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The Advantage

A NEWSLETTER FOR OUR MEMBERS | ISSUE 3 | 2024

Posted 11/18/24
The Advantage Callout

We appreciate you.

Every year, during Medicare’s Annual Enrollment Period, we’re reminded of the many choices you have for your health coverage. We’re honored you’ve chosen us. Serving as your partner in health is both a privilege and a responsibility. And, it’s one we take seriously.

As the only local, not-for-profit provider of Medicare Advantage plans, our priority is the health of our community. That’s why we offer our Maine and New Hampshire neighbors affordable, high-quality plans that go beyond Original Medicare to include the extra benefits you need. Because we know that dental, vision, and hearing care, and helping you stay active are all important to your overall health and should be covered.

We’re especially excited to be able to offer $0-premium plans with Part D prescription drugs and wide provider flexibility in all counties in 2025. We invite you to learn more about our 2025 Generations Advantage plans to see if they may better fit your needs.

Thank you for choosing the Martin’s Point team. We look forward to continuing to serve you in the year ahead.

Seafoam star icon
Martin Wesolowski signature Martin Wesolowski, DO, MBA
VP Associate Chief Medical Officer – Health Plan

Who should get one?

The Centers for Disease Control (CDC) recommend flu shots to everyone 6 months and older. Talk with your provider if you:

  • » Have an egg allergy
  • » Have had a severe reaction to a flu vaccine before
  • » Have a moderate or severe illness or fever

Are flu shots covered? Yes.

Generations Advantage members have two ways to get a flu shot at no cost:

  • » Through a participating pharmacy network: Free at Hannaford, Rite Aid, CVS, Shaw’s/Osco, Walgreens, and Walmart when you show your Generations Advantage member ID card. You can also get a flu shot at a pharmacy that is not in the Vaccine Pharmacy Network. Pay the full cost upfront and submit a reimbursement request form to Generations Advantage to see if it is covered by your plan.
  • » Your primary care provider’s office. There is no cost for a flu shot but you may have an office visit copay, depending on your plan.
  • » You can also get a flu shot at a pharmacy that is not in the Vaccine Pharmacy Network. Pay the full cost upfront and submit a reimbursement request form to Generations Advantage to see if it is covered by your plan.

What else can I do?

Other steps to prevent the spread of flu:

  • » Avoid sick people and limit contact with others when you’re sick.
  • » Cover your sneezes and coughs.
  • » Clean and disinfect shared surfaces.
  • » Wash your hands with soap and water or use sanitizer.

Visit MartinsPoint.org/Flu for more information.

Visit the Drug and Vaccine Coverage page for specific vaccine coverage details.

We can help you manage heart failure.

What is heart failure?

Heart failure is a condition that causes the muscle in the heart wall to slowly weaken and enlarge, preventing the heart from pumping enough blood. The heart keeps working, but the body’s need for blood and oxygen isn’t being met.

For more information on heart health, visit our MartinsPoint.org/HeartHealth.

What are the common symptoms?

  • » Shortness of breath
  • » Fatigue
  • » Coughing or wheezing, especially when you exercise
  • » Swelling in feet and legs
  • » Weight gain from fluid buildup

How can Martin’s Point help?

Many members have experienced improvements in their health and well-being through our care management programs at Martin’s Point. Our care managers provide a coordinated approach to care that includes education, self-management skills, and ongoing support.

If you are experiencing the symptoms listed above, one of our care managers here at Martin’s Point may reach out to you as part of our Care Management program. For more information, please call us at 1-877-659-2403.

Seafoam star icon

“Our goal is to provide the information and resources needed to manage and maintain your health at home.”

Follow these tips
for taking your blood pressure at home.

Patient taking blood pressure

The American Heart Association (AHA) recommends home blood pressure checks for those with a history of hypertension (high blood pressure). These checks complement doctor visits and help track whether treatment is working.

At-home blood pressure checks are only helpful if done correctly. Here are tips for getting accurate results:

  • » The AHA recommends using the automatic, cuff-style monitor designed for the upper arm.
  • » Before purchasing, ensure a good fit—have someone help measure your upper arm.
  • » Bring your monitor to your next doctor’s appointment to make sure you are getting the same results as the doctor’s office monitor.
  • » Before a blood pressure check, don’t exercise, drink caffeine or alcohol, or smoke for at least 30 minutes.
  • » Apply the blood pressure cuff directly on your skin and not over clothes. Ask your doctor if there are restrictions on which arm you should use (e.g., history of breast cancer).
  • » Rest quietly for five minutes before taking your blood pressure.

» Sit in a supportive chair with both feet flat on the floor. Make sure the arm with the cuff is supported.

» Take your blood pressure at the same time every day. Take two readings at least one minute apart. Your doctor can advise you on the frequency of blood pressure checks and when to contact their office.

» AHA recommendation: If your blood pressure is 180/120, recheck in a few minutes. If still elevated but no symptoms, contact your doctor’s office. If you are experiencing any symptoms like chest pain, shortness of breath, back pain, numbness/weakness, vision changes, or difficulty speaking, call 911.

Don’t forget...

You can use your Generations Advantage CVS Over-the-Counter benefit toward the purchase of an automated blood pressure monitor. Learn more at MartinsPoint.org/GAOTC .

Preventing Falls: Your Safety Matters.

Falls may be more common in older adults, but they are not a normal part of aging. If you are having difficulty with walking, balance, or falls, please discuss this with your health care provider. There are many reasons people may be experiencing these problems. Your provider can help determine causes and make recommendations to improve these conditions.

Six Tips to Help Prevent Falls

  • » Talk with your health care provider about medication side effects.
  • » Make your home safer by using night lights, installing grab bars in the bathroom, and securing carpets to the floors.
  • » Stand up slowly to avoid dizziness.
  • » Do strength and balance exercises.
  • » Get your vision and hearing checked regularly.
  • » Use a cane or walker if you need more stability.

Your Generations Advantage plan offers a range of extra benefits to help support balance, promote strengthening, and prevent falls:

OTC icon

Your Over-the-Counter benefit provides a quarterly allowance that can be used to purchase CVS-brand bathroom safety devices, walkers, and canes.

Wellness Wallet icon

Your Wellness Wallet allowance can be used to purchase items and services that promote activity and support balance and strengthening.

Vision icon

Problems with hearing and vision can increase your risk of falls. Your extra vision and eyewear benefits and your hearing aid benefit through Amplifon can help you get the care you may need.

LifeStation icon

LifeStation Medical Alert Devices provides peace of mind with advanced medical alert devices. Alliance members qualify through a Covered Medical Benefit, while Generations Advantage plan members (Access, Select, Prime, and Value Plus) receive a 25% discount as a value-added discount.

For more information about these extra benefits, visit MartinsPoint.org/GAExtraBenefits or call Member Services at 1-866-544-7504.

For more information about LifeStation, visit MartinsPoint.org/LifeStation.

Will your
medication
be affected by
2025 Formulary
changes?

If so, here’s what you can do.

When it comes to your health, making informed decisions about your medications can lead to better outcomes and cost savings. An easy way to help cut health care costs is to choose medications that are on your health plan’s formulary. A formulary is a list of covered drugs that are believed to be a necessary part of an effective treatment program. Formulary medications generally cost less than non-formulary drugs.

Each year there are changes to the formulary. You will be notified if your medication will be negatively impacted in 2025. If the cost of your drug is changing or if your drug will no longer be on the formulary, talk to your provider and use the formulary search tool to view possible alternatives at MartinsPoint.org/PartD.

Try our convenient mail-order: Your Generations Advantage plan offers an option that delivers your prescriptions right to your mailbox. You can also sign up for an automatic refill program—your medications are sent when our records show you should be close to running out. The pharmacy will contact you before shipping each refill to make sure you need more medication.

To learn more or sign up, please call CVS Caremark Customer Care at 1-888-296-6961. You can also find information in your Generations Advantage plan’s Evidence of Coverage document here.

Taking your medications as your provider has prescribed is the best way to make sure your treatment can be effective. That means taking the right doses at the right time, and in the right way.

Tips

  • » Use a weekly pill box.
  • » Create reminders with notes or alarms.
  • » Ask for help if you’re having trouble taking your medications.
  • » Review all your medications with your care team at every health visit.
  • » Get a 90-day supply of your long-term medications.
  • » Check if your pharmacy has automatic refills or medication synchronization.

Talk with your doctor about:

  • » The number of doses you miss weekly or monthly.
  • » Changes to when you take a medication (e.g., morning versus night).
  • » Changes to your dose. If your dose is cut or increased, make sure a new prescription with updated directions is sent to the pharmacy.
  • » Challenges affording your medication.
  • » Medications you have stopped taking or side effects you’re experiencing.

To help you stay on track with your medications, download our Medication Tracker (PDF). This simple form can make it easier to manage your prescriptions.

Mental health awareness message beside smiling man

Support your mental health over the holidays.

While many associate the holidays with joy and celebration, others face increased stress, sadness, and loneliness. Your mental health is as important as your physical health. If you experience seasonal dips, here are some tips from the Substance Abuse and Mental Health Service Administration to help support you.

Keep these tips top-of-mind this season.

OTC icon

Acknowledge how you are feeling. It’s OK to feel unhappy, but it’s difficult to address these feelings if you are not recognizing them.

Wellness Wallet icon

Create a plan for when you feel down, stressed, or lonely. Reach out to a friend or family member, go for a walk, or enjoy a favorite activity like reading or watching a movie.

Vision icon

Prioritize self-care by eating well, exercising, and getting enough sleep—these are essential for both mental and physical health.

LifeStation icon

Talk to your doctor or care team if you experience worsening symptoms in winter or during the holidays. You may need extra support through counseling, medications, or other treatments.

LifeStation icon

Seek help if your mental health becomes overwhelming. The 988 Suicide & Crisis Lifeline is available for support—just call or text 988.

Remember, you are not alone. Caring support is available, 24/7, every day.

988 Important Resources
Behavioral Health Care

A Martin’s Point care manager can assist with ongoing behavioral health needs. To speak with one about our free care management program, call 1-877-659-2403.

Learn how to support adult and child mental health at MartinsPoint.org/MentalHealth.

Watch your mailbox for an exciting new plan feature.

Prepaid debit card for 2025!

Using your Wellness Wallet and Eyewear benefits will be even easier in the upcoming year. You should receive your Martin’s Point Prepaid Mastercard® in the mail soon. Starting January 1, 2025, you can use this card to pay for eligible items at select retailers for up to your plan’s 2025 annual allowed amounts. Visit MartinsPoint.org/WellnessWallet for information about the card, how to use it, and to view a list of participating retailers.

Icon of a shoe representing wellness wallet benefit. Prepaid debit card for 2025 graphic Icon of glasses representing vision benefits.

 

P.S., Don’t forget to use your 2024 reimbursement balances before December 31. You have 90 days after the new year to request reimbursement, but purchases for your 2024 balances must be made in 2024. Visit MartinsPoint.org/WellnessWallet for more information.

We want to know about your health care experience.

As your health plan, we want you to have the best experience when receiving health care. To help us learn more about the quality of your experiences, we hope you’ll take a few moments to respond to a brief survey. Take the survey at Healthcare Experience Survey.

We appreciate you taking time to complete this survey and use your feedback to understand opportunities to improve your health care experience.



Veranda gold star icon Refer a friend.

Do you know someone who deserves great benefits like yours?

Please let them know they can join a Generations Advantage plan now through December 7 during Medicare’s Annual Enrollment.

Have them call 1-877-317-2062 (TTY: 711).

Smiling elderly couple dancing

We’ve been busy in the community.

A team of Martin’s Point employees joined the American Foundation for Suicide’s Out of the Darkness Walk to help communities across the U.S. raise awareness and advocate for suicide prevention. Captained by Anne Theriault of Health Plan Pharmacy Operations, our largest team yet helped support this signature fundraising event in Portland. Learn more at AFSP.org.

Learn more about the many ways Martin’s Point supports our local community at MartinsPoint.org/Community.



If you need us— we’re just a phone call away.

Member Services (for current members):

1-866-544-7504 (TTY: 711)

Call us 8am–8pm, seven days a week from October 1 to March 31; and Monday through Friday the rest of the year.

Interested in becoming a member?

1-844-737-0373 (TTY: 711)

Generations Advantage Website:

MartinsPoint.org/MedicareMember

Material presented in this newsletter is not intended to replace your health care provider’s medical advice. Martin’s Point Generations Advantage is a health plan with a Medicare contract offering HMO, HMO-POS, and local PPO products. Enrollment in a Martin’s Point Generations Advantage plan depends on contract renewal. Martin’s Point Health Care complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.


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