A Quick Guide for Resource Parents Using Your Foster Child s Health Care Plan TennCareSelect
Your Contacts SelectKids Resource Parent Line 1-888-422-2963 8 a.m. to 6 p.m. Eastern Time SelectKids_GM@bcbst.com bluecare.bcbst.com 24/7 Nurseline 1-800-262-2873 Nurses are on call to answer health questions Department of Children s Services (DCS) Resource Parent Helpline 1-877-DCS-KIDS For questions not about health care
Common Questions Who Can Help? How do I get a ride to non-emergency health care visits? What if my child needs several non-emergency visits in a short time frame like several therapy visits in a week? What if I have trouble getting dental care or a prescription? Where do I find a list of health care providers? Your Family Service Worker Your Family Service Worker Your Family Service Worker Find a Doctor at bluecare.bcbst.com or SelectKids 1-888-422-2963 What if the provider needs an SelectKids - eligibility fax to see my child? 1-888-422-2963 or email SelectKids_GM@bcbst.com Where do I find my member SelectKids - handbook and more information 1-888-422-2963 or on covered care and services? SelectKids_GM@bcbst.com or bluecare.bcbst.com 1
Welcome to SelectKids! We salute you for caring for foster children and teens. We re Tennessee s only health plan for children in foster care, and it s a privilege to help your special families. We re here to help. We hope this guide will be useful to you in using your child s health benefits. 2
Table of Contents The Basics Getting Started, ID Cards, 4 Other Insurance Your Child s Benefits Physical, Dental, Pharmacy, Vision, Behavioral Health, 8 Transportation Health Care Providers Best Practice Network, Primary Care Provider (PCP), 12 Find a Provider Your Child s Health TennCare SM Kids, Checkup Schedule, Immunizations, 15 Behavioral health, One-on-One Help, Assessments More Help Inside Back Cover 3
4 The Basics
Getting Started STEP 1 Your foster child receives 45 days of immediate eligibility for TennCare benefits covering routine and emergency services. STEP 2 The Department of Children s Services (DCS) completes the enrollment process for our TennCareSelect health plan administered by BlueCare Tennessee. STEP 3 Once your child is enrolled, we ll assign a primary care provider (PCP). The PCP s name is printed on your child s Member ID card. Two cards are mailed to your Health Advocate Representative one for you and one for your file. Department of Children s Services TennCare BlueCare Tennessee TennCareSelect SelectKids We ll send your DCS Family Service Worker a member handbook to help you understand all benefits. 5
Member ID cards You ll want to keep your child or teen s ID card with you. Show it when they need physical or behavioral health care and dental and vision services. You ll have a separate card for prescription medicines. Need a replacement ID card? It s easy to print a temporary ID card. Just visit bluecare.bcbst.com, log in to BlueAccess SM and follow the instructions. To get a new permanent card, you ll call your DCS Family Service Worker. Other Insurance Your foster child may have health insurance in addition to TennCare. The other insurance is their primary coverage, and it should pay first. But to make sure our members get timely care, we pay claims and contact the other insurance company for payment. Teens age out of foster care when they turn 18. But they may still be covered by TennCare until they re 26 under the Affordable Care Act. We can help you find out more about these benefits. 6
Example Identification Card TennCareSelect CHRIS B HALL Member ID ZEDM12345678 Group No. 125000 VER: 5.1 (PCP) Primary Care Provider JOHN J JONES SelectKids Effective Date 06/01/2013 Member DOB: 01/07/1968 Medicaid Benefit Level: A Copayments: PCP $0 SPEC $0 ER $0 IPH $0 FRONT bluecare.bcbst.com Resource Parent Line: 1-888-422-2963 BlueCare Tennessee and BlueCare are Independent Network Provider Outside Tennessee: Licensees of the BlueCross BlueShield Association 1-800-676-2583 (BLUE) Provider Service: 1-800-276-1978 Prior Authorization: 1-800-711-4104 Advanced Radiological Imaging Auth: 1-877-791-4101 Providers: File all claims with local BCBS Plan. 24/7 Nurseline: 1-800-262-2873 Prior Authorization is required for certain services. Benefits will not be provided for unauthorized services or for non-emergency services provided by out-of-network providers. Members: Always show this card and tell your provider to check for prior authorization. Remember, you get your care from your primary care provider (PCP), listed on the front of this card, except in an emergency. Call your PCP within 24 hours of any emergency care. BlueCare Tennessee Claims Service Center 1 Cameron Hill Circle Suite 0002 This card is for identification, not Chattanooga, TN 37402-0002 for proof of eligibility. 704 (05/13) BACK 7
8 Your Child s Benefits
What We Cover We want to help your child get the most from their benefits. Their health plan covers physical, behavioral, dental and vision care, and prescription medicines. Physical care Regular checkups are covered until age 21 as part of the TennCare Kids program. Please take your child to these important exams - see page 16. Your child s coverage also includes testing, hospital care, physical therapy, home health and certain medical equipment. Emergency care is available any time your child needs it. Emergencies are times when there could be serious danger or damage to your child s health without immediate care. If you think it s an emergency, call 911 or go to the nearest emergency room. Your child s handbook has a complete list of what s covered. We sent a copy to your DCS Family Services worker, and you ll find it online at bluecare.bcbst.com. 9
Dental care Your child s dental health plan is called DentaQuest SM. Children need to see a dentist by the time they re 3 years old. Cleanings and exams are due every six months, and they re covered until age 21. We ll pay for other dental care and braces if they re medically necessary. DentaQuest - 1-855-418-1622 Vision care Eye exams are covered until age 21. Your child can get medically necessary eyeglass lenses and frames and replacements if damaged. We cover other vision care and contact lenses only if they re needed for medical reasons. Prescription medicines Prescription medicines and claims are managed by Magellan Health SM. You ll get a Magellan ID Card to use at the drugstore for prescription drugs. If you need a new card, call your DCS Family Service Worker, or we can help you. Magellan Health - 1-888-816-1680 Behavioral health care Children and teens in foster care sometimes have complex mental health issues. They may also struggle with substance use disorders. We can help you find network providers for their care. There s more information on behavioral health care on page 21. 10
Transportation Do you need help getting your child to health care appointments? Your DCS Family Service Worker can help you get a ride to non-emergency TennCare visits. Some non-emergency rides are also available for: Members on a trial home visit Members with outpatient visits three to five times a week Members who need specialized help because of physical or mental disabilities We can help you set up these rides, but you need to schedule at least 72 hours ahead of time. Call or email us. 11
12 Health Care Providers
Your Child s PCP Your child will be assigned a PCP, and the provider s name is on the Member ID Card. This is the provider your child will see for checkups. Even if other services or specialists are needed, the PCP helps make sure your child gets the right care. CHRIS B HALL Member ID ZEDM12345678 Group No. 125000 VER: 5.1 (PCP) Primary Care Provider JOHN J JONES SelectKids TennCareSelect Effective Date 06/01/2013 Member DOB: 01/07/1968 Medicaid Benefit Level: A Copayments: PCP $0 SPEC $0 ER $0 IPH $0 Foster children have their own group of PCPs, the Best Practice Network. These providers are familiar with the needs of children and teens in foster care. Tennessee also has five Specialized Centers of Excellence. They re for foster children and teens with complicated problems, especially behavioral health issues. Give us a call or talk to your DCS Family Service Worker if you want more information. TennCare won t pay for services you receive from a PCP who isn t listed on your child s Member ID Card. Call us if you want to change your child s PCP. We re happy to help. 13
Use Network Providers TennCareSelect network health care providers including pharmacies are easy to find on bluecare.bcbst.com. Just log in to BlueAccess or click Find A Doctor. You can call or email us for help if that s better for you. 14
Your Child s Health 15
Your Child s Health Regular visits with the health care provider help your child stay healthy. TennCare Kids is a program of free checkups, and physical and behavioral care until age 21. Foster children are required to get their first TennCare Kids checkup at the local health department or at an approved provider within 30 days in your care. A checkup should be scheduled no later than seven calendar days from the date of custody. Do you have questions about these timelines? Talk with your DCS Family Service Worker. Looking for health advice? 24/7 Nurseline 1-800-262-2873 - Nurses are on call to answer health questions. bluecare.bcbst.com/healthwise Search our online library of health topics.? 16
Recommended Checkup Schedule Age At Checkup Vaccines Given Date At birth 3-5 days old By 1 month old 2 months 4 months 6 months 9 months 12 months (1 year) 15 months 18 months 24 months (2 years) 30 months 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 years 17 years 18 years 19 years 20 years 17
What s included in a TennCare Kids checkup? Health history Complete unclothed physical exam Lab tests (as needed) Vaccinations (as needed) Vision/Hearing screening Developmental/Behavioral screening (as needed) Advice on how to keep your child healthy Your exam checklist Make a list of questions or concerns Take a list of your child s medicines Take your child s Well-Being and History Form Take notes if you want during the exam What is this Health & Wellness History Notebook? Can that be merged with this piece? 18
Immunizations Vaccines are safe and protect children and teens against disease. They re available at your local health department or from your child s PCP. Before age 2, children need vaccinations for mumps, measles, chickenpox and other diseases that can be very serious. Your child s PCP will be happy to discuss what s needed with you. At ages 11 and 12, boys and girls need another set of vaccines. They protect against HPV, tetanus, diphtheria, whooping cough and meningitis. Again, you should rely on your child s PCP for advice. The Centers for Disease Control and Prevention also offers useful details about vaccines at cdc.gov. 19
Health & Wellness History Notebook Children in foster care don t always get the right care at the right time. We ve put together a notebook to help you keep up with important health records. If your child doesn t have one, we ll send you a free copy. Just call or email us. 20
Behavioral Health It can be easy to spot a child s physical needs, like when they re hungry or need sleep. But it can be hard to understand mental health needs in children and teens. Is your child angry or sad, anxious or depressed? How do you know what s normal or if you need to seek help? You don t have to see your child s PCP before you get outpatient behavioral health services. But the PCP may be a good place to start looking for help. You may also want to call us or contact your DCS Family Service Worker. We can give you one-on-one help with a number of behavioral health problems. Give us a call at 1-888-416-3025, Monday through Friday, 8 a.m. to 6 p.m. Eastern Time. Common behavioral health issues for foster children include: Attention Deficit Hyperactivity Disorder (ADHD) Depression Trauma-related issues Substance use disorders 21
One-on-One Help Our members have told us they like help when they face health challenges, and they want support to stay healthy. That s why we offer our CareSmart Population Health Program. It s part of your child s membership, so there s no cost. It s voluntary, and you can stop participating at any time. We re here whether your child is well, has an ongoing health problem or a serious health episode. Special Help Every day we work with parents and young members facing many different health issues. But you may need us most for: Diabetes Anxiety Asthma Depression and suicide risk Losing weight Substance use disorder ADHD screenings Trauma 22
We ll help you: Learn more about your child s health problems. Choose healthy food and exercise for your family. Cope with emotional ups and downs. Keep all of your child s providers working together. Develop and stick to a plan of care. Avoid hospital stays and emergency room visits when possible. Want more details? Give us a call at 1-888-416-3025, Monday through Friday, 8 a.m. to 6 p.m. Eastern Time. Assessments Foster families sometimes need additional help with their child s health care needs. We work with you, DCS, your Family Service Worker and the regional nurse to find the right care, set goals and follow up. 23
24 More Help
Tennessee Department of Children s Services - tn.gov/dcs An online guide to resources within the DSC for foster parents and youth aging out of foster care LifeSet Network - lifesetnetwork.org Helps foster teens aging out of state custody find resources and build lives Report abuse at apps.tn.gov/carat or 1-877-237-0004 Like us on Facebook at facebook.com/bluecaretn Health tips and information about using benefits
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