source When you see HIL at the end of a story, just call 1-800-999-1658. Then, enter the four-digit code to hear recorded health messages from our Health Information Library. A guide to your health plan Third Quarter 2009 Lead poisoning Protect your child Lead can harm anyone, especially a child. It can affect how a child learns, acts and grows. You can t see or smell lead in a product. But it can be found in many places and in certain objects, including toys. Follow these tips to help keep your child safe: Be aware of toy recalls. Some new toys may contain too much lead. These toys need to be returned to the manufacturer. Visit the U.S. Consumer Product Safety Commission Web site at www.cpsc.gov or call 800-638-2772 to learn more about toy recalls. Give your child foods high in calcium and iron. They help lower the amount of lead that the body will absorb. These foods include lean meats, beans and low-fat dairy products. Your child s doctor will do routine tests to check for lead as part of his or her TENNderCare checkup. This visit, which includes any shots your child might need, is free. You can call TennCareSelect for a ride to your Questions & Answers Q. Are there any safe fireworks for my kids to use? No. All types of fireworks A. can be dangerous. Even sparklers are risky. They can reach 1,000 degrees or more. Each year thousands of kids are hurt by fireworks. They can cause burns, scars and even blindness. Leave fireworks to the pros. Don t let kids play with fireworks, including sparklers. Let your children watch public displays instead. Source: American Academy of Pediatrics child s TENNderCare checkup if you don t have a way to get there. Find the transportation number for your county on the back page of this newsletter. Source: Centers for Disease Control and Prevention HIL 8578 Para información acerca de TennCare en español, llame al 1-866-311-4290.
allergies Bugs: Avoid the zings of bites and stings They buzz, creep and hover. And sometimes bugs bite or sting. Most people aren t bothered too much by bug bites. But others can have bad reactions and need to get help fast. Bugs can also carry disease, such as Lyme disease and West Nile virus. You can t prevent all insect bites, but to help keep bugs from bugging or harming you: Use insect repellent with DEET to stop bites from mosquitoes, ticks, fleas, chiggers and biting flies. Repellents for children should have only 10 percent DEET. Don t use repellents on babies. Don t use scented soaps or perfumes, which attract bugs. Stay indoors at dawn and at dusk, when there are more bugs around. Stay away from bug hangouts, such as puddles of water, garbage cans and flower gardens. Make sure garbage cans are covered. Keep food and drinks covered if you have them outdoors. Wear long pants, long-sleeved shirts and shoes not sandals in grassy or wooded areas. Check 2 Wear long pants, long-sleeved shirts and shoes not sandals in grassy or wooded areas. your clothes and skin for ticks. If you are allergic to stings, wear a bracelet that says so. Source: American College of Emergency Physicians HIL 3105, 4902 When allergies cause asthma problems Many things that cause allergies can also cause asthma flare-ups. These triggers may include pollen, mold and dust mites. They may make people:» Cough» Wheeze» Have a tight feeling When to act fast If you have a bad reaction to a sting, call 911 right away. If you have special medicine to give yourself a shot, inject it. This will help keep the reaction from getting worse. Signs of an emergency may include: Itching and hives over large parts of the body Swelling of the throat or tongue Trouble breathing Feeling dizzy Feeling sick to your stomach, cramps or diarrhea Fainting. If someone has passed out, lay the person on his or her back while you wait for help to come. Raise the person s legs by resting them on a pillow. Children may cough, choke, drool, sound hoarse or have trouble talking. An allergy may not happen after your first sting. It can happen after a few stings, even over a long time. So watch your kids and yourself for signs of a reaction after someone gets stung. Source: American Academy of Allergy, Asthma & Immunology HIL 3113 in the chest. If you have any of these symptoms, talk to your provider. He or she can help you find ways to avoid the things that trigger problems. Your provider may also have you take medicine. Source: American Academy of Allergy, Asthma & Immunology HIL 4801
wellness Do you have an anger problem? We all get angry it s part of being human. But too much anger can cause problems in our lives and in our relationships. Think you might have an anger problem? Ask yourself these questions. Do you: Get angrier than you should over little things? Feel bad about things you say or do when you are upset? Fight or damage things when angry? Have family or friends who have told you that you need help handling anger? Have lasting physical symptoms? This can mean things such as stomach troubles or feeling worried a lot. Stay cool Finding ways to deal with anger is important. One good way to deal with anger is to let others know how you feel without being pushy or hurtful. Also, these tips can help you calm down: Take a walk. Exercise helps blow off steam. Take deep breaths. Think before you say or do things you might be sorry for later. Say calm words to relax yourself. Remind yourself that anger won t solve things. You might only feel worse. If you have questions, call us at 1-800-325-7864. Help is available If your anger seems out of control, tell a doctor or a counselor. Mental health experts can help people learn how to deal with anger. Mental health services are included as part of your TennCareSelect benefits. We can connect you with the right services to meet your needs. If you have questions about mental health services, call Premier Behavioral Systems of Tennessee at 1-800-325-7864. Sources: American Association for Marriage and Family Therapy; American Psychological Association HIL 3307, 3372 Get help quitting tobacco Quitting smoking is one of the most important things you can do to protect the health of your unborn baby. The Tennessee Tobacco QuitLine is available to help. Call 1-800-QUIT-NOW (1-800-784-8669). The service is free to all Tennessee residents who want to stop smoking or using spit or chew tobacco. Callers are assigned a coach who will give one-on-one help to make a plan to kick tobacco use for good and provide tips to stay on track. The QuitLine is available Monday through Friday from 8 a.m. to 11 p.m., Saturday from 9 a.m. to 6 p.m. and Sunday from 11 a.m. to 5 p.m., Eastern time. Counseling is available in both Spanish and English. QuitLine services for the deaf and hard-of-hearing are available by calling 1-877-559-3816. For more information about quitting tobacco use and the Tennessee Tobacco QuitLine, visit the Web site at health.state.tn.us/tobaccoquitline.htm. HIL 5282, 3332, 3362 take action Call 1-800-QUITNOW today to start a smoke-free life. 3
member news Cavities: What causes them? Cavities are holes in the teeth. Caries is the name for the bacterial infection that causes cavities. An infection starts when the bad bacteria (germs) take over the good bacteria in the mouth. Things that change bacteria from good to bad are: Not enough saliva (spit) Eating foods with lots of sugar and starch Frequent nursing/bottle feeding Transmission this infection is contagious by exchange of saliva. Fillings fix cavities but not the infection. Brushing and flossing does not stop the infection. Caries must be treated by a dentist. Starting regular dental care early is best for your child s health. But it is never too late to start seeing the dentist. If your child is on TennCare, he or she has TENNderCare (EPSDT) dental services until he or she reaches the age of 21. These services include free regular six-month checkups, fluoride treatments and sealants. Your child needs to: Brush twice daily with fluoride toothpaste Clean between the teeth daily with floss Eat healthy foods and limit snacks See a dentist every six months for a checkup and cleaning. If you have TennCare, call Doral Customer Service at 1-888-233-5935 or visit the Web site at doralusa.com: For help finding a dentist For questions about your TennCare dental benefits For help with interpretation and translation For a ride to the dentist. HIL 3852, 3857 Choosing the best treatment for you Your safety comes first with TennCare TennCare takes your safety seriously. That s why TennCare only covers services that are medically necessary. Medically necessary services must be: Ordered by the doctor treating you Required to diagnose or treat your condition Safe and effective Not experimental The least costly alternative that is adequate for your condition. The best value If there is more than one safe and effective treatment, TennCare will pay for the least costly. Here s an example. Home health and private duty nursing are covered benefits when medically necessary as long as: The services are ordered by the treating doctor The treatment and services are given by a registered nurse or a licensed practical nurse That nurse is not the member s immediate relative. Sometimes, an intermediate or skilled nursing facility can give the needed care at a lower cost. In this case, the member has two options: 1. Get services from a nursing facility 2. Have home health care or private duty nursing up to the amount allowed for facility care. By paying for the effective service that costs the least, TennCare is able to provide more people with health care benefits. And that s good news for everyone. 4
staying healthy Know your risk for STDs Are you a sexually active female younger than 30? You could have a disease and not even know it. Chlamydia is one kind of sexually transmitted disease (STD) that can be very serious. It is a bacterial infection that can be very harmful if not treated. If the infection is severe, it can make it hard for a woman to have a baby. Or it can cause newborn babies of infected mothers to be born with an infection. The good news is that chlamydia Law forbids unfair treatment is treatable. Sexually active women younger than 30 should be tested each year. You can be tested when you have your annual well-woman checkup. If you are a woman older than 30, you may want to get tested if you: Have a new sex partner Have more than one sex partner Have sex with someone who has sex with other people Do not use condoms. To learn more, talk to your doctor. HIL 3756, 4533 State and federal laws do not allow unfair treatment in TennCare. No one is treated in a different way because of race, beliefs, language, birthplace, disability, religion, sex, color or age. You have the right to file a complaint if you think you are not getting fair treatment. By law, no one can get back at you for filing a complaint. To complain about: Health care, call 1-800-263-5479 Mental health care, call 1-800-325-7864 Dental care, call 1-888-233-5935. La ley prohíbe el tratamiento injusto Las leyes estatales y federales no permiten el tratamiento injusto en TennCare. No se trata a nadie de manera diferente por raza, creencias, idioma, lugar de nacimiento, discapacidad, religión, sexo, color ni edad. Usted tiene derecho a quejarse si piensa que no está recibiendo un tratamiento justo. Según las leyes, nadie puede vengarse de usted por presentar una queja. Para quejarse acerca de la: Atención médica, llame al 1-800-263-5479 Atención de salud mental, llame al 1-800-325-7864 Atención dental, llame al 1-888-233-5935. Protect yourself from chlamydia There are ways to keep from getting chlamydia. One way is to not have sex. Or you can choose to be in a relationship with someone who has been tested and does not have the disease and be sure neither of you has sex with anyone else. Latex condoms can lower your risk, too. You must use them the right way and use them each time you have sex. It is important to talk with your partner about these things. And talk with your doctor if you have questions. Your doctor is used to talking about this and can give good advice. Sources: National Women s Health Information Center; Centers for Disease Control and Prevention HIL 4503, 4504 5
emergencies A medical emergency Are you ready? Try as you might, you can t avoid every major illness or injury. That s why your hospital s emergency department is there to help. A trip to the ER is bound to be stressful. But if you know what to expect, things can go smoother. Toys can keep kids busy while you wait. Plan to wait People with the most severe problems are helped first. So you might have to wait. A nurse usually decides who goes first. This process may involve checking a patient s temperature, heart rate and blood pressure. If you re asked to wait and your condition gets worse, tell the staff right away. There also may be a wait after you ve seen a doctor. He or she may need to see lab results or talk with a specialist before treating you. All of this can take time. Here s a tip: If you re bringing children with you, pack some books or toys. It ll help keep kids busy during the wait. Be prepared You ll be asked about your overall health and what medicines you take. There will be some forms to fill out. You ll need to provide your name, address and insurance card. Patients who are very ill may need to stay at the hospital for more care. Others will be able to go home after treatment. Source: American College of Emergency Physicians How to know when it s an emergency From time to time, we all get hurt or sick. It s usually something minor, solved with first aid and TLC. But what about problems that go beyond a bandage and a kiss? How do we know which conditions are routine and which ones require a trip to the hospital? It s best to call 911 if you think someone s life is in danger. Experts say signs of serious trouble include:» Uncontrolled bleeding» Trouble breathing» Chest pain or pressure» Fainting» Changes in vision» Confusion» Sudden, severe or strange pains» Severe vomiting» Vomiting blood» Coughing up blood» Ongoing diarrhea» Thoughts of suicide» Trouble speaking. Take special care with children. Kids may not be able to explain how they feel. If you think a child is having a major health problem, see the doctor right away. Remember that urgent care can be an option when you need treatment but it isn t an emergency. If your doctor s office is closed, you might visit an urgent care center for:» Insect stings or animal bites» Minor cuts that need stitches» Fever» Flu» Earaches. Source: American College of Emergency Physicians 6
family health Why older kids need checkups Did you know that all children older than 3 years should get a checkup every year? Even teenagers need a checkup at least once a year. Many older children and teenagers do not get a yearly checkup. But these checkups are really important. They allow the doctor or nurse practitioner to make sure they are growing and developing well. It is also a good time to talk about how to stay safe and how to make healthy choices. School will be starting again soon. Many kids will need sports physicals. This is a great time to see the doctor or nurse practitioner for a checkup. They can sign the forms needed for sports and do the regular checkup at the same visit. Your child s primary care provider has special training to talk about ways to be safe and stay healthy while playing sports. Getting a checkup every year is one of the best things your child can do to stay healthy for life. Call today to set up an appointment and transportation. HIL 8752 We can help you stay healthy If you have a chronic condition or certain diseases, you may be eligible for one of our free Case Management or Disease Management programs. What s the difference? Case Management is for members who have:» Complex chronic conditions» A major trauma» Complicated care needs that involve several providers. Disease Management is for members with:» Diabetes» Congestive heart failure» Asthma» Chronic obstructive pulmonary disease» Coronary artery disease» Pregnancy» Obesity» Bipolar disorder» Major depression» Schizophrenia. TennCareSelect will assign you a case manager when you enroll. This person will be either a registered nurse, a social worker or a behavioral health clinician. Your case manager will give you support and coach you in the program. He or she will help you adopt and maintain healthy habits. What s in it for you? When we recognize issues that may affect your health, we can work with you and your health care provider. We ll help coordinate treatment, services and medicines. For more information or to enroll, call: Case Management, 1-800-225-8698 Disease Management, 1-888-416-3025 HIL 4433 did you know? In Tennessee, African- Americans make up the minority group with the highest death rate for most diseases. Protect yourself by knowing the risks, staying active and watching your weight. 7
Presorted Standard U.S. Postage PAID St. Cloud, MN Permit No. 2260 T take action Talk to a nurse* anytime day or night. 1-800-262-2873 TennCareSelect Customer Service Call about your physical health care; your health plan; help for free interpretation and translation services; or to ask for TENNderCare information in formats for members who are blind or deaf, cannot read, or do not speak English. M F, 8 a.m. to 6 p.m. Eastern time (ET). Calls received after normal business hours will be forwarded to voice mail. 1-800-263-5479 TDD/TTY (only for members with impaired hearing): 1-800-226-1958 Premier Behavioral Systems of Tennessee, LLC** Call about your mental health care, your alcohol and drug abuse treatment, or a ride to your behavioral health visit. 1-800-325-7864 Doral Dental Customer Service** Call about dental (teeth) care for children under age 21. M F, 8 a.m. to 6 p.m. ET 1-888-233-5935 Note: This newsletter is not meant to take the place of your doctor s advice. This document is classified as public information. *A service of an independent company serving TennCareSelect members. **An independent company serving TennCareSelect members. A government agency. Family Assistance Service Center (TennCare hotline) Call about: Applying for TennCare Appeals to get or keep TennCare TennCare premiums and copays Change of address or income Programs like food stamps or Families First. M F, 9 a.m. to 5:30 p.m. ET English: 1-866-311-4287 Nashville: 743-2000 Spanish: 1-866-311-4290 TDD/TTY (only for members with impaired hearing): 1-800-772-7647 Report possible fraud Call to report TennCare fraud or abuse. TennCare: 1-800-433-3982 Medicaid: 1-800-433-5454 TennCareSelect: 1-800-496-9600 Dental: 1-888-233-5935 Transportation* If you need a ride to see your doctor, to get medical care, to go home after a hospital discharge or to go to the pharmacy to get prescription medicine, call toll-free 1-866-473-7565. Schedule a ride at least three days in advance. If an urgent situation arises and you can t give a three-day notice, a ride can be arranged. In case of bad weather, a ride will be provided only if the place you are going is open. source 1 Cameron Hill Circle Chattanooga, TN 37402-2555 vshptn.com Volunteer State Health Plan, Inc. (VSHP), and BlueCross BlueShield of Tennessee, Inc. (BCBST), are independent licensees of the BlueCross BlueShield Association. VSHP is a licensed HMO affiliate of BCBST. No one is treated in a different way because of race, color, birthplace, language, sex, age, religion or disability. Do you think you ve been treated unfairly? Do you have more questions? Do you need more help? You can make a free call to the Family Assistance Service Center at 1-866-311-4287. In Nashville, call 743-2000. Copyright 2009 Coffey Communications, Inc. WHN23725p If you need a ride to mental health or substance abuse care, call 1-800-325-7864.