CareEssentials Articles: Promoting CareEssentials to Your Employees

Transcription

1 CareEssentials Articles: Promoting CareEssentials to Your Employees Use the following articles in your employee newsletters or Web site to promote the CareEssentials tools and resources to your employees. Look for new and updated files at CareEssentials: Keeping you healthy. Making you well...2 Get Healthy with My Care First...6 Manage your Medical Conditions Online...7 Great Beginnings Program for Expectant Mothers...8 Options Discount Program...9 Online Tools to Help You with Prescription Drugs...10 Provider Directory at How to Cut Medication Costs...12 Help from the Case Management Program...13 Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are Registered trademark of the Blue Cross and Blue Shield Association. ' Registered trademark of CareFirst of Maryland, Inc. 1

2 CareEssentials Keeping you healthy. Making you well. At CareFirst BlueCross BlueShield (CareFirst) and CareFirst BlueChoice, Inc. (CareFirst BlueChoice), our goal is to put you in control of your health care choices. We give you the resources you need to make intelligent health care decisions that will help keep you healthy or when you are sick, help make you well. Prevention CareFirst and CareFirst BlueChoice understand that taking the first step to get healthier is one of the toughest. That s why we re providing you with tools to make it easier and fun to get healthy. MyHealthProfile MyHealthProfile is a health risk assessment tool that provides you with a personalized health report. Once you are enrolled in a CareFirst or CareFirst BlueChoice health plan, you can log on to and answer questions about your medical history, what types of preventive services you are receiving, your emotional health as well as your current lifestyle choices. After completing MyHealthProfile, you will receive a customized health report that will alert you to possible health risks and provide you with recommendations on how to stay healthy. The report also includes a summary page that you can take to your doctor to use as a guide when talking about your health. MyHealthProfile is available online, by phone and by mail. Taking it online provides advantages like linking you to helpful tools such as our lifestyle management programs, keeping your personal history up-to-date and tracking your progress using your previous results. Lifestyle Management Programs Our lifestyle management programs provide you with online health information based on your answers from MyHealthProfile. This information is customized just for you and can help you achieve a healthier lifestyle! We have lifestyle management programs to help you: Manage stress Keep a healthy diet Quit smoking Lose weight Maintain an exercise routine Once you enroll, you can: Read your personalized reports Take part in interactive exercises Access external resources with tracking tools, testimonials, quizzes and activities (continued on next page) 2

3 The lifestyle management tools are available only if you complete MyHealthProfile online. If you have any questions regarding MyHealthProfile or our lifestyle management programs, contact a health support representative at (866) Healthy Lifestyle Coaching We also have a Healthy Lifestyle Coaching program that provides you with support if are at risk for a disease. While you may not have a disease, your MyHealthProfile report may determine that you could be at risk. For example. The MyHealthProfile report may identify you if you are a heavy smoker and also have asthma in your family history. If you were to acquire asthma, your condition may be severe because of smoking. You could be invited to participate in health coaching sessions where a health coach helps you set goals to help you quit smoking and not only that, but you can talk to your coach every step of the way until you ve reached your goal(s). Call (866) if you have questions about the Healthy Lifestyle Coaching program. My Care First Visit My Care First, the health and wellness section of for a wealth of health information that can help you manage your health. At My Care First you will find: General information on more than 300 health-related topics. Interactive health calculators that allow you to determine important measurements such as body mass index and target heart rate. Vitality Vitality, our quarterly health magazine, not only gives you updates on your health plan, it also includes health and wellness articles to help you achieve a happier and healthier lifestyle. Each issue is filled with information on a variety of topics such as: Food and Nutrition Physical Fitness Preventive Health Utilization Management Coordinating Care When you need to be hospitalized or need therapy, your doctor will work with the Utilization Management team to ensure that you receive the right care in the right place at the right time. If you are hospitalized, a Utilization Management nurse will review your information and assist with discharge planning as well as approve additional inpatient hospital days if necessary. (continued on next page) 3

4 Prescription Drugs* We have the tools to help you understand the complicated world of prescription drugs. Go to and click on Prescription Drug Information in the Solution Center. Here you can: Download pharmacy claim forms and mail order forms Search the prescription drug database to determine your copay level Get the latest prescription drug news and updates to the preferred drug list Do much more! *This information applies only to those members whose prescription drug program is based on the CareFirst and CareFirst BlueChoice preferred drug list (also called a Formulary). Disease Management CareFirst and CareFirst BlueChoice want to help you achieve the best possible state of health. We know that there are many things to remember when you are living with a chronic condition. That s why our disease management programs can help you manage your condition and help you to avoid complications. We have nurses available to provide you with information and assist you in managing: Asthma Diabetes Chronic obstructive pulmonary disease (COPD) Heart failure Coronary artery disease Low Back Pain Osteoporosis Osteoarthritis Hepatitis C Urinary Incontinence Decubitus (Pressure) Ulcers Atrial Fibrillation Inflammatory Bowel Irritable Bowel Syndrome Fibromyalgia Acid-related Disorders Once you enroll, you will: Be able to call a toll-free number 24 hours a day, seven days a week, to speak with a registered nurse Receive educational materials and quarterly newsletters with information about your condition Receive reminders and tools to help you manage your condition These programs are free, voluntary and confidential. Call (800) to find out if you are eligible or to enroll in one of the programs. Case Management When faced with a serious diagnosis or condition, you and your family have many tough choices and decisions to make. The Case Management program can help you through the complexity of the health care system and provide constant support during your time of need. (continued on next page) 4

5 Some of the conditions most frequently case managed include: Serious trauma Rehabilitation Cancer Special needs Our case managers will: Work closely with you and your doctors to identify a treatment plan Coordinate necessary services Contact you regularly to see how you are doing Answer any of your questions Suggest community resources that may be available This program is free, voluntary and completely confidential. To enroll or to find out more information about the program, call (888) Great Beginnings Program for Expectant Mothers Our Great Beginnings program will supplement the prenatal care you receive from your doctor during pregnancy. When you enroll, you will receive information about your condition and your baby s development. Also, if you experience any complications, a case manager will work with your doctor to coordinate any necessary services and additional support. This program is free, voluntary and completely confidential. To enroll or to learn more about the program, call (888)

6 Get Healthy With My Care First Looking for ways to get healthy and stay healthy? Go surfing on the Web. Visit My Care First, the Health and Wellness section of This award-winning site contains a wealth of health information and interactive features that can help you take an active role in managing your health. If you are looking for information about a specific condition, just select a topic from our health library. You can learn about a variety of health issues from our weekly stories, quizzes and HealthDay news, which is updated several times a week with consumer health information. If you or a loved one has asthma, diabetes or heart disease, visit the asthma center, diabetes center or heart-health center for the information, quizzes and tools you need to help manage these conditions. You can also obtain personalized health information, such as your body mass index, your target heart rate and your ideal weight, by using the health calculators. For even more detail about your health, you can register with the site. Registering will enable you to take a personalized health assessment, set health goals, track your progress and have reminders sent via . You can also get help to manage weight, stress or blood pressure and to quit smoking. To visit My Care First, go to and select Health and Wellness My Care First in the Solution Center. 6

7 Manage Your Medical Conditions Online Have you visited My Care First, the award-winning health and wellness section of the CareFirst BlueCross BlueShield and CareFirst BlueChoice Web site? Go to and select My Care First in the Solution Center. At My Care First, you can play an active role in your health by taking a personalized health assessment or searching for local health classes or support groups. You also can learn more about your health by taking our weekly quizzes. If you or a loved one has asthma, diabetes or a heart condition, or if you want to manage your weight, there are special sections just for you. In the asthma center, you can assess your asthma severity, learn more about how to manage this condition, and download an asthma action plan to complete with your doctor. To go directly to the asthma center on My Care First, go to In the diabetes center, you ll find information about managing diabetes. You can also track your body mass index (BMI) and your cholesterol, hemoglobin A1c and blood sugar levels on our secure servers. To go directly to the diabetes center on My Care First, go to In the tool section of the heart health center, you can assess your risk for heart disease by choosing the Healthy Heart Assessment. You can also track your BMI, weight, blood pressure and cholesterol levels and learn to avoid heart disease. If you already have heart disease, you can learn how to manage it. To go directly to the heart health center on My Care First, go to In the weight management center, you can find up-to-date information on nutrition, physical activity, and changing unhealthy habits. By using the interactive tools, you can assess your health and track your progress on our secure servers. You can also find healthy recipes. If you can t find the information you are seeking, our medical experts, who will post their responses on the site. To go directly to the weight management center on My Care First, go to Remember, My Care First is updated every week, so bookmark it and be sure to visit often to learn more about managing your health. This section is for informational purposes only. The content is not intended to be substituted for professional medical advice, diagnosis or treatment. Please contact your physician with any questions or concerns regarding your medical condition(s). CareFirst BlueCross BlueShield and CareFirst BlueChoice recognize that a number of variables, which are not available to us, must be taken into account, therefore, your doctor is the best qualified in choosing the most appropriate care for you. 7

8 Great Beginnings Program for Expectant Mothers CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. offer support to members during their pregnancies. The Great Beginnings program is designed to supplement the prenatal care and education you receive from your doctor during pregnancy. Our case managers strive to help you and your baby stay healthy during pregnancy. When you enroll in Great Beginnings, a case manager will contact you to review your medical history and to identify any other conditions that may affect your pregnancy. You will then receive information related to your condition and your baby s development. Your case manager will contact you during each trimester to see how you are feeling and to answer any questions. If you have not chosen a pediatrician, the case manager may also assist you in finding a pediatrician close to your home. Also, if you experience any complications during pregnancy, your case manager will work closely with your doctor to coordinate necessary services and provide additional support and information you may need during this time. Case managers are available to answer questions, Monday through Friday, 8:30 a.m. to 4:30 p.m. To find out more information about the program, call (888)

9 Options Discount Program Options is a discount program for a variety of alternative therapies and wellness services including Weight Watchers Online, acupuncture, massage therapy, chiropractic care, yoga, Pilates, personal training, nutritional counseling, guided imagery, tai chi, qi gong, fitness centers, eldercare services, cosmetic dentistry, hearing care centers, mail order contact lenses and laser vision correction. If you are a CareFirst BlueCross BlueShield (CareFirst) or CareFirst BlueChoice, Inc. (CareFirst BlueChoice) member, you automatically have access to these great services at a discounted price. Since it s not a benefit, there are no claim forms, referrals or paperwork. Simply show your CareFirst or CareFirst BlueChoice member ID card and pay the provider fees at the time of service. Gym Memberships You can take advantage of a discounted membership at a gym in your area. National Fitness Network and GlobalFit offer discounted fitness club memberships to CareFirst and CareFirst BlueChoice members through the Options program. National Fitness Network offers up to 40 percent off monthly dues at a regional network of fitness and health clubs in Maryland, Florida, New Jersey, Virginia and the District of Columbia. GlobalFit offers up to 60 percent off monthly dues through its network of more than 1,500 gyms nationwide. Health and fitness centers in the GlobalFit network include Bally Total Fitness, Gold s Gym and selected Curves locations. To register for a gym membership in the GlobalFit network through the Options program, visit and click on Options Discount Program in the Solution Center or call (800) To register through National Fitness Network, visit or call (800) Weight Watchers Online One of the nation s most recognized weight loss programs is online, and CareFirst BlueCross BlueShield and CareFirst BlueChoice members can save $10 on a 3-month subscription to Weight Watchers Online when you sign up through Weight Watchers Online provides a set of personalized tools to help you stay on track. Set up your own Online Journal, meal Planner, Weight tracker, and Progress Charts, and search a database of over 800 Weight Watchers recipes, and calculate points for your own foods and meals. For details on other discounted programs and services available through the Options program, visit our web site at and click on Options Discount Program in the Solution Center. This is a discount program only. The products and services are not covered benefits under your health plan. Your premiums are not affected by this program. Costs of program services and products do not count toward calendar year copayment maximums, and/or plan deductibles. Hospitalization and Medical Services, Inc. CareFirst Blue Cross Blue Shield and CareFirst BlueChoice, Inc. are 9

10 Online Tools Help You With Prescription Drugs Taking prescription drugs can be confusing and overwhelming. Don t worry at CareFirst BlueCross BlueShield (CareFirst) and CareFirst BlueChoice, Inc. (CareFirst BlueChoice), we have the tools to help you navigate the complex world of prescription drugs. Go to and click on Prescription Drug Information in the Solution Center. Here you can: Download pharmacy claim forms and mail order forms. Search the prescription drug database to determine your copay level. Get the latest prescription drug news and updates to CareFirst s preferred drug list. See if your drug requires prior authorization or has quantity limits. Check out answers to Frequently Asked Questions. Refill a mail-order prescription. Locate a pharmacy. While you re there, be sure to check out our latest features: Drug Dictionary: Our dictionary has 60,000 entries and photos of generic and brand-name drugs, as well as immunizations, hormones, vitamins, minerals, herbs and other supplements. Drug Interaction Checker: Need to know if it s OK to take aspirin with your heart medicine? Find out with our drug interaction checker. How to Use Your Drug Plan section: This how-to guide can help you achieve the lowest costs for your prescription drugs by explaining how the CareFirst and CareFirst BlueChoice preferred drug list works. Pricing tool: Through this link, visit the Argus Health Systems Web site to learn how much your drugs will cost and if there are any less expensive alternatives. Preferred drug list: Your out-of-pocket drug cost depends on your drug s status on the CareFirst preferred drug list. Print out an up-to-date copy to take to your next doctor s appointment, and talk with your doctor to find out if there are less expensive alternatives he or she can prescribe. 10

11 Provider Directory at Our online provider directories provide you with the most up-to-date information when you are trying to find a doctor. Visit and click on Members & Visitors and Search a Provider. If you want to find out whether or not a specific doctor participates in one of our networks, type the doctor s last name in the box entitled Search By Provider Name. All doctors with that last name will appear in a chart. Select the appropriate doctor from that list to determine which networks he or she participates in. If you are searching for a new provider, select one of the options listed under Search By Provider Type. From that point, select your particular medical plan. And then click Locate a Provider. The next two screens will allow you to refine your search to the type of doctor or medical facility, the area in which you live, or any of several other options. Complete any of these areas and click search. You may also call the Member Services toll-free number on the front of your ID card for assistance in selecting a PCP or obtaining a printed copy of a provider directory. If you re looking for a specialist and aren t sure what kind of specialist you need, click on What Specialist Do I Need? next to the specialty drop-down box. This list features conditions and the specialists who treat them. If you re looking for a doctor or facility, you can print a listing of the providers who match your search criteria. You can also map driving directions to a provider s location, as well as view details about the provider, such as whether a doctor is a specialist and is accepting new patients. Report any errors you find by clicking on the Update Listing link next to the provider s name. If your plan requires you to choose a primary care physician (PCP), you can use the site to change your PCP. Just click on the Change PCP button and you will be able to change the PCP for yourself and any dependents on your policy. CareFirst and CareFirst BlueChoice appreciate your comments and concerns and will use them to improve the directory. To submit your comments, click on Site Survey at the bottom of the provider directory page at 11

12 How to Cut Medication Costs* CareFirst BlueCross BlueShield s (CareFirst) and CareFirst BlueChoice, Inc. s (CareFirst BlueChoice) prescription drug benefit already saves you money on prescription costs. However, you also may have other alternatives to lower your costs while getting medicines that treat your condition. Here are simple steps you can take: 1. Go to In the prescription drug section of the Web site, you can look up medicines using the online database. You can also log on to a price comparison tool to learn more about the costs associated with the medicines you may be taking. Print a copy of the current preferred drug list to bring to your next doctor s visit. 2. Talk with your doctor. Discuss the medicines you are taking and if they are on the preferred drug list. If your medicine is not on this list a tier 3 or nonpreferred brand-name drug ask if there are more affordable alternatives that may be right for you. 3. Use a participating pharmacy. There are more than 59,000 participating pharmacies nationwide that accept your prescription drug card. Choose one that s convenient, but remember to shop around. Some pharmacies charge more than others, and if you have a plan with coinsurance, those prices may affect how much you pay. 4. Don t forget your benefit card. Take both your prescription and your CareFirst or CareFirst BlueChoice ID card to a participating pharmacy near you to help ensure you receive proper service. 5. Be on the lookout for alternatives. New medicines become available often, so the price of your prescription may rise or fall as a result. Changes in the preferred drug list often happen because a new medicine is introduced to the marketplace or a generic becomes available. *This information pertains to those members who have CareFirst or CareFirst BlueChoice prescription coverage. 12

13 Help from the Case Management Program When faced with health care decisions, you and your family have many questions and difficult choices to make. The Case Management Department of CareFirst BlueCross BlueShield (CareFirst) and CareFirst BlueChoice, Inc. (CareFirst BlueChoice) want to make sure you get all the help you need for any health problems or concerns you have. The Case Management program is part of your medical benefits. As a CareFirst or CareFirst BlueChoice member, you will not be charged for this service. It s one of the ways we can help you to remain active and in the best health possible. When appropriate, case managers can help you with conditions such as (but not limited to): Spinal cord injury Amputation Burns Cancer Heart disease High risk pregnancies High risk newborns Multiple fractures Severe head trauma Stroke Case managers are registered nurses who play an active role in working with your primary care physician to help develop a plan of care that will ensure you receive the best possible care in an efficient and timely manner. Your relationship with your case manager enables you to receive prompt answers to any of your questions or concerns. A case manager will: Work closely with you and your doctors to identify a treatment plan Coordinate necessary services Contact you regularly to see how you are doing Answer any of your questions Suggest community resources that may be available Please keep in mind that since this program is voluntary, you can withdraw at any time. If you want to enroll or would like more information about the CareFirst and CareFirst BlueChoice Case Management program, call (888) , Monday through Friday between 8:30 a.m. and 4:30 p.m. 13