BAKER CITY HERALD • THuRsDAY, DECEmBER 1, 2022 A7
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Medicare Advantage plans
offer key coverage
The details behind Summit Health’s four plans for Eastern Oregonians
Healthy smile,
healthy life
Summit’s Dr. Teri Barichello on the
importance of oral health for seniors
When it comes to good oral health, a lot of
attention goes to a specific demographic: young
kids – and rightly so. After all, it’s important to
take care of your teeth from your earliest days.
But according to Teri Barichello, DMD, vice
president and chief dental officer for Summit
Health, good oral health is crucial for seniors.
“I think it’s important to highlight how critical
good oral health is for seniors,” she said. “It gets
a lot of attention for kids, but not for seniors, and
it’s just as important.”
In a recent interview, Barichello shared some
insights into the correlation between good oral
health and overall health for seniors.
How is oral health connected to overall health?
Summit Health has reduced office visit copays for primary care visits to $0 on most plans.
What do no-cost doctor visits, no-
cost preventive eye and dental exams,
smartphone medical consultations and
gym memberships have in common?
They’re all part of a long list of benefits
offered through Medicare Advantage
plans from Summit Health.
Formed in 2020, Summit Health specializes in
Medicare Advantage plans for the people of
Eastern Oregon. Its four plans offer a range of
coverage and benefits designed to help keep
seniors healthy, active and feeling good.
“Our Medicare Advantage plans have
been designed to offer benefits that
help people thrive,” said Emily Camp,
senior Medicare product manager
for Summit. “We strive to give people
options to find the plan that works
for them.”
The plans
“That makes accessing care quicker and easier for
our membership,” said Walter Burkhartsmeier,
Medicare program director for Summit Health.
Comprehensive coverage
All of Summit’s Medicare Advantage plans
include coverage for routine chiropractic,
acupuncture and naturopathic services, as well
as routine vision, dental and hearing exams. The
company’s plans also cover up to two-thirds of
the cost of hearing aids.
“Hearing aids can be expensive, but our plans
help seniors cover a significant portion of that
price,” Camp said.
Summit has also made telehealth part
of its Medicare Advantage coverage.
The company has partnered with
CirrusMD, a virtual care platform
that lets people connect with real
- Emily Camp, senior
doctors for non-emergency medical
Medicare product manager,
issues via smartphone or tablet.
Summit Health
Patients can text doctors, share images
or video chat 24 hours a day, seven days a week.
“The annual
enrollment period for
Medicare continues
through December 7.”
Summit’s Core Medicare Advantage plan offers
coverage through a Health Maintenance
Organization (HMO) with a Point-of-service
option (POS). Seniors pay a monthly premium
and can get care at a variety of in-network
providers; costs increase for care outside of
Summit’s network. The Core plan does not
include prescription drug coverage.
Summit’s Medicare Advantage plans offer care
management programs for specific conditions,
as well. For example, a diabetes management
program provides patients with a connected
blood glucose meter and unlimited supplies at no
cost. Health professionals are able to remotely
track patients’ blood glucose levels, and diabetes
response specialists can provide coaching.
The other three plans, which also utilize an HMO,
do include drug coverage. HMO-POS plans offer
more flexibility and lower cost sharing for out-
of-network care depending on the plan. The
deductible cost for prescription drugs is waived
for generic drugs and vaccines; costs for other
prescriptions are being lowered this year, so
seniors won’t be paying as much as before.
What’s more, Summit’s Medicare Advantage plans
come with an included fitness benefit. Called the
Silver&Fit Healthy Aging and Exercise program,
it offers more than 1,500 digital workout videos,
gym memberships and coaching from fitness
and nutrition experts, all at no cost. Seniors can
also select a home fitness kit, with options such
as yoga, Pilates, swim and strength kits, or a
wearable fitness tracker.
And speaking of lower costs, Summit has also
reduced the office visit copay for primary care
visits under all its plans with prescription drug
coverage to $0.
Also gone for the coming year are referral
requirements for specialty care. That means
members will be able to save some time when
they’re referred for things like cardiology or
neurology services.
“We’ve really tried to make our Medicare
Advantage plans as comprehensive, beneficial
and valuable as possible,” Camp said. “Seniors in
Eastern Oregon deserve the best kind of care to
fit their lives.”
There are a lot of chronic medical conditions
that are linked to the health of your mouth.
Gum disease has been connected to numerous
chronic medical conditions, including diabetes,
stroke, heart attacks, Alzheimer’s disease and
respiratory diseases to name a few. The risk for
tooth decay can increase as we age, particularly
if there has been gum recession. Recession exposes
the root surfaces of teeth and cavities can get
started very easily and progress rapidly.
What are the warning signs of gum disease?
There are quite a few, including swollen or puffy
gums, bleeding gums when you brush or floss,
bad breath, shifting teeth and receding gums.
How important is good oral health for seniors?
It’s really imperative for seniors – for quality of
life, for the correlations with gum disease and
even just because we use our teeth to chew and
speak. The biggest concern is the risk of chronic
gum inflammation on other conditions, but there
is also the risk of oral cancer.
What about seniors who may be missing teeth
or who wear dentures?
If you have no teeth or wear dentures, you still
need to go to the dentist. We can help prevent
problems, we can help with the fit of your
dentures, which changes over time. And in
an annual oral exam, we’re also screening for
cancer. Some people think ‘I don’t have teeth, so
I don’t need a dentist.’ That’s just not true.
Are there other concerns that seniors should
be aware of?
Especially for seniors, dry mouth can be a side
effect of numerous prescriptions and over-the-
counter medications. Saliva acts as a natural
acid neutralizer and plays an important role
in preventing cavities. Reduced salivary flow
greatly increases the risk for developing cavities.
Any tips for good oral health?
Thankfully, maintaining a healthy smile and
mouth is pretty straightforward. Floss daily and
brush twice a day. Watch for changes in your
mouth. If you use tobacco products, make a plan
to quit. Choose healthy foods and drink plenty
of water throughout the day. And, of course, see
your dentist at least once a year.
The annual enrollment period for Medicare
continues through December 7.
Have questions about pharmacy benefits? Summit has answers
Prescription medications play a big role in keeping seniors healthy
When it comes to Medicare Advantage plans and
prescription drug coverage, people often have
lots of questions.
Does my plan have coverage? Are my medications
included? How much do I have to pay?
Luckily, Summit Health can answer all those
questions – and more – as seniors pick the
Medicare Advantage plan that’s right for them.
“We are here to help members navigate their
benefits,” said Dr. Carly Rodriguez, vice president
and chief pharmacy officer for Summit. “We can
answer any questions, and we encourage people
to reach out so we can help.”
The first question to ask when picking a plan is
whether prescription coverage is included. Three
of Summit’s Medicare Advantage plans include
prescription drug coverage under what is known
as Medicare Part D. And it’s important to make
sure the drugs you need are covered by the plan
you choose.
“When people shop for plans, they need to make
sure that not only does a plan have Part D for
prescription drugs, but also that it covers their
specific medications,” Rodriguez said. “Not all
plans cover all drugs.”
Summit Health makes it easy to see what drugs
are included in its plans by posting complete lists
on its website at www.yoursummithealth.com.
The site also includes a full list of pharmacies in
the Summit network as well as a search tool that
shows drug cost.
Another nice benefit to look for is mail-order
service, which Summit’s plans include. Its mail-
order partners can ship anywhere in the state,
which can be especially useful in the rural areas
of Eastern Oregon.
Even better: This year, Summit is reducing the
cost of prescriptions for members who order
a 90-day supply either through the mail or at a
retail location.
“The benefits to a 90-day supply through the mail
include fewer trips to the pharmacy and avoiding
gaps in therapy because you’re less likely to run
out of your medications,” Rodriguez said. “And
with the way the retail pharmacy landscape has
changed, with some closing and others adjusting
their hours, mail-order can be a more convenient
option.”
If you have more questions about Medicare
Advantage plans and prescription drug coverage,
visit www.yoursummithealth.com.
Summit Health Plan, Inc. is an HMO with a Medicare contract. Enrollment in Summit Health Plan, Inc. depends on contract renewal.
Other providers are available in our network.
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