What You Need to Know about High Blood Pressure

Transcription

1 New YOrk 2013 ISSUe I MEMBER FOCUS What You Need to Know about High Blood Pressure One in three Americans has high blood pressure. High blood pressure, sometimes called hypertension, is a serious condition that can lead to kidney failure, heart disease and other problems. The good news is that it s possible to take charge and manage high blood pressure with a healthy diet, exercise and medicines. What Is Blood Pressure Anyway? when the heart pumps blood, the blood pushes against arteries and veins. The force of the blood against the veins and arteries is called blood pressure. Blood pressure is expressed by two numbers. The first is called the systolic number. It measures blood pressure when the heart is beating. The second is the diastolic number, which measures pressure when the heart is resting. For most people, a healthy blood pressure is 120/80 or lower. How Will You Know if You Have High Blood Pressure? Your health care provider can measure your blood pressure. It s important to have your blood pressure checked even if you feel fine. That s because high blood pressure often has no symptoms. However, there are some risk factors you can control: exercise. eat a healthy diet that s low in salt. Manage stress. Don t smoke. And avoid drinking too much alcohol. How Can You Get Help with High Blood Pressure? work with your health care provider. Your health care provider can monitor your blood pressure and come up with ways you can keep your blood pressure under control. Source: National Heart, Lung and Blood Institute, What Is High Blood Pressure? retrieved from

2 Utilization Management: Reviews to Ensure the Right Care wellcare of New York has a process for reviewing the care members get. It s called the Utilization Management (UM) Program, and it bases decisions on the following: Appropriateness of care service existence of coverage The plan doesn t reward anyone for denying coverage. There are no rewards to encourage fewer services. Questions? Our Customer Service team can help. Just call TTY users may call You ll also find details about the UM program in your Member Handbook. (Also know that you may call to get the handbook and other materials in a different format. This includes other languages, large print and audio tapes. There s no charge for this.) Keep Your Child Safe from Lead Lead is a metal found in some paints, contaminated dust and other sources. It can be harmful, especially to children under the age of six. This is because their bodies easily absorb lead. And kids like to chew things including paint chips, soil and other things that may contain lead. Why Is Lead Harmful? exposure to lead can be bad for developing brains and other organs. It can cause very serious conditions such as: Speech, language and behavioral problems Learning disabilities and attention deficit disorder (ADD) Mental retardation Possibly death If your child has had contact with chemicals and is unconscious or having trouble breathing, call 911. You may also contact your area Poison Control Center 24 hours a day, 7 days a week. Call toll-free: What Can You Do to Protect Your Child? Make sure your child has a blood lead test because there are no visible symptoms for lead poisoning. Your child s primary care provider (PCP) should order a lead blood test at 12 and 24 months of age. Your child should also be screened between ages 2 and 6. Other steps you can take include: wash floors, window sills, toys and pacifiers often. Use cold tap water for making baby formula, drinking and cooking. Let the cold water run for a couple of minutes before using it. Make sure there is no peeling paint in places your child visits. 2 Member Newsletter

3 The Goal of Managed Care? Delivering Quality Care That s Cost-Effective Members sometimes ask, what s the value in managed care? It s a good question, and we d like to share some answers. with managed care, a health plan like wellcare contracts with doctors, drugstores and other providers. These providers give our members the services they need. In most cases, it s less expensive to use providers in the plan s network. Advantages of the managed care system include: Access a choice of quality providers in your area Integrated care a primary care provider (PCP) who coordinates your care, ensures you get preventive services and referrals to specialists Quality Managed care organizations receive scores for their performance and member satisfaction Cost-savings An emphasis on preventive care puts the focus on finding health issues before they become big and more expensive to treat Controlling health care costs is a big challenge. Managed care seeks to control costs while giving members the care they need. Member Newsletter 3

4 CAHPS : Health Care Quality from Your Point of View what is CAHPS? It stands for Consumer Assessment of Health Care Providers and Systems. It s a program that asks members like you what you think about the quality of care you get. You may get a CAHPS survey by mail or over the phone. If you do, please take a few minutes to complete it. Your opinion matters! The answers you give can help us improve the services we give you. It also helps health care providers know how they are doing. The survey asks about your personal experiences with providers and your health plan. Topics in the survey may include: How well you can access the care you need How well your providers communicate with you Your experiences with our customer service The health care information you receive CAHPS is a registered trademark of the Agency for Healthcare research and Quality (AHrQ). Source: To learn more about the CAHPS program and its products and services, visit Keep Your Member ID Card Handy Your member ID card is very important. Think of it as your key to getting health care services. That s why you ll want to keep it with you at all times. Give it to your doctor whenever you get care. It also has useful details about your health plan like the name and phone number of your primary care provider. Please keep your card up to date by calling Customer Service if you move or have other changes. This number is on your member ID card! 4 Member Newsletter

5 Weight-Loss Myths There s a lot of information about ways to lose weight. The trouble is, not all of it is true. we ve checked out these three popular weight-loss ideas and found out they re really false. You may have heard these Myth 1: Starches are fattening. They should be avoided when trying to lose weight. Foods that are high in starch provide the carbohydrates that our bodies use for energy. And many are relatively low in fat and calories. This includes familiar foods like bread, rice, pasta, beans, fruits, potatoes and yams. So it s not the type of food that s the problem. It s eating too much of it or adding fatty toppings like butter, cheese or sour cream. Myth 2: Low-fat or fat-free means no calories. This one is false too. why? Because some low-fat or fat-free foods contain things like sugar, flour or starch thickeners. These are added to improve flavor and texture after fat is removed. But these ingredients add calories. Check the nutrition labels to make sure you know how many calories are in the food you eat. Also be sure to look at the serving sizes. You might be surprised to see one serving is much smaller than what you normally eat. Myth 3: Eating after 8 p.m. causes weight gain. when you eat doesn t affect weight. Instead, weight is affected by: what you eat How much you eat How much physical activity you do during the day No matter when you eat, your body stores extra calories as fat. So if you want to have a snack before bedtime, go ahead. But first think about your calorie intake for the day. Source: Weight-control Information Network ( Member Newsletter 5

6 When Should Dental Care Start? Many parents have a tough time judging how much dental care their kids need. They know they want to prevent cavities, but they don t always know the best way to do so. Easy Dental Guidelines run a damp washcloth over your baby s gums following feedings Schedule your child s first dental visit when their first tooth comes in, but no later than their first birthday Take your child for a dental checkup between ages 1 and 2, and then every six months until age 18 Brushing with just water and a soft toothbrush is recommended for children under age 2 Use a pea-sized amount of toothpaste with fluoride for children 2 and over Begin using floss once your child has two teeth that touch Source: MedlinePlus 6 Member Newsletter

7 Ask about Fluoride Varnish Fluoride varnish is a coating that is painted on a child s teeth. It helps prevent or stop cavities. Ask your child s health care provider or dentist about fluoride varnish. Why Is It recommended? Cavities can cause pain and infections that can be bad for children s general health. They can lead to problems with eating, speaking, playing and learning. Fluoride varnish makes teeth stronger, stops cavities from getting bigger and prevents new cavities from forming. Is It Safe? Yes. It is safe for children of any age. It can be used on babies from the time their first teeth come in. Child Checkups to Keep Kids Healthy Checkups are part of a child s preventive care. They are done by a primary care provider (PCP). And they re tailored to the age of your child to make sure they stay healthy as they grow. There are several things the doctor will check during your child s health checkup: Your child s complete health history and examination Perform an assessment of physical and mental development Provide age-appropriate vaccines (shots), labs or diagnostic tests evaluate possible risk factors for developmental issues and discuss ways to reduce risk as your child continues to develop (as age and gender appropriate) when should these checkups take place? These guidelines show when your child should get checkups and what care services they ll get: Newborn and/or 3-5 days hearing test, newborn screening blood tests and hepatitis B (HepB) vaccine 1 month second dose of HepB vaccine, newborn screening blood test if necessary 2 months vaccines for diphtheria, tetanus, and pertussis (DTaP); rotavirus (rv); polio (IPV); pneumococcal conjugate (PCV) and haemophilus influenzae type b (Hib) vaccines 4 months DTaP, Hib, IPV, PCV and rv vaccines 6 months DTaP, HepB, Hib, IPV, PCV, rv vaccines 9 months well-baby checkup 12 months blood lead test; hemoglobin or hematocrit test; Hib, measles, mumps, rubella (MMr), hepatitis A (HepA), varicella (Chickenpox), PCV and influenza vaccines 15 months DTaP vaccine, urine test and blood lead test if not done at 9 or 12 months This is just a guide. It does not replace your doctor s advice. Talk with your doctor to make sure you and your family get the right tests and care. Source: American Academy of Pediatrics Member Newsletter 7

8 WellCare of New York, Inc. 110 Fifth Ave., 3rd Floor New York, NY Para solicitar este documento en español, llame al Servicio al Cliente al (TTY/TDD ). NY021542_CAD_New_eNG wellcare 2013 NY_02_ In this Issue welcome to this edition. Think of it as a little hello from us, full of information and articles that ll help you and your family. we ve even included information on high blood pressure, well-child doctor visits and how to help prevent lead poisoning, plus much more. So please explore what s inside and enjoy. Click or Call for the Latest Drug Coverage Updates want to find the latest about the drugs we cover? Be sure to stop by our website. You ll find our Preferred Drug List (or PDL for short). You can learn about recent additions and removals. You ll also find changes to any drug requirements or coverage limits. Just go to and select Member. Next click on your plan, then choose Pharmacy. You can also call us for updates. reach us at Numbers to Know We re just a phone call (or click) away! Call Customer Service: TTY Monday Friday, 8 a.m. to 6 p.m. Eastern Or visit newyork.wellcare.com Nurse Advice Line: