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​​​​​THE TRUSTEE 

September 2023
Vol XVII, No. 161

Covid, Flu and RSV – the Triple Threat 

According  to the experts, COVID is here to stay and is now considered endemic along with influenza –the flu, and common cold. Reports show we are experiencing more and more cases and increasing hospitalizations as we move toward the peak season for flu, colds, and respiratory illnesses. The CDC recommends that best defense against the COVID subvariants is to get the vaccines as they become available. Similar to getting a seasonal Flu shot, COVID vaccines can protect people from the severe illnesses of the virus, which may require hospitalization. In most cases people can get both a flu shot and a COVID vaccine at the same time.

Recently the FDA approved the latest vaccines from Moderna and Pfizer (and its partner BioNTech) for people 12 years and older, and under emergency use authorization for children ages 6 months to 11 years old. According to the release from the FDA, the Centers for Disease Control and Prevention will meet to make recommendations for the roll out. Unlike the initial COVID 19 vaccine, the companies have produced ample supplies, so those wanting to get vaccinated will be able to obtain the vaccine from doctors and pharmacies readily. The vaccines should be available by the end of September 2023.  The new vaccine targets the omicron subvariant   VBB.1.5. This strain is already mutating but the vaccine will offer good protection according to recent studies. This vaccine will be given in a single dose.

Respiratory Syncytial Virus (RSV) is also still lurking and prevalent. While healthy adults generally clear the infection, babies, young children, and those over 60 years of age, particularly those with heart or lung disease, or weakened immune systems who are at high risk for life threatening disease caused by the viruses, are most at risk. Currently there are two vaccines, Arexvy and ABRYSVO with FDA approval to combat RSV.

Arexvy, approved in May 2023, was the first RSV vaccine approved by the FDA. According to Peter Marx, M.D., Ph. D., director of the FDA’s Center for Biologics Evaluation and Research, Arexvy is for those over 60 years of age and older, in particular those with underlying health conditions. It is recommended that individuals in that category discuss the vaccine with their health care providers to determine whether they should receive it.  

In August 2023, the FDA approved ABRYSO, the first and only Maternal immunization to help protect newborns immediately at birth through six months from RSV. According to Eric A.F. Simões, M.D., Clinical Professor, Pediatrics-Infectious Diseases, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, “ABRYSVO is a major triumph as it helps ensure no delay in potential RSV protection during an infant’s most vulnerable first six months of life and offers healthcare providers a new opportunity to help prevent severe RSV.” This vaccine can be administered to pregnant women from 32 weeks through 36 weeks gestational age.  Again, the decision to take the vaccine should be discussed thoroughly with your healthcare provider.

Information adapted from US Federal Drug Administration and the Centers for Disease Control and Prevention releases.
 

Important Reminders

It is imperative to notify the Trust Office of any status changes (marriage, divorce, legal separation, births, deaths, dependents, dependent age 26, address, child custody, disability, active/retired), and any condition affecting special programs, such as diabetes, prenatal, infertility, and weight loss. Failure to do so can be costly to the member and may even result in loss of benefits. Please send updated information to enrollment @ktftrustfund.com or call the Trust office at 844-583-3863.

Explanations of Benefits (EOB)

Whether you receive your EOBs via mail or electronically via email notification, please review them. Check to be sure that the charges reflect the services you received. Recently we have experienced some issues with inaccurate billing by providers. We depend on our members to let us know if there are discrepancies. Most times it is a mistake that can be rectified, but we have had instances of fraud. Fraud costs everyone.  If you notice a charge for services not provided, please notify the compliance office at 844-583-3863. If you are not receiving your EOBs electronically and would like to have them sent to you, please contact the Trust office at 844-583-3863 and request access to them.

Prescriptions

Do you have new prescriptions or existing prescriptions for maintenance drugs? If you are currently taking a prescription for a maintenance drug, check to see if it is available through CanaRx.  You can check to see if your medicine is available by going to ktfmeds.com and searching the list of available drugs.  If the Brand Name Prescription Drug is available through CanaRx and you use their service, there is no copay. Your cost to you will be zero!  If your maintenance Brand Name drug is available through CanaRx (with no co-pay) and you choose to obtain it through Manifest or retail, there is a co-pay of $120.

In Memoriam

   Catheryn Berger                  Donna Smedman
         Emelia Moore                       Gerald (Jerry) Spratt

Amelia Altamari                 Rosalie Maneen
       Marian Goodrich                Robert (Bob) Lawrence