New Mexico Health Connections | my connection | Fall 2017

100 STEPS A MINUTE. Drug tier Drug name Benefit plan 2017 cost-share 2018 cost-share Preferred specialty Humira Care Connect Silver HMO Small Group 40 percent after deductible 40 percent after deductible Non-preferred specialty Enbrel Care Connect Silver HMO Small Group 40 percent after deductible 50 percent after deductible Changes to your pharmacy benefit for 2018 N ew individual and group NMHC plans effective on or after Jan. 1, 2018, will have a change in the pharmacy benefit. There will be a new preferred specialty drug tier and a new non-preferred specialty drug tier. Specialty drugs are high-cost medications that target specific, complex conditions. They typically require special handling and monitoring. Below is a com- parison of the old and new tiering and the impact the change could have on the most common small-group plan, Care Connect Silver HMO. Some 2018 NMHC plans will have the same member cost-share amount for both the preferred and non-preferred specialty drug tiers. Please review the details for your NMHC plan by logging in to the new NMHC mem- ber portal at mynmhc.org/my-account-login.aspx . You can also call customer service at 855-769-6642 for help. New prescription drug program limits use of opioids Misuse or abuse of opioids—powerful pain medications that you can get only by prescription—is a serious public health issue. The Centers for Disease Control and Prevention (CDC) reports that more than three out of five drug overdose deaths involve an opioid. Data from the U.S. Department of Health and Human Services show that 44 Americans die from prescription opioid overdose every day. Most of the time, patients should limit opioid use to short-term pain control. However, some patients receive value from longer-term use. Often, patients receive more doses of these medications than they need to treat short-term pain. We are working with OptumRx ® , our pharmacy benefit manager, to start a new program to address this issue. The program is called Opioid Risk Management. Starting Jan. 1, 2018, it may affect many NMHC members. The Opioid Risk Management program will limit new prescriptions for members who are new to opioid therapy to only a seven-day supply, with an allowance for up to two seven-day supplies within a 60-day period. This program also puts other limits on opioid use, including: •   Placing a maximum dose of opioids that members may receive. •   Requiring that a member use 90 percent of a prescription before getting a refill. Learn more about opioid use at cdc.gov/ drugoverdose/opioids/index.html . 150 MINUTES To help stay healthy, that’s how much time adults need to set aside every week for aerobic activities such as brisk walking. If you wear headphones, keep the volume down and watch out for traffic that you might not hear. Most people don’t need to see a doctor before starting a walking program. But it’s a good idea if you have heart disease, diabetes, asthma or joint problems. Number of years that regular exercise may delay brain aging. Older people who get regular moderate exercise have better memory and thinking skills than those who are inactive. Are you a beginning walker? Forget speed and walk at a comfortable pace. Then gradually work up to Wearing lighter colors makes you more visible to cars at dawn and dusk. You might also wear reflective clothing or carry a flashlight. About 6 in 10 Americans say they walked for at least 10 minutes in the past week. 70,000 In one study of more than women, those who walked three or more hours per week cut their risk of a heart attack or other heart problems by 35 percent compared to those who weren’t active. 10 For a healthier you, start walking The best way to boost your health may be step by step. Here’s a look at the benefits of walking workouts—along with some safety tips. Sources: American Council on Exercise; American Heart Association; Centers for Disease Control and Prevention; Health in Aging Foundation; National Institute on Aging 2 { MY CONNECTION } { P R E V E N T I V E S C R E E N I N G A N D I M M U N I Z A T I O N S } { M E M B E R N W S }