Health TALK. Your best shot. Arm yourself against the flu. The Key to a good life is a great plan

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1 fall 2011 The Key to a good life is a great plan Health TALK We can help Do you have a health, mental health, learning problem or disability that prevents you from reading or understanding this information? Do you need information in another language? We can provide this newsletter and other member materials in other languages or formats. Call customer services at for more information. To read this newsletter in Spanish, see our website at Your best shot Arm yourself against the flu. When fall arrives, so does flu season. You can avoid the flu. Get vaccinated every year. The U.S. Centers for Disease Control and Prevention recommends a yearly flu vaccine for everyone age 6 months and older. The vaccine comes in a shot or nasal spray form. Your doctor can tell you when this season s vaccine is available and which type is right for you. PRSRT STD U.S. Postage PAID United Health Group UnitedHealthcare Community Plan 8 Cadillac Drive, Suite 100 Brentwood, TN Don t wait! Talk to your doctor about getting the flu vaccine. Need to find a doctor? See the provider directory at community plan.com or call customer services at (TTY 711). Source: Centers for Disease Control and Prevention ( AMC-020-TN-CAID

2 4 reasons postpartum checkups are important 1. Healing: You ll be checked to make sure you are healing well from childbirth. You will have a pelvic exam. If you had an episiotomy or cesarean section, your incision will be looked at. 2. Depression: Postpartum depression is common. Your provider will ask you questions to check for postpartum depression. If you are having depression that is keeping you from functioning or caring for your baby, get help right away. 3. Sexual health: Your provider will let you know if you are ready to start having sex again. This is a good time to talk about birth control options. 4. Breast-feeding: Your provider will examine your breasts. You can ask questions about breast-feeding. See your doctor or midwife six weeks after you give birth for your postpartum checkup. Call to make this appointment right after your baby is born. If you had a cesarean section, or if you are having any problems or concerns, you should see your provider earlier. Take the first step. Join Healthy First Steps, a care management program for pregnant women and new moms. Call (TTY 711) or HFSTN@uhc.com to find out more about the program. Source: Association of Reproductive Health Professionals ( Fighting the blues Recognizing major depression Everybody goes through times of sadness. When someone is not able to bounce back from being sad, it could be a sign of serious depression. There are also other symptoms. Seek help from a doctor, counselor or psychologist if you have persistent symptoms such as: FEELINGS sad all the time like you re empty inside worthless helpless that there s no hope, that nothing will work out right, or that when bad things happen, it s all your fault anxious or cranky all the time PHYSICAL HEALTH sluggish or low-energy not wanting to eat, or wanting to eat all the time problems falling asleep or getting up in the morning frequent headaches stomach pains or lots of pains in other parts of the body BEHAVIOR losing interest in school, sports or other activities no longer enjoying favorite activities or hobbies trouble concentrating, remembering things or making decisions thinking about death or suicide Get treatment. Having one or two of these symptoms from time to time does not mean that you are suffering from major depression. However, if you are having symptoms like these most of the time, and they affect your life, then it is time to seek help. Talk to your doctor. Or call UnitedHealthcare customer services at (TTY 711). Source: National Institute of Mental Health ( 2 HEALTH TALK

3 MyPlate The food pyramid is no more. MyPlate has replaced it. The new system is simpler. It divides the plate into four sections with one side dish. 1. Fruits and Vegetables: They should make up half your plate. Choose a variety of each. They can be fresh, frozen or canned. 100 percent juice is okay, too. 2. Grains: Eat a variety of grains, like bread, pasta, rice or oatmeal. At least half of these should be whole grains. 3. Protein: Choose lean proteins most often, like fish or skinless chicken. Add protein from vegetable sources, like beans or soy. 4. Dairy: Low-fat or fat-free milk, cheese and yogurt are also part of a healthy diet. Set the table. Learn how to make the best choices in each food group. Find out how many servings of each food group you need. Visit www. choose my plate.gov. Source: U. S. Department of Agriculture ( Screen stars Mammograms are a must for women over 40. Breast cancer can be cured most of the time when caught early, before it has spread. The best way to catch it early is with regular screenings. Mammograms are X-rays of the breasts. They can detect breast cancer years before you can feel it. Women aged 40 to 49 years should talk with their doctor about the best time to begin regular screenings based on personal health and family history. Women aged 50 to 74 years should undergo screening mammography every two years. Talk to your doctor about when you should be screened. Be whole. Janet s Law says that health plans must pay for reconstruction for women who have breast cancer surgery. Do you have questions about your benefits for breast cancer detection and treatment? Call customer services at (TTY 711). Source: American Cancer Society ( fall

4 A medical home UnitedHealthcare Community Plan encourages the use of a medical home. A medical home is more than just a place. A medical home is the central place where primary care is provided. It helps you work more closely with your doctor. The use of a medical home may allow better access to health care. It can also increase your satisfaction with care and improve your health. Please talk to your doctor about your medical home. We care about quality Programs help you get the care and services you need. UnitedHealthcare Community Plan wants you to get the best care and service. That s why we have a quality management (QM) program. Our QM program helps our members get the care and services they need to stay healthy or manage conditions. This includes: helping people with health conditions like asthma, diabetes, heart disease, COPD, weight management, depression and schizophrenia. helping pregnant women have healthy babies. helping people stay healthy with shots, screenings and tests. Another part of QM is measurement. We use national standards to see how well our QM program works. We collect data and compare it to how we did in the past. Then we share the results with members and physicians in a written report called HEDIS. Our latest HEDIS report shows that we improved in the following measures: adolescent well-child visits follow-up after hospitalization for a mental illness cervical cancer screenings It also showed that we can still get better in the following measures: blood pressure control HbA1c control for diabetics follow-up care for children prescribed ADHD medication Get it all. To get a copy of the latest HEDIS report or find out more about the QM program, call customer services at (TTY 711). Stop the cycle Abuse or neglect occurs when a child or elder is mistreated. This mistreatment results in injury or risk of harm. Abuse can be: physical verbal emotional sexual financial report it. To report suspected child abuse, call To report suspected elder abuse, call If you are in immediate danger, call 911. You do not need proof that abuse has occurred. Each concern will be reviewed on a personal basis. 4 HEALTH TALK

5 Free ride You can get a free ride to the doctor for needed health services. Whenever possible, call three days ahead to arrange transportation. The number you call to ask for a ride depends on where you live. EAST TENNESSEE Anderson, Bledsoe, Blount, Bradley, Campbell, Carter, Claiborne, Cocke, Franklin, Grainger, Greene, Grundy, Hamblen, Hamilton, Hancock, Hawkins, Jefferson, Johnson, Knox, Loudon, Marion, McMinn, Meigs, Monroe, Morgan, Polk, Rhea, Roane, Scott, Sequatchie, Sevier, Sullivan, Unicoi, Union and Washington counties LOCAL SHELBY COUNTY MIDDLE TENNESSEE Bedford, Cannon, Cheatham, Clay, Coffee, Cumberland, Davidson, DeKalb, Dickson, Fentress, Giles, Hickman, Houston, Humphreys, Jackson, Lawrence, Lewis, Lincoln, Macon, Marshall, Maury, Montgomery, Moore, Overton, Perry, Pickett, Putnam, Robertson, Rutherford, Smith, Stewart, Sumner, Trousdale, Van Buren, Warren, Wayne, White, Williamson and Wilson counties WEST TENNESSEE Benton, Carroll, Chester, Crockett, Decatur, Dyer, Fayette, Gibson, Hardeman, Hardin, Haywood, Henderson, Henry, Lake, Lauderdale, Madison, McNairy, Obion, Shelby, Tipton and Weakley counties In all fairness Know your anti-discrimination rights. FAIR TREATMENT WITH TENNCARE We do not allow unfair treatment in TennCare. No one is treated in a different way because of race, color, birthplace, religion, language, sex, age or disability. Do you think you ve been treated unfairly? Do you have more questions or need more help? If you think you ve been treated unfairly, call the Family Assistance Service Center for free at In Nashville, call No permitimos el tratamiento injusto en TennCare. Nadie recibe un trato diferente debido a su raza, color de la piel, lugar de nacimiento, idioma, sexo, edad, discapacidad o religión. Cree que lo han tratado injustamente? Tiene más preguntas? Necesita más ayuda? Usted puede llamar gratis al Centro de Servicio para Asistencia Familiar al En Nashville, llame al UNFAIR TREATMENT Federal law says that unfair treatment is not allowed. No one can be treated in a different way because of race, color, birthplace, religion, language, sex, age, beliefs or disability. If you feel that you have been treated unfairly for any of these reasons, you have the right to complain. No one will know. We do not allow unfair treatment in TennCare. If you want to file a complaint, call customer services at (TTY 711) to speak with a customer service representative; fill out the complaint form in your member handbook (located on page 65); contact TennCare at (TTY ); or mail a complaint letter to: UnitedHealthcare Community Plan Attn: Compliance Officer 8 Cadillac Drive, Suite 100 Brentwood, TN La ley federal dice que el trato injusto no está permitido. Nadie puede recibir un trato diferente debido a su raza, color de la piel, lugar de nacimiento, religión, idioma, sexo, edad, creencias o discapacidad. Si piensa que ha sido tratado de manera injusta por alguno de esos motivos, usted tiene el derecho de quejarse. Nadie se enterara. TennCare no permite el trato injusto. Si usted quiere quejarse, llame al serivicio del cliente al (TTY 711). fall

6 Have a healthy family Preventive care is important in all stages of life. It focuses on keeping you healthy. Routine health screenings help prevent disease or detect it in early stages. They are important for adults and children. United- Healthcare Community Plan wants to help keep you and your family healthy! There are things you can do to help ensure good health for your child. Even small things can make a big difference to a child s health. For example: Make sure your child gets a TENNderCare screening regularly. Ask the doctor if your child is up to date on all vaccines. Learn what your child is eating at school. Or, pack a healthful lunch. Encourage lots of physical activity. Your child s checkup Keep your children healthy with EPSDT. TENNderCare is Tennessee s EPSDT program. EPSDT stands for Early and Periodic Screening, Diagnosis and Treatment. TENNderCare is a full program of checkups and health care services for children and teens in TennCare. It pays for medications and necessary care. Children and teens, from birth until age 21, should get regular doctor visits and other health checkups. A child s checkup includes: a health history. a complete physical exam. lab tests (as appropriate). immunizations. vision/hearing screening. developmental/behavioral screening (as appropriate). advice on how to keep your child healthy. It is very important for all children to get regular checkups. Getting checkups on time helps find health problems early. When health problems are found early, they are easier to treat. Please take your child for his or her regular checkup at the recommended time. This will help ensure the health of your child. You do not need permission from UnitedHealthcare for TENNderCare checkups. Just call your child s doctor to schedule one. Your child may need special care from other doctors at times. Your child s doctor will arrange this. Some of these doctors may not belong to our network. In that case, your doctor must first call UnitedHealthcare for permission. If your child needs mental health care, you do not need to ask your doctor first. Call UnitedHealthcare customer services to be referred to a participating mental health professional. 6 HEALTH TALK Make an appointment. Call your child s provider to schedule a checkup today. If you need help scheduling your TENNderCare visit, getting any services recommended at the visit or arranging transportation, please call (TTY 711). See page 5 for more information on your transportation benefit.

7 Who to call Numbers to know UnitedHealthcare wants to hear from you. We are available to help you better understand your health plan. You can ask for help or voice an opinion. You will reach the right person to help you with questions and concerns. Answering your questions and hearing your input is important to us. CUSTOMER SERVICES (TTY 711) Hay una línea telefónica en español para los consumidores hispanos de TennCare. Llame a los servicio del cliente para más información. TRANSLATION AND INTERPRETATION The phone number at the TennCare Advocacy Program has changed. Now you can call them at Free translation and interpretation services are available in the following languages: (Arabic) Bosanski (Bosnian) (Kurdish-Badinani) (Kurdish- Sorani) Soomaali (Somali) Español (Spanish) (Vietnamese) NURSELINE Optum NurseLine is available toll-free 24 hours, every day. You ll reach a nurse who can help you with health problems. HEALTHY FIRST STEPS HFSTN@uhc.com Healthy First Steps helps pregnant women and new mothers have healthy babies. TEXT4BABY Get free text messages to help you through pregnancy and your baby s first year. Text BABY to or register at TENNDENT TennDent provides dental care for members under age 21. TRANSPORTATION East Tennessee: Shelby County: Middle Tennessee: West Tennessee: See page 5 for more information about your transportation benefit. TENNESSEE SUICIDE PREVENTION NETWORK TENNESSEE TOBACCO QUITLINE QUIT-NOW or TENNESSEE DEPARTMENT OF HUMAN SERVICES Family Assistance Service Center Help Desk TENNCARE (TTY ) TENNCARE PARTNERS ADVOCACY LINE Free advocacy for TennCare members with mental illness or substance abuse problems. They can help you understand your plan and get treatment. OFFICE OF INSPECTOR GENERAL (OIG) MEDICAID FRAUD CONTROL UNIT (MFCU) Contact UnitedHealthcare customer services, the OIG or the MFCU to report Medicaid fraud or abuse. fall

8 A custom fit Does your child have attention deficit hyperactivity disorder (ADHD)? Is he or she taking medicine for ADHD? If so, it is important to make and keep appointments with his or her doctor. A one-size-fits-all plan does not work for children with ADHD. What works for one child may not work for another. The child, the family and the doctor should talk about it and make a plan for treatment. A child who takes medicine must be seen by the doctor to make sure it is working and is the right dose. This will happen at a follow-up visit. Follow-up visits should happen within 30 days after the first ADHD visit and then at least 2 more times in the next 9 months. Source: National Institute of Mental Health ( Quit for baby Help is available for pregnant smokers. The Tennessee Tobacco QuitLine can help women stop smoking during pregnancy. It is a toll-free service that provides personalized support for Tennesseans who want to quit smoking or chewing tobacco. The Tennessee Tobacco QuitLine links pregnant women who call with quit coaches who understand the special needs and concerns of pregnant smokers. Telephone quitlines have been shown to be one of the most successful ways to help people quit smoking. The QuitLine number is QUIT-NOW ( ). It s free! The QuitLine is available Monday through Friday, 8 a.m. to 11 p.m., Saturday, 9 a.m. to 6 p.m., and Sunday, 11 a.m. to 5 p.m., Eastern time. Counseling is available in both Spanish and English. The QuitLine website is Question & answer Q. What s the best way to quit smoking? A. There are many resources that can help you quit smoking. Medications can help. You can get support on the phone or online. Local hospitals and community centers offer classes you can take. Keeping a craving journal can help. Counting how much money you are saving by not smoking can help you stay on track. For the best results, use as many resources as you can. Talk to your doctor about creating a quit plan that s right for you. For more information, call the Tennessee Tobacco QuitLine at QUIT-NOW ( ). 8 HEALTH TALK Source: smokefree.gov (

9 Breast is best Infant nutrition is something to think about. The American Academy of Pediatrics recommends breast-feeding for the first year of life. There are many reasons to breast-feed your baby. When you choose to breast-feed your newborn, you save the cost of formula. You also improve both your health and your baby s. Babies who are breast-fed through the first year may be less likely to be overweight as children or adults. Children who are overweight are at risk for diabetes and high blood pressure as adults. Tennessee has high rates of premature births. Babies born early who receive breast milk are less likely to have stomach problems. Mothers who breast-feed report benefits, too. One benefit is a faster return to pre-pregnancy weight and a faster recovery from childbirth. Another benefit is delayed menstruation. Women who breast-feed also reduce their risk of breast and ovarian cancer. Some women say they are afraid to try breast-feeding because they take medications. Some worry they may not have enough milk. But most women can breast-feed successfully. Talk to your doctor about your breast-feeding concerns. On the move? Have you moved? Are you planning to move? It is important to change your address with TennCare. You do this by contacting the Department of Human Services (DHS). There are two easy ways that you can change your address: BY PHONE Call the DHS Family Assistance Service Center Help Desk. The toll-free number is You will be asked for your name as it appears in the TennCare or DHS records, your new and previous addresses and your Social Security number. You will need to fax or mail a copy of a bill or lease that has your name and new address on it. You will be given the fax number or address to send it to. IN PERSON You may go to any DHS office. Locations are usually listed in the blue pages of your telephone book. You will need the same information as when you call. You will need to bring your Tennessee driver s license or state identification card and a copy of a bill or lease. Back to work? Tennessee law supports women who return to work and breast-feed. Employers must provide a clean private place, apart from the restroom, for mothers to use a breast pump. Most employers realize that a healthy baby and a happy mother lead to job satisfaction. Source: U.S. Department of Health and Human Services ( fall

10 CHOICES Long Term Care CHOICES TennCare s program for long term care is called TennCare CHOICES. CHOICES helps with everyday things that you might not be able to do anymore. Maybe you need help because you have grown older or you have a disability. CHOICES can help you with things like preparing meals, bathing or dressing. For long term care services, you might live in a nursing home or you might live in your home or in the community and receive home and community based services (HCBS). Do you have questions about CHOICES and: you already have a CHOICES care coordinator? Call your care coordinator or call United- Healthcare customer services toll-free at (TTY 711). you are a UnitedHealthcare member, but you do not know if you are part of CHOICES? Call UnitedHealthcare customer services toll-free at (TTY 711) and ask about CHOICES. you do not have TennCare yet? Call or visit the local Area Agency on Aging. The local Area Agency on Aging can start the paperwork. Call the area agencies toll-free at Visit their website for more information at comaging/localarea.html. 10 HEALTH TALK Don t get sick You can prevent food poisoning. Every year, 1 in 6 people in the United States gets sick from eating contaminated food. Food poisoning tends to increase during the holiday season. That s because people tend to eat more. Plus, large amounts of food are prepared and left out for people to serve themselves. Serving large groups of people increases the chance of unwashed hands or other types of germs. Food poisoning can hurt anyone. But certain groups of people are more at risk for food poisoning. These include elderly people and people with chronic illnesses. Elderly people get more problems from food poisoning. Age-related health problems, medicines and weaker bodies make it hard to fight off germs. Food poisoning often causes symptoms such as nausea, vomiting, diarrhea and fever. If you think you have food poisoning, you should take four key steps. 1. Contact your doctor or health care provider. 2. Preserve the remaining food to determine your illness. 3. Save all the packaging from the suspect food to give to your doctor. 4. Call your health department if you became ill from a restaurant. You can prevent food poisoning with these tips: CLEAN: Wash hands, cutting boards, utensils and countertops. SEPARATE: Keep raw meat, poultry and seafood separate from ready-to-eat foods. COOK: Use a food thermometer to make sure that foods are cooked to a safe internal temperature. CHILL: Keep your refrigerator below 40 F. Refrigerate food that will spoil. REPORT: Report illness from food to your local health department. If you get sick, don t fix food for others. If you have diarrhea or vomiting, you could spread the germs. Be extra careful when fixing food for children, pregnant women and the elderly. Source: Centers for Disease Control and Prevention (

11 Question & answer Q. How can I keep my child safe in a car? A. Children should ride in the back seat from birth until they are 13 years old. A new guideline says babies should ride in rear-facing car seats until about age 2. Then, children should ride in front-facing car seats with harness straps until they outgrow the seat s size limits. (This can range from 40 to 80 pounds.) The new guidelines also say to keep children in booster seats until they are 4 feet, 9 inches tall, which happens sometime after age 10. Older children should always use seat belts. Source: American Academy of Pediatrics ( Beat the bullies 5 tips for talking about bullying. Bullying takes many forms. It can be physical, like hitting. It can be verbal, like teasing. It can be emotional, like making another kid feel left out. It can even be electronic, like sending mean text messages. Being a victim of a bully can cause serious problems. Kids can become very sad and lonely. They might not want to go to school. Some feel sick, or even think about suicide. Kids who are bullied often don t tell anyone. They might be embarrassed. They might be afraid the bullying will get worse if they tell. What can you do if your child is being bullied? The first step is to talk about it. Here are some tips for talking about bullying: 1. Take your child s situation seriously. Let him or her know it s important to you. 2. Be open about the reasons for bullying. Don t ask what your child did to deserve it. 3. Listen to your child. Ask questions. Thank him or her for telling you. 4. Support your child. Explain that it s not his or her fault. Ask what you can do to help. 5. Take the opportunity to discuss non-violence. Teach your child how to deal with someone who is out of control. Once you understand the problem, talk to your child s teacher or principal. Stay calm. Ask how you can help. If nothing changes, talk to the school again. Stop it. Learn how you can stop bullying at bullying.gov. This website has videos and information for kids, parents and teachers. Source: U.S. Department of Health & Human Services ( fall

12 3 numbers to know for a healthy heart 1. Blood pressure: Ideal blood pressure is lower than 120/ /80 to 139/89 is borderline. High blood pressure is 140/90 or higher. High blood pressure makes the heart work harder to pump blood and oxygen through the body. 2. Cholesterol: Ideal total cholesterol is under 200. HDL ( good cholesterol) should be higher than 50 in women or 40 in men. Ask your doctor what an ideal LDL ( bad cholesterol) number is for you. High cholesterol raises the risk of buildup in your arteries. 3. Blood sugar: Fasting blood sugar under 100 is ideal. Levels of 100 to 125 signal prediabetes. Levels of 126 or more may mean you have diabetes. Diabetes raises the risk of heart disease and stroke. If your numbers are high, work with your doctor to bring them down. If lifestyle changes are not enough, medication can help. Take control. United- Healthcare has programs to help people with heart disease and other conditions. Call (TTY 711) to learn more. Source: American Heart Association ( 12 HEALTH TALK A family affair Understanding sickle cell disease WHAT IS SICKLE CELL? A person with sickle cell disease has red blood cells that are shaped like crescents. (Healthy red blood cells look like plump discs.) Sickled cells don t work well. They die easily and can form clumps. There may not be enough red blood cells to carry all the oxygen the body needs. This leads to chronic pain and tiredness. It also increases the risk of severe problems like organ damage, stroke and infections. HOW DO YOU GET SICKLE CELL? Sickle cell disease is a genetic condition. It runs in families. Babies are born with it. About one in 500 African-Americans has sickle cell disease. About 1 in 12 People of Latino or Mediterranean heritage are African-Americans also at risk for it. Parents who do not have the carries the sickle disease can still have the genetic trait and pass it cell trait. on to their children. HOW IS SICKLE CELL TREATED? Most babies are tested for sickle cell at birth. Sickle cell disease is rarely cured, but it can be managed. People who have it should see their doctors often. There are medications and procedures that can help them feel better and prevent problems. We can help. UnitedHealthcare has care management programs. They help people with sickle cell disease and other serious conditions. You can get help from a nurse and reminders about important tests. If your child has sickle cell disease, call (TTY 711) to ask if you can join. Source: Centers for Disease Control and Prevention (