Tag Archives: answers

Your Preventive Care

Your Yearly Preventive Care and Physical

Getting your yearly physical, where you can get covered preventive care and screenings, helps you be your healthiest. It’s important that you not only know what’s recommended for your age and what you need to stay up to date, but also that you get to the doctor for this each year!

What Happens at Your Physical

Each year, you should schedule a physical with your doctor to focus on your health and wellness. At the appointment, you can:
  • Keep track of your health habits and history
  • Get a physical exam
  • Stay up-to-date with preventive care
  • Get education and counseling and set health goals

Health Habits & History

One of the first things that happens at your annual appointment is a nurse or your doctor will ask you to answer some questions about your health and family history, including questions about:
  • Your medical history
  • Your family history
  • Your sexual health and partners
  • Your eating and exercise habits
  • Your use of alcohol, tobacco, and other drugs
  • Your mental health history, including depression
  • Your relationships and safety
This info can help you in the future. From getting diagnosed to being protected and helping you in an emergency, this information can help save your life.

Physical Exam

At your yearly physical, you can expect your doctors or nurses to:
  • Measure your height and weight
  • Calculate your body mass index (BMI) to check if you’re at a healthy weight
  • Take your blood pressure and temperature
From there, your doctor may give you your regular preventive care screenings and shots or refer you to a specialist for certain screenings, counseling, or care.

Preventive Care

As an adult, certain preventive care and screenings are covered for you, depending on timing and what your doctor recommends.
Immunizations (Shots)
Doses, recommended timing, and need for certain immunizations can vary based on your case:
  • Diphtheria
  • Flu shot
  • Hepatitis A
  • Hepatitis B
  • Herpes Zoster
  • Human Papillomavirus (HPV)
  • Measles
  • Meningococcal
  • Mumps
  • Pertussis
  • Pneumococcal
  • Rubella
  • Tetanus
  • Varicella (Chickenpox)
Condition Screenings & Care
  • Aspirin use – To prevent heart disease for adults of a certain ages
  • Cholesterol screening – For adults of certain ages or at higher risk
  • Blood pressure screening
  • Type 2 diabetes screening – For adults with high blood pressure
  • Colorectal cancer screening – For adults over 50
  • Depression screening
Weight Management
  • Obesity screening and counseling
  • Diet counseling – For adults at higher risk for chronic disease
Alcohol & Tobacco Use
  • Alcohol misuse screening and counseling
  • Tobacco use screening – For all adults and cessation interventions for tobacco users
  • Lung cancer screening – For adults 55 to 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
  •  Abdominal aortic aneurysm – A one-time screening for men of certain ages who have ever smoked
Sexually Transmitted Infection (STI) Screenings
  • Sexually transmitted infection (STI) prevention counseling  – For adults at higher risk
  • Hepatitis B screening – For people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and American-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence
  • Hepatitis C screening – For adults at increased risk and once for everyone born from 1945 to 1965
  • HIV screening – For everyone ages 15 to 65 and other ages at increased risk
  •  Syphilis screening – For adults at higher risk
Women also have some additional covered screenings and benefits. Get more details about this specific preventive care while learning about your well-woman visits. And learn more about what preventive care the United States Preventive Services Task Force recommends you get and when.

Education, Counseling & Health Goals

Your doctor can help you manage your conditions or diseases and prevent future problems by talking to you about your life and health each year. Your doctor might have valuable handouts, websites, advice, and information to help you take care of yourself or might want to refer you to a specialist who can help you further. Your doctor is also the perfect person to help you set goals to maintain or improve your health. From quitting smoking and knowing how to self-check for cancer to changing your diet and exercise for your weight, cholesterol, or blood pressure, your doctor can help you plan to be your healthiest.

Prepare for Your Visit

Preparing yourself with questions to ask and answers to your doctor’s questions can help you make the most of your visit.

Know Your Family History

Your family’s history of health and wellness is an important part of your own health record. Histories of illness and disease can help doctors look out for issues that run in families and more. This family health history tool can help you track your family’s health, so that you’re always organized to talk to your doctor. Not sure about your family history? Filling this out is the perfect time to talk to family members for firsthand details.

Talk to Your Doctor

Prepare for your appointment by knowing any questions or issues you want to talk about ahead of time. Some things you might want to ask:
  • What immunizations or shots you need
  • Your diet and eating healthy food
  • Advice for exercise and getting active
  • Mental health concerns, like depression and anxiety
  • Specific issues you might be having, like sore joints, back pain, migraines, and more

Know What’s Covered

Learn more about your covered immunizations. And log in to Your Health Alliance or search by your member number to see what preventive care your plan covers. You can use our general preventive care guidelines and prescription drugs or our Medicare preventive care guidelines to get an idea of what our plans cover. If you’re not sure what’s covered and what you’ll need a preauthorization for, you can check your coverage and preauthorization lists at Your Health Alliance. Now that you’re ready to go to your annual physical, log in to Your Health Alliance if you need to set a Primary Care Provider (PCP) and find a covered doctor, or start searching for doctors in our network.
Your Personal Health Coach

Vantage Point: A Helping Health Hand

Not every coach is as well known as Pete Carrol of the Seattle Seahawks, but Susan DeLong, our nurse case manager and health coach in our Wenatchee office, is key to our team.

She’s smart, caring, a good listener, and a compassionate advocate. You will probably never see her on TV, but in our members’ eyes, her work is just as important and meaningful as any superstar’s.

Managing a health condition can be hard, and a health coach is someone with extensive experience who can be a consistent source of support. There’s so much information that it can be hard to know what’s key. One of the benefits of a Medicare Advantage plan like ours is the free education and support a health coach can provide.

At Health Alliance, a health coach like Susan can give our members:

  • Answers to questions about their conditions
  • Tools and lifestyle skills to minimize the risk of problems
  • Information about self-care skills
  • Free educational materials and resources about managing conditions
  • Support on the phone at their convenience
  • Help keeping them, their provider, and their caregivers connected
  • Help making the most of their healthcare benefits

Health coaches do not replace medical care from a doctor, but instead work with their primary care physician as part of a team to make sure their management plan is working.

Compassionate nurses like Susan also help identify warning signs for possible health problems, and they make sure members have a plan, day or night, to handle those issues if they become serious.

Susan also works hard to troubleshoot these issues before they become serious health problems. For example, she helps members understand the importance of refilling prescriptions and outlines what they should do if their drugs run out too soon.

Susan even partners with community resource agencies, like Meals on Wheels and the Confluence Health Patient Service Department, to help our members overcome barriers to their care. She knows when a member has a hospital stay or ER visit, and she tracks follow-up appointments and makes sure any meds they’re sent home with will work well with their current prescriptions.

But just like famous coaches, a big part of the job is to motivate. Susan empowers our members to take an active part in their health by setting attainable goals, and we value the important role she plays in our team and in lending a helping hand to our members.

Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant and Okanogan counties in Washington. She has four sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.      

Patient Safety Awareness

Patient Safety Awareness Week

It’s Patient Safety Awareness Week, so we have some tips from the National Patient Safety Foundation to help you protect yourself.

The key is communication with your doctors. This means making sure you understand everything your doctor is telling you, and sharing things that can help them. Tell them things like if you’ve been injured, if you’ve changed your diet or exercise habits, or if you haven’t been able to sleep.

Ask lots of questions! They want you to understand your disease and treatment, so make sure you understand your medicines, condition, and treatment plans.

Take a deep breath

 

If you’ve been diagnosed with a condition, learn more about it. You can protect yourself by learning more with materials from your doctor, online resources, and even disease management info from us.

Working hard to earn her independence

 

Make sure you carry an updated list of the medicines, vitamins, and supplements you’re taking to all your appointments with doctors, so you can make sure your whole care team is on the same page.

4

 

Speak up if you think you’re getting the wrong prescription, treatment, or you think you’re being made to leave the hospital too soon. Your doctor can help you make sure you’re getting the right care.

5

 

If you have a test at the doctor’s office, follow up if you never get or hear your results. Never assume “no news is good news.”

At laboratory

 

Have a list of contacts ready. Make sure you have the names and info to contact all of your doctors available, and that your doctor knows who to contact or who should act for you in an emergency.

7

Save

Medicare Advantage Mythbusting

Long View: Medicare Advantage Truths Might Just Change Your Mind

As I travel around the Illinois countryside, I hear the same misinformation about Medicare Advantage over and over. To tackle some of that, here’s a Q and A.

Question: When I join a Medicare Advantage plan do I lose my Medicare coverage?

Answer: No. If you have a Medicare Advantage HMO or PPO plan, a private health insurance company that has a contract with Medicare, like Health Alliance Medicare, provides the services instead of Original Medicare. People who disenroll from Medicare Advantage plans revert to Original Medicare. In either case, no one loses Medicare coverage.

 

Question: Will I be able to stay with my current doctors?

Answer: Probably, especially with Health Alliance Medicare. That’s why it’s important to check any plan’s provider directory to confirm your doctors work with the plan. People who select a Preferred Provider Organization (PPO) plan can use out-of-network providers, but they typically pay more when they receive services.

 

Question: We travel and might need to use the emergency room. Will Medicare Advantage plans only cover me for emergency care when I’m close to home?

Answer: No. Medicare Advantage plans cover out-of-area emergency and urgently needed care.

 

Question: If something serious happens and we need lots of services, could we predict how much we would pay for care?

Answer: Yes. Medicare Advantage plans have an annual Out-of-Pocket Maximum (OOPM), also called a Yearly Limit. When a Medicare Advantage member reaches that limit, the health plan pays 100 percent for Medicare-approved services. This amount doesn’t include the premium and other limited expenses. You can estimate what your expenses would have been last year on the Medicare Advantage plan you are considering.

 

Question: Medicare Advantage sounds good for me, but wouldn’t the premium be too costly for my 88-year-old mom?

Answer: Not at all. One of the best things about Medicare Advantage plans is the premium is the same no matter the member’s age. You and your mom would pay the same monthly premium if you had the same plan, unless either of you could get extra help paying for coverage based on your income.

 

Question: Would I have to deal with all the paperwork I get when I receive services from Original Medicare plus a Medicare Supplement plan?

Answer: No. You would have much less paperwork with a Medicare Advantage plan. In fact, that’s one reason Medicare Advantage plans exist, and I’m all for less paperwork.

 

Remember, the Medicare Annual Enrollment Period, or AEP, runs from October 15 to December 7. That’s the only time most people can change their coverage for the following year.

If you are thinking about a change for yourself or a loved one, you will have to do a bit of research. Trusted resources like Area Agencies on Aging and your local senior center can help.

Please consider Health Alliance Medicare a resource, too.

We all want to make well-informed choices that don’t depend on myths and misinformation.