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September 2017 ****** Nutrition Education (N. E.) & Public Education (P. E.) Monday Tuesday Wednesday Thursday Friday 4 5 6 7 8

Public Education: Nutrition Education: Closed for Brain Booster #71 Sunday is… 7 Tips to Breaking (Attention Spans are only Grandparents Day Breakfast Barriers Labor Day 8 to 20 minutes)

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Nutrition Education: Whole Grains vs. Regular Grains - What's the Difference?

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Nutrition Education: Public Education: Choosing Whole Grains Medicare Minute

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Nutrition Education: Home Food Safety Mythbusters

This month is Food Safety Education Month, Better Breakfast Month, and Whole Grains Month. Each of these 25 Fun Apple Facts: count as Nutrition http://www.prevention.com/food/apple-varieties-and-recipes Education on the day you read Lady them. Est. 1628 Love story: One of the oldest known varieties, this tiny apple is said to have gotten its name because women would keep them in their purses to sniff when they encountered bad odors. Today, Martha Stewart and other stylists use the blushing red fruit in holiday centerpieces. Taste it: Sweet and delicate, with no tartness. In other words, ladylike.

Baldwin Est. 1750s Love story: The Baldwin was among the most popular American apples until 1934, when a freeze wiped out most of its trees. (Growers reported actually hearing the tree bark snap in the cold.) Thanks to a smattering of farmers who kept cultivating this variety for themselves, it's still found in northeastern farmers markets. Taste it: One bite yields sweetness with a hint of spice.

Gravenstein Est. 1790s Love story: This heirloom hails from Denmark, but in the United States, it's grown almost exclusively in Sonoma County, CA, where it's celebrated with an annual festival. Thank the nonprofit Slow Food USA for keeping the Gravenstein off the endangered species list by adding this apple to its Ark of Taste catalog. Taste it: You'll get ivory flesh and intense, aromatic flavor.

Esopus Spitzenburg Est. Early 1800s Love story: Said to be a favorite apple of Thomas Jefferson, this heirloom was discovered in Esopus, NY, and is still grown at Monticello today. Taste it: It's trickier to grow than modern hybrids—the trees don't grow well if planted too close together—but fans still bend over backward for its floral scent, buttery flesh, and trademark blue-tinged skin. McIntosh Est. 1820s Love story: The Mac is the prize stallion of apples, a thing of beauty that's a powerful breeder. McIntosh is parent to beloved varieties including Empire, Cortland, and Macoun. Taste it: If you had to create a classic "apple" flavor in the lab, it would be modeled on the Mac: juicy, fresh, sweet, and bright—everything an apple should be.

Cox's Orange Pippin EST. 1825 Love story: Discovered by Richard Cox, a London brewer, it was England's favorite apple for more than a century, but it has recently lost ground to more modern varieties like Gala. Taste it: Aficionados are fanatical about this heirloom's nutty, almost pearlike flavor—no wonder it's part of the lineage of many modern apples, including, you guessed it, Gala.

York Est. 1830 Love story: Quaker nurseryman Jonathan Jessup championed this distinctively lopsided, red apple on his farm near York, PA. But it soon won fans in Virginia and further south, where it remains popular. Taste it: Fresh picked, York is a perfect balance of sweet and sharp. It keeps especially well, becoming sweeter and more mellow after several months.

Northern Spy Est. 1840s Love story: New York and Connecticut both claim this apple as their own, but no one knows where it got the name. Taste it: This variety is tart but honeyed; luscious yet subtle. When eaten fresh, it serves up a particularly high level of vitamin C. Granny Smith Est. 1860s Love story: Maria Ann Smith—or "Granny," as she was called—discovered the seedling for this tart green apple growing in her Australian compost pile. Taste it: Picked in November, this late-season apple is a staple in supermarkets because its thick skin helps it travel.

Golden Delicious Est. 1890s Love story: The first seedling was discovered on the Mullins family farm in West Virginia. A family descendant insists a nursery paid just $50 for the tree and all the fruit it produced—a bargain, considering it went on to be one of the most popular apples of all time. Taste it: Think Golden Delicious is bland or boring? You've probably been eating fruit that was picked too early and stored too long. A ripe, fresh-picked GD is exceptionally rich, even custardy.

Cortland Est. 1915 Love story: One of the first man-made hybrids in the US, this much-adored cross between a McIntosh and an apple called the Ben Davis is about to celebrate its 100th birthday. Taste it: Often described as "sprightly" because of its balance of sweetness and acidity, Cortland browns more slowly after cutting than most other apples, which makes it great for fruit salads.

Macoun Est. 1920s Love story: It's pronounced Mac-ow-n, not Ma-coon. Taste it: Macouns were in the '80s what Honeycrisps are today—the "it" apple variety. While consumers have moved on, chefs still treasure Macouns for their intensity of flavor and a movie-sound-effect crunch. Mutsu Est. 1930 Love story: A cross between Golden Delicious and Indo, it's named after the Mutsu Province of Japan, where it was first grown. Mutsu is often sold under its other (more onomatopoeic) name, Crispin. Taste it: One of these oversize green apples can easily feed two people, though its boisterous tang may incline you to keep one all to yourself.

Fuji Est. 1962 Love story: Its parents, Ralls Janet and Delicious, are American, but the Fuji was bred in Japan. With between 15 and 18% Brix, or sugar levels, it is one of the sweetest apples around. No wonder it was an instant global hit. Taste it: Great for eating fresh, Fujis are too juicy for baking. Use them to add a touch of sweetness in salads and slaws.

Twenty Ounce Est. 1963 Love story: In 1976, Kathy Wafler used this enormous apple to win the world record for the longest apple peel: 172 feet, 4 inches. Taste it: Grown primarily for food manufacturers—bigger apples mean easier peeling and less waste—these giants are still available at some farm stands in the northeast. A single apple can make an entire pie.

Empire Est. 1966 Love story: This cross between a McIntosh and a Red Delicious is named for New York (the Empire State), where it was first bred. Star qualities: Medium-sized, it is not easily bruised. Taste it: Tart + sweet = hard not to love. Ginger Gold Est. 1960s Love story: Found as a chance seedling growing near a Golden Delicious orchard in Virginia, Ginger Gold is considered one of the best early-season apples. Taste it: It wows with its succulent texture and spice. Choose fruits with yellow skin over ones that are green.

Honeycrisp Est. 1960s Love story: Demand is so great—and supply still so limited—that Honeycrisps often sell out within a few weeks, even with prices at $4.50 a pound in some places. Though growers are rushing to plant more trees, Honeycrisp grows best in cold climates, so there's worry that the new crops from warmer climates may disappoint. Taste it: Expect explosive juiciness and smack-you- over-the-head sweetness.

Liberty Est. 1978 Love story: Liberty was one of the earliest apples bred to be resistant to a pesky disease called apple scab. (The next one was called Freedom.) Taste it: Liberty's bright flavor wins over lovers of tart apples, who find this variety mostly at farm stands in the Northeast.

Pink Lady Est. 1970s Love story: Pink Lady was the first to be marketed with a brand name. The move set off a trend of trademarking apple names, which allows breeders and associations to control quality and collect fees on every apple sold. Taste it: The princess-pink skin draws most people to this apple. It has a mild but pleasant flavor and plenty of crunch. Piñata Est. 1986 Love story: This German-bred variety was first called Pinova, then Corail, then Sonata. But none of them stuck. Finally, breeders settled on Piñata, a name with appeal to the growing Latino community in the United States. Taste it: Sweet and crisp with a hint of tropical fruit.

Goldrush Est. 1994 Love story: "Gold" refers to its old man, Golden Delicious; "Rush" alludes to the burst of snappy, tangy flavor. Taste it: Tart-apple lovers, can we hear you say hallelujah? This late-season apple (look for it at the end of October) has a complex flavor—was that a hint of anise?—that improves with age. Even better: A fresh GoldRush will keep in the refrigerator until summer.

Rubyfrost Est. 2013 Love story: Developed to avoid browning and for high vitamin C, it's the perfect apple for a brown-bag lunch. RubyFrost is found in limited quantities and only in the Northeast, but it's gaining in popularity. Taste it: It's zippy, almost effervescent.

SnapDragon Est. 2013 Love story: This is Honeycrisp 2.0. SnapDragon looks and tastes like its in-demand predecessor but presents none of the production headaches that plague growers. Taste it: Crunch! [a dribble of juice down your chin] Bam! [a burst of ambrosia] The Unnamed Apple Of The Future Est. 2018? Love story: Growers on five continents created the marketing consortium IFORED to develop this specialty apple, which has red flesh for maximum antioxidants. Fans-to-be: anyone obsessed with cramming more phytochemicals into their day. Taste it: Early iterations were too sour for mainstream tastes. Through patient experiments, growers are said to have tamed the extremes and are on their way toward perfecting a classic. Wait, there's more—they're breeding like rabbits Mother Nature has created her share of fantastic apples, from Golden Delicious to Granny Smith. But many new ones are the products of human ingenuity. Today's breeders use both traditional grafting and cutting-edge genomics to develop fruit that meets Americans' demands for apples that are sweet, tart, crunchy, and juicy all at once. Among the most storied breeding programs is the New York State Agricultural Experiment Station in Geneva, NY. Every year, horticulturists harvest at least 10,000 seeds and manage 33 acres of seedlings. "In the lab, we use molecular markers to tell if the apple will be red or yellow, sweet or sour, or resistant to disease," says Susan Brown, the center's associate director and a professor at Cornell University. "If you think of apple breeding as playing the lottery, this lets us stack the deck." The careful work pays off: Over the past 100 years, the program has introduced 65 varieties, including Empire, Macoun, Jonagold, Cortland, and, in 2013, SnapDragon, which is squaring up to be the next must-eat apple. Beans and Legumes with the Most Protein

W F Q E G A A S I K M A X Z D A S F J N Find These Words: H T U L O T U W E F N W U X A N A V W H ADZUKI I I M T W M L I Y T A D J N A L A P W N BAKED BEANS T V K R M V P I G E O N P E A S G N U M BLACKEYES E J U U C H L P J B O K B F H G H M L P BLACK TURTLE D R H T Z X K J I H L D E Z J F F I P D CHICKPEAS X Y R K F D Y G V N E L W Z V N S P G I FALAFEL G P B C B A A W V K T D R G U J C C B J FRENCH Q N I A G H V P A A P O S J J R J H F V HUMMUS X G E L H P G B F L T Y E L L O W I F I MISO J D Q B O N P U R S R W O P K R Q C K J MUNG B D M O C Y N V D P Q K W A E J N K S N NAVY L L G A C I V B L P S N O K W V M P V Z PEANUTS J H A S T U N A E P M I H N M J Y E W E PIGEON PEAS N C G C S P U G N P K P Z I Y Y Q A Z J PINK T N D U K Y D R G V A R S Q R V V S V L PINTO T E N L U E F R L M J O Y W Y A W U M V WHITE N R R F R L Y X Q F P M K X Q Y E C S Y YELLOW V F K C K B H E H O T C L T I A W X R S X X S R X K C J S R U B F Z O W A M S X Nutrition Education For more info, go to https://www.healthaliciousness.com/articles/beans‐legumes‐highest‐protein.php

Words Related to Pears

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Secret Message: Harvest season for pears is from August to Listing Game: February. Cooking them can really bring out their fabulous flavor, so try them…

For more info, go to http://www.health.com/food/15-best-superfoods-for- fall#pears-1 “mail”. Nutrition Education

can that rhyme with Rhyming Fun: Write as many words as you

N.E., Sept. 5 7 Tips to Breaking Breakfast Barriers

These simple strategies do not give you any excuses to skip your a.m. meal.

Breakfast is considered the most important meal of the day for a reason. People who regularly eat a healthy, balanced breakfast tend to concentrate better and get more physical activity than those who skip it. Breakfast eaters also have an easier time managing their weight and have lower cholesterol levels.

Take a bite out of the habit of skipping breakfast with these strategies:

1. Get into the habit. Start with grabbing just a piece of fruit as you walk out the door. Gradually include other food groups. 2. Curb your sweet tooth the healthy way. Try making French toast using whole-grain bread dipped in a batter made of egg whites or an egg substitute, a pinch of cinnamon and a few drops of vanilla extract. Fry in a nonstick skillet or use a cooking spray. Top with thinly sliced apples, unsweetened applesauce, berries or sliced banana for sweetness. 3. Prepare in advance. If you’re rushed in the morning, set the table the night before with bowls and spoons for cereal or slice some fruit ahead of time and place your smoothie blender out on the counter. Keep easy favorites such as hard-boiled eggs, fresh fruit, instant whole-grain oatmeal and low-fat yogurt on hand. 4. Think out of the (cereal) box. Do not limit yourself to traditional breakfast foods. Leftover vegetable pizza or a turkey sandwich on whole-wheat bread can make a healthy breakfast. 5. Take it with you. If there is no time to eat breakfast at home, pack a brown-bag breakfast or grab a banana and take it with you. 6. Split it up. If you are not hungry first thing in the morning, eat a slice of whole-wheat toast or drink a glass of 100 percent fruit juice. Later, eat a healthy mid-morning snack. 7. Change gradually. Have breakfast on two mornings at first, and three mornings a little later. Your eventual goal is to eat breakfast every day.

Whenever you are tempted to skip your morning meal, just remember that a good breakfast also helps keep you from becoming ravenously hungry later in the day, so you will not eat as much.

ADSS Nutrition Team Summer FY17 P.E., Sept. 7 From "101 Brain Boosters" by Terry Eckmann

#71: Take brain breaks because a person's attention span is 8 to 20 minutes, depending on age and interest in the subject matter.

The brain learns best when it is engaged in learning, like when things are novel or the topic or subject matter is interesting. Even when the learner is engaged, the brain tends to downshift after 8 to 20 minutes. It is helpful to take a break to allow the brain to absorb what it is learning, doing, or experiencing and give it necessary time to be ready to refocus. Brain breaks can also get blood flowing and get necessary oxygen and fluids to the brain. For example, during a SO-minute class time, the learner will remember best what is learned first, second best what is learned last, and third best what is in the middle. If there is a brain break after 20 minutes, it will help the brain to absorb and remember better. If the brain break is an activity that uses the information learned in the first 20 minutes it will help in processing and remembering the information.

A brain break that is movement-oriented is also very effective. A short walk is a good brain break. Standing up and going to get a drink of water or a healthy snack incorporates movement with providing fluids or nutrients the brain needs. Marching in place or seated in a chair is another option. A seated stretch walking hands down to the ankles and coming back up to a seated position will stretch muscles and increase blood flow. Sitting up straight and tall while engaging the abdominal muscles as shoulders are lifted and rolled up _a~d back wil_l help the body ge_t back in good posture while giving the brain a break. S1tt1ng up straight and tall, reaching the hands behind the back and grasping the opposite elbow while lo?~ing over one ~houlder _and then the other gives the brain and the back a break. Practicing the breathing exercises in #29 or the cross lateral mov~ments in #73 ~re more br~~n break option~. Move, breathe and hydrate to give the brain a boost and increase ability to pay attention. Apple Varieties: Most grocery stores have a full 11 varieties of apples in rotation (Red Delicious, Golden Delicious, Granny Smith, McIntosh, Rome Beauty, Fuji, Jonathan, York, Gala, Idared, & Yello w Newton). And while that's nothing compared to the 15,000 breeds that once grew in the US, it illustrates a diversity success story still unfolding, as growers revive heirlooms of yore & high-tech breeders create new strains for every taste: tart apples, sweet apples, apples that don't brown after cutting (kids eat more if they're sliced, after all). N R D F M R R Z I X V B K G O X Y Z P M Find These Apples: J O P L N I E T S N E V A R G G T Z S C BALDWIN CORTLAND R Q R F O K X C X N I H P U O E R F I I COXS ORANGE PIPPIN B U E T M G O C O S A E K B U Y E A R N EMPIRE U C B U H R R G M A C O U N L W B N C T ESOPUS SPITZENBURG A G T Y T E A E Y D A L T E D T I G Y O FUJI GINGER GOLD P S N L F R R F G F L T D Z H P L R E S GOLDEN DELICIOUS U M A I D R D N L N W A G T P I X A N H GOLDRUSH E N K P W E O P S E I H U I B Ñ B N O V GRANNY SMITH D M A T M D B S N P S G P P Z A Z N H H GRAVENSTEIN HONEYCRISP I N P A P X L T T F Y E S S G T T Y Q T LADY S L N I R S Y A J J G Z A S B A P S Q D LIBERTY M N G E R O H H B N I L F U L F C M P K MACOUN U M C G U E V E A H B O X P Q S Q I N J MCINTOSH MUTSU D V Y N H S U R D L O G N O T C F T S G NORTHERN SPY I P C X E O O W P X C C T S L C U H T G PINK LADY J E K U H S D J G Y F E D E Z O B T J Z PIÑATA U I T G X G O L D E N D E L I C I O U S RUBYFROST SNAPDRAGON F Y A O G J Y F E Z Y Q Y A E C H F F O TWENTY OUNCE M V C A M S J U B P I N K L A D Y R W M UNNAMED Nutrition Education For more info, go to http://www.prevention.com/food/apple‐varieties‐and‐recipes YORK What Do Kiwi Have?

Secret Message: Kiwis are harvested between September and March. They are great mixed with strawberries, cantaloupe, or oranges and can be combined with pineapple to…

For more info, go to http://www.health.com/food/15-best-superfoods- Nutrition Education for-fall#pears-1

Listing Game: In honor Grandparent’s Day, last Sunday, Rhyming Fun: Write as

list memories of joy you had with your Grandparent’s. many words as you can Then, list memories of YOU being the Grandparent. that rhyme with “hair”.

N.E., Sept. 12 Whole grains vs. regular grains: What's the difference?

Whole grains provide a variety of healthy nutrients and are naturally low in fat. Choose whole grains for at least half of all the grains you eat. Read on to learn about the different types and why you should skip refined and enriched grains.

Types of grains (also called cereals):

Whole grains. These unrefined grains have not had their bran and germ removed by milling; therefore, all of the nutrients remain intact. Whole grains are better sources of fiber and other important nutrients, such as selenium, potassium and magnesium. Whole grains are either single foods, such as brown rice and popcorn, or ingredients in products, such as buckwheat in pancakes or whole wheat in bread.

Refined grains. In contrast to whole grains, refined grains are milled, a process that strips out both the bran and germ to give them a finer texture and longer shelf life. The refining process also removes many nutrients, including fiber. Refined grains include white flour, white rice, white bread and degermed cornflower. Many breads, cereals, crackers, desserts and pastries are made with refined grains, too. These processed foods will not keep your blood sugar levels steady, which is why you will be hungry again soon after consumption.

Enriched grains. Enriched means that some or many of the nutrients that are lost during processing are added back in later. Most refined grains are enriched, and many enriched grains are also fortified — meaning nutrients that do not occur naturally in the food are added — with other vitamins and minerals, such as folic acid and iron. Enriched grains lack fiber and are not as an optimal choice as whole grains because while they have traces of nutrition, many important vitamins and nutrients are lost during processing.

ADSS Nutrition Team, Summer FY17 Fall Begins September 22. Here are the 15 Best Superfoods for Fall: S N K K Q V L V D F R I P N E W Z C P J Find These Words: O W B S P B S K I G N C B F Y W A Q O W APPLES BRUSSELS SPROUTS S B E L J Q O A W S V N M Y L U B Y M S CAULIFLOWER Y E L E U O G Z I A U W Y S L L E M E T DATES I P T A T A S C K K B L S I J Z S D G V GRAPEFRUIT P Y S A B P K E F E K S F S R A E P R P KIWI PARSNIPS R H H A D F O V N W I L O R T P G I A D PEARS T A T P B O A T O I O P U M P K I N N G POMEGRANATES Q U X V G S V Y A W R F A M K X S D A V PUMPKIN R N G A B K B F E T U E S R T D P B T Y RUTABAGA SQUASH I O J P K J T R J Y O A G U F Q I M E F SWEET POTATOES B J A P T Z T B V X G E F N P F N V S I TANGERINES U B Z L Y Y V U H S D Z S U A Y S T H O TURNIPS J T S E I T I U R F E P A R G T R I D D T D R S R Y L M P N I B Q F J P A I R V Nutrition Education V X H D Q P Z Y A G I V D L G G P W L W A B J Q X Y Q L C Z W P C M A N Z O J D C P F V N B F F S U Z U S J C T Q M T Y For more info, go to C B R U S S E L S S P R O U T S P L F O http://www.health.com/food/ 15-best-superfoods-for- P J V W J A C R I H D D G U Z X O L Q H fall#pears-1

The weather is getting cooler, but your produce choices are heating up. These amazing superfoods are either hitting their peak in the garden or can easily be found in your local farmers market or grocery store. They're the perfect excuse to get cooking on cool nights! What Do Winter Squash Have?

Secret Message: Winter squash's harvest season is between October and February. Because of its thick skin, it can be stored for months. It tastes best with other fall flavorings...

Nutrition Education For more info, go to http://www.health.com/food/15-best-superfoods-for-fall#pears-1

st Rhyming Fun: Write as many Listing Game: September 21 is World words as you can that rhyme Alzheimer’s Day. In honor of this day, list with “sky”. as many things as you can that people can do to keep their brain healthy.

N.E., Sept. 19 Choosing Whole Grains .

Eat whole grains rather than refined grains as often as possible. Examples of whole grains include: Barley Brown Rice Buckwheat Bulgur (cracked wheat) Millet © 2017 Mayo Foundation for Medical Education and Research. All Oatmeal rights reserved. Popcorn It is not always easy to tell which grains are in a particular product, especially bread. A brown bread Whole-wheat Bread, Pasta or Crackers is not necessarily whole wheat. If you are not sure, check the product label or the Nutrition Facts panel. Wild Rice Look for the word "whole" on the package, and make sure whole grains appear among the first items in the ingredient list. How to enjoy more whole grains in your diet:

 Enjoy breakfasts that include whole-grain cereals, such as bran flakes, shredded wheat or oatmeal.  Substitute whole-wheat toast or whole-grain bagels for plain. Substitute low-fat bran muffins for pastries.  Make sandwiches using whole-grain breads or rolls. Swap out white-flour tortillas with whole-wheat versions.  Replace white rice with kasha, brown rice, wild rice or bulgur.  Feature wild rice or barley in soups, stews, casseroles and salads.  Add whole grains, such as cooked brown rice or whole-grain bread crumbs, to ground meat or poultry for extra body.  Use rolled oats or crushed bran cereal in recipes instead of dry bread crumbs. Eating a variety of whole grains not only ensures that you get more health-promoting nutrients but also helps make your meals and snacks more interesting.

ADSS Nutrition Team, Summer FY17 P.E., Sept. 22

Medicare Minute Script – August 2017 Medicare’s Open Enrollment Notices

You can make changes to your Medicare coverage each year during Medicare’s Open Enrollment Period, which runs October 15 to December 7. Around September, you will start to receive notices with information about any changes to your coverage for the coming year. It is important to read and understand these notices so that you can decide if your coverage will continue to meet your needs or if you should change it.

Point 1: Know where to find general information about what Medicare covers. If you are enrolled in Medicare, you should receive the 2018 Medicare & You handbook in the mail in September. If you do not receive the handbook, you can call 1-800-MEDICARE and request that a copy with information for your region be mailed to you. The printed copy of Medicare & You also includes a list of private Medicare health and drug plans available in your area. These plans must cover the same benefits listed in the handbook for Original Medicare, but their costs and coverage rules will vary. If you have Original Medicare, you can find out about Original Medicare benefits in the handbook. It is also available online at www.medicare.gov.

Point 2: Understand your Annual Notice of Change (ANOC) and Evidence of Coverage (EOC). If you have a Part D prescription drug plan or a private Medicare health plan (known as a Medicare Advantage Plan), you should receive a notice called an Annual Notice of Change (ANOC) and an Evidence of Coverage (EOC). The Annual Notice of Change is typically mailed along with the plan’s yearly Evidence of Coverage (EOC) Notice. A plan’s EOC provides a more comprehensive explanation of its costs and coverage in the following year. Your plan should send you these notices by September 30. If you do not receive them contact your plan to request copies.

These notices list any changes for your plan in 2018. There are three things to look for: 1) changes in the plan’s costs; 2) changes in the plan’s provider network; or 3) changes in the plan’s formulary, which is a list of drugs your plan covers. 1. Costs: Find out what you can expect to pay for services in 2018. Deductibles, copayments, and drug costs can change each year. For example, even if your plan did not have had a deductible in 2017, it could in 2018. 2. Provider network: Check to see if your doctors, hospitals, and other health care providers and pharmacies will still be in the plan’s network for 2018. Plan networks can change each year. If you see an out-of-network provider, your plan may not cover any of the cost of your care. 3. Covered drugs. Look through the plan’s formulary. It can change from year to year, meaning a drug may not be covered in 2018 even if it was covered in 2017. If you are unhappy with any of the changes to your plan, you may want to enroll in a different plan for 2018.

SHIP National Technical Assistance Center: 877-839-2675, www.shiptacenter.org | [email protected] SMP National Resource Center 877-808-2468| www.smpresource.org | [email protected] © 2017 Medicare Rights Center | www.medicareinteractive.org | The Medicare Rights Center is the author of portions of the content in these materials, but is not responsible for any content not authored by the Medicare Rights Center. Page 1 of 2 continued

Point 3: Learn if there are any problems with your current plan. Plans leaving the Medicare program in the coming year send out a Plan Non-Renewal Notice in October to people enrolled in the plan. If you receive this notice, you should take action to make sure you are covered in 2018. You can choose to enroll in a new Part D prescription drug plan or Medicare Advantage Plan during Medicare’s Open Enrollment Period, which runs from October 15 through December 7 every year. If you receive a Plan Non-Renewal Notice, you can also enroll in a new plan up until the last day in February 2018; however, you will be disenrolled from your previous plan starting January 1. Therefore, if you do not pick a new plan by then, you will likely experience a gap in coverage until you enroll in a new plan.

Medicare also sends a Consistent Poor Performance Notice to people enrolled in a plan that has received a low rating for three or more years in a row. A low rating is three stars or fewer out of five. Plans are rated on their quality and performance. The notice encourages you to look at other plan options in your area.

Take action: 1. Review any notices you receive from Medicare or your plan. Make note of any changes that will affect you in 2018. Contact your State Health Insurance Assistance Program (SHIP) if you have any questions about these notices. SHIP counselors provide unbiased counseling to help you understand and assess your Medicare options. 2. If you are unhappy with plan changes, you can look for a new plan. You can change your plan during Medicare’s Open Enrollment and your new coverage starts on January 1, 2018. 3. Contact your Senior Medicare Patrol (SMP) if you suspect plan marketing violations or enrollment fraud. For example, contact your SMP if you receive a notice but are not sure if it is from your plan or not.

Local SHIP Contact Information Local SMP Contact Information

SHIP toll-free: SMP toll-free: SHIP email: SMP email: SHIP website: SMP website: To find a SHIP in another state: To find an SMP in another state: Call 877-839-2675 or visit www.shiptacenter.org. Call 877-808-2468 or visit www.smpresource.org.

The production of this document was supported by Grant Numbers 90ST1001 and 90NP0003 from the Administration for Community Living (ACL). Its contents are solely the responsibility of the SHIP National Technical Assistance Center and Senior Medicare Patrol National Resource Center and do not necessarily represent the official views of ACL.

Medicare Minute Teaching Materials – August 2017 Medicare’s Open Enrollment Notices

1. What is Medicare’s Open Enrollment Period? Medicare’s Open Enrollment Period occurs each year from October 15 to December 7. During this time, you can make changes to your health insurance coverage, including adding, dropping, or changing your Medicare coverage. Even if you are happy with your current health and drug coverage, Medicare’s Open Enrollment Period is the time to review what you have and compare it with other options in your area to make sure that your current coverage is still best for you in the coming year. In September, you will start to receive notices with information about any changes to your coverage for the coming year. It is important to read these notices so that you can decide if your coverage will continue to meet your needs, or if you should change it. Even if you are happy with your current Medicare Advantage or Part D plan, you should check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price.

The State Health Insurance Assistance Program (SHIP) is an important resource for helping you weigh your options (contact information on last page). If you decide to change your coverage, your SHIP can help you. You can also call 1-800-MEDICARE (1-800-633-4227) for assistance or visit mymedicare.gov. Any changes you make will take effect January 1 of the next year.

2. What is the Medicare & You handbook? If you are enrolled in Medicare, you should receive the 2018 Medicare & You handbook in the mail in September. If you do not receive the handbook, you can call 1-800-MEDICARE and request that a copy with information for your region be mailed to you. You can download the general handbook at www.medicare.gov. If you have Original Medicare, look through the handbook to read about Original Medicare benefits. Medicare & You also includes a list of Medicare Advantage Plans and stand-alone Part D prescription drug plans available in your area. These plans must cover the same benefits listed in the handbook for Original Medicare, but may have different costs and rules for coverage.

3. How do I read my Annual Notice of Change (ANOC) or Evidence of Coverage (EOC)? If you have a Medicare Advantage Plan or a stand-alone Part D plan, you should receive an Annual Notice of Change (ANOC) and an Evidence of Coverage (EOC) from your plan by September 30. If you do not receive these notices, contact your plan to request copies.

Review these notices for any changes in the plan’s costs, benefits, network of providers, covered drugs, and/or rules for the upcoming year. If you are dissatisfied with any upcoming changes, you can make changes to your coverage during Medicare’s Open Enrollment Period. Any changes you make will take effect January 1 of the next year.

Three details to look for are any changes in a) the plan’s costs, b) the plan’s provider network, or c) the plan’s formulary (list of drugs your plan covers).

1. Find out what you can expect to pay for services in 2018. Costs such as deductibles and copayments can change each year. For example, your plan may not have had a deductible in 2017, SHIP National Technical Assistance Center: 877-839-2675, www.shiptacenter.org | [email protected] SMP National Resource Center 877-808-2468| www.smpresource.org | [email protected] © 2017 Medicare Rights Center | www.medicareinteractive.org | The Medicare Rights Center is the author of portions of the content in these materials, but is not responsible for any content not authored by the Medicare Rights Center. Page 1 of 5 EXTRA

but it will have one in 2018. A deductible is the amount of money you owe out-of-pocket before your plan begins to cover your care. 2. Check to see if your doctors, hospitals, and other health care providers and pharmacies will still be in network for 2018. Plan networks can change each year, which means your doctor may not be in your plan’s network for 2018. You have the lowest out-of-pocket costs if you go to providers and pharmacies that are in your plan’s network. If you see an out-of-network provider, your plan may not cover any of the cost of your care, leaving you to pay the cost out-of-pocket (unless you receive emergency care from an out-of-network provider). 3. Look through the plan’s formulary. Formulary changes can happen from year to year, meaning your drug may not be covered in 2018 even though it was covered in 2017. Make sure your drugs will still be covered next year. If they are not, then you may want to select a different drug plan that covers all of your drugs. If the formulary is incomplete, or you do not see your drug(s) on the list, contact the plan directly to learn more.

4. How do I know if my plan will be offered next year? In October, plans leaving the Medicare program in the coming year send out a Plan Non-Renewal Notice to people enrolled in the plan. If you receive this notice, you should take action to make sure you are covered in 2018. You can choose to enroll in a new Medicare Advantage Plan or Part D prescription drug plan during Medicare’s Open Enrollment Period. After Medicare’s Open Enrollment Period, you can enroll in a new plan up until the last day in February of the following year.

If you do not pick a new Medicare Advantage Plan by January 1, however, you will be disenrolled from the Medicare Advantage Plan and enrolled in Original Medicare without any drug coverage. You will have until the end of February to enroll in a new Medicare Advantage Plan.

If you do not pick a new stand-alone Part D plan before January 1, you will be disenrolled from the plan and will not have drug coverage. You will have until the end of February to enroll in a new Part D plan.

5. How do I know if I am enrolled in plan with a low rating? You will receive a Consistent Poor Performance Notice if you are enrolled in a plan that has received a low rating for three or more years in a row. A low rating is three stars or fewer out of five. Plans are rated on their quality and performance, such as how well they handle appeals. This notice encourages you to look at other plan options in your area. If you want to change your plan, you can do so during Medicare’s Open Enrollment Period. If you are enrolled in a plan with a low rating, you can also change your plan at any time during the year. You can also check their plan’s rating online at www.medicare.gov.

6. Will I receive marketing materials from Medicare Advantage and stand-alone Part D plans? Yes. Beginning in October you will start to get mail from different insurance companies about the plans that they offer. Note that a plan cannot use language that suggests their plan is preferred by Medicare, or call or email you if you did not ask them to do so. You can use this marketing information to compare your options. If you have questions about any of the benefits that a plan offers, it is best to contact the plan directly. If you are thinking about changing your plan, you do not have to make the decision right away. You can take time to go over your choices and make an informed decision.

7. What notices do I receive if I am enrolled in Extra Help? Extra Help is a federal program that helps pay your prescription drug costs if you have limited income and assets. There are a number of notices people with Extra Help may receive starting in September, depending on the situation.

In September you may receive a grey Loss of Deemed Status Notice if you will no longer have Extra Help as of January 1, 2018. If you think this is a mistake, such as if your income has not changed, you can re- apply for Extra Help through the Social Security Administration (800-772-1213).

You may receive an orange Change in Extra Help Copayments Notice. This notice tells you if the Extra Help copays you pay for covered drugs will change starting January 1, 2018. You should get this notice in October. Extra Help copays usually change a small amount each year.

You may receive a blue Reassignment Notice in October if your Medicare Advantage Plan or stand-alone Part D plan is leaving the Medicare program. This notice lets you know that you will be reassigned to a new plan. If you want to enroll in a plan of your choice, you must actively choose a new plan by December 31, 2017. If you do not take action you will be assigned to a pla, which may or may not meet your needs.

You may receive a different blue Reassignment Notice in October if the premium for your plan’s drug coverage is going up above the amount that Extra Help covers. This is called the benchmark amount. If your plan’s drug coverage premium is going to be above the benchmark in 2018, you will be reassigned a plan unless you actively enroll in the plan of your choice by December 31, 2017.

If you chose your current drug plan and are enrolled in Extra Help, you may receive the Low-Income Subsidy Choosers Notice in November. This grey notice lets you know that your plan premium is increasing above the Extra Help benchmark amount (the maximum premium amount that Extra Help covers). If you do not actively change your plan to one with a lower premium, you will pay a portion of the premium in 2018.

8. What is a notice of creditable coverage? If you are enrolled in a prescription drug plan through your current or former employer, you may receive a notice telling you that your prescription drug coverage is creditable. Creditable means that the coverage is as good as or better than the standard Medicare prescription drug benefit. This notice is important because having creditable drug coverage means that you can delay Medicare Part D without a late enrollment penalty. Keep these notices each year. If you decide to enroll in a Part D plan in the future, you may need these notices as proof that you had creditable coverage and should not have a late enrollment penalty.

Note: If you get a notice that your plan is no longer creditable, or that the plan is ending, you should enroll in Medicare Part D to avoid a possible late enrollment penalty. You will have a Special Enrollment Period to enroll in Part D. The SEP starts the month you learn that you are losing creditable coverage and lasts for two months after you lose coverage or receive notice, whichever is later.

9. Who can I contact if I have questions? State Health Insurance Assistance Program (SHIP): Contact your SHIP if you have questions about any notices you receive. SHIP counselors can help you review your options and pick a plan that meets your needs (contact information is on the last page).

Senior Medicare Patrol (SMP): Contact your SMP if you receive any notices that seem suspicious. SMP representatives can teach you how to spot and protect yourself from potential Medicare fraud (contact information is on the last page).

1-800-MEDICARE: Contact Medicare if you want to change your coverage during Medicare’s Open Enrollment Period. You can also call Medicare for help finding plans in your area.

Medicare Advantage Plan/Part D plan: Contact a plan directly if you have questions about its benefits, coverage, or costs. If you do not receive your ANOC or EOC, contact your plan to request a copy.

Case example Otto meets with a local SHIP counselor for free Medicare counseling during Medicare’s Open Enrollment Period. He is currently enrolled in a Medicare Advantage Plan and is not sure if he should change his plan for next year. Otto brings his ANOC with him so that the SHIP counselor can help him understand the changes.

What will the SHIP counselor explain Otto? • The SHIP counselor goes through the ANOC with Otto and they note the following changes: o Otto’s yearly deductible of $300 will stay the same. Otto has to pay out of pocket for his health care until he has spent $300. Then his insurance company will start to cover his care. o Otto’s copay for his primary care physician will increase from $20 to $30. The copay is the set amount Otto pays each time he sees his primary care physician, once he has met his deductible. o Otto’s plan will have a yearly deductible of $100 for his drug coverage, meaning he will have to pay for his drugs out of pocket until he has spent $100. o Otto’s brand name anxiety medication is no longer on the formulary, but there is a generic option. o None of Otto’s doctors have left the plan’s network. • Otto decides that it is within his budget to pay the copay and drug deductible increases. He prefers to pay the increases rather than look for a cheaper plan and have a different provider network. • The counselor lets Otto know that he should speak with his doctor about his anxiety medication. Otto has only ever taken the brand name medication, but his doctor may know if the generic is an appropriate alternative. If there are any problems with the formulary alternative, Otto may want to look for a new plan in 2018, depending on what he and his doctor decide.

SMP case example Selena is 79 years old and enrolled in Original Medicare. She received a phone call from someone telling her that she had to sign up again for Medicare or she would lose her Medicare coverage for 2018. The caller said that he needed her Medicare number to complete the process. Selena gave the caller her Medicare number, but had second thoughts after hanging up. She asks her neighbor if he received the call. He said no and told her she should call her Senior Medicare Patrol (SMP) to learn if the call was legitimate.

What happens when Selena calls the SMP? • If Selena doesn’t know how to find her SMP, she can go to www.smpresource.org or call 877-808-2468 to receive contact information. • Her local SMP representative will explain that Selena does not have to sign up again for Medicare and will educate her about legitimate Medicare Plan marketing versus suspected Medicare scams, enrollment fraud, and identity theft. • The representative will let Selena know that she was right to call the SMP, who will alert the proper authorities about how her Medicare number was stolen over the phone. • The SMP will educate Selena about her options for receiving education and counseling about the annual Medicare Open Enrollment Period, including contacting her local State Health Insurance Assistance Program.

Local SHIP Contact Information Local SMP Contact Information

SHIP toll-free: SMP toll-free: SHIP email: SMP email: SHIP website: SMP website: To find a SHIP in another state: To find an SMP in another state: Call 877-839-2675 or visit Call 877-808-2468 or visit www.shiptacenter.org. www.smpresource.org.

R W P H W N B W S G G E M S Y C N T J O Find These Words: A R S F B L B E S C T J E R R Z I Q W M BALSAMIC VINEGAR BITTER TASTE U P A P Y Q P M R S M I W P A I C T A V BRUSSELS SPROUTS J W G G R T K D A M G F O U U C E Z Y O DECEMBER E G T S E M G T J G I O K Y R L B N G Y FEBRUARY P K P M H N R W E R K L A G B D U D M W FOLATE IRON P Z B L V E I V H F V A D N E U H F W N JANUARY X E F O T W Y V B I W T S T F L L T V Y MARCH R A K T H I H R C H B E E Z A N O R I E MILD TASTE Q A I R S G N J E I G P C B P S A L T I NOVEMBER OCTOBER U B R E B M E V O N M T U V S A T Z A H SAVORY SAUCES T A N G Y S A U C E S A A W E V A E M E SEPTEMBER R X S T U O R P S S L E S S U R B X I K TANGY SAUCES J E P D X P T X I K E H Y L L N Z U N I VEGGIES VITAMIN K T A B R T O V E E U F G R Q A Q F M K Z Nutrition Education S A N M K P K N I R X E O H I B A P I N X J W U E O C T O B E R V P R R B T D B K O M V A C U P C U Q B A V C N A L M N For more info, go to G F X M C R E W X Y T B S H U Z S D Z M http://www.health.com/food /15‐best‐superfoods‐for‐ H R W G Q R Y D A V E M L C Z N J N N U fall#pears‐1 Brussels sprouts' Harvest season is September to March. Made the correct way, these veggies taste divine. They have a mild, somewhat bitter taste, so combine them with tangy or savory sauces, like balsamic vinegar. To Utilize the Earthy Flavor of Rutabagas, Roast Them with One of These

Secret Message: The rutabaga harvest season is from October – April. Other ways to utilize their earthy flavor include adding them to casseroles, and pureeing them with turnips and carrots to...

For more info, go to http://www.health.com/food/15-best- Nutrition Education superfoods-for-fall#pears-1

Rhyming Fun: Write as Listing Game: In honor of Emergency many words as you can that Preparedness Month, create as many words as you rhyme with “light”. can using letters from “Emergency Preparedness”.

N.E., Sept. 26 Home Food Safety

Source: Fightbac.org

[Cite your source here.] Leftovers are safe to eat until they smell bad.

FACT: The types of bacteria that do cause illness do not affect the taste, smell or appearance of food. If you are unsure how long your leftovers have been sitting in the refrigerator, do not take the risk – when in doubt, throw it out!

Putting raw chicken in a colander and rinsing it with water will remove bacteria like salmonella.

FACT: Rinsing raw poultry in a colander will not remove bacteria and can cause cross- contamination. It can spread raw meat juices around your sink, countertops and onto ready- to-eat foods. Bacteria such as salmonella can only be killed when the poultry is cooked to an internal temperature of 165° F.

I don’t need to wash my produce if I am going to peel it.

FACT: You should wash fresh fruits and vegetables under running tap water before eating, cutting or cooking to remove any harmful bacteria that could be on the outside of the produce. If you peel or cut it first without washing it, the bacteria could be transferred to the edible part.

I use bleach and water to sanitize my countertops and the more bleach I use the more bacteria I kill.

FACT: There is no advantage to using more bleach. In fact, overuse of bleach can be harmful because it is not safe to consume. To create a sanitizing solution, it is recommended that you use 1 tablespoon of liquid bleach per gallon of water.

ADSS Nutrition Team, Summer FY17 Spoiler Alert… Answers to Unscramble Games

o September 5, 2017: o Unscramble: Sweet, Juicy, Fiber, Copper, Vitamin C o Secret Message: Harvest season for pears is from August to February. Cooking them can really bring out their fabulous flavor, so try them… baked or poached. o September 11, 2017: o Unscramble: copper, potassium, vitamin C, tropical flavor o Secret Message: Kiwis are harvested between September and March. They are great mixed with strawberries, cantaloupe, or oranges and can be combined with pineapple to… make a tangy chutney. o September 18, 2017: o Unscramble: vitamin A, fine texture, slightly sweet flavor, omega-3 fatty acids o Secret Message: Winter squash's harvest season is between October and February. Because of its thick skin, it can be stored for months. It tastes best with other fall flavorings... like cinnamon and ginger. o September 25, 2017: o Unscramble: Ginger, Lemon, Honey o Secret Message: The rutabaga harvest season is from October – April. Other ways to utilize their earthy flavor include adding them to casseroles, and pureeing them with turnips and carrots to... make a sweet soup.