VOLTEE PARA ESPAÑOL! SPRING 2016 Health THE KEY TO A GOOD LIFE TALK IS A GREAT PLAN Did you know? Nearly one in 10 Americans now has diabetes. That s more than 29 million people. More than 8 million of these people don t yet know they have it. Also, more than one in three adults has prediabetes. Hello Welcome to IA Health Link. We are proud to provide your IA Health Link health benefits. We will work to make it easier to get the care you need. With UnitedHealthcare Community Plan, you and your family will get the benefits and services you deserve. We have thousands of doctors. Your current doctor may already be in our network. This means you will have a doctor who already knows your needs. See your doctor as much as you need. You and your children can get exams, immunizations and checkups, including sports and camp physicals. If you have a chronic illness or need extra support to manage daily activities at home, one of our Nurse Care Coordinators can help. We re here to help. Please call us at 1-800-464-9484 (TTY 711) if you ever have a question or need help. PRSRT STD U.S. Postage PAID United Health Group UnitedHealthcare Community Plan 1089 Jordan Creek Parkway, Suite 320 West Des Moines, Iowa 50266 AMC-038-IA-CAID
Health4Me UnitedHealthcare Community Plan has a new member app. It s called Health4Me. The app is available for Apple or Android tablets and smartphones. Health4Me makes it easy to: find a provider call Nurseline view your ID card read your Member Handbook get help and support in your community learn about your benefits contact Member Services Download it today. Do you use a tablet or smartphone? Download the free Health4Me app today. Use it to connect with your health plan wherever you are, whenever you want. Help us help you UnitedHealthcare Community Plan offers special benefits and programs to help improve your health. The Health Assessment tells us which services can help you. By answering just a few questions, you can be matched with the right programs for you. We ask new members to take a Health Assessment within 30 days of joining the plan. Taking a Health Assessment is easy. Just visit the secure member website at myuhc.com/ Community Plan. Or, call 1-800-464-9484 (TTY 711) and complete it over the phone. You can also ask that a paper copy be mailed to you. Get it right Where to go for the right care, at the right time Your first option: Your PCP For most illnesses and injuries, your primary care provider s (PCP s) office should be the first place you call when you need care. You might get an appointment for later that day. You may be given advice for self-care. Your doctor could call in a prescription to your pharmacy. You can even call at night or on weekends. Examples: Throat, ear, respiratory or eye infections. Colds and flu. Skin problems. Mild asthma symptoms. Stomach viruses. Your next option: Urgent care If you cannot get in to see your doctor, you could go to an urgent care center. Urgent care centers take walk-in patients. They treat many kinds of illnesses and injuries. They can perform some kinds of diagnostic tests. Many urgent care centers are open at night and on weekends. Examples: Same as PCP, plus sprains or minor broken bones. Cuts requiring stitches. Moderate asthma or diabetes symptoms needing quick treatment. For true emergencies: Call 911 or go to a hospital emergency room Emergency rooms are for major medical emergencies only. Go there only when you think your illness or injury could result in death or disability if not treated right away. Examples: Signs of stroke or heart attack. Uncontrolled bleeding. Serious pregnancy complications. Major asthma or diabetes symptoms. Hello, nurse! UnitedHealthcare has a 24/7 NurseLine. You can talk to a nurse, day or night. The nurse can help you decide the best place to get care. Call NurseLine 24/7 at 1-800-464-9484 (TTY 711). 2 HEALTH TALK
Q&A You have questions. We have answers. Q. What is IA Health Link? A. IA Health Link is the name of your health insurance program. It is a new way you receive Medicaid services. IA Health Link is managed care that combines health care (like doctor visits) with community long-term services and supports (like help in your home). Your IA Health Link health plan, UnitedHealthcare Community Plan, provides your services. Q. Do I have to choose a primary care provider (PCP)? A. Yes. Each family member can have their own PCP, or you may all choose to see the same person. Q. Can I continue to see specialist doctors? A. Yes. We have many specialists in our provider network. You will be able to see network specialists or other network providers for treatment or follow-up if you need to. Q. What will change for me? A. All of the services covered through your medical card, including in-home and nursing home services, will be coordinated and covered by UnitedHealthcare Community Plan. Q. Can I still get mental health services? A. Yes. All the mental health services provided before are available to you now through UnitedHealthcare Community Plan. Q. Can I still get prescription medicine? A. UnitedHealthcare Community Plan includes prescription medicine. As long as your doctor prescribes your medicine, you can continue to take it. We may talk with your doctor about medicines that do the same thing but may cost less. Q. Will my Home and Community Based Services (HCBS) waiver services change? A. HCBS waiver services will be managed by the IA Health Link health plan you choose or are assigned to. When your plan of care is due for review, there might be changes, but the health plan care manager will make sure you get the services you need. More questions? Call Member Services at 1-800-464-9484 (TTY 711). Or visit our website at UHC CommunityPlan.com. SPRING 2016 3
By the book Have you read your Member Handbook? It is a great source of information. It tells you how to use your plan. It explains: the benefits and services you have the benefits and services you don t have (exclusions) how to find network providers how your prescription drug benefits work what to do if you need care when you are out of town when and how you can get care from an out-of-network provider your member rights and responsibilities our privacy policy if, when and how you may need to submit a claim where, when and how to get primary, after-hours, behavioral health, specialty, hospital and emergency care how to voice a complaint or appeal a coverage decision how to request an interpreter or get other help with language or translation how the plan decides if new treatments or technologies are covered how to report fraud and abuse What to expect Get it all. You can read the Member Handbook online at myuhc.com/communityplan. Or call Member Services toll-free at 1-800-464-9484 (TTY 711) to request a copy of the handbook. Remember your postpartum checkup. It s easy for a new mom to neglect her own health. But it s very important to see your doctor or midwife six weeks after you give birth. If you had a Cesarean section, you should also see your doctor or midwife two weeks after you give birth. At your postpartum checkup, your provider will: check to make sure you are healing well from childbirth screen you for postpartum depression do a pelvic exam let you know if you are ready to start having sex again talk about birth control options answer questions about breast-feeding and examine your breasts Pregnant? Join Healthy First Steps. This free program provides support and information. Call 1-800-464-9484 (TTY 711) to learn more. 4 HEALTH TALK
The right care How utilization management works UnitedHealthcare Community Plan does utilization management (UM). All managed care health plans do. It s how we make sure our members are getting the right care at the right time and in the right place. A doctor reviews all coverage requests when the care does not seem to meet guidelines. Approval or denial decisions are based on care and service as well as your benefits. The decisions are not made because of financial or other rewards. Members and doctors have the right to appeal denials. The denial letter will tell you how to appeal. The appeal request must be submitted within 90 days of the denial. Questions? You can talk to our UM staff. Just call 1-800-464-9484 (TTY 711), toll-free. 5 facts about chlamydia Your partner in health Your primary care provider (PCP) is the person you turn to when you are sick. He or she provides or coordinates your health care. But your PCP also wants to see you when you are well. Well visits help you and your provider get to know each other. They are also a good time for: important screenings and tests needed immunizations checking on chronic conditions monitoring medications you take coordinating care given by any specialists you see counseling about a healthy lifestyle discussions about mental health, substance use, safety and other topics When you see your PCP, tell him or her about: any medications or supplements you take any other providers you see, such as specialists or alternative providers any tests or treatments you have had any mental health or substance abuse treatment you get Well visits are covered at no cost to you. Has it been more than a year since your last well visit? Call your PCP to make an appointment today. See your PCP. You should feel comfortable with your PCP. If you are not, choose a new one. Visit myuhc.com/communityplan or use the Health4Me app. Or call Member Services toll-free at 1-800-464-9484 (TTY 711). 1. Chlamydia is the most commonly diagnosed sexually transmitted infection. Both men and women can get it. 2. The bacteria that cause chlamydia are spread through sex. Using condoms can reduce the risk. 3. Chlamydia doesn t usually have any symptoms. Experts recommend sexually active women and teens aged 25 and younger get tested for it each year. Testing can be done on urine. 4. Chlamydia can be cured with antibiotics. Both partners should be treated. You should not have sex until treatment is complete. 5. If not treated, chlamydia can cause infertility. It can be passed to a baby at childbirth. It can also cause pregnancy complications or other serious problems. SPRING 2016 5
Know your drug benefits Do you know where you can get more information about your prescription drug benefits? Visit our website to learn about: 1. What drugs are on our formulary. This is a list of covered drugs. You are encouraged to use generic drugs when possible. 2. How to get your prescriptions filled. There are thousands of network pharmacies nationwide. You can find one near you that accepts your plan. You may also be able to get certain drugs by mail. 3. Rules that may apply. Some drugs may only be covered in certain cases. For example, you might need to try a different drug first. (This is called step therapy.) Or you might need approval from UnitedHealthcare to use a drug. (This is called prior authorization.) There may also be limits to the amount you can get of certain drugs. Resource corner Look it up. Find information on your drug benefits at myuhc.com/communityplan or on the Health4Me app. Or, call Member Services toll-free at 1-800-464-9484 (TTY 711). Member Services Find a doctor, ask benefit questions or voice a complaint, in any language (toll-free). 1-800-464-9484 (TTY 711) NurseLine Get 24/7 health advice from a nurse (toll-free). 1-800-464-9484 (TTY 711) Baby Blocks Join a rewards program for pregnant women and new moms. UHCBabyBlocks.com Text4baby Get messages about pregnancy and your baby s first year. Text BABY to 511411 for messages in English. Text BEBE to 511411 for messages in Spanish. Or sign up at text4baby.org. Our website and app Find a provider, read your Member Handbook or see your ID card, wherever you are. myuhc.com/communityplan Health4Me KidsHealth Get reliable information on health topics about and for children and teens. UHCCommunityPlan.com/IAkids Your privacy We take your privacy seriously. We are very careful with your family s protected health information (PHI). We also guard your financial information (FI). We use PHI and FI to run our business. It helps us provide products, services and information to you. We protect oral, written and electronic PHI and FI throughout our business. We have rules that tell us how we can keep PHI and FI safe. We don t want PHI or FI to get lost or destroyed. We want to make sure no one misuses it. We check to make sure we use PHI and FI carefully. We have policies that explain: how we may use PHI and FI when we may share PHI and FI with others what rights you have to your family s PHI and FI It s no secret. You may read our privacy policy in your Member Handbook. It s online at myuhc.com/communityplan. You may also call Member Services toll-free at 1-800-464-9484 (TTY 711) to ask us to mail you a copy. If we make changes to the policy, we will mail you a notice. 6 HEALTH TALK