now through March 31, 2O13. Remember to bring your Preferred Care Partners Membership I.D. By getting your flu vaccine this year, you can protect yourself from influenza. You will also reduce the chance of spreading the flu to others.

‘s

WHAT

WHEN

WHY

WHO

WHERE

W

7www.myPreferredCare.com

Recommended Preventive Care for Adults Age 65 and Older {Based on U.S. Preventive Services Task Force}

VACCINES:• Influenza vaccine (annual)• Pneumococcal vaccine (one time)• Tetanus vaccine (every 10 years)• Zoster (shingles) vaccine (one time)

SCREENINGS:• Alcohol use screening and counseling• Breast cancer screening (mammography every 1-2 years)• Blood pressure screening• Colon cancer screening (up to age 75)• Depression screening• Diabetes screening (in those with blood pressure over 135/80 mm Hg)• Lipid disorder screening (in all men & in women at increased risk of heart disease)• Obesity screening (with counseling intervention for those who are obese)• Osteoporosis screening (in women at risk)• Ultrasound to screen for abdominal aortic aneurysm (one-time screen for men aged 65-75 who have ever smoked)

SCREENINGS

It is predicted that by 2030 about 20% of the U.S. population will consist

of persons aged 65 and older1. While it is important to take measures to

prevent diseases or injuries to persons of all ages, preventive care is

especially important for older adults and their immune system health.

& IMMUNIZATIONSCAN KEEP YOU WELL.

1. Journal of the American Medical Association, December 23/30, 2009 – Vol. 302, No. 24

Unfortunately, adult immune systems can become less efficient with age. As one’s central nervous system ages, it can also become less sensitive to the body’s immune signals. When this happens, the central nervous system does not react as quickly or efficiently to infections.

PREVENTIVE CARE

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

PRESORT STD

US POSTAGE PAID

MIAMI, FL

PERMIT NO.869

HEALTH AND WELLNESS OR PREVENTION INFORMATION ENCLOSED

HOW TO REPORT FRAUD, WASTE AND ABUSE

If you suspect fraud, waste, or abuse, you can contact Preferred Care Partners’ Special Investigations Unit at: Phone: 1-866-678-8822 (TTY) 711 toll free (for the hearing impaired) Fax: 1-888-659-0617

Email: reportfraud@mypreferredcare.com

ONLINE: http://www.mypreferredcare.com/en/members/report-fraud.aspx

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

You may remain anonymous and you are protected from retaliation.

You can also contact the Centers for Medicare and Medicaid Services (CMS),

Office of the Inspector General at:

Phone: 1-800-447-8477 (TTY) 1-800-377-4950 Fax: 1-800-223-8164

Email: HHSTips@oig.hhs.gov

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

ONLINE: OIG.HHS.gov/fraud/hotline

H1045_PCPMK2847: File & Use 09/04/2012

LOOK FOR YOUR 2013 ANNUAL NOTICE OF CHANGE/EVIDENCE OF COVERAGE BEGINNING IN OCTOBER!

Your Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) book will contain important information about your 2013 Preferred Care Partners health plan benefits – including out of pocket costs, provider and

pharmacy networks and Part D prescription drug coverage. Your ANOC and EOC books will also contain information about your medical benefits and rights as a health plan member.

We will also be extending the Member Services department’s hours of operation to better serve you. From October 1, 2012 through February 14, 2013, you can speak with a Member Services representative at

1-866-231-7201/TTY 711 toll free (for the hearing impaired) from 8:00am to 8:00pm 7 days a week. Beginning February 15, 2013: Monday thru Friday, 8:00 am-8:00pm.