NEW JERSEY 2016 ISSUE III MEMBER FOCUS Communicating With Your Doctors for Better Coordination of Care All your health care providers should coordinate your care together. You will benefit when your primary care provider (PCP) or hospital coordinates your care, because they will be working together to give you the right care. If you are going to a new specialist, your PCP should talk with the new specialist to explain why you need the added care. If you are going home from the hospital, a plan should be in place for your care at home. Here are some steps you can take to help coordinate your care: Carry with you important information about yourself, about your condition, your PCP and your pharmacy. Take a list of your medications to your appointment with your new provider or hospital. If you have a family member or friend who helps take care of you, take him or her with you to your appointment. Write a list of questions before your appointment or hospital stay. Ask about anything you do not understand. When you leave the hospital, make an appointment with your PCP within seven days. Take your hospital discharge plan to your appointment. Source: Center for Advancing Health, The Handoff: Your Roadmap to a New Doctor s Care, retrieved from www. cfah.org/prepared-patient/prepared-patient-articles/thehandoff-your-roadmap-to-a-new-doctor-care Numbers to Know We re just a phone call (or click) away! Call Member Services: 1-888-453-2534 TTY 1-877-247-6272 Monday through Friday, 8 a.m. to 6 p.m. Or visit www.wellcare.com/new-jersey Call the Nurse Advice Line if you want to speak to a nurse: 1-800-919-8807 TTY 1-877-247-6272 24 hours a day/7 days a week
Your Rights as a WellCare Member You have the right as a WellCare member to: Get information about the organization, its services, its practitioners and providers, and member rights and responsibilities; Be treated with respect and dignity; Have your privacy protected; Work with providers to make decisions about your health care; Talk about appropriate or medically necessary treatment options for your conditions, regardless of cost and benefit coverage; Voice complaints or appeals about the plan or the care it provides; Make recommendations about the plan s member rights and responsibilities policy; and Get a second opinion. These are only a few of your rights. You have responsibilities as a member to: Supply information that the plan and its providers need to provide care; Follow plans and instructions for care that you have agreed on with your doctor; Understand your health problems; and Help set treatment goals that you and your doctor agree to. These are only a few of your responsibilities. YOU HAVE MORE RIGHTS and responsibilities. Find them in your Member Handbook. Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor s advice. It is based on third-party sources. We are presenting it for your information only. Also, WellCare does not guarantee any health results. You should review your plan or call Member Services to find out if a service is covered. Call 911 or your doctor right away in a health emergency. 2
We Need Your Help We want to hear from our members. Please consider joining one of our community advisory committees, which meets four times each year. By joining you have the opportunity to: Have a say in member rights and responsibilities; Suggest changes to the way we do business; Suggest, review and comment on educational materials; Get health information that may help you and your family; Suggest community outreach activities; Meet members of organizations that serve your community; and Much more. IF YOU WANT TO JOIN OR ATTEND any meetings, call Molly Auciello at 1-973-274-2116 or Maria Santos at 1-973-274-2138. Visit Your Dentist Every 6 Months Routine dental visits have two parts: 1. Cleaning; and 2. Check-up (finding and treating dental problems). Great reasons for getting routine dental care every six months are: Brighter smile; Fresh breath; Keeping your teeth and gums healthy; Preventing cavities; Stopping tooth loss; and Boosting overall health (regular cleanings help lower risk for some diseases, such as heart disease and stroke). People with healthier mouths and bright smiles are happier and more confident! 3
Flu and Pneumonia The flu is a very contagious viral infection. It can be very serious; millions of people die from the flu every year. That s why you should get a flu vaccine every year. You can get it as a shot or a nasal spray. The flu vaccine is covered by your WellCare health plan. There is no charge for you. If you are homebound, you can still receive the flu vaccine. Contact your care manager by calling Member Services at 1-888-453-2534 (TTY 1-877-247-6272). Also, ask your doctor if you need a pneumonia vaccine. All adults older than age 65 and those with certain long-term health problems should get the vaccine. There are two different pneumonia vaccines for older adults. For more details, visit www.cdc.gov. Community Assistance Line CAL NUMBER VIDEO RELAY 866-775-2192 855-628-7552 We offer non-benefit resources such as help with food, rent and utilities. CommUnity Assistance Line: 1-866-775-2192 WellCare Health Plans can connect you to Education resources; helpful social service resources, such as: and Food banks; More. Housing assistance; Please contact the CommUnity Assistance Transportation; Line at 1-866-775-2192 for help. Utility assistance; 4
Working With a Community Leader Representative Donald M. Payne Jr. invited WellCare of New Jersey s leadership team to his office in May of 2016 to thank them for their continued partnership on several of the Congressman s healthy lifestyle events, including: The Happy and Healthy Holiday event; Health fairs; and The DOC (Diabetes Outreach Campaign) in the House events, where participants receive free screenings and From left: Cort Adelman, WellCare s government diabetes management information. affairs director; Vanessa Negron, WellCare s community relations specialist; Rep. Payne; John We also had the opportunity to thank Kirchner, president of WellCare of New Jersey; Rep. Payne for the work he does to and Molly Auciello, WellCare s community improve the health and well-being of relations manager the people in New Jersey. Caring for Caregivers To coincide with National Public Health Week in April of 2016, WellCare of New Jersey s HealthConnections Council and the city of Elizabeth embarked upon a new initiative to support caregivers in Union County. The collaborative project includes 8 focus groups within Union County to hear from youth and adult caregivers and advocate for the resources, programs, and services that would strengthen caregiver quality of life. Caregivers devote their time and focus to caring for others, but don t often take time to care for themselves, said Aviva Woog, WellCare of New Jersey s community advocacy manager. This community initiative is designed to help ensure caregivers get the assistance they need. From left: Paulette Hussey, with Neighborhood Health Services Corporation; Aviva Woog, WellCare s community advocacy manager; Mireya Toll, a caregiver and resident of Elizabeth, New Jersey; and John Kirchner, president of WellCare of New Jersey 5
Healthy Habits Help You Get the Sleep You Need If you feel tired during the day, chances are you didn t get enough sleep the night before. Experts recommend seven to nine hours of sleep for most adults. Not getting enough shut-eye can have a big impact on the way you feel every day as well as your health. Too Little Sleep Takes a Toll Skimping on sleep too much can: Damage your nervous and immune systems; Impair memory; Affect physical performance; and Increase your risk for accidents and injuries. Long-term sleep deprivation can lead to mood swings, hallucinations and chronic disorders such as heart disease. before going to bed. Avoid caffeine, alcohol and nicotine before bedtime. These substances can disrupt your sleep cycle. Set up a regular bedtime routine, such as taking a warm bath, listening to music or reading. Designate your bedroom a sleeponly zone. Avoid watching television or doing work in your bedroom. If you have trouble falling asleep, get up and read until you feel tired. For many people, following these guidelines can help them feel rested the next day. However, if you still feel fatigued, talk with your provider or a sleep specialist. You may have an underlying sleep disorder. Positive Bedtime Habits Enhance Sleep Sleep is not only about quantity. Quality counts, too. Try these tips to improve your slumber: Go to bed and wake up at the same time every day even on weekends. Aim for 30 minutes of moderate exercise most days. However, try not to exercise too soon 6
Member Information Update Check our website often for new and updated information. You will find the Member Handbook at www. wellcare.com/new Jersey. The Handbook has information on: Benefits, services and exclusions from coverage; Co-payments and other charges you might be responsible for; Benefit restrictions about out-of-network and outof-service-area providers; Language assistance; Filing complaints/ grievances/appeals; Providers in our network; Primary care services; Specialty, behavioral health and hospital services; After-hours care; Emergency care when to use 911 or go to the emergency room; Getting coverage when out of the service area; and How we evaluate new technology. You may request hard copies of information from our website. Call Member Services at 1-888-453-2534. Hours are 8 a.m. to 6 p.m. TTY users, call 1-877-247-6272. You may leave a voice mail message after hours. Calls are returned within 24 business hours. If you speak a different language or need information in Braille or audio, don t worry. We can provide translations and alternate formats at no cost to you. Just give us a call toll-free at 1-888-453-2534 (TTY 1-877-247-6272). Click or Call for the Latest Drug Coverage Updates Want to find the latest about the drugs we cover? Visit our website www.wellcare.com/ New-Jersey. You will find our Preferred Drug List (PDL). You can learn about drugs we have added or removed, along with changes to any drug requirements or coverage limits. 7
550 Broad St., 12 th Floor Newark, NJ 07102 PRSRT STD U.S. POSTAGE PAID WELLCARE HEALTH PLANS Para solicitar este documento en Español, llame al Servicio al Cliente al 1-888-453-2534 (TTY 1-877-247-6272). 10867MB In This Issue We are pleased to bring you another issue, in which we cover dental care, healthy habits, and coordination of care. There is much more inside, so take a moment to explore. As always, we wish you good health. NJ034285_CAD_NEW_ENG State Approved 10252016 092-16-63 WellCare 2016 NJ_06_16 NJ6CADNEW76912E