Watch Your Weight, Eat Healthy and Exercise More

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Tracy Carson
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Overweight people are at higher risk for: Heart disease; Diabetes; Arthritis-related conditions; High blood pressure; and Some cancers. Eat a healthy diet: Eat a balanced breakfast.

1 SOUTH CAROLINA 2016 ISSUE I Watch Your Weight, Eat Healthy and Exercise More Did you know that South Carolina s adult obesity rate is 31.7%? That makes it the 10th highest adult obesity rate in the nation. You can take steps to fight obesity. Start small. Little steps can lead to big success! Overweight people are at higher risk for: Heart disease; Diabetes; Arthritis-related conditions; High blood pressure; and Some cancers. Eat a healthy diet: Eat a balanced breakfast. Include protein, whole grains, fruits and vegetables. Limit fast food and junk food. Drink 8 cups of water daily. Snack on fruits and vegetables. Eat low-fat and reduced-fat foods. Talk with your doctor about diet and exercise plans to fit your needs. How can you control your weight? Here are some suggestions. Exercise at least 30 minutes a day. Do this five days a week. Try these exercises: Walking; Raking leaves; Riding a bike; Swimming; Running or jogging; or Climbing steps for 10 minutes. Source: Weight-control Information Network; The State of Obesity, The State of Obesity in South Carolina, retrieved from Go for a swim. Take a jog around your neighborhood. Hula-hoop with your kids. Buy a jump rope and have fun! Take the stairs.

2 What Is the Healthy Behaviors Program? The Healthy Behaviors Program rewards you for taking steps that help you live a healthy life. When you complete a healthy behavior, we ll send you a $20 CVS Select Gift Card. Complete another healthy behavior and we ll load another $20 onto your gift card. It s that simple. Start Earning Rewards Now! WellCare of South Carolina members can start earning rewards now. When you complete your first healthy behavior, you will get your gift card in the mail. Keep making the healthy choices shown on the chart. As you do, we ll add more rewards to your card. Money will be automatically reloaded to your card. Please keep it in a safe place. Want to check the balance on your card? Go to net/cvs/mini.asp. 2 Member Newsletter

3 Healthy Behaviors Program Well-child visit: ages 0 15 months Child health checkup: ages 3 6 Adolescent checkup: ages 7 21 Healthy pregnancy behavior Adult checkup Reward Type Reward Amount Reward Criteria Children Healthy Behavior Reloadable CVS Select Gift Card Reloadable CVS Select Gift Card Reloadable CVS Select Gift Card $20 $20 $20 Healthy Pregnancy Behavior Baby stroller or portable playpen Reloadable CVS Select Gift Card N/A Adult Healthy Behavior $20 Members ages 0 15 months: Complete a well-child visit per schedule (reward for each visit, up to six visits). Members ages 3 6: Complete an annual child health checkup visit (EPSDT). Members ages 7 21: Complete an annual adolescent checkup visit. Pregnant members: Complete six prenatal visits and one postpartum visit. Members ages 18 39: Complete a checkup every one to three years. Members ages 40 64: Complete a checkup every one to two years based on risk factors. Member Newsletter 3

Speak Up to Improve Your Care Behavioral health is hard to talk about with providers. But when you Speak Up, you can have a better experience. Do you have questions or concerns? Speak up.

4 Speak Up to Improve Your Care Behavioral health is hard to talk about with providers. But when you Speak Up, you can have a better experience. Do you have questions or concerns? Speak up. Still don t understand? Ask again. Don t be embarrassed. Don t assume anything. Make sure you get the right care by the right professionals. Educate yourself. Learn about your treatment or service plan. Share information with your primary care provider. Tell him or her about care you get from other doctors. Also, talk about any medicines you take and allergies you have. Get an advocate. This is an advisor or supporter. It can be a family member, friend or peer. WellCare can help. Call our crisis line at Know what medicines you take and why. Ask about side effects. Do research before you get services. Ask whether the organization has experience helping people like you. Participate in your care. You and your staff should agree on everything Source: The Joint Commission, Speak Up, retrieved from assets/1/18/speakup_bhc.pdf Follow-Up After a Behavioral Health Hospitalization If you ve been hospitalized for a behavioral health disorder, take these steps before you leave the hospital: Make sure you understand discharge and/or after-care instructions. Learn all about your medications. Schedule a follow-up appointment with your behavioral health care provider within seven days of leaving the hospital. Need help coordinating your care? Contact your behavioral health provider. Or call Customer Service to get help from our Care Management Program at no cost to you. 4 Member Newsletter

Well-Child Visits Are Important During well-child checkups, your child s primary care provider will: Do a full physical and mental health exam; Give any needed immunizations (shots); Do any needed

eating habits; and Measure your child s height, weight, blood pressure, vision and hearing. These checkups help find health concerns before they become bigger problems. They are no cost to you.

5 Well-Child Visits Are Important During well-child checkups, your child s primary care provider will: Do a full physical and mental health exam; Give any needed immunizations (shots); Do any needed blood and urine tests; Check your child s mouth and teeth; Test your child for tuberculosis and lead; Give you health tips based on your child s age; Ask about your child s growth, development and eating habits; and Measure your child s height, weight, blood pressure, vision and hearing. These checkups help find health concerns before they become bigger problems. They are no cost to you. Schedule your child s checkup today. Need help scheduling an appointment? Call Customer Service. The number is on the back page. Are You Getting Enough Sleep? Getting enough sleep is important. It helps you function well when you re awake. Lack of sleep is linked to several chronic illnesses. These include diabetes, heart disease, obesity and depression. To improve the quality of your sleep, try these tips: Go to bed at the same time each night. Rise at the same time each morning. Sleep in a quiet, dark and relaxing environment. It shouldn t be too hot or too cold. Use your bed only for sleeping and not for other activities. Remove all TVs, computers and other gadgets from the bedroom. Think you have a sleep disorder? Get checked out by a health care provider. Source: Centers for Disease Control and Prevention, Are you getting enough sleep? retrieved from Sleep Member Newsletter 5

How to Keep Your Health Insurance You re a member of a Medicaid Managed Care health plan. This means you must get recertified every year to keep your coverage.

6 How to Keep Your Health Insurance You re a member of a Medicaid Managed Care health plan. This means you must get recertified every year to keep your coverage. Healthy Connections will send your Annual Review Form about one month before you need to renew your coverage. Please fill it out. Return it to Healthy Connections. This way, you can keep your Medicaid health insurance. Submit the form on time. If you don t, you may be at risk for losing your WellCare health benefits. Do you have any questions about your application or need help? Call Customer Service at , Monday Friday, 8 a.m. to 6 p.m. Our representatives can help. CAHPS : Health Care Quality From Your Point of View What is CAHPS? It stands for Consumer Assessment of Healthcare Providers and Systems. It s a survey. It asks members what they think about the care their children get. You may get a CAHPS survey by mail or over the phone. If you do, please complete it. It can help us improve our services. It also tells providers how they re doing. Survey topics may include: Access to the care your child needs; Providers communication; Our customer service; and How much your child s primary care provider knows about care received from other providers. Do you have questions? Call Customer Service at CAHPS is a registered trademark of the Agency for Healthcare Research and Quality. To learn more about CAHPS, its products and its services, visit 6 Member Newsletter

Utilization Management: The Right Care in the Right Setting The decision-making for WellCare s Utilization Management (UM) Program is based only on appropriateness of care, service and existence of

7 Utilization Management: The Right Care in the Right Setting The decision-making for WellCare s Utilization Management (UM) Program is based only on appropriateness of care, service and existence of coverage. WellCare does not specifically reward practitioners or other individuals for issuing denials of coverage. Financial incentives for UM decision-makers do not encourage decisions that result in underutilization. If you have questions about the Utilization Management Program or coverage decisions, or need language assistance, please call Customer Service at (TTY ). You may also review the Utilization Management Program section of your Member Handbook. You may call to ask for materials in a different format. This includes other languages, large print and audiotapes. There is no charge for this. Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor s advice. WellCare does not guarantee any health results. You should review your plan or call Customer Service to find out if a service is covered. Call 911 or your doctor right away in a health emergency. Member Newsletter 7

8 200 Center Point Circle, Suite 180 Columbia, SC PRSRT STD U.S. POSTAGE PAID WELLCARE HEALTH PLANS Para solicitar este documento en Español, llame al Servicio al Cliente al (TTY ). SC031926_CAD_NEW_ENG State Approved WellCare 2016 SC_10_ In This Issue We re pleased to bring you the first issue of Member Focus for It s full of helpful ideas about ways to live healthier. Take a moment to explore. As always, we wish you good health. Click or Call for the Latest Drug Coverage Updates Want to find the latest about the drugs we cover? Stop by our website, You ll find our Preferred Drug List (PDL). You can learn about drugs we ve added or removed. You ll also find changes to any drug requirements or coverage limits. You can also call us. Numbers to Know We re just a phone call (or click) away! Call Customer Service: TTY Monday Friday, 8 a.m. to 6 p.m. Or visit South-Carolina Nurse Advice Line: MD

Watch Your Weight, Eat Healthy and Move More

ILLINOIS 2016 ISSUE I Watch Your Weight, Eat Healthy and Move More More and more people are overweight and obese. Overweight people are at higher risk for: Heart disease; Diabetes; Arthritis-related conditions;