What’s InsIde 8 14 · or visiting a dentist d orm Treat Yourself When it comes to choosing a...

myhealthmylife

What’s InsIde

2014 Issue 3

Want to Know Your BMI? 18

What Every Member Needs to Know 8

14Be Smart! Use Antibiotics Wisely

TM

YourselfTreat

$45 in gift cards for diabetes tests

$20 gift card for a mammogram

$10 gift card for a well-child visit

$40 gift card for prenatal visits

$20 gift card for a spirometry test

$10 gift card for visiting a PCP

$20 gift card for a Pap test

$10 gift card for visiting a dentist

$10 gift card for returning your HRA form

Treat YourselfWhen it comes to choosing a health plan, we know you have a lot of options. We’re glad you chose Passport, and now that you’re with us, we want you to enjoy all that we can offer you!

As a member, it’s up to you. You can treat yourself to a whole new world of health and wellness. Just imagine what you can do...

Share the Treat!If you know someone who'd like to treat themselves to some of these benefits, tell them to give us a call at 1-800- 578-0603. Remember, you have a choice when it comes to your health plan- and we’re glad YOU chose Passport!

Treat yourself to a free gift card for making healthy choices or attending a doctor’s visit. You can receive $10, $20 and $40 gift cards to buy the things you need and want! For more details, just call us at 1-877-903-0082.

Treat yourself to a kind and caring staff of nurses, member service representatives and community workers. We understand the issues you face and want to help. When we say, We Take the Time to Care, we really mean it.

Treat yourself to your own case manager right here in Kentucky. A case manager can work with you one-on-one and help you get the care you need. When you have Passport, you’re not alone!

toBetter

Health

Treat yourself to the wonderful doctors in our network. We have over 14,000 network doctors, and the number is growing!

Visit us online at www.passporthealthplan.com2

$45 in gift cards for diabetes tests

$20 gift card for a mammogram

$10 gift card for a well-child visit

$40 gift card for prenatal visits

$20 gift card for a spirometry test

$10 gift card for visiting a PCP

$20 gift card for a Pap test

$10 gift card for visiting a dentist

$10 gift card for returning your HRA form

If you’re a woman 50 years and older, having a yearly mammogram could save your life! A mammogram can find breast cancer early before you feel a lump or have any other symptoms. Finding a problem early is the key because it can be easier to treat.

If you have a family history of breast cancer, start getting tested before age 50. You can ask your doctor when to get tested.

Passport covers mammograms at no cost to you! Don’t wait another minute. Having a mammogram could save your life and help you live longer, healthier and happier! If you’d like us to set up your appointment, please call 1-877-903-0082.

Mam

mogram

s Can Save Lives

Sources: The Clinical Guide to Prevention Services 2012, US Preventive Services Task Force /Agency for Healthcare Research Quality

3Member Services 1-800-578-0603, TDD/TTY 1-800-691-5566

Did you know just a small amount of lead can hurt your child’s growth and IQ? Children who are around lead may have reading problems, miss more school days and are less likely to finish school.

Protect Your ChildYou can protect your child with a lead test. Ask your child’s primary care provider (PCP) to do a lead test at your child’s next checkup. Our Early and Periodic, Screening, Diagnosis and Treatment (EPSDT) program covers checkups for children and teens at these ages:

1 month 9 months 24 months

2 months 12 months 30 months

4 months 15 monthsevery year from age

3 to age 206 months 18 months

Source: American Academy of Pediatrics

What can parents do to help?

• If you rent a home or apartment, talk with your

landlord about fixing peeling paint.

• Keep children away from chipping paint.

• Remove any lead-based products

from the home.

how do children get lead in their bodies?

Eating paint flakes. Older paint may have lead in it. Children can put things in their mouths that have paint flakes or paint dust on them.

Playing in dirt. Some dirt may have lead in it.

drinking hot water from faucets in homes built before 1978. Some old pipes have lead in them.


Children and LeadDon't Mix!

Source: Global Initiative for Chronic Obstructive Lung Disease (GOLD Standard)

If you’re having a baby, congratulations! We hope your pregnancy will be a wonderful time. You can share the news with your loved ones, pick out names and have baby showers.

Now that you’re pregnant, the key is to take good care of yourself. Babies need healthy moms! Taking care of your health is the best gift you can give your baby.

Important Reminder for new Moms:As soon as your baby is born, you must call the Department for Community Based Services (DCBS) at 1-855-

306-8959 to report the birth. Please call right away to make sure your baby gets enrolled and receives benefits. If you do not call, your baby will not have coverage.

Ways to have a healthy and safe Pregnancy

1. Make an appointment with an obstetrician (OB) right

away. An OB is the doctor who sees you during pregnancy. Your OB will make sure you and your baby get off to a good start.

2. Go to all of your appointments. If you have questions in between visits, call your OB.

3. Do not smoke, drink alcohol or use drugs.

4. Take a prenatal vitamin every day.

The Best GiftYou Can Give Your Baby

You Can earn Rewards!Besides covering you and your baby for pregnancy care, we can offer you extra rewards just for joining our “Mommy Steps” program and keeping your doctor appointments. You can earn gift cards for a crib or car seat, and to buy gas and groceries. To find out more, please call us at 1-877-903-0082.


Keep your stress level down.

3 Try to keep a good balance in your life.

3 Don’t overcommit to doing too many things at once!

eat healthy and be active.

3 Eat fresh fruits and vegetables, whole grains and lean meats.

3 Find ways to be physically active for at least 2½ hours a week.

Be smoke-free.

3 Smoking is one of the worst things you can do for your health.

3 If you would like to quit smoking, please call us 1-877-903-0082.

handle and prepare food safely:

3 Wash your hands and surfaces often.

3 Keep raw meat, poultry, seafood, and eggs away from ready-to-eat foods and eating surfaces.

3 When you’re done cooking, put leftovers in the refrigerator right away.

travel safely.

3 Always wear a seat belt.

3 Use a car seat that fits your child’s age and size. Check the owner’s manual to install and use the seat properly. Never place a rear-facing car seat in front of an active air bag.

3 Keep children ages 12 and under in the back seat.

Watch children closely.

3 Keep an eye on children while they eat and play.

3 Keep small toys, food, drinks and coins out of their reach.

help a friend in an abusive relationship.

3 1 in 3 women are physically or sexually abused at some point in their lives.

3 Never blame a friend for what is happening. Listen to them and let them know they’re not alone.

3 Encourage them to call the Center for Women and Families at 1-877-803-7577.

Be Healthy

Be Safe

Source: Centers for Disease Control and Prevention,

www.foodsafety.gov

TO BE


Is Alcohol a Problem? We Can Help!We know how common alcohol problems can be. Now, we can cover your treatment and help you get the support you need.

When It’s a ProblemMost people can have a drink from time to time without any trouble. But, some people drink too much and it causes problems on their job, at school, or with the people they love.

You may have an alcohol problem if you:• Feel guilty or embarrassed about drinking. • Lie about drinking. • Have friends or family who worry about your drinking. • Black out or don’t remember what happened. • Drink more than planned. • Have tried to cut back or stop drinking, but couldn’t do it.

Not Ready ReadyUnsure

Call us!If you would like our help and support, please call us at 1-855-834-5651. We’re here for you.

Learning how to stop drinking will take time. You have to decide to stop for yourself– no one can decide for you. Here are the first steps to getting sober:

1. Admit you have a problem.

2. Get help. Go to a rehab or self-help program, or see a therapist.

3. Treat other problems. Some people drink to cover up depression, bipolar disorder, work stress or other problems. If you want to be sober for good, get help from your doctor or therapist.

are you ready to make a change? If you have an alcohol problem, you can get help and recover. The question is – how ready are you to change?

Source: Mayo Clinic Alcoholism Handout, www.helpguide.org

Be Safe


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Passport Health Plan is a managed care health plan. You may also hear some people call Passport an “MCO” or Managed Care Organization. Managed care means we help you get care and find ways to stay healthy.

You Can Choose a Network Doctor• We have a large group (network) of

doctors and specialists who can help you.

• You can choose the doctors you know and trust. To see if a doctor is in our network, or if you can’t find one in our Directory, please call us at 1-800-578-0603.

You Have a “PCP” • For most members, you will have a primary care provider (PCP).

• Your PCP’s name will be listed on your member ID card. If you would like to change your PCP, please call us right away!

• If your member ID card says No PCP Required, we still encourage you to find a PCP (medical home) who will get to know your health history.

What Every Member Needs to Know

What are the benefits of managed

care?


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We Help You Live a Healthy Life• We cover lots of preventive care to help you avoid major

health problems.

• We offer you free gift cards for visiting your doctor and making healthy choices. You can use the cards for groceries, gas, personal care products, cribs and car seats! To find out more, please call us at 1-877-903-0082.

• We offer health programs to help you with illness and disease.

• We have case and disease managers who can work with you one-on-one. They can give you health tips and help you get the care you need.

• We have a 24/7 nurse advice Line. You can call 1-800-606-9880 and get medical advice anytime of the day or night.

Words You May Hear The main doctor who gives you most of your care and makes referrals when you need them. Your PCP gets to know your health history and knows what’s right for you.

The main doctor who organizes and helps you get care. Think of your PCP as your “medical home,” the place that knows you the best.

Something you need from your PCP to see some specialists. Referrals are a way for your PCP to help you see the right doctor the first time!

Some medicines and services must be pre-approved before you can get them. Your doctor will send Passport a PA request when it’s needed. We’ll look at the request and make sure it’s covered.

Primary Care Provider (PCP)

Medical home

Referral

Prior authorization (Pa)


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My To-Do List - 4 Things to Do

Set up a “well visit” with your PCP• Visit your new PCP right away,

even if you aren’t sick. The purpose of this visit is to let your PCP get to know you and get an idea of how to treat you.

• The more your PCP knows about your health history, the more he or she can help you. When you do get sick, your PCP can then get right to the problem.

Fill out your “HRA” form and mail it back to us• The Health Risk Assessment (HRA)

form was mailed to you inside your member welcome packet.

• Fill out the HRA and mail it back to us in the postage-paid envelope. Your answers will help us find the services and programs that are right for you.


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nowCount on Us –

Call Member Services! 1-800-578-0603

• Our Member Services team is ready to help you find the answers you need. We’re caring people who work hard to treat you with the respect you deserve.

• We’re based right here in Kentucky and really understand the issues you face.

• We know how the system works because we’ve been here for 17 years listening to members just like you.

Know who to call when you get sick, need medical advice or need help figuring out what to do.

What’s happening Who to Call When to Call

I feel sick and need to see my PCP. Your PCP’s Office

Call 24 hours a day, 7 days a week. If you call after hours, the doctor

on-call will call you back.

I need medical advice.

Your PCP’s Office-or-

Nurse Advice Line1-800-606-9880

Call 24 hours a day, 7 days a week. Your PCP and the Nurse Advice Line

can give you medical advice.

I need help figuring out what to do or where to go for care.

Your PCP’s Office -or-

Nurse Advice Line 1-800-606-9880

Call 24 hours a day, 7 days a week. Your PCP, the doctor on-call or the Nurse

Advice Line can help you decide what to do or where to go for care.


how soon can I get a dental appointment?• Checkups and teeth cleanings - the dentist should see you within 3 weeks. • urgent care – the dentist should see you within 48 hours for problems that cannot wait.

• Medicaid covers rides to and from dental visits if you don’t have a car in the household.

• To schedule a ride, call the transportation broker in your are• a 3 days ahead of time. The phone number is listed in your member

handbook called Your Guide to Passport health Plan. If you cannot find the number, you may call us at the number listed above.

I Need a Ride

Taking good care of your teeth is more important than you may think. Taking care of your teeth can not only give you a nice smile, but it can help your whole body stay healthy.

My Dental Benefits My Cost

1 cleaning per year for adults (21 years and older) $0

Other services for adults, as needed $0

2 cleanings per year for children and teens (under age 21)

$0

Other services for children and teens, as needed $0

1 plaque removal for pregnant women $0

You can receive a $10 gift card for visiting a dentist! To find out how, call us at:

As a Passport member, your dental care is covered! Here’s a quick look at what’s covered for you.

Your Teeth

Taking Care of

1-800-578-0603


I Need a Ride

My Dental Benefits My Cost

1 cleaning per year for adults (21 years and older) $0

Other services for adults, as needed $0

2 cleanings per year for children and teens (under age 21)

$0

Other services for children and teens, as needed $0

1 plaque removal for pregnant women $0

You can receive a $10 gift card for visiting a dentist! To find out how, call us at:

Give us a call– Our Care

Connectors are ready to

help you.

Services You Can Use

Without Approval

We Can help You!If you need help setting up a visit or getting care, please call us at 1-877-903-0082.

We can:

• Set up your office visits, tests and follow-up care.

• Set up rides to and from your visits.

• Set you up with a case or disease manager.

• Answer your health questions.

• Help you get your medicines.

• Find resources to help you pay for electric bills, food and housing.

You can use some services without getting an approval or seeing your primary care provider (PCP). These services are called Direct Access. To use a direct access service, you can set up an appointment at any time.

Vision care

Behavioral (mental) health care

Chiropractic care

Dental care

Diabetes eye test

Family planning (birth control)

Pregnancy care

Immunizations (shots)

Routine women’s care (GYN, gynecology)

Mammograms (breast cancer test)

Pap smears (cervical cancer test)

Orthopedic care (bones and joints)

Sexually transmitted disease and tuberculosis testing/treatment

Drug and alcohol treatment

Testing for Human Immunodeficiency Virus (HIV), HIV-related illnesses and other diseases passed from person to person

direct access services

1-800-578-0603


Be Smart! Use Antibiotics WiselyAntibiotics are strong medicines that fight bacteria. It’s important to know is not all illnesses are caused by bacteria. Some are caused by viruses. If your illness is caused by a virus, antibiotics will not help you.

My mucus looks yellow or green. does this mean I need antibiotics?No. Yellow or green mucus does not mean you have a bacterial infection.It’s normal for mucus to become thick and change colors during a cold.

Source: Centers for Disease Control and Prevention

What’s my illness?

Is it caused by a bacteria

or virus?What do I need to get better?

Strep Throat

Urinary Tract

Infection (UTI)

Bacteria

Bacteria

If you test positive for Strep, your doctor will order antibiotics.

If you have a UTI, your doctor will order antibiotics.

Colds, Flu VirusColds and the flu go away on their own. The key is to get lots of rest

and drink lots of fluids.

Bacteria or Virus

Your doctor will decide if you need antibiotics. If you do take antibiotics,

be sure to take all of the medicine until it’s gone.

Ear and Sinus

Infection,Bronchitis

Use this handy chart to learn when taking antibiotics is a good thing and when time and rest are all you need!


Use Antibiotics Wisely

Source: Centers for Disease Control and Prevention

Want a copy of our pdl or Over-The-Counter drug list?Our Preferred Drug List (PDL) is a list of all the medicines we cover and any limits that may apply. We also cover some over-the-counter medicines when your doctor gives you a prescription.

We make changes to the PDL throughout the year. To find the most up-to-date list, please visit www.passporthealthplan.com. Once you are on our website, click on Find a Medicine:

• To view our PDL, click on Printable Formulary.

• To view our over-the-counter drug list, click on Over-the-Counter Drug Coverage.

If you do not use a computer and would like some help, just call our Member Services team at 1-800-578-0603.

When you get sick, call your Primary Care Provider (PCP) first. You can call your PCP 24 hours a day, 7 days a week. If the office is closed, be sure to leave a message. The doctor on-call will call you back shortly.

If you cannot reach your PCP, you may also call our Care for

You Nurse Advice Line at 1-800-606-9880. Registered nurses are here for you 24 hours a day, 7 days a week. They can give you medical advice and help you decide what to do.

Getting the Right Care

Getting the right care for a non-emergency can save you a lot of time and trouble. Some examples of non-emergencies are sore throats, stomach aches, colds, minor cuts and bruises and sprained muscles. The next time you have a non-emergency, here’s what you can do:

A true emergency is when you have a life-threatening illness or injury that will likely harm your health if you don’t get care right away. If you have a true emergency, please go to the emergency room or call 911 right away.


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If you have to stay in the hospital, make sure you know what to do when it’s time to go home. You can talk with your doctor about your discharge plan. Your plan will include a follow-up visit. It’s important to go to your follow-up visit. Your doctor can see how you’re doing and help you stay healthy and well.

ask QuestionsAsk your doctor questions before you leave the hospital. If you don’t understand or agree with something, speak up! Here are some questions you might ask:

1. What can I do to get better?

2. What problems should I look for and what can I do about them?

3. Can you give me a list of all my medicines?

4. Can I bathe or shower, climb stairs, cook, shop, clean house and drive?

5. Can you show me how to change my bandage or anything else I need to do?

6. Can I talk to a social worker about any problems I might have when I go home?

We’re here to help!If you have any rough spots once you

get home, please call us at 1-877-903-0082. We can help you set up your follow-up visit and get the

medicines you need.


What is Cholesterol?Cholesterol is a fat that comes from the food you eat.

There are good and bad types of cholesterol.

Check Your Cholesterol and Live healthier!Keeping your cholesterol levels normal is a big part of living a healthy life. If you have heart disease or diabetes, see your doctor at least once a year to have your cholesterol checked.

If you have a history of high cholesterol, or if you take medicine for it, you may need to get checked more often. Always follow your doctor’s orders.

Source: www.diabetes.org/diabetes-basics/prevention/checkup-america/cholesterol.html

Ways to Keep Your Cholesterol Levels normal• Stop smoking

• Lose weight

• Exercise for 30 minutes 5 days per week. Talk to your doctor before you start exercising.

• Eat low-fat foods like fruits and vegetables, low-fat milk and cheese, and whole grains like oatmeal.

• Take cholesterol medicine if your doctor orders it.

What Should My Cholesterol Be?

“Good” (hdL) Cholesterol

40 or more (men) 50 or more (women)

“Good” (hdL) Cholesterol

Good cholesterol is called HDL. You need

good cholesterol to keep your body working right.

“Bad” (LdL) Cholesterol Bad cholesterol is called

LDL. LDL can clog the blood vessels that carry blood through your body. This

could cause a heart attack.

triglyceridesTrigylcerides are another kind of fat found in your

blood. If your triglyceride level is too high, your

chances of having a heart attack or stroke go up.

“Bad” (LdL) CholesterolLess than 100

triglyceridesLess than 150


Once you know your BMI number, you will fall into one of the categories listed here. If your BMI is too low or too high, you have a higher risk for major health problems.

3 steps to Calculate BMI Example: Maria weight 150 pounds and is 5 feet tall (60 inches)

Multiply your weight in pounds by 703. 150 x 703 = 105,450

Divide that answer by your height in inches. 105,450 ÷ 60 = 1757.50

Divide that answer by your height in inches again. 1757.50 ÷ 60 = 29.3

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how to Get Your BMI At your next office visit, you can ask your doctor for your BMI number. You can also calculate your BMI on your own. Here are the steps to calculate your BMI:

*These categories are only for adults. If you

would like to know what category your child or

teen falls into, please visit http://apps.nccd.cdc.gov/

dnpabmi/.

BMI and Your Overall healthIt’s important to know that BMI is only one part of your overall health. What you do every day is another big part!

Talk to your doctor about your BMI and daily lifestyle habits. Together, you can decide if you need to make changes such as eating smarter and getting more exercise.

Want to know your BMI?A good way to see if your weight is healthy for your height is to look at your Body Mass Index

(BMI). Your BMI tells you how much body fat you have. Having too much body fat and being overweight puts strain on your heart and can lead to major health problems.

Source: http://www.eatright.org/Public/content.aspx?id=6844

underweight: BMI below 18.5

normal weight: 18.5 to 24.9

Overweight: 25.0 to 29.9

Obese: 30.0 & above


Want to learn more?If you want to learn more about COPD or what you can do, call us at 1-877-903-0082. We’re here to help!

a spirometry test tells you:

3 If you have asthma, COPD or both.

3 How well your lungs are doing.

3 If your treatment is working.

3 If your lungs are getting better or worse.

If you have one or more of the problems listed here, you could have Chronic Obstructive Pulmonary Disease (COPD).

3 A cough that never goes away.

3 Shortness of breath when you are active.

3 Coughing up mucus or phlegm.

3 You get bronchitis a lot.

3 You are around things that cause COPD, like tobacco smoke.

If you have any of these problems, ask your doctor for a simple breathing test called spirometry.

Do You Have

COPD?

Source: Spirometry for Health Care Providers, Global Initiative for Chronic Obstructive Lung Disease (GOLD)


Marketing and Community Engagement Department5100 Commerce Crossings DriveLouisville, KY 40229

Passport does not guarantee the availability or quality of care. We are not responsible for any act or omission of any provider.

All providers contracted with Passport are independent contractors and not employees or agents of Passport.

Any information included in this newsletter is not intended to replace medical care or advice from your doctor. Any

references to other companies or internet sites are not an endorsement or guarantee of the services, information or products

provided. Passport does not take responsibility for anything that may result from the use, misuse, interpretation or

application of the information in this newsletter.

Helping Kentuckians

Live Healthier Lives™

MARK-40353 APP_8/21/2014

Visit our Facebook page every Tuesday at 12:00 p.m. and answer the question of the day. If you’re the first person to answer the question correctly and like our page, we’ll send you a $10 gift card!

www.facebook.com/passporthealthplan

AND WIN $10

CHECK OUTTRIVIA TUESDAYShTRIVIA TUESDAYSh

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