2018 Lunchtime Seminar Benefit Series July 26, 2018 · 2018-08-22 · 2018 Lunchtime Seminar...
Transcript of 2018 Lunchtime Seminar Benefit Series July 26, 2018 · 2018-08-22 · 2018 Lunchtime Seminar...
What is Preventive Care/Why is it important?
LAwell Plan Eligibility & Access
◦ Medical, Dental, & Vision presentations
Questions
Preventive Care services are services such as examinations, screenings, education, etc. that are provided with an objective to prevent illness or injury and to identify at-risk diseases as soon as possible.
Preventive Care services can improve your long term health
LAwell members and dependents have access to Preventive Care services through their current Dental, Medical, and Vision plans.
Preventive Care services are generally offered by your plan at low-cost or no cost to you.
Your LIVEwell program, and other wellness programs, are other tools available to you
Preventive Care Service Presentations: ◦ DENTAL
Delta Dental – Dental
◦ VISION
EyeMed - Vision
◦ MEDICAL
Kaiser Permanente – Medical
Anthem Blue Cross – Medical
The Basics of Preventive Care Delta Dental of California
July 26, 2018
deltadentalins.com deltadentalins.com
1. Brush twice a day
2. Floss every day
3. Eat a balance diet
4. Visit the dentist regularly
• Cleanings
• Exams
Preventive care
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Prevent cavities
Stop tooth loss
Why get a cleaning? 5 things a cleaning can do for you
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Brighten your smile
Freshen your
breath
Boost your
overall health
• Identify any dental problems early
• Get screened for oral cancer
• Catch symptoms of other diseases
Why get a dental exam?
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Osteoporosis
Leukemia
Oral cancer
Diabetes
Heart disease
Pancreatic cancer
Symptoms in the mouth
Over 120 conditions have oral symptoms
Acid reflux
Bulimia
Anemia
Psoriasis
Kidney disease
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• Glaucoma
• Dementia
• Migraines
• Respiratory disease
• Acid reflux
• Cardiovascular disease
• Diabetes
• Kidney disease
• Pre-term baby
• Rheumatoid arthritis
Your mouth and your body The far-reaching impact of oral health
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2 cleanings and exams a year
100% at an in-network dentist
80% at an out-of-network dentist
PPO
Preventive
DeltaCare USA
Pay nothing for preventive care Compare your options
2 cleanings and exams a year
100% at any Delta Dental dentist
No copayment
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mysmileway.com es.mysmileway.com
• 100+ articles on everything from acid reflux to x-rays
• Short videos
• Tooth-friendly recipes
• Quizzes to assess your dental risks
• Sign up for Grin! e-magazine
SmileWay® Wellness Site
Dental health resources
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Brush and floss regularly
Visit your dentist for regular cleanings and exams
Eat a balanced diet
What YOU Can Do
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The comprehensive eye exam
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s).
Disclosure or distribution to and review or use by any unauthorized Luxottica EyeMed associate(s) and external parties is prohibited. 1
The exam includes: Dilation (if needed) Case history Patient observation Clinical diagnostic testing, including binocular function Refractive status Color vision testing Stereopsis testing Assessment, diagnosis and treatment plan
Our providers conduct comprehensive eye examinations to diagnose or detect existing conditions of the eye and vision system. Our standards follow those established by the American Academy of Ophthalmology in the “Preferred Practice Patterns” & the American Optometric Association in Clinical Practice Guidelines.
When should a member visit their medical doctor? For any eye disease or serious condition that may be found during their eye exam.
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or distribution to and review or use by any unauthorized Luxottica EyeMed associate(s) and external parties is prohibited. 2
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or distribution to and review or use by any unauthorized Luxottica EyeMed associate(s) and external parties is prohibited.
• Ocular diseases:
o Glaucoma
o Cataracts
o Macular degeneration
• Systemic diseases
o Diabetes
o High Blood Pressure
o High Cholesterol
Early detection is key
The identification of the high-risk eye and general health conditions can vary due to several factors, including the frequency of examinations and the sharing of family history of eye health with your eye care professional. The following reveals some of the benefits of early detection:
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or distribution to and review or use by any unauthorized Luxottica EyeMed associate(s) and external parties is prohibited. 3
Answers to member questions
I don’t wear glasses and can see fine! Why do I need an eye exam? Getting an eye exam is not just about finding out if you need glasses; it’s about your health. An eye exam can detect eye health problems like glaucoma or cataracts, but it can also help identify early signs of diseases that impact your whole body- high blood pressure, diabetes and high cholesterol (just to name a few).
How often should I get an eye exam? As with any type of ongoing health care, annual eye exams are a good rule of thumb, unless otherwise directed by your doctor.
Why does the eye doctor perform so many tests? Eye doctors perform various tests to examine all parts of the eye, as well as to gauge your overall health. Some procedures are designed to evaluate your vision, others allow the doctor to look at the structure of the eye, and still others help detect specific diseases. You can visit EyeSiteOnWellness.com for additional information and videos about what to expect during an eye exam.
How do I find a provider in the network? There’s 3 ways to find a provider:
• Via the Enhanced Provider Search tool at www.eyemedvisioncare.com/cityofla (where you can also schedule an appointment at many locations)
• By calling EyeMed’s Customer Care Center 855.695.5418 • Through the EyeMed Members App
A BETTER WAY TO TAKE CARE OF BUSINESS
Population Health Management
Leading California in 39
effectiveness-of-care
measures
In 2017, Kaiser Permanente
led California as the top
performer in 39 HEDIS®
effectiveness-of-care
measures — the most of any
health plan.2
The measures include:
• Care for cardiovascular and
respiratory conditions
• Comprehensive diabetes
care
• Maternal care
• Medication management
• Mental health
• Prevention and screening
• Smoking cessation
• Prevention
• Health Promotion
• Chronic Disease Management
• Technology-Enabled
• Culturally Responsive
• Evidence-Based
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2Kaiser Permanente 2017 HEDIS® (Healthcare Effectiveness Data
and Information Set) scores. Benchmarks provided by the National
Committee for Quality Assurance (NCQA) Quality Compass® and
represent all lines of business. Kaiser Permanente combined region
scores were provided by the Kaiser Permanente Department of Care
and Service Quality.
A BETTER WAY TO TAKE CARE OF BUSINESS
What is Preventive Care?
Keep track of your health when you have
not shown any symptoms
Includes routine check-ups and preventive
screenings
Preventive vs Diagnostic Services – Cost of sharing
may apply if the primary reason for the office visit
is other than the delivery of preventive care services
A BETTER WAY TO TAKE CARE OF BUSINESS
Covered without a copayment when delivered by a network provider
Age-appropriate preventive medical examinations
Blood pressure, cholesterol, and type-2 diabetes screenings
Colon cancer, Mammogram and prostate cancer screenings
Immunizations
– Hepatitis A, Hepatitis B, influenza, measles, mumps, rubella, pneumococcal, tetanus, diphtheria, pertussis, varicella
Certain over-the-counter drugs prescribed by a physician
– Aspirin to reduce rick of heart attack,
– Folic acid for women to reduce the risk of birth defects
Preventive Services
A BETTER WAY TO TAKE CARE OF BUSINESS
Member Resources
Medical Centers
• Center for Healthy Living Classes
• Preventive Services
• Flu Shots
• Chronic Disease Management
Online and Telephone
• Total Health Assessment
• Healthy Lifestyle Programs
• Telephonic Coaching
Kp.org
kp.org/centerforhealthyliving
kp.org/healthybalance
A BETTER WAY TO TAKE CARE OF BUSINESS
kp.org — a hub for health management
TELEHEALTH AT KAISER PERMANENTE | COLORADO
What it is: A single portal for connecting with Kaiser Permanente doctors
and care providers
What it offers:
Scheduling and changing routine appointments
Checking most lab results
Refilling most prescriptions
Making personal action plans for ongoing care
Managing a family member’s care
Getting timely reminders for screenings and more
I love that I scheduled my doctor appointment online and by
the time I got home, I saw my lab results. “ ” — Kaiser Permanente member, 2016
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Your members need to beInformed, invested and in charge of their health care
City of Los Angeles
Preventive Care
July 2018
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Your members need to beInformed, invested and in charge of their health care
What is Preventive care?
Preventive Care Services include routine
examinations, screenings, tests, education, and
immunizations administered with the intent of
preventing future disease, illness, or injury.
Services are considered preventive if you have
no current symptoms or prior history of a
medical condition associated with that
screening or service.
Preventive Care Services and Immunizations
are at no cost to you.
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Your members need to beInformed, invested and in charge of their health care
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What is included?
Adult Preventive Care• Physical Exams
• Screening Tests
• Immunizations
• Women Well Visits
• Male Well Visits
Child Preventive Care• Physical Exams
• Screening tests
• Immunizations
For more information refer to the
Preventive Health Guidelines on the
website below:
https://www13.anthem.com/cp/web/cityofla/
health-wellness
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Your members need to beInformed, invested and in charge of their health care
Programs That Can Help
Solera
• Diabetes Prevention Program (DPP) at
no cost (if qualified)
• Helps participants lose weight, adopt
health habits and reduce their risk for
type 2 diabetes
• The program is 16 weeks
• Take a 1 minute quiz to see if you
qualify at solera4me.com/anthemca
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Your members need to beInformed, invested and in charge of their health care
Programs Continued
Future Moms
A program that can answer your questions, help
you make good choices and follow your health care
provider’s plan of care. It can help you have a safe
delivery and a healthy child
• Talk to a nurse coach 24/7 about your pregnancy
• The Mayo Clinic Guide to a Healthy Pregnancy
book that shows changes you can expect for you
and your baby during the next nine months
• Other helpful information on labor and delivery,
including options and how to prepare5
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Your members need to beInformed, invested and in charge of their health care
• Doctor House Calls
• Appointment times from 8am to
8pm, 7 days a week, 365 days a
year
• No cost for Preventive
• Easy to schedule a doctor via an
App, Phone or Web
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Programs Continued
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Your members need to beInformed, invested and in charge of their health care
Anthem Blue Cross Life and Health Insurance Company is an independent
licensee of the Blue Cross Association. ANTHEM is a registered trademark
of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are
registered marks of the Blue Cross Association.
Questions?