ILLINOIS 2017 ISSUE I MEMBER FOCUS CAHPS : Health Care Quality From Your Point of View Consumer Assessment of Healthcare Providers and Systems (CAHPS) is a survey. It asks members about the care they received. The survey is mailed or provided over the phone. Please complete the survey. It helps us to know what is important to you. It helps us create new programs to get the care you need. It tells us how our providers are treating you. We want you to always get the care and treatments you need. We are making changes to our provider directory. These will make it easier for you to get the care, tests and treatments you need. The survey is mainly yes or no questions. Some questions ask you to rate us on a scale from 0 to 10. Giving us a 10 means you think we are the best health plan possible. Giving us a 0 means you think we are the worst health plan possible. Numbers to Know We re just a phone call (or click) away! Call Member Services: 1-800-608-8158 TTY 1-877-650-0952 Monday Friday, 8 a.m. to 5 p.m. Or visit www.harmonyhpi.com DO YOU HAVE QUESTIONS? Call Member Services at 1-800-608-8158. Or visit www.cahps.ahrq.gov. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality. Nurse Advice Line: 1-800-919-8807 24 hours a day/7 days a week
ACT NOW! You Could Lose Your Medicaid Insurance Coverage As a Harmony member, you should know about the Illinois Medicaid Redetermination Project (IMRP). The project processes the backlog of Medicaid cases that require immediate redeterminations. It ensures that redeterminations will be processed in a timely way going forward. When you get a redetermination letter in the mail, take action before its due date. If you don t, you could lose your Medicaid coverage and your coverage with Harmony Health Plan. For more information and frequently asked questions about IMRP, go to www.tinyurl.com/hcu6wme. What is redetermination? It s a process to determine eligibility for Medicaid, All Kids, SNAP or cash assistance. This eligibility must be reviewed every year. Do More Online As a Harmony Health Plan member, you can register for a secure account in just a few clicks. It s easy to sign up. Once you do, you can log in to our secure site anytime, 24 hours a day. A secure online account lets you: Change your primary care provider; Order a replacement member identification card; Order member materials, such as a member handbook or provider directory; Order over-the-counter items; Find out what health services you might be missing; Check your eligibility, authorization and claim status; Update your address; Check the status of your orders; Complete a wellness appraisal; Ask a nurse a question; and Find a drug cost. Get the information you want, when you want it. Visit www.harmonyhpi.com to register today. Choose the Login/Register link. Then follow the instructions for registering for an account. 2 Member Newsletter
We re Excited to Offer These Extras to Our Members You ll get things like: FREE GED exam for members ages 16 and older who don t have a high school diploma. FREE pair of approved glasses for members ages 21 and older. Choose from glasses outside of what is covered by Medicaid. FREE weight-loss program for qualified members. Get a three-month membership to Curves. This includes one-on-one counseling with a health coach. Discounted gym membership to Anytime Fitness or LA Fitness. Diaper program for members who complete a postpartum appointment and the recommended baby immunizations. Get up to six packs of diapers. Healthy Rewards Program for members who complete a qualified healthy behavior. Get a $20 CVS Select gift card for each healthy behavior completed. FREE over-the-counter (OTC) supplies through Harmony +10. Get $10 for OTC items each month. That s $120 a year! No co-pays for office visits, hospital visits and generic drugs. And no co-pays for children younger than age 19, pregnant women, Native Americans and Alaskans. FREE Healthy Kids Club for kids ages 4 11. Kids get health tips and tools to encourage immunizations and checkups. FREE dental cleanings every six months for members ages 21 and older, with no co-pay. Hypoallergenic bedding for qualified members. Get hypoallergenic bedding to avoid asthma triggers. Illinois Client Enrollment Services will send you information about your health plan choices when it is time for you to make a health plan choice and during your Open Enrollment period. Member Newsletter 3
Take the Worry Out of Talking About Anxiety Are you worrying too much, feeling fear or dread, having panic attacks or unable to sleep at night? Telling your doctor can put you on the road to feeling better. Anxiety disorders affect nearly one in five adults in the U.S. Yet many people find it hard to admit that they are struggling with a behavioral health issue. These steps can make it easier for you to talk about your concerns: Have a Plan Make the most of your time with your doctor. Before your visit: Write down your symptoms, how they affect your daily life and how you feel when they occur. If you get nervous during the appointment, refer to your notes so you don t forget important details. Do some research online to learn the basics about the diagnosis and treatment of anxiety disorders. You can start at www.nimh.nih.gov/health. Jot down your questions. Set a goal for the visit. For example, you may want to leave with the answer to a certain question or a referral to a behavioral health specialist. Or you may want a plan for dealing with an immediate concern, such as sleeplessness or symptoms interfering with your job. Go for It Try to speak openly and honestly with your doctor. Explain what you think is going on. Be as clear and direct as possible. For example, you could start by saying, I think I might have an anxiety disorder, then describe your symptoms. Click or Call for the Latest Drug Coverage Updates Want to find the latest about the drugs we cover? Stop by our website, www.harmonyhpi.com. 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 for updates. 4 Member Newsletter
WellCare has a Utilization Management (UM) Program. This program makes decisions about care. These decisions are based only on: Whether care is appropriate; Service; and Whether the care is covered. We don t reward anyone for denying coverage. UM decision-makers don t get paid to make decisions that don t use care. Do you have questions about the UM Program or coverage decisions? Or do you need language help? Call Member Services. The number is on the front page. You may also review the UM 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. Community Assistance Line CAL NUMBER 1-866 - 775-2192 VIDEO RELAY 1-855- 628-7552 W e offer non-benefit resources such as help with food, rent and utilities. Your well-being includes access to basic resources. That s why we connect people with services. These include: Food banks or meal Financial help; delivery; Transportation; and Housing help; Education. Member Newsletter 5
Get a Flu Shot Each year, experts create a flu vaccine. It protects against the viruses most likely to affect people that year. Schedule Tips your for Getting flu shot Prescriptions as soon as it Filled becomes available. When your doctor gives you a Everyone ages prescription, 6 months go and to older a network should pharmacy get the vaccine. It s even more to get important it filled. Show if you your are at Harmony high risk for complications. This includes member people ID who: card. Want to find the latest Are pregnant; about the drugs we cover? Visit our website, www.harmonyhpi.com. You can Have a chronic medical condition; and also call us for updates. The number is Live with on the someone back page who of has this a chronic newsletter. condition. We Can Help With Transition of Care Getting you the care you need is important to us. That s why we ll work with you to make sure you get your care when: You re leaving another health plan and just starting with us; One of your providers leaves our network; You leave our health plan to go to another one; and You re growing up and need help choosing an adult primary care provider. We want to be sure you keep seeing your doctors and getting your medications. Please call or have your provider call. The number is on the front page. We Welcome Your Feedback Harmony invites you to join our Enrollee Advisory Committee. You can help us make Harmony better. The committee meets quarterly. It reviews Harmony s member communications. It discusses ways to reach members, evaluate provider access, identify problems and evaluate Member Services. Most importantly, committee members give feedback on the plan s performance from their own perspectives. Are you interested in joining? Please call 1-800-684-3925. 6 Member Newsletter
Get the Low-Down on Lead Exposure to lead, a toxic metal, can be dangerous. Children have a higher risk for lead poisoning. Their little bodies take in more lead than adults bodies do. Lead poisoning can harm their brains and nervous systems. Kids also come into contact with more lead because they can touch something that contains lead and then put their hands in their mouths. Lead can be found in: Soil; Pipes in homes built before 1986; Dust; Older toys and play jewelry; and Paint in homes built before 1978. Take Action Against Lead You re not powerless against lead. Here s what you can do to keep your family safe: Wipe children s hands and remove their shoes after playing outdoors. Use cold water to prepare food and drinks. Clean floors with a damp mop each week. Don t let kids play in dirt excessively. Wipe down flat surfaces, like windowsills, weekly with a damp paper towel. Wash pacifiers, toys or bottles that fall on the floor. Protect Your Family In certain counties around the U.S., children younger than age 6 may have higher levels of lead in their blood. No matter where you live, ask your child s doctor to test blood lead levels before age 2. If you rent, you have rights when it comes to avoiding lead. If your landlord doesn t respond to your complaints, call your county health department. Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor s advice. Also, Harmony does not guarantee any health results. You should review your plan or call Member Services to find out if a service is covered. Member Newsletter 7
Harmony Health Plan, Inc. 29 North Wacker Drive, Suite 300 Chicago, IL 60606 PRSRT STD U.S. POSTAGE PAID WELLCARE HEALTH PLANS 10867MI Harmony Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-608-8158 (TTY: 1-877-650-0952). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-608-8158 (TTY: 1-877-650-0952). UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-800-608-8158 (TTY: 1-877-650-0952). IL035500_CAD_NEW_ENG State Approved 01052017 WellCare 2017 IL_09_16 IL7CADNEW78795E 78795