Tag Archives: coverage

Preventing Colorectal Cancer

Preventing Colorectal Cancer

It’s Colorectal Cancer Awareness Month, and colorectal cancer is the second-leading cause of cancer-related deaths.

About 1 out of 3 people are not up to date with their colorectal cancer screening, which can help identify precancerous polyps so you can get them removed before they turn into cancer.

Colorectal Cancer Symptoms

Colorectal cancer often doesn’t cause symptoms, which is why screenings are key to diagnosing cancer.

Your Colon and Cancer Symptoms

Those who do have symptoms experience:

  • Blood in stool
  • Persistent, ongoing stomach pain and cramps
  • Unexplained weight loss

Colorectal Cancer Screenings

There are a few different screenings for colorectal cancer available to you. The level of preparation needed for them, invasiveness, and frequency you’ll need them all vary.

Fecal Occult Blood Tests and Fecal Immunochemical Tests

Fecal Occult Blood Tests and Fecal Immunochemical Tests

A fecal occult blood test (gFOBT) or a fecal immunochemical test (FIT) can check for hidden blood in your stool, which can be a sign of cancer. 

These tests are noninvasive and don’t require a bowel cleanse before your appointment. They also need to be repeated each year because they don’t give your doctor a firsthand look at your colon’s health.

You simply collect your stool sample at home and mail it or bring it in to a lab for processing, and they’ll let you know your results.

FIT-DNA Tests

FIT-DNA Test

A FIT-DNA test checks for blood in the stool as well, but it also looks for DNA changes that may be a sign of cancer or precancerous polyps. 

This test is noninvasive and doesn’t require a bowel cleanse before your appointment. They also need to be repeated every 3 years, because they don’t give your doctor a firsthand look at your colon’s health.

You simply collect your stool sample at home and mail it or bring it to a lab for processing, and they’ll let you know your results.

Flexible Sigmoidoscopy

Flexible Sigmoidoscopy

A flexible sigmoidoscopy is similar to a colonoscopy, but it only looks at part of your colon. 

This procedure may require a bowel cleansing the night before, but its prep is not as extensive as what’s required for a colonoscopy. It’s usually done in your doctor’s office or a procedure room, and it must be repeated every 5 years.

The procedure involves a thin, flexible scope being inserted into the rectum to view the lower third of the colon so your doctor can look at its condition firsthand. Pieces of tissue can also be removed and evaluated for any abnormal cell changes.

Colonoscopy

Colonoscopy

A colonoscopy provides the best view of the entire colon. 

Bowel cleansing is required the night before this procedure. It’s usually done in an outpatient surgery center, and it is usually recommended once every 10 years. If your provider is concerned though, they can recommend you have them more frequently.

A thin, flexible scope is inserted into your rectum to view your entire colon.  Pieces of tissue or polyps can also be removed and evaluated for any abnormal cell changes.

The Screening That’s Right for You

You should work with your doctor to choose the screening that’s right for you and your situation. No matter which screening you choose, most of our plans will cover 100% of the cost. If more testing or services are needed besides your normal screenings, you may be responsible for paying a copay.

To check your exact coverage, log in to Your Health Alliance to review your benefits or contact us.

Reduce Your Risk of Colorectal Cancer

Reducing Your Risk of Colorectal Cancer

A healthy lifestyle can reduce your risk of colorectal cancer. What can you do?

  • Maintain a healthy weight. 
  • Eat a diet that’s high in fiber and includes plenty of fruits and vegetables.
  • Get regular exercise.
  • Don’t smoke.
  • Limit saturated fats and alcohol.
 

This March, talk to your doctor about scheduling your next screening.

Change in the Air

Vantage Point: Change Is Near

As our days get shorter, our nights get longer, the temperature drops, and the cool crisp air hits our faces, we know winter is approaching. It’s also a reminder that the year is about to end, and a busy time is coming.

Our grocery lists start to get longer as we start preparing for Thanksgiving. We begin our research for recipes to outdo our dessert from last year. Then, we gather with our family and friends, share what we’re all thankful for, and of course, enjoy a delicious meal.

I personally start to reflect on the year I’ve had. Was this a good year? What would I do differently? Did my health change? Do I need to look at my coverage?

As you all know, we’re in the Medicare Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year. This is the time for you to reassess what type of coverage you might need for the upcoming year.

In September and October, Medicare beneficiaries’ mailboxes were full of marketing materials from many different insurance companies. So much information is provided that it can be hard to keep track of everything that’s coming in. Each company has different prices, networks, copays, and perks.

It’s hard to handle all of this alone. Your family might be able to try to help sort everything out, but even then, it is a hard task to take on without any background knowledge. You want to make sure you’re making the right decision for the year ahead and that you’re not missing out on the perfect plan for yourself. Who should you turn to?

Luckily, Health Alliance Northwest has a local office in Wenatchee with a staff ready to assist current or future members. Our local office is a great asset to our community. We know insurance is already hard, and getting help over the phone can be an added barrier. We’re able to sit down with you and your family to answer and explain any questions you might have.

Our Wenatchee office is open Monday through Friday, 8 a.m. to 5 p.m., and no appointment is needed to sit down with our representatives. We want to help educate you, put you at ease before the holidays begin, and make sure you’re ready for a new year.

Jessica Arroyo, born and raised in Wenatchee Valley, is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. During her time off, she enjoys spending time with her husband and infant son.

Time for Change

Long View: Is It Time for a Change?

“Everyone appreciates the long, light evenings. Everyone laments their shortage as Autumn approaches; and nearly everyone has given utterance to regret that the clear, bright light of an early morning during Spring and Summer months is so seldom seen or used.”

This was written by a London builder named William Willett, who proposed daylight saving time from an idea conceived by Benjamin Franklin.

“Spring forward. Fall back,” was how I learned it! I remember daylight saving time when I was a child was a big deal. The Saturday night before the official time change would take place, my entire family worked together to make sure that all the clocks and watches in our household were set, not to mention the clocks in my parents’ cars. It never failed. There was always that tiny clock on the top of our stove that we would miss. My mom always caught it when she went to set the oven timer!

Then, once the clocks were all set, my sister and I pondered whether we lost or gained an hour of sleep. We always had to sit there for a minute or 2 and do the math before coming up with the answer.

For most of us today, time changes are not nearly as complicated as they used to be. Our world is much more hurried, and automation is everywhere. It’s accepted that almost every clock, watch, appliance, iPhone, and computer is programmed for daylight saving time. We really don’t have to worry about making sure all of our timepieces make the change. With our schedules so full, we don’t even realize we’ve gained an hour or lost an hour of sleep.

Just like the time change happens each November, Medicare’s Annual Enrollment Period (AEP) happens each October. Medicare beneficiaries can review their current plan and make any changes they feel are needed from October 15 through December 7.

Every year, the AEP is a good time to check your drugs and review upcoming services with your doctor, then make sure the plan you’re on is still the best fit. You might even want to get your family together to make sure you didn’t miss anything.

Some resources available to help you this AEP include Medicare.gov, which is easy to navigate and packed with information, and Illinois’ very own Senior Health Insurance Program (SHIP). The Illinois Department of Insurance offers this free, impartial counseling service for people who are Medicare-eligible. Visit Insurance.Illinois.gov or call them at 1-800-548-9034. You can also find the nearest SHIP office in this directory, or, in Iowa.

And don’t forget to check out your current insurance info at HealthAllianceMedicare.org. If you need to research plan options, you can “fall back” on us! We’re ready to help with any questions you may have for the upcoming plan year.

Mervet Adams is a community liaison with Health Alliance. She loves her grandson, family, nature, and fashion.

Answers to Your Health Insurance Questions

Vantage Point: Time to Answer Important Health Insurance Questions

It’s that time of year again. My husband comes home with a huge packet of healthcare information. Yep, it’s open enrollment for his employer health plan. It’s time for us to look at the options and choices that best suit our family in the coming year.

Every year, Medicare beneficiaries get this kind of event too. It’s called the Annual Enrollment Period (AEP). Each year from October 15 to December 7, they have the opportunity to look at the options available in their service area and choose which plan is the best for them and their health.

This is an important time for everyone. As we age, our health may change too. Understanding and knowing what coverage is best for you can be a daunting task, so you should ask yourself some very important questions each and every year.

Am I happy with my current plan? What’s changing for the new year? Is the premium going up on the plan I currently have? Do I need more coverage?

I understand that as Medicare members, you’re sent an enormous amount of marketing material during this time of year. All the Medicare Advantage, Medicare Supplement, and prescription drug plan companies are trying to get your attention and your business.

How do you weed through all the material? And even more important questions come up for you each year. Do I know the difference between Medicare Advantage and Medicare Supplement? Is the prescription drug plan I’m currently on the best value for the prescription drugs I’m taking? Finding the answers can be confusing and frustrating.

The answers you seek can be found quickly and easily. Visit our website or call us directly for answers to your health insurance questions. There are also independent brokers available to you, like GHB Insurance located right in Olympia, to help you with all the plan information you receive. In the Thurston County area, there are also SHIBA (Statewide Health Insurance Benefit Advisors) representatives who volunteer their time to help you understand Medicare and all the parts associated with it. They can be found at both the Lacey and Olympia senior centers.

So never fear, your Medicare questions can be answered here. Or at least, we can assist you in getting the answers you need. Remember, you have resources available to you. All you have to do is use them.

Joy Stanford is a community liaison with Health Alliance, serving Thurston County. She’s been involved with Medicare for 20+ years and truly enjoys it. She enjoys gospel, R&B, and country music, and she owns over 100 pairs of shoes.

Finding Medicare During the Annual Enrollment Period

Vantage Point: The Season for Informed Choices

It’s October, and folks living in North Central Washington are looking forward to beautiful fall colors and freshly picked apples. For those on Medicare, it’s also the start of the Annual Enrollment Period (AEP), when beneficiaries can shop for their 2016 coverage. It runs October 15 to December 7. But because of confusing plan changes and choices, some dread the AEP rather than looking forward to it.

But there are people who can help make these decisions easier. A trusted resource for Medicare eligibility throughout the year is the Statewide Health Insurance Benefits Advisors (SHIBA) program. The SHIBA program was formed to help consumers understand Medicare and their options for supplementing it. SHIBA counselors keep client information 100% confidential, and their main mission is to help clients see Medicare plan comparisons so that the client can choose using unbiased and accurate information.

At educational presentations in the past, I’d learned a lot from Dick Anderson, a certified SHIBA counselor, and recently had the pleasure of meeting with him one-on-one. Hearing Dick describe some of his stories captured what a valuable service he and other advisors provide. Counseling to help others by these trained volunteers truly comes from the heart.

Dick says there’s no Medicare plan that’s right for everyone, so instead he tries to get his clients to talk about their individual needs. This helps him determine what’s most important to them, so they can make a measured choice that meets their personal needs.

The rewards for this work are illustrated by Dick’s powerful stories of people from all different backgrounds, incomes, and educational levels who have come to him heavy with feelings of helplessness and confusion and after meeting with him, left with their cloud of anxiety lifted.

At Health Alliance, we strive to have quality, sustainable Medicare plans, but we agree with Dick that there’s no perfect plan for every person’s needs. Therefore, we value and respect the work SHIBA volunteers do to help people make informed choices.

For current Health Alliance members, we’re holding special meetings the first week of October in Wenatchee, Moses Lake, and Omak about our 2016 benefits and to answer any questions.

If you want to meet with a SHIBA counselor, you can make an appointment by calling Community Choice at 1-888-452-0731 or Aging and Adult Care at 509-886-0700.

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

Your Insurance Team's Support

Vantage Point: We Work Together to Support You

Painted in the stairwell of Samaritan Hospital is an inspirational message, “All of us, for each of you.” The same can be said of our Health Alliance Medicare team in North Central Washington that works together to provide elevated customer service for members and our provider partnerships.

Eileen, our program assistant, is the first face members see when they visit the Wenatchee office. Eileen feels that by supporting staff and prioritizing tasks, she can focus all her attention on members when they come in.

“Health Alliance isn’t just insurance coverage,” she says. “It is a place to come if you have questions, are seeking information, or would just like a cup of coffee and an ear.”

Jessica, our bilingual customer service representative, says, “The most rewarding part of my job is having the ability to see our members face to face, build relationships, and let them know I am here to listen and help.”

Through her role at Health Alliance, Teri, our customer service lead, hopes to insure our members only have good experiences when adverse situations arise. Teri credits the overall team from claims to medical management for its support in helping her achieve her goal.

Major procedures, hospitalization, surgeries, and discharge plans all need prior approval, and Cindy, our utilization review nurse on the medical management team, uses her experience in risk management, coupled with patient advocacy, to take care of our members through major health issues, thus controlling unnecessary costs.

Medicare is not only complicated for our members, it can be complicated for providers as well. Therefore, Leslie, our provider relations specialist, works directly with clinical staff members to help them understand policies, procedures, and operating systems. By providing face-to-face customer service at the provider offices, it makes providers’ jobs easier, positively impacting their care of our members.

The Centers for Medicare & Medicaid Services ranks Medicare Advantage plans on a five-star scale, and factors within that quality scale relate to providers assessing, managing, and controlling chronic conditions. Amanda, our coding consultant, works directly with physicians to provide coding education and finds it rewarding when she and the doctors learn something from each other, ensuring overall great health care to our members.

Whether they’re working with members or providers or making medical decisions behind the scenes, these are just a few of the local people committed to working together toward the common goal of ensuring quality of care, setting Health Alliance Medicare apart in North Central Washington.

SEP Changes like Moving

When Change Happens, We Can Help

Things change. We understand that the unexpected is a part of life. But there are ways we can help you get covered when the unexpected happens.

If you weren’t able to get coverage during this Annual Enrollment Period, or if something important has changed and you need a new plan, you may be able to get a Special Enrollment Period (SEP).

During an SEP, you can buy a new plan or make changes to your current plan.

To get an SEP, you need a qualifying life event (something that has changed your insurance needs). Qualifying life events include:

  • Getting Married
  • Having, adopting, or the placement of a child
  • Permanently moving to a new area offering different health plan options
  • A change in income or household status, which can change how much government help you can get
  • Losing other health coverage because of:
    • Job loss
    • Divorce
    • Loss of eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)
    • Expiration of COBRA coverage
    • Your health plan no longer meets the requirements of the Affordable Care Act (ACA)
    • Reduction or termination of employer contributions
    • Significant increase in the cost of your plan

If any of these items describes your situation, you have 60 days after that event to enroll in a new plan. You can shop with us online or call us at 1-877-686-1168 for help finding a plan.

Your new coverage date will depend on the kind of life event you had and what day of the month you enroll. Learn more about when your new plan will start.

Losing your coverage doesn’t always mean you get an SEP. You can’t get one if you lose your insurance because:

    • You didn’t pay your premiums
    • You chose on your own to quit your other health coverage
    • You lost a short-term plan or (in some cases) a Catastrophic plan

If you can’t get an SEP, you can always get covered with a short-term plan at any time. While they do help with your health costs, they aren’t qualified health plans under the ACA, which means you could still have to pay a tax penalty in the next year.

Still not sure what to do in your situation? Call us at 1-877-686-1168 for help figuring out your options.