Provider directory on the Web

You can quickly and easily search our large network of doctors, hospitals, and other health care providers online. Go to www.upmchealthplan.com and click on the "Find a Doctor" link on the right side of the screen.

You can search for a doctor by name, office location(s), specialty, hospital or medical group affiliation, gender, languages spoken, and whether the doctor is accepting new patients. You can also see if the doctor's office has any restrictions. In addition, the listing includes the doctor's office hours and board certifications, if any. When a doctor is board certified, that means he or she has additional education.

If you are looking for a hospital, you can search by name, location, and accreditation status. The hospital listing includes the address, phone number, and services offered; for example, on-site lab or dialysis services.

You can also call UPMC for Life at 1-877-539- 3080 for help finding a doctor or hospital or to request a printed Provider Directory. Health Care Concierges are available Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m. TTY/TDD users should call 1-800-361-2629.

Your "shot" to stop the flu

The weather may still be warm, but it is not too early to get a flu shot.

If you have ever had the flu, then you know just how bad it can make you feel. Body aches, fever, chills ... no one wants to get the flu. The very best way to prevent the flu is to get a special shot — called a vaccine.

According to the Centers for Disease Control and Prevention (CDC), everyone who is six months old or older should get a flu vaccine this season.

Visit your doctor to get your free flu shot. Or get your flu shot at a designated location in your community. If you pay out of pocket for your flu shot, UPMC for Life will reimburse you. To print a flu shot reimbursement form, go to www.upmchealthplan.com. Scroll down to Members and then select Commonly Used Forms. You can also call your Health Care Concierge and ask to have a copy of the form mailed to you.

Health Care Concierges are available Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m.

Note: Not all people should receive this vaccine. Talk to your doctor to find out if this vaccine is right for you.

Getting the health care information you need — how you need it

Understanding health care information is challenging for everyone. And talking about health care can be especially confusing when English is not a member's first language.

UPMC for Life members who do not speak English can call us at 1-877-539-3080 and be connected with a translator.

Visit www.upmchealthplan.com/medicare to find health care providers who speak languages other than English. Click on the "Find a Doctor" link, and use the language tab to pick the language you prefer. You may also call UPMC for Life and ask a Health Care Concierge to provide you with this information.

If you need information about how to get UPMC for Life materials in a different language or format, contact us and we will work with you to meet your needs. Contact UPMC for Life toll-free at 1-877-539-3080. Health Care Concierges are available Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m. TTY/TDD users should call 1-800-361-2629.

Don't forget ... to ask the doctor

Your primary care doctor is the best resource you have to keep you on the path to good health. Don't feel like you have to hurry through your appointment. Take the time to ask questions. Here are some examples:

How can I reduce my risk of falling?
As we age, our bodies change. Many of these changes, including vision problems, arthritis, and balance disorders, become risk factors for falls. And chronic conditions such as stroke, osteoporosis, osteoarthritis, multiple sclerosis, and Parkinson's disease increase our chances of falling. But the good news is that many falls are preventable through simple safety measures, daily exercise, and lifestyle changes.

How much should I exercise?
There may not be a fountain of youth, but millions have discovered that staying physically active helps them feel better. Regular exercise can prevent or delay chronic health conditions like diabetes and heart disease; reduce arthritis pain, anxiety, and depression; and help you stay independent. As a member of UPMC for Life, you can get regular exercise by enrolling today in Silver&Fit^®. Designed specifically for UPMC for Life HMO and PPO members, Silver&Fit offers exercise and healthy aging classes as well as social activities to help you become physically fit. There are no copayments, coinsurance, or deductibles for any of the Silver&Fit programs and benefits. Talking to your doctor is the first step on the way to a healthier lifestyle. Take time to talk to your doctor.

Should I have a test for osteoporosis?
While there are treatments for osteoporosis, prevention of this disease is very important because there is no cure. The National Osteoporosis Foundation (NOF) suggests these five steps to bone health and osteoporosis prevention:

1. Get your daily recommended amounts of calcium and vitamin D.
2. Engage in regular weight-bearing exercise.
3. Avoid smoking and drinking too much alcohol.
4. Talk to your health care provider about bone health.
5. When appropriate, have a bone density test and take medication if necessary.

Why do I need flu and pneumonia vaccines?
Anyone can get the flu and/or pneumococcal disease. Pneumococcal disease can lead to a serious infection of the lungs (pneumonia), the blood (bacteremia), and the covering of the brain (meningitis). The Centers for Disease Control and Prevention (CDC) recommends that all adults age 65 and older be vaccinated against pneumococcal disease, especially those with certain health risks and long-term health problems.

And we all know how horrible the flu makes us feel. Body aches, fever, and chills. The flu can even be deadly. No one wants the flu. And the very best way to avoid the flu is to get vaccinated. Medical experts decided that everyone who is six months old or older should get a flu vaccine this season. They believe that this "universal" flu vaccination will help protect more people against the flu.

What can I do to treat or manage my bladder problems?
The bladder is an important storage area for urine that has been excreted from the kidneys. An unhealthy bladder can be prone to infection and disease. Have a complete annual medical checkup, including a test of your urine for blood. Consult your doctor at the first sign of a problem, particularly if you see blood in your urine, but also if you have pain when urinating or increased urinary frequency or urgency.

What about preventive exams and tests?
If you practice healthy behaviors, stay current with preventive exams, manage existing illnesses, and continue to engage with family and friends, you'll be more likely to remain healthy, live independently, and have fewer health-related costs. Take advantage of the preventive services that UPMC for Life offers all of our HMO and PPO members, including:

• Annual wellness exam
• Immunizations (e.g., flu and pneumonia)
• Screenings and exams
• Breast cancer screening with mammogram
• Pap test and pelvic exam
• Prostate exams and screenings
• Smoking cessation (counseling to stop smoking)
• Bone mass measurement
• Colorectal exams and screenings

Save the date for Drug Take Back Day — October 29 from 10 a.m. to 2 p.m.

More than seven million Americans currently abuse prescription drugs, according to the 2009 Substance Abuse and Mental Health Administration's National Survey on Drug Use and Health. Each day, approximately, 2,500 teens use prescription drugs to get high for the first time according to the Partnership for a Drug Free America. Studies show that most abused prescription drugs are obtained from family and friends, including the home medicine cabinet.

In an effort to address this problem, the Drug Enforcement Administration (DEA), in conjunction with state and local law enforcement agencies throughout the United States, recently conducted two National Prescription Drug Take Back Days. These efforts were a huge success in removing potentially dangerous prescription drugs, particularly controlled substances, from our nation's medicine cabinets.

DEA has scheduled another National Prescription Drug Take Back Day, which will take place on Saturday, October 29,
from 10 a.m. — 2 p.m.

Multiple drop-off locations will be available throughout western Pennsylvania. For more information, visit www.zerowastepgh.com or call the Pennsylvania Resources Council at 412-488-7452 for specific locations.

Can you identify a stroke?

For a person who's had a stroke, getting quick medical care is vitally important. An FDA-approved clot-buster medication is available that may reduce long-term disability for the most common type of stroke. However, this medication must be given within three hours of the first symptom, so it's very important to be able to quickly recognize the signs of a stroke. Use the word "FAST" as your guide!

FACE: Ask the person to smile. Does one side of the face droop?

ARMS: Ask the person to raise both arms. Does one arm drift downward?

SPEECH: Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?

TIME: If you observe any of these signs, call 9-1-1 immediately.

There are different types of strokes, but this fast test can help you identify when a person has suffered the most common kind.

If you know or even suspect a person has had a stroke, call 9-1-1 immediately.

Source: National Stroke Association

We've taken the check out of checkup

Your once-a-year checkup is just one of a long list of preventive services with a $0 copayment!

Call your doctor for your annual checkup. While you're there, ask which $0 copayment preventive services you need to have.*

For Women:

• Osteoporosis bone mineral density test
• Pap test/pelvic exam
• Mammogram

For Men:

• Prostate cancer screening (PSA test)

For Women and Men:

• Cholesterol screening
• Diabetes screening
• Colon cancer screening
• Seasonal flu vaccine
• Pneumonia vaccine
• HIV screening
• Smoking cessation counseling
• Annual wellness exam
• Nutrition therapy for members with diabetes or renal disease
• Vision care — glaucoma and diabetic retinal eye screenings

These important tests and services prevent problems before they start. Don't wait. Call today. For more information, call UPMC for Life toll-free at 1-877- 539-3080 from 8 a.m. to 8 p.m., seven days a week. TTY/TDD users should call 1-800-361-2629. From February 15 through October 14, we are available from 8 a.m. to 8 p.m. Monday through Friday, and from 8 a.m. to 3 p.m. on Saturday.

*A separate copayment may apply if additional medical services are received during the same doctor visit. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information, contact the plan.

Y006_12_043 CMS Approved 07/062011

Our Quality Improvement Program works for you!

The quality of your health care is important. Our Quality Improvement Program helps us improve the quality of your care, service, and safety. A committee of network doctors and health care professionals oversee the program. They are dedicated to improving quality of care and service to members and promoting hospital safety.

UPMC Health Plan combines the resources of the region's premier hospitals, doctors, and a behavioral health organization to provide high-quality health care for our members. We continually work to improve care and service by:

• Carefully selecting a network of qualified providers by checking their credentials and evaluating their performance.
• Working with you and your providers to promote wellness and manage your care if you have multiple health needs or a chronic condition.
• Measuring the number of members who receive:
• Preventive care
• Chronic care for conditions like osteoporosis and heart disease
• Medication management
• Behavioral health care

Our Quality Improvement Program has had many successes. More members received the recommended care for women's health, heart health, diabetes, respiratory health, and colorectal cancer screening.

UPMC for Life received a high overall member satisfaction rating, as well as strong ratings indicating that members believe they are receiving the care they need. Members were also satisfied with their ability to get information about prescription drug coverage and cost. And they reported being satisfied with their doctors' communication skills.

We are working to improve our service and care even more. Future plans include improving:

• Follow-up with members to facilitate preventive care and care for clinical conditions
• Members' experience with using our website
• Internet tools to help members manage their health, track the status of claims, and find information about the pharmacy benefit

To learn more about our Quality Improvement Program, go to www.upmchealthplan.com. There you can also:

• Find a doctor or hospital.
• Learn about a provider's credentials, including specialty, board certification, and participation in national recognition programs. You can see what languages the provider speaks and get a list of all the office locations.
• Learn about a local hospital's quality and safety records.
• Find a local pharmacy, review your pharmacy benefits, and check prescription coverage.
• Manage your health with self-directed wellness tools, access your claims status, and calculate your costs for care.
• Discover discounts for health food stores, cultural organizations, and other services through the MyHealth Community discount program.

If you would like a paper copy of the website information, or if you would like more information about our Quality Improvement Program, please contact UPMC for Life at 1-877-539-3080. Health Care Concierges are available Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m. TTY/TDD users should call 1-800-361-2629.

Prevent foot wounds

Foot wounds are common in people with diabetes because they are more likely than other people to have calluses, dry skin, and nerve damage. This combination can lead to an increased risk of open sores and infections. Along with loss of feeling in their feet, many people with diabetes also have a vision problem, which means they might not be able to see a small wound on their foot until it becomes much more serious.

A wound that becomes serious can do a lot of damage to tissue and bone. In some cases, it can lead to amputation. Research shows that an open sore precedes most lower limb amputations in people with diabetes. That's why it's so important to avoid foot wounds. If you do get a foot wound, make sure you care for it before it becomes serious.

The best way to avoid wound problems is to prevent them:

1. Check your feet daily. Look for blisters, calluses, chafing, and redness. This is the very best thing you can do to prevent diabetic foot problems. If you have trouble seeing, have someone else check your feet every day.
2. Pay attention to your skin. Check for small, seemingly minor skin problems like infected hair follicles or inflamed areas around the toenails. If you notice a problem, make an appointment with your doctor right away.
3. Moisturize your feet. Use moisturizer to keep the skin on your feet soft and supple. But don't use lotion between your toes because this can lead to a fungal infection. To treat athlete's foot, use a gel instead of a cream antifungal product. Gels don't leave a moisture residue between the toes.
4. Wear proper footwear. Wearing well-fitting shoes can help you avoid blisters. Wear closed- toe shoes even around the house to reduce the risk of foot injury. If you have trouble finding shoes that fit properly, talk to your doctor. You may need a custom-made shoe.
5. Inspect your shoes every day. Make sure you don't have a pebble or another object stuck inside your shoe, or a rough area on the inside of your shoe that could give you a blister.
6. Choose the right socks. Buy socks that wick moisture away from skin. Avoid socks with seams. Buy socks made for people with diabetes.
7. Wash your feet every day. And be sure to dry them carefully, including between the toes.
8. Smooth away calluses. After your bath or shower, use an emery board or pumice stone to gradually remove calluses. Never cut calluses with scissors or a nail clipper.
9. Keep toenails clipped and even. Ingrown toenails can lead to foot problems. Have your doctor check your feet regularly.

Have you moved?

If you have recently moved or are planning to move, please let UPMC for Life know! Call our Health Care Concierge team with your new address and phone number. We are available at 1-800-818-8762 or 1-877-539-3080 Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m.

We've taken the check out of checkup: Your VISION checkup, that is

Once a year, your eye care professional or ophthalmologist can provide a glaucoma screening and/or a diabetic retinal eye exam with a $0 copayment.*

• Glaucoma screenings are important because you may not have any symptoms and still be at risk. Left untreated, it can cause blindness. The test is quick and painless.
• Diabetic retinal eye exams are important because, like glaucoma, you may not have symptoms and still be at risk. Finding and treating diabetic retinal eye problems reduces risk of vision loss by up to 60%.

For more information, call your Health Care Concierge at 1-877-539-3080 Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 3 p.m. TTY/TDD users should call 1-800-361-2629.

*A separate copayment may apply if additional medical services are received during the same doctor visit. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.

Y0069_12_044 CMS Approved 07/20/2011

Annual Notice of Changes arrives in September

Each fall, UPMC for Life sends you an Annual Notice of Changes packet as required by Medicare guidelines. These materials identify changes in your medical and prescription drug coverage for the coming year. Review these materials for important changes in your medical and prescription drug coverage. All changes become effective at the beginning of the next calendar year.

Inside your 2012 Annual Notice of Changes packet, you will receive:

• Updates to benefits, including premiums, deductibles, and coverage limits
• Evidence of Coverage
• A formulary (drug list)

Please note that this document is only a brief summary and not a comprehensive description of your benefits.

Members enrolled in an employer group plan may not receive this information until later in the year depending on when the open enrollment season begins.

Enjoy the Sights — and the Savings — at the Heinz History Center this Fall!

Limited-time offer: 40% off annual memberships for UPMC Health Plan members, families, and friends through December 21!

As chilly weather returns to Pittsburgh, you'll find delightful indoor exercise for your body and mind at the Senator John Heinz History Center, 1212 Smallman Street in Pittsburgh's Strip District.

Six floors of original artifacts and interactive exhibits highlight our region's past 250 years. A new exhibit, Stars & Stripes: An American Story, features the people behind our nation's flag. Take the stairs between floors to view SmartSteps, a fit and fun exhibit in the stairwells created by UPMC Health Plan and the History Center. Climb to all six floors and receive a genuine Heinz pickle pin!

Now through December 21, UPMC Health Plan members and their families and friends can save 40% on Heinz History Center individual and family memberships. Memberships include admission to all Smithsonian museums, including the History Center; subscriptions to Smithsonian and Western Pennsylvania History magazines; and museum shop discounts. Call 412-454-6436.