All For Health & Wellness

Transcription

1 All For Health & Wellness Good health s so mportant to lvng a happy, actve lfe. How you stay healthy, or get well when you re sck, s entrely up to you. But we re here to help wth nformaton, programs and servces that ft nto even the busest day. EAT HEALTHY There are few better ways for mprovng your overall health than by eatng well. So, we re connectng you wth local farms so you can get fresh food close to home. And f eatng healthy to lose weght s your goal, check out our local, natonal and onlne partners. eat healthy Here are fve easy ways to get you started. For detals on these programs and more, go to: KEEP MOVING Exercse s a key component to any healthy lfestyle. But we also know that fndng the tme and money to stay ft can be a challenge. We ve got some great deas and resources for you, whether you want to work out n a gym or fnd a nearby park to throw a Frsbee wth frends and famly. And they nclude dscounts wth local gyms, as well as lnks to many other local ftness and outdoor actvtes. keep movng

2 KNOW YOUR STUFF Educaton s a crtcal pece to health and wellness. The more you know, the better prepared you ll be to make decsons wth your physcan about the best and most affordable ways to manage your health. You can start wth an onlne health assessment to help dentfy areas to focus on. Then choose from the onlne lbrary of wellness topcs and podcasts to help you reach your goals.* You can also get 24/7/365 advce from a nurse.* know your stuff GET CONNECTED A communty can be a powerful thng. Sometmes the resources you need to stay well or to get you back on track from an llness are rght around you. In many cases they re free. There s help avalable from local health professonals, hosptals and communty groups. Whether you want nformaton on how to stay ft, or need help after a hosptal stay, we ll help fnd the resources you need. get connected SAVE MONEY Who doesn t lke to save money? Maybe one of the reasons you chose HealthyCT s because we re nonproft, so money we don t spend goes back to mprovng programs and servces or nto stablzng premums over tme. We re also fndng ways to connect you wth dscounts on a varety of health and wellness-related servces such as gym membershps and fresh, local produce delvered to your door. save money Learn more at These programs are just a start! Check back often for new offerngs. Ind v1.0 *Comng n the fall Ths pece s for nformatonal purposes and not ntended to be medcal advce. Please drect any medcal questons or concerns to an approprate healthcare provder. Copyrght 2014 by HealthyCT, Inc. All rghts reserved. No part of ths document may be reproduced or transmtted by any means, electronc or mechancal, for use wth any entty other than HealthyCT, Inc. wthout the express wrtten permsson of HealthyCT, Inc.

3 LARGE GROUP Your Pharmacy Beneft Prescrpton drugs can help you feel better when you re sck. They can also help you manage a medcal condton. That s why HealthyCT plans provde coverage for prescrpton drugs wth all of our plans. Your pharmacy program helps you get the medcne you need when you need t. Look for the Catamaran logo on your member ID card. Catamaran s our pharmacy benefts manager. We work wth them to create the lst of drugs your plan covers. Catamaran also: Processes your pharmacy clams. Manages your mal-order program and sends your prescrptons to your home. Offers a specalty drug program. FILL PRESCRIPTIONS LOCALLY OR BY MAIL You can fll many prescrptons at major retalers, supermarkets and communty drug stores that are n the Catamaran network. fnd a partcpatng pharmacy go to healthyct.org/rx choose natonal formulary clck select clck contnue clck locate a pharmacy Plus, wth HealthyCT pharmacy coverage, you pay the same copayment for a 90-day supply of prescrpton drugs flled at your local pharmacy or by mal. A BROAD LIST OF COVERED DRUGS The drug formulary s the lst of medcatons your pharmacy beneft covers. Drugs on the lst are categorzed nto groups or ters. The ters determne your cost for a medcaton. coverage broad lst of covered drugs choce 90-day supply by mal or retal access large, statewde network

4 LARGE GROUP A BROAD LIST OF COVERED DRUGS Ter 1. Includes generc drugs, the least expensve drugs to treat many common llnesses. The U.S. Food and Drug Admnstraton (FDA) follows the same revew and approval process for genercs as they do for brand-name drugs.to save money on your medcatons, ask f a generc verson s avalable and rght for you. SPECIAL GUIDELINES Some covered drugs may have safety restrctons, based on FDA gudelnes, medcal lterature, and nput from physcans and the Catamaran Pharmacy and Therapeutcs (P&T) Commttee. Ter 2. Includes preferred brand drugs that usually cost more than genercs. Ter 3. Includes non-preferred brand drugs whch generally cost more than those n Ter 2, so your share of the cost s hgher. You may be able to save money by askng f a preferred brand or generc drug s avalable and rght for you. Specalty drugs These are hgh-cost drugs used to treat complex medcal condtons. Brand and generc specalty medcatons appear n multple ters throughout the Natonal Formulary. Please note, specalty drugs are not avalable through local retal pharmaces. A 30-day supply can be delvered rght to your home through Catamaran s BrovaRx specalty pharmacy program. Preventve Drugs Certan categores of preventve drugs wth A and B ratngs are 100% covered as recommended by the U.S. Preventve Servces Task Force. For example, wth a prescrpton, some asprns and fluorde supplements are no cost for members meetng certan age/gender requrements. Quantty Lmts. A lmt on how much of, or how long, you can take the drug. Pror Authorzaton. Some drugs and supples need our approval before your plan can cover them. Step Therapy. You may need to try a lower cost medcaton before usng the one your physcan prescrbes. to look up a drug go to healthyct.org/rx choose natonal formulary clck select clck contnue enter drug name >> clck search restrctons=yes >> clck name LEARN MORE Please refer to your Certfcate of Coverage for full detals of your prescrpton drug beneft. To fnd your Certfcate of Coverage and the Summary of Benefts & Coverage for your plan, please vst or call Member Servces usng the number on your ID card. Ind v2.0 (LG) Ths pece s for nformatonal purposes and not ntended to be medcal advce. Please drect any medcal questons or concerns to an approprate healthcare provder. Copyrght 2014 by HealthyCT, Inc. All rghts reserved. No part of ths document may be reproduced or transmtted by any means, electronc or mechancal, for use wth any entty other than HealthyCT, Inc. wthout the express wrtten permsson of HealthyCT, Inc.

5 An Ounce of Preventon Preventve medcne s key to your overall health and well-beng. Early detecton can help you stay healthy. It can also stop small problems from becomng bgger ones. Your HealthyCT plan covers those common preventve servces gven an A or B ratng by the Unted States Preventve Servces Task Force (USPSTF). (The USPSTF s an ndependent panel of prmary care physcans who are experts n preventon and evdence-based medcne.) no cost n-network preventve medcne Because preventve medcne s so mportant, these servces are avalable at no cost to you when you receve them from a physcan or healthcare professonal who s n our network. You'll fnd some examples of covered preventve servces on the back of ths page. For a complete lst, along wth coverage gudelnes and lmts, vst If you have questons about your coverage, please call Member Servces at the phone number on your ID card. better health through preventon comprehensve lst of covered servces

6 PREVENTIVE SERVICES FOR ADULTS Preventve medcne goes beyond a routne physcal exam. Your HealthyCT plan covers many preventve servces, ncludng: Alcohol msuse screenng and counselng Asprn to prevent cardovascular dsease n men and women of certan ages Blood pressure screenng Colorectal cancer screenng (adults over 50) Depresson screenng Flu shots and other mmunzatons Obesty screenngs and counselng Preventve physcal exam Tobacco use screenngs and cessaton products Type 2 dabetes screenng for adults wth hgh blood pressure PREVENTIVE SERVICES FOR WOMEN Addtonal screenngs and counselng are avalable for women, ncludng: Breast cancer screenng/mammogram Breast cancer chemopreventon counselng for women at hgher rsk Cervcal cancer screenng Domestc and nterpersonal volence screenng and counselng Folc acd supplements for women who may become pregnant Osteopoross screenng for women over age 60 dependng on rsk factors Preventve physcal exam Tobacco use screenng and nterventons for all women, and expanded counselng for pregnant tobacco users PREVENTIVE SERVICES FOR PREGNANT WOMEN Preventon s especally mportant to the health of an expectant mother and her baby. Recommended preventve servces for pregnant women nclude: Anema screenng Bacterura urnary tract and other nfecton screenng Breastfeedng support and counselng Gestatonal dabetes screenng for women 24 to 28 weeks pregnant and those at hgh rsk of developng gestatonal dabetes Hepatts B screenng Rh ncompatblty screenng PREVENTIVE SERVICES FOR CHILDREN These covered preventve servces help promote chldren s growth and development: Behavoral assessments at certan ages Blood pressure screenngs at certan ages Fluorde chemopreventon supplements for chldren wthout fluorde n ther water source Immunzatons Iron supplements for chldren of certan ages Lead screenngs Obesty screenngs and counselng Oral health rsk assessments Preventve physcal exams Vson screenngs Ind v1.0 Ths pece s for nformatonal purposes and not ntended to be medcal advce. Please drect any medcal questons or concerns to an approprate healthcare provder. Copyrght 2014 by HealthyCT, Inc. All rghts reserved. No part of ths document may be reproduced or transmtted by any means, electronc or mechancal, for use wth any entty other than HealthyCT, Inc. wthout the express wrtten permsson of HealthyCT, Inc.

7 Focus On Patent- Centered Care As a HealthyCT member, you chose a health plan started by physcans. You can get hgh qualty healthcare from a large network of hosptals and healthcare professonals across Connectcut. And that ncludes many prmary care physcans who can help you stay well and treat or manage a medcal condton. THE IMPORTANCE OF PRIMARY CARE Prmary means frst, essental, central. So t should be no surprse that prmary care physcans or PCPs should be your frst choce when t comes to your health. They can help you get essental screenngs to avod or dentfy and treat some llnesses. And your PCP and staff serve as command central when you need medcal tests or care they don t offer. pcp prmary care physcans are your 1st choce Because PCPs get to know ther patents well over tme, they can be n the best poston to: Support and gude you when you re well, to better help you when you re sck. Make sure you get mportant health screenngs to prevent or detect problems. Treat many llnesses; usually at much less cost than a vst to the ER or urgent care. Help you understand your medcal choces and choose the rght ones. Refer you to other health specalsts for tests and appontments, when needed. Keep your medcal fle, ncludng servces and reports from them and other healthcare provders. Focus on your overall health and well-beng. care from a team that knows you better manage your healthcare costs

8 IMPROVING PRIMARY CARE Many PCPs are changng the way they work wth patents to delver a hgher level of care and servce. Patents n these practces can expect a great deal of support when t comes to gettng the help they need. Longer offce hours usually makes accessng care easer. And patents learn how to keep themselves healthy. When PCP practces meet the hgh standards for patent-focused care set by the Natonal Commttee for Qualty Assurance, they can receve specal recognton as a patent-centered medcal home or PCMH. HEALTHYCT AND PATIENT-CENTERED CARE We re workng closely wth physcans, ncludng our Prmary Care Provder Advsory Councl. Wth the Councl, we re educatng physcans, employers and members about the value of prmary care and the extra value offered by PCMH practces. We ve nvested n educaton for PCP practces that want to earn PCMH recognton. And we re creatng a new model to support prmary care and pay patent-centered practces farly for the addtonal work and dedcaton requred to practce truly patent-centered care for you and your famly. FIND A PRIMARY CARE PHYSICIAN To fnd a PCP n our network, vst Select Fnd a Doctor. To fnd a PCMH-desgnated practce, enter your search nformaton and select Yes under the PCMH dropdown menu. THE PCMH DIFFERENCE: Lower total cost of care. Reduced use of unnecessary and avodable servces. Improved health measures. Increased use of preventve care. Better access to care. Improved patent satsfacton. Source: Connectcut Health Polcy Project Issue Bref, June 2014, Ind v2.0 Copyrght 2014 by HealthyCT, Inc. All rghts reserved. No part of ths document may be reproduced or transmtted by any means, electronc or mechancal, for use wth any entty other than HealthyCT, Inc. wthout the express wrtten permsson of HealthyCT, Inc.