Highmark Lifestyle Returns SM Enjoy the many rewards of a healthy lifestyle!
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1 SM Enjoy the many rewards of a healthy lifestyle! Page 1 of 11
2 Take charge of your health and enjoy the benefits! We know that the way we live has a real impact on the way we feel. When we take care of ourselves, we have more drive and energy. Good habits promote positive attitudes and healthier lives. Unhealthy lifestyles, on the other hand, can lower the quality of our lives. Often the impact is profound. Many serious health problems are directly attributed to lifestyle-related behaviors. Being overweight can lead to diabetes and heart disease. Stress weakens the immune system, opening the way for all kinds of illnesses. And there is no longer any question on the dangers of smoking; it s the single largest cause of preventable death in our country today. The costs of a less-than-healthy lifestyle can also be measured in dollars and cents. People with lifestyle-related illnesses spend significantly more on their medical bills. Companies also pay, in both higher health coverage costs and lower employee productivity. So how do we deal with the enormous tolls caused by unhealthy lifestyles? If you re like most people, you know you should have healthier habits, but there doesn t seem to be enough time to do everything you should. And you have other obligations, including your job. Now your employer is making it easier for you and your family to lead healthier lives. Your company is offering you a convenient way to enhance your lifestyle and improve your health. And you will actually be rewarded for your efforts! Lifestyle Returns gives you everything you need to take charge of your health. You start by logging onto your member Web site at and taking the online pledge. Then you complete your Personal Wellness Profile. The Profile provides you with a comprehensive health analysis along with recommendations for a healthier approach to life. Then you will be given the tools, programs and information you need to eat more sensibly, exercise more often, reduce your stress, to even make more informed and appropriate health care decisions. Unlike other wellness programs that provide one approach for all members, Lifestyle Returns is tailored to your specific health needs. No matter what your health status, your age or gender, Lifestyle Returns has the programs and tools you need to enhance your healthstyle. And Lifestyle Returns works for all family members, even children, as it provides educational support for such problems as childhood obesity, diabetes and asthma. That s why Highmark encourages you and all your Highmark-covered family members to participate in the program. And what is the best thing about participating in Highmark s Lifestyle Returns? The rewards you enjoy will last a lifetime! Page 2 of 11
3 Program Requirements: Five steps to a healthier lifestyle is an innovative program that helps change your role with your health. By following program requirements, you take an important step toward a healthier lifestyle. Lifestyle Returns is an easy-to-follow program that identifies health and lifestyle areas in need of improvement, then helps you develop (and keep!) new, healthier habits. You have nine months from the program s effective date to complete the Lifestyle Returns program requirements. Your deadline date is included in your pledge and after you accept your pledge you will receive periodic reminders on where you stand with meeting your requirements. While all family members would benefit from program offerings, only the plan subscriber is required to complete all requirements. Lifestyle Returns begins when your health coverage takes effect and you receive your Highmark member ID card. STEP 1: Take the Pledge It s easy to become a program participant. If you are not yet registered on the Highmark member Web site, you must establish a logon ID and a password. Just follow the steps indicated on the home page at and keep your ID and password in a convenient place so you have them handy. Once you are registered on the Highmark member Web site, simply log onto connect to My BlueLink SM home page and click on. Your pledge is your commitment to improving your health. You pledge to: Make an effort to live a healthy lifestyle. Support family members to take part in healthy activities. Be an educated health care consumer by using Highmark s health education tools and materials. Take the online Personal Wellness Profile (PWP). Page 3 of 11
4 Have routine physical exams and health screenings based on your age and gender. Participate in two lifestyle improvement or condition management programs or one program plus Blues On Call SM. Use an online Self-Care Guide and complete a follow-up online survey. By accepting the pledge, you acknowledge your commitment to meeting these program requirements. (Please note that, while your covered dependents can, and should, take part in the program, only the plan subscriber is required to accept the pledge and meet the program requirements.) As a Lifestyle Returns participant, you will receive monthly s directing you to the member message center where you can learn which requirements you ve met and still need to meet. These helpful updates assure that you re always aware of your program status. STEP 2: Complete Your Profile You complete the online health assessment, the Personal Wellness Profile, or PWP. It will take you approximately minutes to complete this assessment and you will get your results online within minutes. While not required, for the most accurate results, it s a good idea to know your cholesterol and blood pressure scores before completing the Profile. The Personal Wellness Profile is a self-health analysis that covers all aspects of your health, including personal fitness and exercise, nutrition, stress, safety, substance use, heart health, cancer risk, etc. The Profile assesses family history, current health status and lifestyle-related information to generate an individual action plan to better health. STEP 3: Get Your Preventive Care Lifestyle Returns requires you to receive, or to schedule within your health care benefits year, preventive exams/screenings applicable to your age and gender. For instance, women over the age of 40 should receive an annual mammogram and men should receive prostate exams as appropriate. For your convenience, and to help you track your exam results, as well as cholesterol, blood pressure and BMI (body mass index) readings, please take the My Wellness Scorecard (included with this information) with you to your physician. Ask your physician to complete the appropriate information. After you receive your exams and screenings, document your visit and screening results on your Lifestyle Returns link at your member Web site, Page 4 of 11
5 Please keep in mind that while Lifestyle Returns allows you to schedule your exam for anytime within your 12-month benefit coverage period, you must document your visit date on the member Web site within nine months of the program s effective date in order to get program credit. Also, please remember that it makes sense for you to schedule your physician visit as soon as possible. Remember, this preventive care is covered under your Highmark health coverage.* And getting your results early will give you a clearer picture of your health status so you can take advantage of the most appropriate health-enhancement programs and tools. *Services may be subject to cost-sharing provisions. Your ID card will indicate your office visit copayments. STEP 4: Participate in Lifestyle Improvement and/or Condition Management Programs You receive your Personal Wellness Profile report. Depending on your health status and lifestyle, Profile recommendations may include Lifestyle Improvement Programs and/or Condition Management Programs. You will be required to do one of the following: Participate in two Lifestyle Improvement and/or Condition Management Programs. Take one Lifestyle Improvement or Condition Management Program and start a dialogue with your Blues On Call Health Coach. Health Coaches are available online or toll-free at BLUE-428. Coaches are specially trained registered nurses, dietitians and respiratory therapists who can assist you in making the most informed health decisions for yourself and your family. They can also assist with a health symptom assessment, provide health information, and confidentially discuss treatment options, including self-care when appropriate. Take one Lifestyle Improvement or Condition Management Program and receive a flu shot, regardless of your risk category. Just indicate the date and location of the service on your Lifestyle Returns link at your member Web site. Of course, you are encouraged to take all the programs that are recommended based on your Profile and to participate in additional Lifestyle Improvement and Condition Management Programs. Page 5 of 11
6 Health Media Lifestyle Improvement Programs on the member Web site, Breathe TM Smoking Cessation Program is personalized to meet your individual quitting needs and increase confidence and motivation while giving you the tools you need to quit for good. Program length: 23 days from your quit date. Nourish TM Nutrition Program is designed to improve your eating habits over the long term through smart, simple and creative strategies. Program length: eight weeks. Balance TM Weight Management Program offers techniques and strategies for making healthy food choices and increasing physical activity; also helps you identify and avoid triggers that lead to overeating. Program length: six weeks. Relax TM Stress Management Program helps you effectively cope with stress, reduce your stress levels, and better manage the physical and psychological consequences of chronic stress. Program length: five weeks. Care for Your Health TM Self-Management Program is designed to help individuals with certain chronic conditions such as diabetes, asthma, migraines, high blood pressure and high cholesterol, better manage their condition. Program covers medication compliance as well as emotional issues such as stress and depression, symptom management and lifestyle behaviors. Program length: monthly newsletters for one year following completion of initial questionnaire. Lifestyle Improvement Programs at the Worksite: In addition to the previous online programs, your employer may offer the following programs at your worksite. Eat Well for Life - promotes wellness and long-term weight management through good nutrition, exercise and stress management. Eat Well for Life encourages a healthy attitude toward food and emphasizes a non-diet approach to weight management, focusing on the relationship between nutrition and health. Program length: eight weekly one-hour sessions. Osteoporosis Prevention: Build Strong Bones for Life - focuses on the prevention of osteoporosis through lifestyle management. Program provides an overview of osteoporosis, including risk factors, signs and symptoms, and emphasizes lifestyle factors to help prevent the disease. Program length: three weekly one-hour sessions. Strides for Health - encourages participants to begin or maintain an active lifestyle through walking for fitness. This self-paced program helps to enhance overall health and helps participants develop a regular commitment to walking for fitness and experience the benefits of an active lifestyle. HeartBEATS - focuses on education related to cardiovascular health and covers lifestyle factors that impact cardiovascular health, including overall wellness, nutrition, physical activity, stress management and social support. Program length: five weekly one-hour sessions. Page 6 of 11
7 Relaxation for Mind & Body - helps individuals identify and reduce stressors through learned relaxation techniques. Participants learn coping skills and stress management techniques, including deep breathing, visualization and progressive muscle relaxation. Program length: six weekly one-hour sessions. 10,000 Step Challenge - helps individuals become more physically active by using a pedometer to track the number of steps they take each day. Goal is to increase daily baseline activity every day. Program length: 12 weeks. Lifestyle Improvement Programs at Community/Hospital Locations: In addition to the worksite, these programs are offered in community and hospital locations. You can locate the programs nearest you on the Highmark Web site at and clicking on Community Wellness Programs in the search box. Eat Well for Life - promotes wellness and long-term weight management through balanced nutrition. Participants learn how to make healthy food choices and adopt nutrition practices that result in long-term weight management. Program length: four weekly 90-minute sessions. HOPE (Highmark Osteoporosis Prevention and Education) - focuses on healthy choices to prevent or manage osteoporosis. Program covers nutrition education, strength training, medication options and stress management. Program length: six weekly two-hour sessions. Personal Nutrition Coaching - available through physician recommendation, for individuals seeking nutrition counseling related to weight management, heart health and diabetes. Includes individual nutrition plan and enrollment in a group or Web-based program. Discover Relaxation Within - identifies and reduces individual stressors through learned relaxation techniques. Program length: four weekly 90-minute sessions. Ornish Advantage - helps to prevent heart disease and improve overall health. The clinically proven Dean Ornish Program for Reversing Heart Disease includes stress management, exercise, social support and nutrition. Program length: six weekly two-hour sessions. Page 7 of 11
8 Condition Management Programs through Blues On Call For those with certain chronic conditions, Personal Wellness Profile recommendations may include Condition Management Programs that provide more in-depth information on their condition, including educational materials. Condition Management Programs cover all aspects of these chronic conditions, including medication compliance, emotional issues, symptom management and lifestyle behaviors that impact health. All involve working with Blues On Call Health Coaches. Coronary Artery Disease - participants work with Health Coach to address all aspects of this chronic illness and to work more effectively with their physician and receive appropriate tests and treatment. Program requires participants to receive their Lipid Panel to measure cholesterol level. Diabetes - participants work with Health Coach to address all aspects of this chronic illness and to work more effectively with their physicians and receive appropriate tests and treatment. Program requires individuals to enter date and reading of the following tests: Hemoglobin A1c (measures blood glucose level); Dilated Retinal exam (detects diabetic retinopathy to prevent vision loss); Microalbumin Test (measures protein in urine) and Lipid Panel (measures cholesterol level). Asthma - participants work with a Health Coach to address all aspects of this chronic illness and to work more effectively with their physicians and receive appropriate tests and treatment. Back Pain Management - participants complete an online quiz and, depending on results, may be referred to the Health Coach for further information. Maternity - participants complete an online questionnaire, then phone a Health Coach to discuss any current or pending medical tests. Health Coach helps individuals ask the right questions of their OB/GYN. Participants also receive a complimentary Pregnancy Booklet outlining key issues throughout pregnancy. Depression - program may be recommended from results of Personal Wellness Profile. Participants complete a confidential online questionnaire, print out, then review offline with their physician, who determines appropriate follow-up. STEP 5: Log onto Your Member Web Site for a Healthy Education Since Highmark offers you an exceptional range of online health-education reference tools, you will want to take full advantage of these resources. Lifestyle Returns requires you to access at least one online Self-Care Guide, then to complete an online follow-up survey about the Guide that you used. Page 8 of 11
9 Online Self-Care Guides include, but are not limited to, the following: Healthwise Knowledgebase comprehensive database with prevention and home care information on every kind of medical condition. The Knowledgebase also contains indepth information on thousands of medications. Health Encyclopedia, an extensive illustrated, educational full-color health information resource that contains thousands of articles on diseases, symptoms, injuries, surgeries and more. Women s, Men s, Children s, Senior s and Pregnancy special health sections that address age- and gender-specific health issues. Health Crossroads modules that provide alternative care choices for a wide range of health conditions, providing a more complete and unbiased picture of your care options. Page 9 of 11
10 Your Role As Program Participant By following Lifestyle Returns requirements, you can take an important step toward a healthier lifestyle for both yourself and your family. And you also enjoy the reward that your employer offers exclusively to program participants. With a customized healthy action plan, a wide selection of Lifestyle Improvement and Condition Management Programs and a variety of Web-based health education offerings, Highmark Lifestyle Returns represents an innovative, results-driven approach to health coverage. Lifestyle Returns is the one program that can actually make you and your family healthier! Take this Wellness Scorecard with you to your physician s office so he/she can document your applicable test results. After you receive your exams and screenings, document your visit and screening results online on your Lifestyle Returns link at the Highmark member Web site, My Wellness Scorecard Indicate date of service/screening and results when applicable: Service Date Screening Date Results Annual Physical Blood Pressure Reading (systolic/diastolic) Annual Gyn Exam/Pap Cholesterol Reading (Lipid Panel) Total HDL LDL mg mg Mammogram Body Mass Index (BMI) Score Prostate Cancer Screening -- PSA -- Digital Rectal Exam Positive Negative Page 10 of 11
11 Fifth Avenue Place 120 Fifth Avenue Pittsburgh, PA Blue Cross, Blue Shield and the Cross and Shield symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Blues On Call and My BlueLink are service marks of the Blue Cross and Blue Shield Association. Highmark is a registered mark of Highmark Inc. is a service mark of Highmark Inc. Healthwise Knowledgebase is a registered trademark of Healthwise, Incorporated. (4/05) Page 11 of 11
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