Best of health Information about the Michigan Public School Employees Retirement System health plan

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1 Best of health Information about the Michigan Public School Employees Retirement System health plan SUMMER 2014 What you need to know about Medicare before you re eligible As you get closer to turning 65, there are things that you must know about your health coverage. At 65, you will automatically be enrolled in Medicare and your health coverage will change. You may select original Medicare as your primary health plan, but Medicare will provide you only basic coverage not the Blue Cross benefits you re used to. However, Your Retirement System offers a plan with coverage that is like the non-medicare plan you re used to, called Medicare Plus Blue Group PPO. This Medicare Advantage plan combines Medicare Parts A and B with the Retirement System s hospital and medical coverage into one comprehensive plan that maximizes your Medicare coverage. With this MA plan, you ll continue to have access to network doctors, preventive care coverage, online benefit details and more. You also will be eligible to participate in wellness programs and get medical advice anytime by calling our 24 hour Nurse Line. If you re already collecting Social Security benefits, you ll be enrolled in Medicare Part A and Part B automatically. If you re not enrolled in Social Security when you turn 65, you can sign up for both Social Security and Medicare at ssa.gov. You just have to be enrolled in Part B to enroll in this MA plan. Around your 65th birthday, you will receive a red, white and blue Medicare card in the mail. For most, the transition into BCBSM s MA plan will take place automatically. However, Blue Cross may reach out to you if additional information is needed to get you enrolled in your new plan. Questions about Medicare? Medicare Customer Service is available 24 hours a day, seven days a week. Call to speak to a Medicare representative at TTY users please call Questions about Medicare Advantage? BCBSM Customer Service is available to answer your questions Monday through Friday, 8:30 a.m. to 5 p.m. EST. Call to talk to a representative at TTY users please call 711. Medicare terms to know Medicare A government provided health insurance program for people ages 65 and older, comprised of two main parts; Part A and Part B. Medicare Part A Hospital coverage, hospice, home health services, skilled nursing facility care Medicare Part B Medically necessary services and supplies and preventative services (such as doctor visits) Medicare Advantage Combines Medicare Parts A and B with the Retirement System s hospital and medical coverage into a single, comprehensive plan

2 Download Larky to save money with your smartphone Did you know that approximately 100 million Americans will use digital coupons in 2014? A rapidly growing number of people are using their computers, smartphones and tablets to save money with coupons and perks. Larky, a free smartphone app, is a great way to use your smartphone to save when you re on the go. Larky helps you manage your membership discounts and reminds you to use them. When you download Larky, you can select all of the perks and memberships that apply to you. For example, you have access to discounts on products and services related to health, wellness and recreation through BCBSM s Healthy Blue Xtras SM discount program. You may also select discounts such as AARP or an alumni association. Larky uses the GPS technology on your smartphone to send you a reminder notification when you re near a retailer where you receive a discount. The average Larky user can save up to $1,000 a year. Larky can be downloaded on iphone devices. An Android app is scheduled to be released soon. To download Larky or learn more, visit larky.com.* *Blue Cross Blue Shield of Michigan and your Retirement System do not control this website or endorse its general content. LivingWell: Healthy foods for your summer menu Maintaining good health is an ongoing journey. Visiting your doctor for a yearly exam and completing an annual health assessment are two steps in the right direction. Staying on the right path requires making healthy meal choices regularly. Keep your diet on track this summer by adding a little variety (and lots of nutrients) to your menu with these ingredients: Pomegranate is a fruit full of edible seeds and health benefits. Research has linked the antioxidants in pomegranates, called polyphenols, to reduced risks of chronic disease and improved heart health. Pomegranate seeds make a great snack. They are high in fiber, which helps you feel full to manage your weight. Quinoa is a grain that is similar to couscous or rice when cooked. Quinoa is packed with protein, all nine essential amino acids, and contains double the amount of fiber in other grains. Mix your favorite vegetables into a quinoa-based casserole for a nutritious meal that won t leave you hungry. Kale is a dark leafy green. A one-cup serving of kale contains 10 percent of the daily recommended amount of calcium. Kale is rich in omega-3 fatty acids, which support brain and heart health, and fight inflammation. Steam kale and serve as a side with a weeknight meal, or mix it into your favorite dish. Reminder: Complete your Verification of Coverage The deadline to complete your Verification of Coverage form is July 15, Complete your form online at mpsers.coverageupdatecenter.com or by phone at (TTY: ). 2 Best of health

3 Questions about your coverage? Your Retirement System provides a comprehensive plan that includes medical, prescription drug, dental and vision coverage. To bring you the best coverage for the best value, your Retirement System partners with Blue Cross and other vendors to provide different services, along with subject matter experts to help answer any questions you have about your coverage. Be sure to know which carrier to contact with questions about your coverage. Medical coverage Contact Blue Cross Blue Shield of Michigan for questions regarding: Health care claims ID cards medical and vision Participating providers in Michigan Medical equipment and supplies BCBSM can be reached by phone at (TTY: 711) on weekdays, 8:30 a.m. to 5 p.m. Eastern time. You may also view information about your coverage or find a doctor by visiting bcbsm.com. BlueVision coverage Contact VSP for questions regarding: Vision benefits (vsp.com) Participating vision providers (vsp.com/advantage) VSP can be reached by phone at See Page 7 for customer service hours. Prescription drug coverage Contact Catamaran for questions regarding: Pharmacy claims Covered drugs Pharmacy ID cards Participating pharmacy providers Catamaran customer service representatives are available 24 hours a day, 7 days a week. Call or visit catamaranrx.com. Dental coverage Contact Delta Dental Plan of Michigan for questions regarding: Dental claims Dental ID cards Participating dental providers Delta Dental customer service representatives are available weekdays, 8:30 a.m. to 8 p.m. Eastern time. Call Delta Dental at , or visit deltadentalmi.com. Best of health 3

4 Prevent age related macular degeneration Age related macular degeneration is an eye condition that affects the macula, the pencil eraser size part of the retina where precise vision forms, causing loss of central vision. It s rare that AMD leads to total vision loss. However, losing central vision can make every day activities such as reading and driving much harder. Although AMD is a preventable condition, eye care professionals say it s on the rise among Americans. There are treatment options that help slow AMD s progression, but eye doctors urge individuals to take preventative measures to stop AMD before it starts. Here are a few ways you can help prevent AMD from developing and slow its progression: Get an annual eye exam. Eye care professionals agree that an annual eye exam is the most important step you can take to detect and slow the progression. An examination is the only way to spot early warning signs. Protect your eyes from the sun. The sun s harmful ultraviolet rays can cause a wide range of eye problems. These problems include AMD and other conditions that impair eyesight. A simple measure you can take to protect your eyes against the sun is to wear sunglasses with UV blocking lenses. Eat eye healthy nutrients. Research shows that foods rich in certain nutrients are linked to a decreased risk of developing AMD and cataracts, as well as other eye diseases. Here are a few eye friendly foods to include in your diet: Dark green, yellow and orange vegetables. Sweet potatoes, carrots, red peppers and broccoli are examples of vegetables that are rich in beta carotene, which is converted into Vitamin A inside our bodies and essential to healthy eyesight. Dark green, leafy vegetables. Vegetables such as spinach and kale contain lutein, a nutrient that reduces the risk of chronic eye diseases. Citrus fruits and black currants. Oranges, grapefruits, and black currants are high in Vitamin C, which is shown to lower the risk for cataracts and AMD. Eggs, whole grain cereals, pork, lamb and beef. These foods contain zinc, a mineral that is critical to producing a protective pigment for your eyes called melanin. 4 Best of health

5 Keep out-of-pocket costs lower with a PPO dentist As part of the Delta Dental PPO (Standard) plan, dentists are reimbursed for your claims based on the Delta Dental PPO Fee Schedule. You are welcome to visit any dentist of your choice, but visiting a Delta Dental PPO dentist will keep your out-of-pocket costs lowest. How does visiting a non-ppo dentist affect my out-of-pocket costs? It is important to note that Delta Dental Premier dentists and nonparticipating dentists are not part of your network. Your claims are paid differently if you visit a dentist outside your network. If you see a Delta Dental Premier dentist, you are responsible for paying the difference between the amount paid (based on the fee schedule) and your dentist s fee, in addition to any copayments. If you see a nonparticipating dentist, Delta Dental will pay for covered services based on the dentist s submitted fee or the amount in the Delta Dental PPO Fee Schedule, whichever is less. Delta Dental will pay you directly, and you will be responsible for paying the dentist. Non-PPO dentists have the option of charging you the difference between their rates and the Delta Dental PPO Fee Schedule. How can I find a Delta Dental PPO Dentist? To find a Delta Dental PPO dentist near you, you can call Delta Dental s customer service department to speak to a representative toll-free at , or call Delta Dental s Automated Service Inquiry system, available 24 hours a day at You can also access the online provider directory by visiting deltadentalmi.com/findadentist. Here s an example of how a PPO dentist lowers out-of-pocket costs. ADULT CLEANING Delta Dental PPO Delta Dental Premier Non Participating Dentist s fee: $90.00 $90.00 $90.00 Maximum approved fee: $54.00 $77.00 N/A Delta Dental PPO dentist fee: $54.00 $54.00 $54.00 Coverage level: 95% 90% 90% Amount Delta Dental pays: $51.30 $48.60 $48.60 AMOUNT YOU PAY: $2.70 $28.40 $41.40 NOTE: Payment examples above are illustrative only. Fees and reimbursements can vary by location and dentist. They do however represent how payment is determined. Best of health 5

6 Traveling this summer? Don t leave home without your medications. If you re leaving for summer vacation soon, keep in mind that packing the necessary supply of your medication is just as important as remembering to bring your suitcase. Managing your health on the road by taking your medications will help you make the most of your vacation. Keep an eye on your supply Before you hit the road, make sure you have enough medication to last your whole trip. If you don t have enough, your pharmacy may be able to transfer your prescription to a nearby pharmacy in your network. Check with your local pharmacy for their prescription transfer policies. Contact Catamaran member services at to find a network pharmacy. Consider an extended supply If you don t have enough of your medication currently on hand and will not have access to a network pharmacy during your vacation, talk to your doctor about getting a 90 day supply of your medication. Refilling your extended supply If you already have a prescription for a 90 day supply, please note that you can refill your prescription when you have less than 25 percent (about 22 days) of your medication left. If you have questions about your next refill, contact Express Scripts at (TTY: ). Prescription drug update The patents on some brand name drugs have expired, which means members can now save by using the generic equivalents. Any drug that was available on the formulary in its brand name form will continue on the formulary in its generic form. Your pharmacist will automatically dispense the generic on new or refilled prescriptions for these drugs. Brand name Generic name Indication/use Anticipated generic availability Actonel risedronate Osteoporosis prophylaxis & treatment: Paget s disease June 2014 Nasonex mometasone furoate Seasonal & perennial allergic rhinitis; nasal polyps July 2014 Lumigan bimatoprost Glaucoma: ocular hypertension August 2014 Renagel sevelamer hydrochloride Hyperphosphatemia associated with chronic kidney disease September Best of health

7 How to reach us When contacting us, help us help you by providing your contract number. Blue Cross Blue Shield of Michigan For questions about health care claims, ID cards or participating providers in Michigan: Call: TTY: 711 Weekdays, 8:30 a.m. to 5 p.m. EST Write: Blue Cross Blue Shield of Michigan Attention: MPSERS 600 E. Lafayette Blvd., Dept. X521 Detroit, MI Website: bcbsm.com BlueCard PPO providers outside Michigan Call: BLUE ( ) Medical equipment and supplies For questions about medical equipment and supplies in Blue Cross Blue Shield of Michigan Member Services: Call: TTY: 711 Weekdays, 8:30 a.m. to 5 p.m. EST Medicare Call: MEDICARE ( ) TTY: Website: medicare.gov Catamaran For questions about pharmacy claims, ID cards, or participating providers, contact Catamaran at: Call: Customer service representatives are available 24 hours a day, 7 days a week BlueVision For questions about vision benefits, contact VSP. Call: Monday through Friday, 8 a.m. to 11 p.m. EST Saturday, 10 a.m. to 11 p.m. EST Sunday, 10 a.m. to 10 p.m. EST For vision ID cards, call Blue Cross Blue Shield of Michigan at TTY: 711 Weekdays, 8:30 a.m. to 5 p.m. EST Website: For benefit information vsp.com To find a provider vsp.com/advantage Delta Dental Plan of Michigan Call: Customer service representatives available weekdays, 8:30 a.m. to 8 p.m. EST Automated service seven days a week, 24 hours a day Website: deltadentalmi.com Michigan Public School Employees Retirement System For pension information, contact the Customer Information Center: Call: Weekdays, 8:30 a.m. to 5 p.m., EST Website: michigan.gov/orsschools For address and membership changes: Write: Office of Retirement Services P.O. Box Lansing, MI Website: catamaranrx.com Upcoming Pension Payment Dates July 25, 2014 August 25, 2014 September 25, 2014 Best of health 7

8 Michigan Public School Employees Retirement System Blue Cross Blue Shield of Michigan 600 E. Lafayette Blvd., MC 517J Detroit, MI PRESORT STANDARD US POSTAGE PAID BLUE CROSS BLUE SHIELD OF MICHIGAN Best of health Best of health is published four times a year for retirees of the Michigan Public School Employees Retirement System by Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd. MC 517J, Detroit, Michigan Editor: Christine Paul Copyright 2014 Blue Cross Blue Shield of Michigan, an independent licensee of the Blue Cross and Blue Shield Association. NOTICE: The information contained here is a summary of coverage and is not a contract. If statements in the description differ from the applicable group contracts, then the terms and conditions of those group contracts will prevail. The Public School Employees Retirement Board and the Department of Technology, Management & Budget reserve the right to change the plan. For more detailed information about benefit provisions, contact Blue Cross Blue Shield of Michigan customer service. Non Medicare R028631