We are happy to share that First Choice has. First Choice: (Toll-Free) (TTY)

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1 S u m m e r I n S I d e First Choice Puts Quality First Can You Spell O.B.E.S.I.T.Y. Prevention?... 2 Pregnant? There Is A Free Program to Keep You and Your Baby Healthy...4 Healthy Recipe: Black Beans with Corn and Tomatoes...5 Keep Kids Safe This Summer... 7 Is Your Child Ready for School We are happy to share that First Choice has received Excellent Accreditation status from the National Committee for Quality Assurance (NCQA). Excellent Accreditation is the highest rating a health plan can receive. NCQA rates health plans on how well they provide quality care. First Choice received the status of Excellent because its service and clinical quality met or exceeded NCQA s rigorous requirements. We want to thank you for being a member. First Choice is excellent because of you. First Choice: (Toll-Free) (TTY)

2 Now you know how to spell o.b.e.s.i.t.y. prevention. Visit and check the Member Benefits section to learn more ways to fight childhood obesity. Can You Spell O.B.E.S.I.T.Y. Prevention? O Overweight: Find out where your child falls on a weight chart. Know your child s BMI (body mass index). Your child s height and weight measurements determine his or her BMI. B Balance: Try to stay away from: Eat more: E Exercise: Sweets Fatty fast foods Fried foods Processed foods Sodas Fruits Vegetables Whole grains Lean meat and fish Water Get moving! Try going for a family walk, taking the stairs instead of the elevator or parking in the back of the lot so that you walk more. S Stop: I Initiate: T Time: Y You: Stop and make an appointment with your child s doctor. Talk with the doctor about your child s health. Initiate (start) a plan for healthier lifestyle choices. A healthier weight will follow. Make time to plan meals and be active. Try to go to the grocery store instead of picking up fast food. Childhood obesity prevention starts with you the parent. Lead by example. Turn off the TV, computer and video games. Spend quality time with your child by making healthy meals at home. Take your child on a walk in the park. Join a sports team or gym. 2 Healthy Now Summer 2011 Select Health of South Carolina

3 Have Diabetes? Keep an Eye on Your Feet If you have diabetes, pay close attention to your feet. Poor blood flow (cold feet) and loss of feeling can cause dryness, calluses, skin ulcers (sores), poor healing, numbness, pain and a burning sensation. If this problem is left untreated, you could lose your toes or foot. How can you protect your feet? Keep your feet clean and dry, especially between the toes. Use lotion on your feet, except between the toes. Do not use sharp scissors or clippers to trim your nails. Use a nail file and file straight across to prevent ingrown nails and cuts to toes. Check your feet daily. Make sure your doctor checks your feet at each visit. Remove your shoes and socks before your doctor enters the room. Do not walk around barefoot, especially outside. Be sure you are wearing the correct size shoe. Make a doctor s appointment if you have any of these problems: A foot infection, sore or bruise that does not heal in 1 to 2 days Corns, calluses or bunions on your feet An ingrown toenail Itching or cracking between your toes Constantly cold feet Pain or cramps in your legs or feet Changes in the color of your skin Lots of pain when walking Remember, you can prevent foot problems by taking control of your diabetes. Summer Spring Healthy Now 3

4 Pregnant? There Is A Free Program to Keep You and Your Baby Healthy First Choice has a free program for pregnant members called Healthy Moms and Babies. We have prenatal nurses that are here to talk with you about your pregnancy. They can answer any questions you may have. Our nurses can help with transportation problems, medicine questions or general pregnancy issues. We also have NICU (special-care nursery) nurses if you have delivered a baby that has been in the NICU or has special-care needs. These nurses can talk with you about your baby s care or answer your questions. They can also help with scheduling follow-up visits and home health visits for your baby. We have free educational materials for expecting and new parents. If you would like to get these, please call Select member option 1 and enter extension Ask to talk with a prenatal or NICU nurse. If you would like more information about our Healthy Moms and Babies program, call Select option 1 and enter extension Please ask to talk with a prenatal or NICU nurse. We will be happy to answer any questions or send free information. 4 Healthy Now Summer 2011 Select Health of South Carolina

5 Healthy Recipe: Black Beans with Corn and Tomatoes Ingredients 1 15-ounce can lowsodium, no-fatadded black beans 1 cup cut tomatoes, fresh or canned 1 tsp. fresh parsley, chopped ½ tsp. chili powder 1 cup frozen corn, thawed 1 clove garlic, pureed or roasted ⅛ tsp. cayenne pepper or to taste Directions 1. Drain and rinse beans. 2. In a bowl, combine beans, corn, tomatoes and garlic. 3. Add parsley, pepper and chili powder. 4. Mix all ingredients well and serve. Yield: 4 servings Serving size: ¾ cup Each serving provides Calories: 260 Fat: 2 g Cholesterol: 0 mg Sodium: 8 g Protein: 10 g Summer 2011 Healthy Now 5

6 You May be Wondering, What Is Case Management? Our case managers are nurses who, if you call us, can talk with you over the phone for free. He or she will ask health-related questions. Your privacy is respected and protected. The information will help the nurse to know what resources and services will best serve you. A nurse case manager is a great resource. The nurse: Answers health questions Explains tests and why they are needed Works with you to set goals Explains medicines Helps with pharmacy problems Helps you when you have trouble getting your health needs met Shares helpful resources, like health clinics, health screenings and electricity bill and food assistance Is a coach Can talk with staff at doctor s offices, hospitals and pharmacies to help you get the care you need Some of our programs that case managers help you with are: Breathe Easy for members with asthma In Control for members with diabetes Living Well for members with heart failure Intensive Case Management for complex health issues Healthy Moms and Babies for our pregnant members Sickle Cell for members with sicklecell disease Short-Term Care for members who need home IV antibiotics, wound care and home therapy For case-management, call toll free Healthy Now Summer 2011 Select Health of South Carolina

7 Renewing Your Medicaid Have you gotten a notice in the mail from South Carolina Healthy Connections? If you or a family member has First Choice, you ll want to watch for it. It is your Medicaid Eligibility Annual Review Notice and it comes once a year. Medicaid reviews any changes you or your family may have and decides if you are still eligible to get benefits. You must complete and return the form to your local Department of Health and Human Services office as soon as possible. If you delay, it could affect your eligibility. The address where you need to send it is on the form. Remember, you must mail it back even if there are no changes. Have you moved recently? Make sure the review form is sent to your new address. Contact your caseworker and update your information. If you don t return the form, or if it s not received by the due date, you will lose your Medicaid benefits. If you lose your Medicaid benefits, you will also lose First Choice. If you have questions, call First Choice toll-free at Or you can call the Healthy Connections helpline at You must complete and return the form to your local Department of Health and Human Services office as soon as possible. Summer 2011 Healthy Now 7

8 Take Charge of Your Sickle Cell Use the information below to take charge of your sickle cell disease. General tips for sickle cell: Watch for sores on your legs. Poor blood flow can cause sores. This is a sign that your sickle cell may not be under control. Drink plenty of water, at least 8 to 10 glasses a day. Call your doctor if you have a fever higher than degrees. If have chest pain, go to the ER. Take folic acid. Your doctor can order this for you. You can have it filled at the drugstore. It is a vitamin that you can take daily to help prevent low iron levels in your blood (anemia). Talk with your doctor about what kind of pain medicine works best for you. If you snore when sleeping, tell your doctor. Living Healthy: Don t smoke! Smoking causes poor blood flow. Stay active. Exercise, but don t overdo it. Don t take part in rough contact sports. Talk about appropriate exercise activity with your doctor. Limit alcohol intake. It takes the fluid out of your body. Avoid caffeine. It affects normal blood flow. Don t swim in cold water. Take warm baths or showers. Wear warm clothes inside cool rooms. Try not to go in and out of the heat (such as from a hot outdoors to an air-conditioned room). Call your doctor if you suffer from: Swollen hands and feet Skin or nail beds light in color (pale) Yellow color of the skin or eyes (jaundice) Fever or signs of infection Swelling in the belly Weakness on one side of the body, sudden change in speech, hearing or seeing Headache, limping, or joint, stomach, chest or muscle pain If you need to go to the hospital or ER, be sure to: Take your medicine as ordered by the doctor Make a follow-up appointment with your doctor, as instructed For follow-up care, you may see your primary doctor (PCP) or a hematologist. A hematologist is a doctor who treats patients with blood problems. First Choice has free over-the-phone case management and education for our members with sickle cell. To learn more, call Healthy Now Summer 2011 Select Health of South Carolina

9 Quality Care that Meets Your Cultural Needs The National Committee for Quality Assurance (NCQA) recently awarded your health plan, First Choice, the Multicultural Health Care Distinction. This distinction recognizes First Choice s commitment to quality healthcare and its efforts to provide culturally and linguistically appropriate services. We offer these programs so that you get the best care possible, and we do that by making sure we understand your unique healthcare needs. Medicine Updates The 2011 Preferred Drug List (PDL) is a list of the medicines covered by First Choice. There have been some changes to the list since its appearance in the Winter 2010 Healthy Now newsletter. Those changes are: Low-dose Seroquel (less than 150 mg per day) now needs prior approval for members ages 13 to 64 who are not on an antidepressant (SSRI/SNRI) and will be taking it longer than 30 days. Vytorin now requires prior approval. Several strengths of Hydrocodone/APAP have been added to the list. The mg, mg and mg tablet versions do not need prior approval. Dulera inhalation was added to the PDL, so it no longer needs prior approval. To see the complete PDL, visit our website at Go to the Pharmacy section, and click on Preferred Drug List. First Choice Benefit Changes Home healthcare benefits are available to First Choice members. These are services provided at your home that include intermittent skilled nursing, home health aid, and physical, occupational, and speech therapy. Members 21 years of age and older are limited to 50 visits a year. There are no limits on the number of visits for children under 21 years of age. Children under 19 years of age, pregnant women, people getting emergency services and federally recognized Native Americans do not have copayments for services. As of August 1, 2011, the copayment for office visits (doctor, nurse practitioner, licensed midwife), clinic visits and home health visits will increase from $2.30 to $3.30 for other adult members 19 years old and older. This increase is consistent with changes being made by Medicaid for copayments. Summer 2011 Healthy Now 9

10 Need a Ride? If you need a ride to your doctor s appointments, you can call the South Carolina Medicaid Transportation Broker in your county. You will need to call at least 3 work days before your appointment. Be sure to have your ID card and the address of the doctor s office on hand. Medical Transportation Management (MTM) County List If you live in one of these counties, call: If you have any problems or complaints, call: Abbeville Anderson Cherokee Chester Greenville Greenwood Lancaster Laurens Oconee Pickens Spartanburg Union York LogistiCare If you live in one of these counties, call: (To find out where your ride is, call ) Edgefield Fairfield Lexington McCormick Newberry Richland Saluda If you live in one of these counties, call: (To find out where your ride is, call ) Aiken Allendale Barnwell Bamberg Calhoun Clarendon Kershaw Lee Orangeburg Sumter If you live in one of these counties, call: (To find out where your ride is, call ) Beaufort Berkeley Charleston Colleton Dorchester Hampton Jasper If you live in one of these counties, call: (To find out where your ride is, call ) Chesterfield Darlington Dillon Florence Georgetown Horry Marion Marlboro Williamsburg 10 Healthy Now Summer 2011 Select Health of South Carolina

11 Is Your Child Ready for School? Enjoy the fun, sunny summer days with your child. But don t forget to prepare for a healthy, happy school year in the fall. Have you taken your child for a yearly well-child visit? Well-child visits (checkups) are important, even when your child is healthy. At well-child visits, the doctor will look at your child s general health, growth and development. The doctor may also check your child s teeth, eyes and ears. It is important to have a primary doctor and to use the same doctor as much as possible. If you always go to the same doctor, he or she will know your child s medical history and will keep track of important medical services, like shots. A well-child visit is the perfect time to ask about: Nutrition Health and safety Sleep habits Behavior and discipline Emotional, social or learning problems Concerns about family problems or about puberty Is your child up-to-date on immunizations (shots)? No shots, no school! South Carolina law requires that kids get the proper shots before they can start school. If they are not up-to-date, they must qualify for an exemption. Making sure your child has his or her shots is very important. Talk with your doctor about the shots your child needs. You can learn more about well-child visits and shots on our website. Visit www. selecthealthofsc.com/firstchoice and visit the Member Benefits section. Does your child have a good routine? A healthy breakfast is the best way to prepare your child for a day at school. Kids who eat breakfast learn better, are more alert and are more likely to take part in activities during the day. A good night s sleep is also important. Sleep affects how well kids do in school. Sleep helps with problem-solving skills, memory, learning and physical well-being. An active lifestyle helps kids unwind and release their energy. After a long day at school, kids should have time to play outside. Now your child is ready to start the school year off right! Summer 2011 Healthy Now 11

12 PrSRT Std U.S. POSTAGE Paid Permit No. 372 LONG Prairie, MN Para obtener una copia de este documento en español, por favor llame al Departamento de los Servicios para Miembros al Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date health information. But no publication can replace the advice of medical professionals, and readers are cautioned to seek such help. Models used for illustrative purposes only. 5526M Keep Kids Safe This Summer Summer is here! Kids are out of school and looking for fun activities outside. Make sure they stay safe this summer by following these tips. Make sure your child wears a helmet when riding a bike, skateboarding or roller skating. If your child falls, a helmet will protect his or her head. A helmet should sit on top of the head in a level position. It should not rock forward, backward or side-to-side. Teach your children about water safety. Teach your children how to swim and make sure they never swim alone. An adult should always be watching. Tell children never to go near a pool drain, either with or without a cover, and to pin up long hair when in the water. Always wear a life jacket in and around open water. Children should wear a U.S. Coast Guard approved life jacket when on a boat, near open bodies of water or when participating in water sports. Don t forget the sunscreen! Remember to put sunscreen on your child each day before he or she goes outside to play. Make sure the playground is safe. Check any equipment to make sure it is safe and in good condition before letting children play on it. Your children can be hurt by falling from a swing onto cement. Sand is better. Teach your children how to be safe when on a playground. For example, tell them they shouldn t walk near a moving swing. Teach children not to play in or around vehicles.