Health Care Happenings

HOW’S YOUR HEART?

Did you know heart disease should be one of our most important concerns in midlife?

Though we may want the sports car or change to a career that is more fun and exciting, we also want to be healthy.  Health includes a Healthy Heart.

Accordinging to a study at the Northwestern University Feinberg School of Medicine, blood pressure plays a significant role in the long-term outlook of your heart health.

Eat Right!

Exercise!

Healthy Weight Level!…………………………….we know these are important factors to heart health, and our overall physical and mental health.

Often when we think of heart disease, we associate men with the condition.

However, heart disease is the leading cause of death for women in our country.

…And, women don’t always know or recognize the threat of heart disease or understand the risk factors associated with the disease.

In addition to high blood pressure,  other risk factors for both men and women include:

• high cholesterol
• diabetes
• overweight and obesity
• smoking
• lack of physical activity
• unhealthy diet
• stress

Want to learn more?  Visit the U.S. Department of Health and Human Services and make YOUR HEART and YOUR LIFE, A HAPPY ONE

First Lady, Michelle Obama announced new regulations to the Family  and Medical Leave Act (FMLA) which will support military families and caregivers of the wounded, ill and injured this week at the Department of Labor.

“We want to recognize the extraordinary dedication, sacrifice and service of our nation’s caregivers, not simply with words, but with deeds,” said Mrs. Obama.  “These are men and women and children who will do anything for their loved ones, no matter the cost, no matter the sacrifice, no matter the consequences.” 

Labor Secretary Hilda Solis joined the First Lady to recognize the contributions and highlight the many challenges facing servicemembers and their families when they come home–”many come home stressed, ill and injured…they need attention, care and support.” 

Generally, FMLA allows eligible employees to take up to 12 weeks of unpaid, or job protected leave in a 12-month period for specified family and medical reasons such as birth, adoption or placement of a child, care of a family member with a health condition, or the employee’s own health condition.

The Act was further expanded in 2008 to provide certain family members of the National Guard, Reserves or Regular Armed Forces up to 26-workweeks in a single 12-month period to care for a servicemember with a serious injury or illness incurred in the line of duty.

The White House-Labor’s rule changes would extend FMLA leave protections to not only include military caregivers, but also military families as a whole. Key aspects of the new rules would allow for:

• 26-weeks of military caregiver leave entitlement to cover family members caring for recent veterans with serious line of duty injuries or illness, including conditions that may surface up to five years after the member leaves military service.
• Family members whose spouse, child or parent of an active duty member to take leave to deal with deployment-related issues and events such as financial, legal, child care arrangement, attend military events before, during or after deployment to a foreign country.
• Up to 15-days of leave to spend time with a servicemember during rest and recuperation leave.

I was heartened to see such support continue to be a priority in our government as well as very senior officials at the highest levels of the Departments of Defense, Veterans Affairs and Labor in attendance to celebrate these families-caregivers and endorse the new changes to the FMLA.

But, nothing compared to the humble and extremely appreciative response of those military, veterans, families, and caregivers in the audience that day.

One caregiver, RyAnne Noss, spouse of Sgt. 1st Class Scott Noss who was injured in a helicopter crash in Afghanistan in early 2007, refected this appreciation, but more important, the incredible strength, determination and unfailing love she has for her husband–to care for him no matter what.

“I’m proud to have been by Scott’s side through his rehabilitation and proud to have him home with me now where he continues to require around-the-clock-care…I’m proud to be my husband’s caregiver” RyAnne told attendees. 

Like RyAnne, many caregivers and military families, appreciate any and all the help they can get.

And MOAA wants ReAnne and other caregivers-families to know they can count on us to to support them and be their voice.

Before the holidays we provided an update on the ongoing Walgreen’s – Express Scripts negotiations and the plan for the way ahead if not resolved.  We now know that Walgreen’s will cease to be a network provider for TRICARE through the Express Scripts government contract.  Below we have addressed many of the questions that our blog readers had.  Here they are:

Responses to MOAA Members Concerns

1. Why isn’t TRICARE weighing in on the dispute between Walgreens and Express Scripts?

According to the September 15, 2011 American Forces Press Service article, “TRICARE Promises Continued Access to Prescription Meds.” Navy Rear Adm. Christine Hunter, deputy director of the TRICARE Management Activity, called the dispute between Walgreens and Express Scripts, Inc. “a business matter.”

RADM Hunter also stated, “Don’t let that advertising, letter and Internet outreach campaign scare you. Even if contract renewal negotiations fall through and Walgreens drops out of TRICARE’s retail pharmacy network on Jan. 1, beneficiaries still will have plenty of other options for getting their prescriptions filled.”

To read the full article, please visit http://www.defense.gov/news/newsarticle.aspx?id=65353

2. I am concerned about the safety of my medications when they sit in my mailbox all day.   

Throughout the year, Express Scripts works diligently to ensure your medications are sent to you in the safest way possible and in compliance with the medication manufacturers suggested shipping standards.  According to Christopher Meilinger, a Senior Pharmacy Director at TRICARE Pharmacy Home Delivery, “The vast majority of non-refrigerated medications are not negatively affected by the temperature differences seen during the normal shipping process. Express Scripts has done, and continues to do, research into the stability and potency of various medications as it relates to shipping during all months of the year. Using the research and information obtained from pharmaceutical manufacturers, medications are evaluated for the need for special packing and shipping processes during the warmer months of the year.”

Express Scripts pharmacists are available to answer questions you have about your medication 24 hours a day/7 days a week. Call 1-877-363-1303 to contact Express Scripts.

3. Can Express Scripts ship refrigerated medications to me?

Yes. Express Scripts will ship medications requiring refrigeration in cold packs. Please note, refrigerated medications cannot be shipped to APO/FPO addresses. To learn more, visit www.express-scripts.com/TRICARE or contact Express Scripts at 1-877-363-1303.

4. I am concerned that my medication could be stolen from my mailbox.

If your medication is stolen from your mailbox, contact Express Scripts at 1-877-363-1303. A Patient Care Advocate will work with you to obtain replacement medication.

5. I am going on vacation, and I do not have enough medication to last me while I am traveling.

If you do not have enough medication to last you while you are traveling, contact Express Scripts at 1-877-363-1303. A Patient Care Advocate will work with you to obtain a refill.

If you are traveling to a destination for a longer period of time, Express Scripts can ship your medications to a temporary address.

Express Scripts ships to the following destinations:

• All 50 states
• PO boxes
• APO/FPO addresses
• U.S. territories

To change your shipping address, contact Express Scripts at 1-877-363-1303 or update your address information online at www.express-scripts.com/TRICARE.

6. I normally have my prescriptions filled at Walgreen’s. Where can I find a listing of pharmacies who participate in the TRICARE program?

To find other pharmacies in your area who participate in the TRICARE program, Contact Express Scripts at 1-877-363-1303. A patient care advocate will locate participating pharmacies in your area, or go to www.express-scripts.com/TRICARE. Click on the Find a Pharmacy link in the Resources section. Enter your zip code to find a participating pharmacy.

You can also manage your prescriptions on the go with any Web-enabled mobile device to order refills, check status, find a pharmacy, and more. Visit http://www.express-scripts.com/mobile/ to learn more.

7. Do I have to contact Express Scripts every time I need my Home Delivery medications refilled?

No. Express Scripts offers an auto refill program, which takes the worry out of refilling your maintenance medications. Enrollment is free and when you enroll in this program, Express Scripts will automatically refill and mail your medication to you. Seven days before your medication is scheduled to be refilled, Express Scripts will notify you by phone or email that your prescription is going to be filled.  At any time before the prescription processes, you may cancel or reschedule the automatic refill. To register online for the auto refill program, visit www.express-scripts.com/TRICARE or call Express Scripts at 1-877-363-1303.

8. I like talking to my pharmacist when I pick up my medications.  Does Express Scripts offer the same service?

Yes. Express Scripts has pharmacists available 24 hours a day/7 days a week to answer questions about medication appearance, dosing, safety, side effects, drug interactions, temperature and medication sensitivity.  If you need to speak with a pharmacist, please call Express Scripts at 1-877-363-1303.

9. Can I order controlled substances through Home Delivery?

Yes, the home delivery pharmacy can fill a prescription for a controlled substance. In order to do so, your prescribing provider must provide his or her individual Drug Enforcement Administration number on the prescription and a complete street address. An adult’s signature is required upon delivery. Please note that controlled substances cannot be shipped to a PO Box.

Some controlled substances are not refillable by law. Check with your provider.

10. I recently had my prescriptions filled and noticed the copays have changed.  Can you tell me more about this?

On August 5, 2011, the Office of the Assistant Secretary of Defense (Health Affairs) approved changes to pharmacy copayments which go into effect on October 1, 2011. The following table provides the new copay structure as of October 1, 2011:

In a news release titled “TRICARE Reduces Pharmacy Home Delivery Co-Pays” dated September 7, 2011, Navy Rear Adm. Christine Hunter, deputy director of the TRICARE Management Activity, stated “These new copays make using TRICARE Pharmacy Home Delivery more affordable than ever” and “Home Delivery offers a great value for patients taking maintenance medications for chronic conditions.”

To read the full press release, visit http://www.tricare.mil/mediacenter/news.aspx?fid=736.

11. Over the last several months, my doctor has been adjusting my medications. I am concerned that if I use Home Delivery, I will be throwing away more medication than I use.

It is better to use a participating TRICARE retail pharmacy if your doctor is adjusting your medication. However, once your medication is adjusted, Home Delivery will provide you with more cost savings.

To begin using Home Delivery, go online to www.express-scripts.com/TRICARE and register or call the Member Choice Center at 1-877-363-1433.

There will be an important change to your pharmacy benefit effective the 1st of January 2012.  This concerns the retail chain of Walgreens.

As we have highlighted a few weeks ago, Walgreens will no longer be a part of the Express Scripts pharmacy network.  If you continue to fill your prescriptions at a Walgreens pharmacy after 1 January, you will have to pay 100% of your prescription costs and submit a paper claim for NON-NETWORK reimbursement, which will dramatically increase your out of pocket costs.

Walgreens remains in the TRICARE pharmacy network through Dec. 31, 2011, but the time for you to act is now.  According to ESI there are more than 56,000 pharmacies in the TRICARE network, excluding Walgreens.  On average, there is another network pharmacy within one-half mile of any Walgreens.  Now is also a good time to consider moving the medication you take on an ongoing basis to TRICARE Home Delivery.

Remember with the Home Delivery method you get:

1. Savings that add up quickly
2. Convenient delivery and refills (and refills come automatically..)
3. Safety
4. Personal service, as you can speak with a pharmacist anytime day or night from your home.

For more information on the Home Delivery option go to: www.express-scripts.com/TRICARE   and click on the ‘Get started with Home Delivery’ link on the left side of the screen.

The TRICARE Young Adult (TYA) Prime option is available for purchase on December 1, 2011, with coverage beginning January 1, 2012. Offering young adult beneficiaries TRICARE Prime coverage, TYA Prime has a monthly premiums of $201. To purchase TYA Prime, dependents must be under age 26, unmarried, not eligible for their own employer-sponsored health care coverage and reside within a TRICARE Prime service area.

Additionally in January 2012, TRICARE Young Adult Standard option monthly premiums are lowered to $176 with the same benefit structure previously enjoyed. See TYA  for full program details.

Last week, in conjunction with MOAA’s Annual Meeting in San Antonio, the MOAA Board of Directors Healthcare Committee was  provided a tour of the “new” Brooke Army military medical center located on the grounds of Fort Sam Houston.  We had a first hand view of one of the military’s premier hospitals and observed the care they give to our wounded warriors and their families.

Many will no doubt remember that BRAC 2005 directed the realignment of the inpatient medical function of the 59^th Medical Wing (Wilford Hall Medical Center) to Brooke Army Medical Center (BAMC) in San Antonio to create the San Antonio Military Medical Center (SAMMC). This deadline was met on Sept. 6, 2011, when the final relocated inpatient service opened at Brooke Army Medical Center. BAMC, the hospital, is now known as SAMMC. Brooke Army Medical Center now refers to the headquarters that oversees all Army clinics in San Antonio and the surrounding area. Wilford Hall Medical Center is now known as the Wilford Hall Ambulatory Surgical Center.

The SAMMC medical center serves as a world class health science center for inpatient and ambulatory care, consisting of Graduate Medical Education (GME) & training, a Level 1 Trauma Center, and the only American Burn Association verified Burn Center within the DoD.  We had an extensive tour of this burn center and it is truly state of the art.  They not only take care of patients air-evaced from the theatre of war, but also care for the severely burned victims from the surrounding civilian community.

Wounded warriors and their families are also cared for in a holistic approach.  One of the unique features on the grounds of the medical center is the Warrior Family Support Center.  This center grew from a conference room filled with food, clothing and shelter for wounded families to a state of the art 12,500 square foot facility.  This center is a haven for recreation and support and boasts of a miniture golf putting green, to a large multi-use kitchen which frequently serves family feasts.

The San Antonio community is known as the most “military friendly” city in America.   By the end of our visit we certainly felt the same way!