one one Take It Away! Begin a healthier life today, with our support and your commitment

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1 WINTER 2008 one TO one Take It Away! Begin a healthier life today, with our support and your commitment - Prevent Colds And Flu - Better Dental Care - Support the Special Olympics SNOWSHOEING IN SUN VALLEY

2 ONE TO ONE: a new year, a new you 2008 IDAHO STOCK IMAGES (LEFT), 2008 TETRA IMAGES (BOTTOM RIGHT), 2008 PHOTODISC, INC (TOP RIGHT) For many of us, the new year is a time to make New Year s resolutions. Maybe you ve committed yourself to quitting tobacco, resolved to lose 10 pounds or decided it s time to begin exercising regularly. Unfortunately, it s often this initial step that s the easiest to do. The hardest part is following through on your decision and changing your lifestyle for good. We ve got just the thing to help you: WellConnected is an assortment of online health assessment and lifestyle management programs available at bcidaho.com. Start on your path to better living by taking a = YOUR HEALTH INSURANCE DICTIONARY EOB. An explanation of benefits form is exactly what its name implies: it s an explanation. It s not a bill. The EOB displays the medical service, who provided the service, who submitted the claim, the cost of the service, what we paid and your savings from receiving services from a contracting provider. It also tells you how much you owe the provider, if you need to take any more action and how to appeal any coverage decisions. 2 quiz that assesses your current health and provides a personalized report. Then, select the program that you need most. We offer supportive tools to help you lose weight, de-stress, quit smoking and sleep better. Even if your resolution is simply to be more in tune with your health care, WellConnected can also help. You can search the health library, review preventive guidelines and learn how best to prepare for your next doctor s visit. With all this available at bcidaho.com, don t give up on your New Year s resolutions. We wish you a happy and healthy 2008.

3 = Q & A The Facts About Colds and Flu Q IT SEEMS EVERYBODY AT WORK IS SICK. HOW CAN I STAY HEALTHY? You can help prevent A the cold and flu by maintaining your overall wellness and avoiding germs. Wash your hands and encourage your coworkers to do the same. Drink plenty of liquids, get enough sleep, manage your stress and eat nutritious food. Q I VE GOT A COLD, BUT I NEED TO GET TO THE OFFICE TO COMPLETE A PROJECT. WHAT CAN I DO TO KEEP MY GERMS TO MYSELF? First: Are you sure A you need to be in the office? It s best to stay home and rest so you don t spread your germs and so you can feel better faster. If you must go out in public, avoid close contact with others and wash your hands regularly. When you cough or sneeze, do so into your arm and not into your hands. Try not to touch your eyes, mouth and nose. Q = PHARMACY generic update Below, we list the brand-name drugs (by condition) recently released in a generic form. I JUST CAN T GET SICK THIS SEASON. WHAT CAN I DO TO AVOID GETTING A COLD OR FLU? The bottom line A is that there is no sure-fire way to fend off illness. What you can do, however, is ask your doctor about getting a flu shot and keep up healthy habits like eating well and exercising regularly. Condition Brand Name Generic Fungal Infections Lamsil Terbinafine Breathing Problems Duoneb Ipratropium/Albuterol High Blood Pressure Verelan PM Verapamil Viral Infections Famvir Famciclovir Heart Failure Coreg Carvedilol Ear Infections Floxin OTIC Ofloxacin Seizures Trileptal Oxcarbazepine Hemorrhoids Peranex-HC Hydrocortisone/ Lidocaine/Aloe Vera STOP SMOKING, START LIVING BETTER Quitting smoking is easy, I ve done it hundreds of times, Mark Twain once said, proving the point that kicking the habit is anything but easy. But if you ve made the wise decision to quit smoking, Blue Cross of Idaho can help. We offer our members free online smoking cessation programs that provide step-by-step support, tips and advice. The process begins with a two-week Planning to Quit program, which lets you prepare to quit smoking, an important step toward success. Then, depending on your age and lifestyle, you choose one of the three Quit for Good programs. Each program lasts six weeks and encourages you to stick to your commitment. Every week, you ll receive tips like strategies to break nicotine habits or avoid weight gain and even motivational insights like how much money you re saving by quitting. Plus, you ll get follow-up s after the program ends, to keep you on track. = QUITTING TIME Blue Cross of Idaho will support you on your path to a smoke-free lifestyle. Learn more at bcidaho.com/ Health_Wellness. 3

4 PREVENTION: Brushing Up On DENTAL CARE Are you giving your teeth adequate attention? There s more to dental health than having a dazzling smile. In fact, maintaining your teeth and gums is a good way to support your total health. Several studies have shown a relationship between good oral health and good overall health. Why? Because when your mouth is unhealthy, it contains certain bacteria that can enter the bloodstream and damage internal organs, attack arteries, cause blood clots, affect blood pressure or harm a pregnancy. The best way to ensure your oral health is to eat well, visit your dentist and keep up your daily dental care at home. Eating well for your mouth means following a wellbalanced diet and limiting between-meal snacks. You should avoid foods high in sugar and foods that tend to get stuck in your teeth. Better snack options include vegetables and cheese. And drinking plenty of water helps fight the impact of sugar on your teeth. If you do give into your snack cravings, brush your teeth afterward. Brushing your teeth both regularly and correctly is important. Choose a toothbrush that has soft bristles and a small head. Use a pea-sized amount of fluoridated paste. Make sure you give attention to all parts of your mouth your tongue, all sides of your teeth and your gums. To reach plaque under your gums, tilt the bristles at a 45-degree angle to your teeth, and slide the tips of the brush gently under your gums. Jiggle the bristles carefully. Lastly, take your time. Spend at least three minutes brushing STOCKBYTE (LEFT), 2008 MASTERFILE (RIGHT) The BEST Basics B rush right: Use a soft-bristled toothbrush that is in good condition. Choose a fluoride toothpaste that is American Dental Association accepted. Replace your brush every three to four months. E at a balanced diet. Choose foods from the basic food groups: fruits, vegetables, low-fat dairy products, meats and grains. And try to limit snacking between meals. S ee your dentist regularly. Professional cleanings are an important weapon against gum disease. T ake time to floss: Clean between your teeth every day. Dental floss gets the plaque that your toothbrush can t reach. 4

5 Time for a Checkup? It s important to see your dentist every year. If you haven t seen your dentist in the past year or if you notice any of the following signs, call for an appointment immediately: - Bleeding gums - Red, swollen, tender gums - Gums that are pulling away from teeth - Chronic bad breath or bad taste in the mouth - Loose or separating teeth To find the right dentist for you, go to bcidaho.com. Under the Tools section, click Find a Provider. 5

6 CONSUMER BEWARE: health care fraud: what s it to you? You may be paying for more than you think. More than 4 billion health insurance benefit transactions processed each year are fraudulent. And although this number represents only a small fraction of total transactions, fraudulent claims carry a high price tag. The National Health Care Anti-Fraud Association (NHCAA) estimates that at least 3 percent of the billions spent on health care is the direct result of outright fraud. Although the immediate targets and victims of fraud are private health payers and government-funded health plans, every one of us ultimately pays with higher health insurance premiums, higher copayments and higher taxes. You Can Help To reduce what we all pay for fraud, follow these tips: - Keep track of your medical treatments and services, and check your bills to make sure there are no errors. Always remember to write down: - The date you received medical care. - Where the service took place. - What services you received. - The names of the providers. - What tests or additional services were ordered or recommended. - When you get a statement from your provider, double check to make sure the services and charges match your records. - When you get a prescription, check the dosage, quantity and frequency of medication. If you have questions about a prescription, ask the pharmacist, check with your doctor or call customer service to review your plan coverage. Protect Yourself Be cautious of free medical services or exams, copayment waivers or services covered by insurance. To help prevent errors or fraud, carefully review your Explanation of Benefits (EOB) and payment notices from Medicare and Medicaid. The payment notices show what the provider submitted to your insurance company for reimbursement, what was paid and what you owe. Make sure your claims only include health care services or equipment that you received. You are the best defense against health care errors. If you have questions about the services a provider has billed, contact his or her office first. In most cases, errors are the result of a clerical mistake, and the provider will gladly correct it. It s In Your Hands If you suspect fraud, call our Fraud Hotline at (800) or fraudreporting@bcidaho.com. 6

7 TAKE IT ONLINE : Do Good, FEEL GOOD Register at bcidaho.com, and you ll support Special Olympics Idaho BRITT ERLANSON/GETTY IMAGES (LEFT), 2008 COMSTOCK SELECT/CORBIS (RIGHT) When you register as a member at bcidaho.com, you can take advantage of WellConnected, our comprehensive health and well-being program. And right now, your registration supports Special Olympics Idaho. Each time a member registers between now and March 31, Blue Cross of Idaho will give $1 to Special Olympics Idaho. The Special Olympics is a nonprofi t organization that improves the lives of people with intellectual disabilities with sports and athletic competition. In turn, the program touches the lives of everyone who gets involved. You can get involved in this valuable effort by simply registering at bcidaho.com. Once you register, you ll have access to all of the tools and support that WellConnected offers. Our free WellConnected services include: - Personal health assessments and programs proven to improve your health. - Decision support tools to calculate costs and compare plans and hospital quality. - Customized programs to help you meet your health and well-being goals. - An online health library and daily news feeds of health-related news. Don t delay. Register today to begin your WellConnected experience and support our Special Olympians in Idaho. Sign On to Help Yourself and Others All it takes is fi ve easy steps to register: 1. Go to bcidaho.com/ members. 2. Next, click the Register Now link. 3. You will need information from your Blue Cross ID card to register. 4. Blue Cross will send you an with a password. 5. You will then click the link in this to log in. Our system will ask you to reset your personal password. Once logged in, you ll have access to the wellness support tools that are part of WellConnected TETRA IMAGES (LEFT) 7

8 2008 TODD KAPLAN/IDAHO STOCK IMAGES (FRONT COVER) MEMBER STORIES: CASE IN POINT When you re managing a serious health condition, you shouldn t have to worry about managing the health care system, too. James Pearl can attest to that. He has a life-threatening hereditary disease that requires him to receive infusions every two weeks to maintain a controlled metabolism. These infusions are essential but extremely expensive. Fortunately for Pearl, Blue Cross of Idaho provides no-cost case management, to help members with complex conditions coordinate their care. After looking at his treatment plan, Pearl s case manager knew he would exhaust his policy maximum unless he made some changes. The case manager worked with Pearl, his physician and Blue Cross of Idaho s contracting providers together, they found a way to get Pearl s infusions for less than half the original price. When we started this process, we had no idea where to look, said Pearl. Our case manager helped us fi nd alternatives that we never would have found on our own. 3 WAYS CAN HELP YOU TODAY: 1 Need a new doc? Search by location, gender or specialty. 2 Learn the generic equivalent of your brand name drug. 3 Order a new ID card. James Pearl s story demonstrates the value of our case management system. Case management services are available to members with complex conditions. To find out if you re eligible for case management, call Customer Service at the number on your ID card. The service is free and participation is voluntary E. Pine Ave. Meridian, ID PRSRT STD U.S. POSTAGE PAID One to One Published by McMurry All rights reserved. No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement not take the place of the recommendations of your health care provider. Consult your physician before making major changes in your lifestyle or health care regimen. McMurry makes no endorsements or warranties regarding any of the products and services included in this publication or its articles. ID