1. No category

myhealthmylife
TM
2014 Issue 3
What’s Inside
What Every Member
Needs to Know
8
Be Smart!
Use Antibiotics Wisely
14
Want to Know
Your BMI?
18
Treat
Yourself
Treat Yourself
When it comes to choosing a health plan, we know
you have a lot of options. We’re glad you chose
Passport, and now that you’re with us, we want you
to enjoy all that we can offer you!
As a member, it’s up to you. You can treat yourself
to a whole new world of health and wellness. Just
imagine what you can do...
to
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t
Bet th
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e
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Treat yourself to the wonderful doctors in
our network. We have over 14,000 network
doctors, and the number is growing!
Treat yourself to a free gift card for making healthy
choices or attending a doctor’s visit. You can receive $10,
$20 and $40 gift cards to buy the things you need and
want! For more details, just call us at 1-877-903-0082.
Treat yourself to a kind and caring staff of nurses,
member service representatives and community workers.
We understand the issues you face and want to help.
When we say, We Take the Time to Care, we really mean it.
Treat yourself to your own case manager right
here in Kentucky. A case manager can work with
you one-on-one and help you get the care you need.
When you have Passport, you’re not alone!
Share the Treat!
If you know someone who'd like to treat themselves to
some of these benefits, tell them to give us a call at
1-800- 578-0603. Remember, you
have a choice when it comes to
your health plan- and we’re glad
YOU chose Passport!
2
Visit us online at www.passporthealthplan.com
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If you have a family history of breast cancer,
start getting tested before age 50. You can
ask your doctor when to get tested.
Passport covers
mammograms at no
cost to you!
Don’t wait another minute. Having
a mammogram could save your life
and help you live longer, healthier
and happier! If you’d like us to set
up your appointment, please call
1-877-903-0082.
Mammograms Can Save Lives
If you’re a woman 50 years and older,
having a yearly mammogram could save
your life! A mammogram can find breast
cancer early before you feel a lump or
have any other symptoms. Finding a
problem early is the key because it can be
easier to treat.
Sources: The Clinical Guide to Prevention Services 2012, US Preventive Services Task Force /Agency for Healthcare Research Quality
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
3
Children and Lead
Don't Mix!
Did you know just a small amount of lead
can hurt your child’s growth and IQ?
Children who are around lead may have
reading problems, miss more school days
and are less likely to finish school.
How do children get lead in
their bodies?
Eating paint flakes. Older
paint may have lead in it.
Children can put things in
their mouths that have paint
flakes or paint dust on them.
What can
parents do to help?
• If you rent a home or
apartment, talk with your
Playing in dirt. Some dirt may landlord about fixing peeling paint.
have lead in it.
• Keep children away from
chipping paint.
Drinking hot water from
faucets in homes built before
1978. Some old pipes have
lead in them.
• Remove any
lead-based products
from the home.
Protect Your Child
You can protect your child with a lead test. Ask your child’s primary care
provider (PCP) to do a lead test at your child’s next checkup. Our Early
and Periodic, Screening, Diagnosis and Treatment (EPSDT) program
covers checkups for children and teens at these ages:
1 month
9 months
24 months
2 months
12 months
30 months
4 months
15 months
6 months
18 months
Every year from age
3 to age 20
Source: American Academy of Pediatrics
4
Visit us online at www.passporthealthplan.com
The Best Gift
You Can Give Your Baby
If you’re having a baby, congratulations! We hope your
pregnancy will be a wonderful time. You can share the
news with your loved ones, pick out names and have
baby showers.
Now that you’re pregnant, the key is to take good care
of yourself. Babies need healthy moms! Taking care of
your health is the best gift you can give your baby.
Ways to Have a Healthy and Safe Pregnancy
1. Make an appointment with an obstetrician (OB) right
away. An OB is the doctor who sees you during
pregnancy. Your OB will make sure you and your baby
get off to a good start.
2. Go to all of your appointments. If you have questions in
between visits, call your OB.
3. Do not smoke, drink alcohol or use drugs.
4. Take a prenatal vitamin every day.
Important
Reminder
for New Moms:
As soon as your baby is born,
you must call the Department
for Community Based
Services (DCBS) at 1-855306-8959 to report the birth.
Please call right away to make
sure your baby gets enrolled
and receives benefits. If you
do not call, your baby will not
have coverage.
You Can Earn Rewards!
Besides covering you and your
baby for pregnancy care, we
can offer you extra rewards
just for joining our “Mommy
Steps” program and keeping
your doctor appointments. You
can earn gift cards for a crib
or car seat, and to buy gas and
groceries. To find out more,
please call us at 1-877-903-0082.
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
5
TO BE
Be
Healthy
Keep your stress level down.
3 Try to keep a good balance in
your life.
3 Don’t overcommit to doing too
many things at once!
Eat healthy and be active.
Handle and prepare food safely:
3 Wash your hands and surfaces
often.
3 Keep raw meat, poultry, seafood,
and eggs away from ready-to-eat
foods and eating surfaces.
3 When you’re done cooking, put
leftovers in the refrigerator right away.
Travel safely.
3 Always wear a seat belt.
3 Use a car seat that fits your child’s age and size. Check the
owner’s manual to install and use the seat properly. Never place a
rear-facing car seat in front of an active air bag.
3 Eat fresh fruits and vegetables,
3 Keep children ages 12 and under in the back seat.
3 Find ways to be physically active
Watch children closely.
whole grains and lean meats.
for at least 2½ hours a week.
Be smoke-free.
3 Smoking is one
of the worst
things you can
do for your health.
3If you would like to quit
smoking, please call us
1-877-903-0082.
3 Keep an eye on children while they eat
and play.
3 Keep small toys, food, drinks and coins
out of their reach.
Help a friend in an abusive relationship.
3 1 in 3 women are physically or sexually abused at
some point in their lives.
3 Never blame a friend for what is happening. Listen to them and
let them know they’re not alone.
3 Encourage them to call the
Center for Women and Families
at 1-877-803-7577.
Source: Centers for Disease Control and Prevention,
www.foodsafety.gov
6
Be
Safe
Visit us online at www.passporthealthplan.com
Is Alcohol a Problem?
We Can Help!
We know how common alcohol problems can be.
Now, we can cover your treatment and help you get the support you need.
When It’s a Problem
Most people can have a drink from time to time without any trouble.
But, some people drink too much and it causes problems on their job,
at school, or with the people they love.
You may have an alcohol problem if you:
•
•
•
•
•
•
Feel guilty or embarrassed about drinking.
Lie about drinking.
Have friends or family who worry about your drinking.
Black out or don’t remember what happened.
Drink more than planned.
Have tried to cut back or stop drinking, but couldn’t do it.
Are you ready to make a change?
If you have an alcohol problem, you can get help and
recover. The question is – how ready are you to change?
Not Ready
Unsure
Ready
Learning how to stop drinking will take time. You have to decide to
stop for yourself– no one can decide for you. Here are the first steps to
getting sober:
1. Admit you have a problem.
2. Get help. Go to a rehab or self-help program,
or see a therapist.
3. Treat other problems. Some people drink to
cover up depression, bipolar disorder, work stress
or other problems. If you want to be sober for
good, get help from your doctor or therapist.
Call Us!
If you would like our help
and support, please call us
at 1-855-834-5651. We’re
here for you.
Source: Mayo Clinic Alcoholism Handout, www.helpguide.org
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
7
What Every Member
Needs to Know
What Every Member Needs to Know
Passport Health Plan is a managed care health plan.
You may also hear some people call Passport an “MCO”
or Managed Care Organization. Managed care means
we help you get care and find ways to stay healthy.
8
You Can Choose a
Network Doctor
What are
the benefits
of managed
care?
• We have a large group (network) of
doctors and specialists who can help you.
• You can choose the doctors you know and trust. To see if a
doctor is in our network, or if you can’t find one in our
Directory, please call us at 1-800-578-0603.
You Have a “PCP”
• For most members, you will have a primary care provider (PCP).
• Your PCP’s name will be listed on
your member ID card. If you
would like to change your PCP,
please call us right away!
• If your member ID card says
No PCP Required, we still
encourage you to find a PCP
(medical home) who will get
to know your health history.
Visit us online at www.passporthealthplan.com
• We cover lots of preventive care to help you avoid major
health problems.
• We offer you free gift cards for visiting your doctor and
making healthy choices. You can use the cards for groceries,
gas, personal care products, cribs and car seats! To find out
more, please call us at 1-877-903-0082.
• We offer health programs to help you with illness and disease.
• We have case and disease managers who can work with you
one-on-one. They can give you health tips and help you get
the care you need.
• We have a 24/7 Nurse Advice Line. You can call
1-800-606-9880 and get medical advice anytime of
the day or night.
Words You May Hear
Primary Care
Provider
(PCP)
The main doctor who gives you most of your
care and makes referrals when you need them.
Your PCP gets to know your health history and
knows what’s right for you.
Medical
Home
The main doctor who organizes and helps
you get care. Think of your PCP as your
“medical home,” the place that knows you
the best.
Referral
Something you need from your PCP to see some
specialists. Referrals are a way for your PCP to
help you see the right doctor the first time!
What Every Member Needs to Know
We Help You Live a Healthy Life
Prior
Some medicines and services must be
Authorization pre-approved before you can get them.
(PA)
Your doctor will send Passport a PA request
when it’s needed. We’ll look at the request
and make sure it’s covered.
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
9
My To-Do List -
What Every Member Needs to Know
4 Things to Do
10
1
Fill out your “HRA” form and mail
it back to us
• The Health Risk Assessment (HRA)
form was mailed to you inside your
member welcome packet.
• Fill out the HRA and mail it back to us
in the postage-paid envelope. Your
answers will help us find the services and
programs that are right for you.
2
Set up a “well visit”
with your PCP
• Visit your new PCP right away,
even if you aren’t sick. The
purpose of this visit is to let
your PCP get to know you and
get an idea of how to treat you.
• The more your PCP knows about
your health history, the more he
or she can help you. When you do
get sick, your PCP can then get
right to the problem.
Visit us online at www.passporthealthplan.com
What’s Happening
Who to Call
When to Call
I feel sick and need
to see my PCP.
Your PCP’s Office
Call 24 hours a day, 7 days a week.
If you call after hours, the doctor
on-call will call you back.
I need medical
advice.
Your PCP’s Office
-orNurse Advice Line
1-800-606-9880
Call 24 hours a day, 7 days a week.
Your PCP and the Nurse Advice Line
can give you medical advice.
I need help figuring
out what to do or
where to go for care.
Your PCP’s Office
-orNurse Advice Line
1-800-606-9880
Call 24 hours a day, 7 days a week. Your
PCP, the doctor on-call or the Nurse
Advice Line can help you decide what to
do or where to go for care.
Count on Us –
Call Member Services!
1-800-578-0603
3
4
What Every Member Needs to Know
Know who to call when
you get sick, need medical
advice or need help
figuring out what to do.
• Our Member Services team is ready to help you find
the answers you need. We’re caring people who work
hard to treat you with the respect you deserve.
• We’re based right here in Kentucky and really
understand the issues you face.
• We know how the system works because we’ve been
here for 17 years listening to members just like you.
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
11
Taking Care of
Your
Teeth
Taking good care of
your teeth is more
important than you
may think. Taking
care of your teeth
can not only give
you a nice smile,
but it can help your
whole body stay
healthy.
As a Passport member, your dental
care is covered! Here’s a quick look
at what’s covered for you.
My Dental Benefits
My
Cost
1 cleaning per year for
adults (21 years and older)
$0
Other services for adults,
as needed
$0
2 cleanings per year for
children and teens
(under age 21)
$0
Other services for children
and teens, as needed
$0
1 plaque removal for
pregnant women
$0
You can receive a $10 gift card for
visiting a dentist! To find out how,
call us at:
1-800-578-0603
How soon can I get a dental appointment?
• Checkups and teeth cleanings - the dentist should see you within 3 weeks.
• Urgent care – the dentist should see you within 48 hours for problems that cannot wait.
I Need a Ride
•
Medicaid covers rides to and from dental visits if you don’t have a
car in the household.
•
To schedule a ride, call the transportation broker in your are
a 3 days ahead of time. The phone number is listed in your member
handbook called Your Guide to Passport Health Plan. If you cannot
find the number, you may call us at the number listed above.
•
12
Visit us online at www.passporthealthplan.com
Services You Can Use
Without Approval
You can use some services without getting an approval or seeing your primary
care provider (PCP). These services are called Direct Access. To use a direct
access service, you can set up an appointment at any time.
Direct Access Services
Vision care
Pap smears (cervical cancer test)
Behavioral (mental)
health care
Orthopedic care
(bones and joints)
Chiropractic care
Sexually transmitted disease and
tuberculosis testing/treatment
Dental care
Drug and alcohol
treatment
Diabetes eye test
Testing for Human
Immunodeficiency Virus (HIV),
HIV-related illnesses and other
diseases passed from person to
person
Family planning
(birth control)
Pregnancy care
Immunizations (shots)
Routine women’s care
(GYN, gynecology)
Mammograms
(breast cancer test)
We Can
Help You!
If you need help setting
up a visit or getting care,
please call us at
1-877-903-0082.
We can:
• Set up your office visits,
tests and follow-up care.
• Set up rides to and from
your visits.
• Set you up with a case or
disease manager.
• Answer your health
questions.
• Help you get your
medicines.
• Find resources to help
you pay for electric bills,
food and housing.
Give us a
call– Our Care
Connectors
are ready to
help you.
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
13
Be Smart! Use Antibiotics Wisely
Antibiotics are strong medicines that fight bacteria. It’s important to know is not all illnesses are caused by bacteria.
Some are caused by viruses. If your illness is caused by a virus, antibiotics will not help you.
Use this handy chart to learn when taking antibiotics is a good thing and when time and rest are all you need!
What’s my
illness?
Is it caused
by a bacteria
or virus?
Strep
Throat
Bacteria
If you test positive for Strep, your
doctor will order antibiotics.
Urinary
Tract
Infection
(UTI)
Bacteria
If you have a UTI, your doctor will
order antibiotics.
Virus
Colds and the flu go away on their
own. The key is to get lots of rest
and drink lots of fluids.
Bacteria
or Virus
Your doctor will decide if you need
antibiotics. If you do take antibiotics,
be sure to take all of the medicine
until it’s gone.
Colds, Flu
Ear and
Sinus
Infection,
Bronchitis
What do I need to get better?
My mucus looks yellow or green. Does this mean I need antibiotics?
No. Yellow or green mucus does not mean you have a bacterial infection.
It’s normal for mucus to become thick and change colors during a cold.
Source: Centers for Disease Control and Prevention
14
Visit us online at www.passporthealthplan.com
Getting the Right Care
Getting the right care for a non-emergency can save you a lot of time and trouble. Some examples of non-emergencies
are sore throats, stomach aches, colds, minor cuts and bruises and sprained muscles. The next time you have a
non-emergency, here’s what you can do:
When you get sick, call your Primary Care Provider (PCP)
first. You can call your PCP 24 hours a day, 7 days a week. If the
office is closed, be sure to leave a message. The doctor on-call
will call you back shortly.
If you cannot reach your PCP, you may also call our Care for
You Nurse Advice Line at 1-800-606-9880. Registered nurses
are here for you 24 hours a day, 7 days a week. They can give
you medical advice and help you decide what to do.
A true emergency is when you have a life-threatening illness or injury
that will likely harm your health if you don’t get care right away. If you have
a true emergency, please go to the emergency room or call 911 right away.
Want a copy of our pdl or Over-The-Counter Drug List?
Our Preferred Drug List (PDL) is a list of all the medicines we cover and any limits that may apply. We also cover
some over-the-counter medicines when your doctor gives you a prescription.
We make changes to the PDL throughout the year. To find the most up-to-date list, please visit
www.passporthealthplan.com. Once you are on our website, click on Find a Medicine:
• To view our PDL, click on Printable Formulary.
• To view our over-the-counter drug list, click on Over-the-Counter Drug Coverage.
If you do not use a computer and would like some help, just call our
Member Services team at 1-800-578-0603.
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
15
Leaving the hospital
16
If you have to stay in the hospital,
make sure you know what to do
when it’s time to go home. You
can talk with your doctor about
your discharge plan. Your plan
will include a follow-up visit. It’s
important to go to your follow-up
visit. Your doctor can see how
you’re doing and help you stay
healthy and well.
Ask Questions
Ask your doctor questions before you leave
the hospital. If you don’t understand or
agree with something, speak up! Here are
some questions you might ask:
1. What can I do to get better?
2. What problems should I look for and
what can I do about them?
3. Can you give me a list of all my
medicines?
4. Can I bathe or shower, climb stairs,
cook, shop, clean house and drive?
5. Can you show me how to change my
bandage or anything else I need to do?
6. Can I talk to a social worker about any
problems I might have when I go home?
We’re Here to Help!
If you have any rough spots once you
get home, please call us at
1-877-903-0082. We can help you set
up your follow-up visit and get the
medicines you need.
Visit us online at www.passporthealthplan.com
What is Cholesterol?
Cholesterol is a fat that comes from the food you eat.
There are good and bad types of cholesterol.
“Good” (HDL)
Cholesterol
Good cholesterol is
called HDL. You need
good cholesterol to keep
your body working right.
“Bad” (LDL) Cholesterol
Triglycerides
Bad cholesterol is called
LDL. LDL can clog the blood
vessels that carry blood
through your body. This
could cause a heart attack.
Trigylcerides are another
kind of fat found in your
blood. If your triglyceride
level is too high, your
chances of having a heart
attack or stroke go up.
What Should My Cholesterol Be?
“Good” (HDL)
Cholesterol
“Bad” (LDL) Cholesterol
Triglycerides
Less than 100
Less than 150
40 or more (men)
50 or more (women)
Check Your Cholesterol
and Live Healthier!
Keeping your cholesterol levels normal is a big
part of living a healthy life. If you have heart
disease or diabetes, see your doctor at least
once a year to have your cholesterol checked.
If you have a history of high cholesterol, or
if you take medicine for it, you may need to
get checked more often. Always follow your
doctor’s orders.
Ways to Keep Your Cholesterol
Levels Normal
• Stop smoking
• Lose weight
• Exercise for 30 minutes 5 days
per week. Talk to your doctor
before you start exercising.
• Eat low-fat foods like fruits and
vegetables, low-fat milk and cheese,
and whole grains like oatmeal.
• Take cholesterol medicine if your doctor
orders it.
Source: www.diabetes.org/diabetes-basics/prevention/checkup-america/cholesterol.html
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
17
Want to know your BMI?
A good way to see if your weight is healthy for your height is to look at your Body Mass Index
(BMI). Your BMI tells you how much body fat you have. Having too much body fat and being
overweight puts strain on your heart and can lead to major health problems.
How to Get Your BMI
At your next office visit, you can ask your doctor for your BMI number. You can
also calculate your BMI on your own. Here are the steps to calculate your BMI:
3 Steps to Calculate BMI
1
2
3
Multiply your weight in
pounds by 703.
Example: Maria weight 150 pounds
and is 5 feet tall (60 inches)
150 x 703 = 105,450
Divide that answer by your
105,450 ÷ 60 = 1757.50
height in inches.
Divide that answer by your
1757.50 ÷ 60 = 29.3
height in inches again.
Once you know your BMI number, you will fall into one
of the categories listed here. If your BMI is too low or too
high, you have a higher risk for major health problems.
Underweight:
BMI below 18.5
Normal weight:
18.5 to 24.9
Overweight:
25.0 to 29.9
Obese:
30.0 & above
BMI and Your Overall Health
It’s important to know that BMI is only one part of your overall health. What
you do every day is another big part!
Talk to your doctor about your BMI and daily
lifestyle habits. Together, you can decide if
you need to make changes such as eating
smarter and getting more exercise.
Source: http://www.eatright.org/Public/content.aspx?id=6844
18
Visit us online at www.passporthealthplan.com
*These categories are
only for adults. If you
would like to know what
category your child or
teen falls into, please visit
http://apps.nccd.cdc.gov/
dnpabmi/.
Do You Have
COPD
?
If you have one or more of the problems
listed here, you could have Chronic
Obstructive Pulmonary Disease (COPD).
3 A cough that never goes away.
3 Shortness of breath when you are
active.
3 Coughing up mucus or phlegm.
3 You get bronchitis a lot.
3 You are around things that cause
COPD, like tobacco smoke.
If you have any of these problems, ask
your doctor for a simple breathing test
called spirometry.
A spirometry test tells you:
3 If you have asthma, COPD or both.
3 How well your lungs are doing.
3 If your treatment is working.
3 If your lungs are getting better or
worse.
Want to learn more?
If you want to learn more
about COPD or what you can
do, call us at 1-877-903-0082.
We’re here to help!
Source: Spirometry for Health Care Providers, Global Initiative for Chronic Obstructive Lung Disease (GOLD)
Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566
19
Marketing and Community Engagement Department
5100 Commerce Crossings Drive
Louisville, KY 40229
Helping Kentuckians
Live Healthier Lives™
Any information included in this newsletter is not intended to replace medical care or advice from your doctor. Any
references to other companies or internet sites are not an endorsement or guarantee of the services, information or products
provided. Passport does not take responsibility for anything that may result from the use, misuse, interpretation or
application of the information in this newsletter.
Passport does not guarantee the availability or quality of care. We are not responsible for any act or omission of any provider.
All providers contracted with Passport are independent contractors and not employees or agents of Passport.
CHECK OUT
TRIVIA TUESDAYSh
AND WIN $10
Visit our Facebook page every Tuesday at 12:00 p.m.
and answer the question of the day. If you’re the first
person to answer the question correctly and like our
page, we’ll send you a $10 gift card!
www.facebook.com/passporthealthplan
MARK-40353 APP_8/21/2014