You can have Medicare + Medicaid in one plan with even more benefits.

As a Horizon NJ Health member, you may be eligible for our new plan called Horizon NJ TotalCare (HMO SNP), which combines all covered Medicare and Medicaid managed care benefits into one plan, plus it includes extra benefits and services at no cost to you.

• $0 premiums • $0 copayments • $0 deductibles

What is exciting about this plan is that it combines your coverage into one plan, making it easier for our Care Manager to coordinate your care.

Why this plan may be good for you:

• One ID card: Use one ID card for all your care.

• No money out of pocket: $0 copayments, premiums, deductibles.

• Total coverage: Vision, dental, hearing, and behavioral health coverage.

• Valuable extras: $125 per quarter for over-the-counter (OTC) health products.

• 24-hour support: 24/7 Nurse Line as well as Personalized Care Management services.

Eligibility requirements

You must:

• Live in one of the following 15 New Jersey counties: Atlantic, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Monmouth, Morris, Passaic, Salem, Somerset, Sussex, Union or Warren.

• Have Medicare Parts A and B.

• Have full Medicaid eligibility.

• Not be diagnosed with End-Stage Renal Disease (ESRD) at the time of enrollment (with certain exceptions.)

• Not be enrolled in a Program for All Inclusive Care for the Elderly (PACE). You must disenroll from PACE in order to enroll in this plan.

For more information about Horizon NJ TotalCare (HMO SNP), or to enroll, call toll free 1-888-328-5736 (TTY/TDD 711), 24 hours a day, seven days a week. You can also visit HorizonBlue.com/TotalCare.

horizonNJhealth.com

Issue 1, 2017

A newsletter for Horizon NJ Health members

Blue Notes

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Lead testing for childrenLead poisoning can cause serious problems to your child’s development, behavior, hearing and learning. The good news is that lead poisoning can be prevented. A simple blood test is performed in your doctor’s office to see if your child has lead poisoning.

It is important that the lead screening is done early. All children between the ages of 9 months and 18 months (preferably at 12 months) should be tested. They will also be tested again between 18 months and 26 months (preferably at 24 months).

If your child’s test results are not within the normal limits for lead in the blood, his or her doctor will recommend testing more often. A Horizon NJ Health nurse will also work closely

with you until your child’s blood lead level is within the normal range.

Children can get lead poisoning from swallowing or inhaling lead. Lead can be found in a variety of places, such as in older homes with paint chipping or peeling from the walls. Lead can also be found in:

• Drinking water from lead pipes and solder in plumbing

• Homes built before 1978

• Some toys and jewelry made outside the USA, including in China and Mexico

• Some soil, spices, imported candies, makeup, folk medicine, stained glass and batteries

You can play a role in preventing falls • Exercise to improve your strength and balance. • If your doctor has recommended a cane or walker, make sure to use it whenever

you walk. • Remove loose rugs and clutter on the floors. They can make you fall or trip at home. • Talk to your doctor to find out if your medications can make you dizzy.

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How to read a prescription label

Managing your medication

There is a lot of important information on a prescription label, including instructions on how to take your medicine correctly. Here are some tips to help you find the information you need.

If you have any questions about your prescription medication, speak with your pharmacist, or doctor, or call the Horizon NJ Health Pharmacy Department at 1-800-682-9094 (TTY/TDD 711).

If you take prescription drugs to manage your chronic condition like diabetes or asthma, you should take the necessary steps to make sure you are managing your medication. With multiple daily medications, it can sometimes be difficult to remember to take them as directed, or even make sure you have all of your medications available when you need them. Taking your medication correctly is key in managing your health condition.

What you can do to manage your medication • Talk to your doctor – review all medications

you take (both prescription and over-the-counter (OTC)) and let your doctor know if you are experiencing any side effects, like dizziness.

• Talk to your pharmacist – make sure you understand the instructions for taking your medicines.

• Refill your prescriptions timely – refill your prescription before you run out of your medication. You can also ask your pharmacy about automatic refills so your medication is always refilled and ready for you.

• Fill all of your prescriptions at the same pharmacy – this allows your pharmacist to see all the medication you take and helps them manage your care.

If you have any questions about your medication, talk to your doctor or pharmacist.

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Formulary Changes Horizon NJ Health would like to let you know about recent changes to our formulary list, also called drug list (see box). The changes found in this list will be added to our drug formulary list on our website at horizonNJhealth.com. You can also find the approved drug list, which includes an explanation and listing of step therapy, quantity/age limitations and drugs requiring prior authorization.

Here is a list of recent changes:

Covered Change Description

Brand (Generic) Drug Name Alternatives (if applicable)

Covered Nuplazid (pimavanserin) N/ACovered Alogliptin N/ACovered Alogliptin/metformin N/ACovered Alogliptin/pioglitazone N/ACovered Zomacton (somatropin) N/ACovered Xuriden (uridine triacetate) N/A

Not Covered Fanapt (iloperidone) Risperidone, Quetiapine, Aripiprazole, Clozapine, Olanzapine, Ziprasidone, Paliperidone

Not Covered Saphris (asenapine) Risperidone, Quetiapine, Aripiprazole, Clozapine, Olanzapine, Ziprasidone, Paliperidone

Not Covered Januvia (sitagliptin) Alogliptin

Not Covered Janumet, Janumet XR (sitagliptin/metformin) Alogliptin/metformin

Not Covered Omnitrope (somatropin) Zomacton, Humatrope

Not Covered Cleocin T (clindamycin) gel, lotion Clindamycin solution

Not Covered Accu-Chek products One Touch products

Please talk with your Primary Care Provider (PCP) about these changes. If your PCP decides that, for medical reasons, you must take a drug that is not on the formulary list or needs pre-approval, including a brand name medication exception, he or she can call us and ask for special permission (prior authorization) for you to get the drug. Please note that Horizon NJ Health’s maximum days supply limit is 30 days.

Your PCP may call the Horizon NJ Health Pharmacy Department at 1-800-682-9094 to request a prior authorization.

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Quality Improvement ProgramFor more information about Horizon NJ Health’s Quality Improvement Program and its progress toward goals, please call Member Services toll free at 1-800-682-9090 (TTY/TDD 711) and ask for the Quality Department, or go to horizonNJhealth.com/qualityimprovement.

Member rights and responsibilitiesYour member rights and responsibilities can be found in your Horizon NJ Health Member Handbook, or at horizonNJhealth.com. Under the Member Support tab, select Resources.

Hand washing prevents the spread of diseaseRegular hand washing is one of the best ways to remove germs and stop the spread of germs to others. It is also a great way to keep you from getting sick. Washing your hands with soap and water before and after certain activities will help prevent the spread of many diseases.

When should you wash your hands? • After blowing your nose,

sneezing or coughing • After using the toilet • Before and after caring for someone who is sick • Before and after treating a cut or wound • Before, during and after preparing food • Before you eat

It is important to follow these steps to wash your hands properly:

1. Wet your hands with clean, running water and apply soap.

2. Lather your hands by rubbing them together with the soap. Wash the backs of your hands, between fingers and under nails.

3. Scrub your hands for at least 20 seconds. You can hum the “Happy Birthday” song twice to help you keep track of time.

4. Rinse your hands under clean, running water.

5. Dry your hands using a clean towel, or air dry.

For more information on hand washing, visit cdc.gov/handwashing.

Source: Centers for Disease Control and Prevention

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Our Notice of Nondiscrimination

Horizon NJ Health

210 Silvia Street West Trenton, NJ 08628 horizonNJhealth.com

CMC0008199 (0716) Independent licensees of the Blue Cross and Blue Shield Association* Horizon NJ Health, a product of Horizon HMO*

Notice of Nondiscrimination

Horizon NJ Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Horizon NJ Health does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.

Horizon NJ Health provides free aids and services to people with disabilities or those whose first language is not English, to communicate effectively with us, such as:

Qualified sign language interpreters Information written in other languages

If you need these services, contact Horizon NJ Health’s Director of Regulatory Compliance at the phone number, fax or email listed below.

If you believe that Horizon NJ Health has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a grievance with:

Horizon NJ Health – Director, Regulatory Compliance Three Penn Plaza East, PP-16C Newark, NJ 07105 Phone: 1-800-658-6781 (TTY/TDD 711) Fax: 1-973-466-7759 Email: ComplianceAndEthicsOffice@HorizonBlue.com

You can file a grievance in person, or by mail, fax or email. If you need help filing a grievance, Horizon NJ Health’s Director of Regulatory Compliance is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

Office for Civil Rights Headquarters U.S. Department of Health and Human Services

200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201

1-800-368-1019 or 1-800-537-7697 (TDD)

Complaint forms are available at www.hhs.gov/ocr/office/file/index.html.

Para ayuda en español, llame a 1-800-682-9090 (TTY/TDD 711).

7

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-844-498-9393 (TTY/TDD 711).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-844-498-9393 (TTY/TDD 711).

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-844-498-9393 （TTY/TDD 711）.

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-844-498-9393 (TTY/TDD 711)번으로 전화해 주십시오.

ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-844-498-9393 (TTY/TDD 711).

UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-844-498-9393 (TTY/TDD 711).

ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-844-498-9393 (TTY/TDD 711).

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-844-498-9393 (TTY/TDD 711).

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-844-498-9393 (телетайп 711).

ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-844-498-9393 (TTY/TDD 711).

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-844-498-9393 (TTY/TDD 711).

ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-844-498-9393 (ATS 711).

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1-844-498-9393 (TTY/TDD 711).

Y0090_MultiLangPost2017 Accepted

Information in other languages

210 Silvia Street West Trenton, NJ 08628

Para solicitar este boletín informativo en español, llame al Departamento de Servicios para los Miembros al 1-800-682-9090 (TTY / TDD 711).

BLUE NOTES is published as a community service for the friends and patrons of Horizon NJ Health, 210 Silvia St., West Trenton, NJ 08628. Information in BLUE NOTES comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your health care physician. Models may be used in photos and illustrations.Member Services 1-800-682-9090 (TTY/TDD 711) 24 hours a day, seven days a week. horizonNJhealth.comThis information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Medicaid will cover in full your Part B premium. Members must use a SNP network provider. Members must use a SNP network DME (Durable Medical Equipment) supplier. Members must use a SNP network pharmacy. Members will be enrolled into Part D coverage under the SNP and will be automatically disenrolled from any other Medicare Part D or creditable coverage plan in which they are currently enrolled. Members must understand and follow the SNP’s rules on referrals.The Formulary may change at any time. You will receive notice when necessary. Horizon NJ Health is part of the Horizon Blue Cross Blue Shield of New Jersey enterprise, an independent licensee of the Blue Cross and Blue Shield Association. © 2017 Horizon Blue Cross Blue Shield of New Jersey. Three Penn Plaza East, Newark, New Jersey 07105.Facebook® is a registered mark of Facebook, Inc. Twitter™ is a registered trademark of Twitter, Inc. Y0090_H2898_CMC0009460 Accepted

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Vitamin D is important for strong and healthy bones. It also helps your body fight infection and benefits your overall health. Your body makes its own vitamin D from sunlight and turns it into calcium. Sometimes, your body may not get enough vitamin D, which results in a condition known as vitamin D deficiency.

People with vitamin D deficiency may feel tired, or have aches and pains. Some people may not have any symptoms. It is more common to be vitamin D deficient during the winter months, when you are not spending as much time outside getting sunlight. Research has shown that people who have had low levels of vitamin D in their blood are at a higher risk of developing type 2

diabetes later in life. That is why it is especially important for young people to get enough vitamin D. If you think you may be vitamin D deficient, talk to your doctor. He or she can perform a blood test to check the amount of vitamin D in your blood.

Ways you can get vitamin D

• Exposing your skin to sunlight

• Certain foods: beef liver, cheese, egg yolks, fatty fish such as tuna and salmon

• Taking vitamin D supplements – talk to your doctor for your correct dosage

Source: vitamindcouncil.org

Getting enough vitamin D