How Care Management Can Help You. Disease Management Program

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1 south carolina 2015 ISSUE II How Care Management Can Help You Got a question or concern about your health? Care Management helps members with special needs. It pairs a member with a care manager. The care manager is a nurse. He or she can help the member with issues. These include: Complex medical needs; Solid organ and tissue transplants; Children with special health care needs; and Lead poisoning. We re here to help you! Call us for more information. The number is on the back page. Ask for the Care Management Department. You may be eligible to receive this service at no cost to you. Disease Management Program Disease Management is similar to Care Management. The program supports members with health problems. These may include, but are not limited to: Asthma; Diabetes; Hypertension; Heart disease; and HIV/AIDS. Do you have any of these conditions? Are you interested in this program? Please call Customer Service. The number is on the back page. You can get educational materials. In some cases, you may get coaching from a registered nurse.

2 Get Everyday Drugstore Items With New Benefit Your health and your family s health are important to WellCare of South Carolina. We want you to be your healthiest. One way to do that is by using your over-thecounter (OTC) benefit. With this benefit, you can choose from more than 150 health and wellness items. This includes things like: Allergy, fever and heartburn medicine; Cough and cold medicine; Toothbrushes, toothpaste and floss; First aid items; Sunblock; and Vitamins. First, you make your choices. Then we have a couple of ways for you to place your order: 1. Call Customer Service. The toll-free number is (TTY ). We re here to help Monday Friday, 8 a.m. 5 p.m. Option 1: Use our automated phone service to place your order. Just follow the instructions. Be sure to have your item number(s) ready. Option 2: Talk with someone on our team. Follow the phone instructions. Have your item number(s) handy. 2. Log on to our website. If you have a computer or smartphone, go to southcarolina.wellcare.com. Sign in from the home page. Don t have a username and password? You can register. Click on Member sign up. It s easy to sign up. Just follow the instructions. Now you re logged in. Click Over-the- Counter (OTC) Items to get started. You can order items until they add up to your monthly $10 allowance. We ll ship your order right to your home. It s that easy! Here is how you can get the most out of your OTC benefit: Make sure to order your items each month. If you don t, you ll lose your $10 allowance for that month. It will not carry over to the next month. Use your monthly order to stock up on different items. Important reminders: Your OTC allowance is for each family. It s not for each family member who s on our plan. Items, quantities, sizes and values may change. This will depend on availability. The brand names of the OTC items listed are trademarks of their respective owners. 2 Member Newsletter

3 Team Up to Keep Asthma Under Control Do you have asthma? You and your health care provider can team up to keep it under control. Here are some parts of a long-term asthma strategy: You should receive a written asthma action plan. It will give you tips on how to handle attacks. You should get regular asthma checkups. When seasons change, your asthma action plan may change, too. Your checkup may include a test called spirometry. This measures how much air you can inhale and exhale. It also tests how fast you can push air out of your lungs. You ll get medication. Some will be for long-term control and some for quick relief. You ll find out about allergens or irritants you ll want to avoid. Remember that asthma can change over time. That means your action plan may have to change, too. Work with your provider on a regular basis. This is the key to success. Do you have concerns or questions about your health? Remember, the Nurse Advice Line is there for you. You can talk to a nurse 24/7. It s no cost to you. The number is (TTY 711). Source: National Heart, Lung, and Blood Institute, retrieved from Member Newsletter 3

4 Start Your Tobacco-Free Life With a Successful Quit Day Have you decided to finally quit tobacco? Then congratulations! Cigarettes, pipes, hookahs and smokeless tobacco are all bad for you. Quitting is one of the best things you can do for your health. Now you can focus on that first step your Quit Day. This is the day you begin a tobacco-free life. Here are some tips for getting through your Quit Day. They come from Reach Out for Support Use a support program. Call QUIT-NOW ( ) to learn more. Are you using medications like gums or patches to help you? Use them as directed. Our Disease Management Department can help. Get educational materials and advice on how to quit. Call Customer Service. The number is on the back page. Ask for the Disease Management Department. Keep Busy Stay as busy as possible on your Quit Day. Go to a movie or take long walks. Spend time in places where smoking isn t allowed. Do you miss having a cigarette in your hand? Hold something else. Try a pencil. Have a craving? Try chewing on gum, hard candies, toothpicks, or carrot or celery sticks. Drink plenty of water or fruit juice. But avoid drinks that may be triggers. This could be alcohol or coffee. Source: Steps to Take on Your Quit Day, retrieved from The Health Benefits of Quitting Heart and circulation improve 1MINUTE 10YEARS 3-6MONTHS Easier to breathe Cancer risk cut in half Stroke, heart attack and lung disease risks drop 1YEAR Source: Centers for Disease Control and Prevention, Health Effects of Cigarette Smoking, retrieved from 4 Member Newsletter

5 WellCare and Dawn Staley Help Children Stay Healthy Three-time Olympic gold medal winner Dawn Staley and WellCare of South Carolina have teamed up to give children new sneakers. The program is for children who are low income and/or homeless. Staley is the new spokesperson for WellCare of South Carolina. WellCare supports her organization, Innersole. It gives sneakers to children so they can build confidence and stay active. Staley grew up in an inner-city housing project. There, people have a hard time getting health care for themselves and their loved ones, she said. Children who are not healthy may not be able to get ahead in life. So Staley and WellCare are delivering sneakers and health care to children who need them most. Healthy children have a better chance to succeed. Since 2013, 5,700 children in the state have gotten sneakers. Innersole wants to give sneakers to all homeless children in the state by the end of To learn more, go to News Update! You may have gotten a telephone call from us recently. We may have been asking whether you or your child has had a checkup. Or if you have diabetes, we may have asked whether you had a recent hemoglobin A1C test or an eye exam at your doctor s office. The reason we are calling is simple. We want to let you know that you re eligible for these benefits. We also want to help you make appointments. And we want to help you get transportation to your appointments. Our goal is to partner with you to keep you in the best health possible. Here s to a healthy you! Member Newsletter 5

6 WellCare s Commitment to Quality We want to make sure you are getting the right care for your health. In 2014, the WellCare Quality Program did many things to improve the quality of your health care. The program: Responded to reported quality concerns; Encouraged you to go to well visits, including mammograms, eye exams, immunizations and more; Made sure you can reach doctors by phone, get a timely appointment and find a doctor near your home; Made sure we answered your calls quickly; and Ensured that claims were paid accurately. Here are some of our goals for 2015: We will continue to measure the quality of the care and services you receive. We will continue to ask if you are satisfied. This helps us make sure you are pleased with us and your doctors. We will ask what your doctor(s) think of our service. We will continue to review and update our guidelines. Want to receive a copy of our Quality Improvement Program description? Call Customer Service. The number is on the back page. Click or Call for the Latest Drug Coverage Updates Want to find the latest about the drugs we cover? Stop by our website. You ll find our Preferred Drug List (PDL). You can learn about drugs we ve added or removed. You ll also find changes to any drug requirements or coverage limits. Just go to southcarolina. wellcare.com. You can also call us. The number is on the back page. 6 Member Newsletter

7 Help Is Available for Substance Abuse Problems Anyone at any age can get into trouble with drugs and/or drinking. People often use drugs and/or alcohol to relieve stress or deal with emotional pain. Drugs and/or alcohol may seem to work for a while. But they only make things worse in the end. What is a substance abuse problem? It is any drinking and/or drug use that harms the user or puts others at risk. The good news is substance abuse can be treated. You can talk with your doctor or a substance abuse counselor. Ask him or her for help to quit. Be honest. Talk about what you use, how much and how often. Anything you say will be kept confidential. The following are some helpful resources: Substance Abuse and Mental Health Services Administration: SAMHSA 24/7 Treatment Referral Line: HELP (4357) Partnership for a Drug-Free America: Narcotics Anonymous: Cocaine Anonymous: Alcoholics Anonymous: South Carolina Department of Mental Health: comments.htm Sources: Substance Abuse Consumer Fact Sheet, NC Division of Mental Health, Developmental Disabilities and Substance Abuse; Health Bulletin #61, New York City Department of Health and Mental Hygiene Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor s advice. It is based on third party sources. We are presenting it for your information only. It does not imply that these are benefits covered by WellCare. Also, WellCare does not guarantee any health results. You should review your plan or call Customer Service to find out if a service is covered. Call 911 or your doctor right away in a health emergency. Member Newsletter 7

8 200 Center Point Circle, Suite 180 Columbia, SC PRSRT STD U.S. Postage Paid Wellcare Health Plans Para solicitar este documento en Español, llame al Servicio al Cliente al (TTY ). SC028543_CAD_NEW_ENG State Approved WellCare 2015 SC_12_ In This Issue We re pleased to deliver another newsletter issue. It s full of helpful ideas about ways to live healthier. Here s what you ll find inside: Tips on getting everyday drugstore items; How to start a tobacco-free life; and Information on our Care and Disease Management programs. There s much more inside. Please take a moment to explore. As always, we wish you good health. Numbers to Know We re just a phone call (or click) away! Call Customer Service: TTY Monday Friday, 8 a.m. 5 p.m. Or visit southcarolina.wellcare.com Nurse Advice Line: (TTY 711) 24 hours a day/7 days a week 10867MD