Highmark Health Options

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1 A NEWSLETTER FOR HIGHMARK HEALTH OPTIONS MEMBERS Highmark Health Options NEWSLETTER IN OTHER FORMATS We are committed to providing outstanding services to our applicants and members. If you need printed materials from the website, including this newsletter, call Member Services at If you require these materials in an alternate format, including large print, Braille, or in another language, please call us at to request these free services. TTY/TDD Users phone (711) or Weather changes come fast and Highmark Health Options would like to make sure our members know how to prepare for an emergency. Make sure you have enough supplies to last for at least three days. Think about where you live and your needs. Consider having a large kit at home, and smaller kit that you can take with you in the car or your workplace. Think of food, water, safety, hygiene, and medical supplies. Remember to pack your medications. Don t forget to think about infants, elderly, pets, or any family members with special needs! For a detailed Emergency Supply Kit checklist visit the FEMA website: Highmark Health Options is an independent licensee of the Blue Cross and Blue Shield Association

2 Lifestyle Management Program Having a chronic health problem doesn t mean you can t live an active life. We re here to help! Highmark Health Options welcomes you to participate in the Lifestyle Management Program. Participation in our programs is voluntary and at no additional cost. What do our programs offer? You may get health information through the mail. You may get a call from care managers who will help you better understand your condition. Highmark Health Options has a free nurse line available 24 hours a day at A nurse can help answer your questions and concerns. Asthma For members age 2 or older. Learn about: How a controller medicine is different from a rescue inhaler. How to identify and avoid your asthma triggers. How to use an asthma action plan. This plan can help you when you are sick. Cardiac For members age 21 or older. Learn about: Simple ways to take care of your heart that will help you to live better. Better choices with diet and activity. Why certain medications are ordered and how they help you. COPD For members age 21 or older. Learn about: How you can manage your COPD. How diet and exercise can help your breathing. How to use your inhaler correctly. Diabetes For members of all ages. Learn about: How to keep blood sugars under control to help prevent diabetic complications like heart disease, blindness, amputations, and kidney problems. How taking your medications and testing your blood sugar as recommended by your doctor can help you stay on top of your diabetes.

3 Pregnancy For pregnant members How getting the following tests every year may catch problems even before you have symptoms. Urine test A1C- (blood sugar) LDL-C (cholesterol) Dilated Retinal Eye Exam In the MOM Options program learn about: How we can get you in touch with community services. Signs of preterm labor. How we can get a nurse to visit you in your home before or after your baby is born. If you would like more information about a Lifestyle Management program call TDD/TTY 711 or Care Coordinators are available Monday Friday, 8:00 am to 5:00 pm. Be Wise, Immunize Influenza, or the flu is a contagious respiratory illness. It can cause mild to severe illness, and at times can even be fatal. This flu season, the Centers for Disease Control and Prevention (CDC) recommends that everyone six months old and above, including those with chronic health conditions, get a yearly flu vaccine. In addition to getting the flu vaccine, you should take preventive steps to stay healthy. Stay away from individuals who are sick and wash your hands to reduce the spread of the flu germs. Take Good Care of Yourself If you have flu symptoms, call your physician. If you have any questions about where to go for your flu vaccine, or how to be reimbursed if you paid for your vaccine, call Member Services at

4 Preventing Cervical Cancer Almost all cervical cancers are caused by the Human Papillomavirus (HPV). Most new HPV infections occur in 15 to 24 year olds. In most cases people clear the virus on their own. But for those who don t, it can cause cancers in both women and men. The HPV vaccine is for both girls and boys, and protects against cervical cancer and other HPV-related cancers. To get the most protection, 2 doses of the vaccine are recommended around the age of 11 or 12. Older adolescents and young adults may also get the HPV vaccine. Regular screening is also important for preventing cervical cancer. Most women 21 to 64 years old should get a Pap test every 3 years. The Pap test is different from a pelvic exam that your doctor may do during a check-up. It s important to talk to your doctor about cervical cancer screening to make sure that you are up to date.

5 Birth Control: What is LARC? Long-acting reversible contraceptives (LARC) are types of birth control that provide strong protection from pregnancy for a long period of time. How useful are LARC methods? The IUD and the implant are the most effective forms of reversible birth control available. Over the long term, LARC methods are 20 times more effective than birth control pills, the patch, or the ring. What is the intrauterine device (IUD)? The IUD is a small, T-shaped, plastic device that is inserted into and left inside the uterus. Only your doctor can insert and remove the IUD. The device works by preventing fertilization of the egg by the sperm. What is the birth control implant? The birth control implant is a single flexible rod about the size of a matchstick that is inserted under the skin in the upper arm. It releases progestin into the body. It protects against pregnancy for up to 3 years. To find out if LARC methods are right for you, talk with your doctor. A list of these and other types of reliable birth control methods are available at Planned Parenthood. News You Can Use Have you read your Member Handbook? It s a great source of news. Click here to read more information about: Hospital Discharge Planning Member Rights and Responsibilities Notice of Privacy Habits and HIPAA What Highmark Health Options Does With Protected Health Information (PHI) Prior Authorization Tips on How to Quit Smoking and Tobacco Cessation Counseling To request a printed copy of these topics or a copy of the Member Handbook, call Member Services at (TTY 711). Search our new Community Repository! This list can help you find local services for wellness, screenings, food banks, housing, legal aid, you name it. Really you can make suggestions! Go to and check out the helpful resources around the state, or around the corner.

6 Complex Case Management Highmark Health Options provides a Complex Case Management program for eligible members. A Care Coordinator can help you to better understand your health condition, your benefits, and can also help to coordinate your health care services by talking with your doctor. A Care Coordinator can tell you about community organizations and resources that may meet your needs. Eligible members may include: Members with multiple medical conditions Members with a complex medical history Members that need assistance to become more self-reliant in managing their health care Participation in this program is voluntary. To make a referral, please call: Highmark Health Options will review the request for enrollment and make the final decision for inclusion in the program. Apple Oatmeal Muffins Makes: 6 Muffins Buy apples while they are in season and on sale and make batches to put in the freezer for later. You can also substitute whole wheat flour to make your muffins healthier. Ingredients 1/2 cup milk, non-fat 1/3 cup applesauce 1/2 cup flour, all-purpose 1/2 cup quick-cooking oats (uncooked) 1/4 cup sugar 1/2 tablespoon baking powder 1/2 teaspoon ground cinnamon 1 apple (tart, cored & chopped) Directions 1. Preheat oven to 400 F. 2. Place 6 cupcake holders in baking tin. 3. In a mixing bowl, add milk and applesauce. Stir until blended. 4. Stir in flour, oats, sugar, baking powder, and cinnamon. Mix until moistened (do not over mix). 5. Gently stir in the chopped apples. 6. Spoon into cupcake holders. 7. Bake for minutes or until an inserted toothpick comes out clean. 8. Cool in pan 5 minutes before serving. Store unused portions in an airtight container. Learn more about the benefits of apples and other healthy fall recipes at the USDA s What s Cooking website at

7 5 Try to eat at least 5 veggies and fruits each day Try to eat veggies at least 3 times a day, and eat at least 2 fruits a day. Fruits and veggies are high in nutrients and low in calories, giving energy throughout your day. 2 Cut down on TV watching and other screen time Work toward a goal of no more than 2 hours a day of TV watching. Avoid snacking and try to be as active as possible while watching TV. 1 Try to get at least 1 hour a day of physical activity All children should get at least 1 hour per day of physical activity, at least five days a week. This is a good goal for adults as well, especially if you are overweight. Almost None Avoid all sugar-sweetened beverages Sugar-sweetened beverages, such as sodas, sweet tea and fruit-flavored drinks, are high in calories and sugar and contain almost no nutrients.. A Healthier You is just one click away For more of these nutrition and exercise tips, visit the Healthy Delaware website at Know your Body Mass Index (BMI). BMI measures your weight in relation to your height. BMI is one way to tell if you are at a healthy weight, overweight, or obese. To learn how to measure your BMI, visit our website at

8 Emergency Room or Urgent Care Center? When deciding whether or not you need to seek emergency treatment or urgent care, keep in mind a few things. Emergencies are considered life threatening events such as severe chest pain, trouble breathing, heavy bleeding, poisoning, or severe head, neck, or back injury. An urgent care center can save you time from waiting hours in an ER, and takes care of things that are less serious such as sprains, strains, and minor fractures (broken bones), urinary tract infections, severe sore throat, cough, and fever. The staff of an urgent care center is made up of doctors, nurse practitioners, doctor assistants, and nurses. If you do go to an urgent care and a doctor decides that more care is needed, you will be sent to the ER for further treatment. For a listing of participating urgent care centers, please call Member Services center at , or visit our website at LTSS Reminder Some members have long-term care needs, including some who may qualify for Health Options Diamond State Health Plan Plus (DSHP Plus) or Long-Term Services and Supports (LTSS). To find out if you qualify for long-term care benefits, please call the DMMA Central Intake Unit (CIU) at

9 Understanding Breast Cancer: Early Detection Saves Lives Women should have a mammogram starting at age 50, or earlier if requested by your doctor. Regardless of age, during your yearly gynecological exam, your healthcare provider should do a clinical breast exam to check for lumps or changes in breast tissue and underarms. You should perform a breast self-exam every month to check for changes in breast tissue. Did you know? Highmark Health Options continues to make it easy for you to get the care you need. Female members may self-refer for a mammogram. We do not require a script for an annual mammogram screening. However, some radiology facilities may still request a script. Ask if a script is required when you call to schedule your visit. Please take your member ID card with you on the day of your visit. Speak with your doctor about any concerns you may have. For more resources and news, call the Delaware Breast Cancer Coalition at or go to

10 Discrimination is Against the Law Highmark Health Options complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Highmark Health Options does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Highmark Health Options offers: Provides free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages If you need these services, contact the Civil Rights Coordinator. If you believe that Highmark Health Options has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Civil Rights Coordinator, P.O. Box 22278, Pittsburgh, PA 15222, Phone: , TTY: 711, Fax: You can file a grievance in person, by mail, or fax. If you need help filing a grievance, the Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C , (TDD) Complaint forms are available at

11 Highmark Health Options is an independent licensee of the Blue Cross and Blue Shield Association.

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13 Resource Corner Join the Highmark Health Options Member Advisory Council. It s your health plan. Let your voice be heard! Call the Member Advocate phone number at HIGHMARK HEALTH OPTIONS PHONE NUMBERS MEMBER SERVICES (M-F 8 a.m.-8 p.m.) BEHAVIORAL HEALTH (M-F 8 a.m.-5 p.m.) HEALTH OPTIONS FRAUD AND ABUSE HOTLINE OTHER IMPORTANT PHONE NUMBERS CARE MANAGEMENT (M-F 8 a.m.-5 p.m.) PHARMACY NURSE LINE NON-HIGHMARK HEALTH OPTIONS NUMBERS BEHAVIORAL HEALTH CRISIS SERVICES Northern Delaware (serving New Castle County and greater Smyrna in Northern Kent County) Southern Delaware (serving Sussex County and Kent County south of greater Smyrna) LOGISTICARE TRANSPORTATION SERVICES NON-EMERGENCY Transportation Where s My Ride? Hotline LANGUAGE SERVICES HEALTH BENEFIT MANAGER ENROLLMENT , Pin # OUTSIDE RESOURCES DELAWARE TOBACCO QUITLINE (Stop Smoking) STATE OF DELAWARE DIVISION OF SOCIAL SERVICES Customer Relations NATIONAL DOMESTIC VIOLENCE HOTLINE OPERATOR FOR DEAF MEMBERS TTY LINE or Highmark Health Options is an independent licensee of the Blue Cross and Blue Shield Association.