MISSOURI 2015 ISSUE I Weight-Loss Myths: 3 Popular Weight-Loss Ideas That Are False Myth 1: Starches are fattening. Foods that are high in starch provide the carbohydrates that our bodies use for energy. This includes bread, rice, pasta, beans, fruits, potatoes and yams. Eating too much of these can cause problems. So can adding fatty toppings like butter, cheese or sour cream. Myth 2: Low-fat or fat-free means no calories. Low-fat or fat-free foods contain things like sugar, flour or starch thickeners. These add calories. Check nutrition labels. This way, you know how many calories are in the food you eat. BMI Below 18.5 Weight Status Underweight 18.5 24.9 Normal 25.0 29.9 Overweight 30.0 and above Obese What is BMI? It is a number that shows body fat. It s a measure of your weight and height. BMI can screen for weight issues. Refer to the chart above. To calculate your BMI online, visit 1.usa.gov/1dSzT3p. Myth 3: Eating after 8 p.m. causes weight gain. When you eat doesn t affect weight. Weight is affected by what you eat. It s also affected by how much you eat and how much physical activity you get. Your body stores extra calories as fat. So think about your calorie intake for the day. Also watch your body mass index, or BMI. Source: Weight-control Information Network, http://win.niddk.nih.gov/publications/myths.htm MOC15038
Keep Your Child Safe From Lead Lead is a metal. It s found in some paints, dust and other sources. It can be harmful, especially to children younger than age 6. Why Is Lead Harmful? Exposure to lead can be bad for developing brains and other organs. It can cause serious problems, such as: Speech, language and behavioral problems; Learning disabilities and attention deficit disorder (ADD); and Damage to the brain and nervous system. What Can You Do? Yearly verbal lead assessments should begin at age 6 months and continue through age 6. A blood lead test should happen at ages 12 and 24 months or each year until age 6 if in a high-risk area. Other steps you can take: Wash floors, windowsills, toys and pacifiers often. Use cold tap water for making baby formula, drinking and cooking. Let the water run for a couple of minutes first. Remove peeling paint from where your child visits. You can also call us to speak with a nurse who can help to answer your questions about keeping children safe from lead. The Nurse Advice Line can even help to coordinate care. Call 1-800-919-8807 (TTY 711) 24 hours a day, seven days a week. Prevent Childhood Lead Poisoning When lead-based paint peels, it makes lead dust. This dust can poison children if they breathe it or swallow it. Certain water pipes may contain lead. Lead may be found in candy imported from other countries. Lead can be found in some toys. Source: Centers for Disease Control and Prevention, www.cdc.gov 2 Member Newsletter
Heart Disease Facts: What You Need to Know About Heart Disease, High Blood Pressure and Cholesterol According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for both genders. To reduce your risk for heart disease, maintain healthy blood pressure and cholesterol levels. Ask your primary care provider (PCP) to screen you. Here are some tips to protect your heart: Have your PCP check your blood pressure yearly. A reading of 119/79 or lower is normal blood pressure. If you re taking medications, take them as directed by your PCP. Get your cholesterol checked at least every five years. Refer to the chart below. Eat lots of fruits, vegetables and lowfat dairy. Avoid too much salt and saturated fat. Take three brisk 10-minute walks a day, five days a week. Limit alcohol. Don t smoke. If you smoke, quit as soon as you can. Visit www.cdc.gov/tobacco for tips. Make an appointment with your PCP for screenings. Or call Member Services at the number on the back page for help with choosing a PCP. Healthy Cholesterol Levels Total cholesterol LDL, or bad, cholesterol HDL, or good, cholesterol Triglycerides Less than 200 mg/dl Less than 100 mg/dl 60 mg/dl or higher Less than 150 mg/dl Sources: American Heart Association, retrieved from www.heart.org; Centers for Disease Control and Prevention, retrieved from www.cdc.gov/heartdisease/facts. htm, www.cdc.gov/dhdsp/data_statistics/ fact_sheets/fs_cholesterol.htm, www.cdc. gov/dhdsp/data_statistics/fact_sheets/ fs_bloodpressure.htm Member Newsletter 3
Utilization Management The Right Care in the Right Setting What is utilization management? It s a review process. It helps everyone get the best quality of care available. This process helps determine the right place and care for a condition. Here are some things you should know about the process: Decisions are based on the best use of care and services. The people who make decisions don t get paid to deny care. No one does. We don t encourage denial of care in any way. If you have questions about the utilization management program or coverage decisions, or need language assistance, please call Member Services at 1-800-322-6027. TTY users call 1-800-735-2966. You may also review the Utilization Management Program section of your Member Handbook. You may call to ask for materials in a different format. This includes other languages, large print and audiotapes. There is no charge for this. Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor s advice. It is based on third party sources. We are presenting it for your information only. It does not imply that these are benefits covered by Missouri Care. Also, Missouri Care does not guarantee any health results. You should review your health plan or call Member Services to find out if a service is covered. Call 911 or go to the nearest emergency room if it is an emergency. 4 Member Newsletter
Seeing a Specialist? Let Your PCP Know! You and all the doctors who give you care are a team. The team works best when everyone on it knows what everyone else is doing. Your primary care provider, or PCP, is your primary doctor. He or she coordinates all your care. When you see a specialist, you should allow that doctor to send information to your PCP. When your PCP has information about care that other doctors give you, he or she can stay up to date with your health needs. It s easy to allow a specialist to share information with your PCP. Just write the name of your PCP on the form you fill out when you see a new specialist. It may also help to talk about the care you get from other doctors when you see your PCP. And remember that you can always call your PCP when you have questions. Did you know adolescents should get a checkup once a year, even if they are not sick? It s true. This should be a comprehensive well-care checkup with a primary care physician or an OB-GYN. It is no cost for members. Checkups include: A complete physical; Growth, development and mental health assessments; and Vision, hearing and dental screenings. Checkups may include: Immunizations; Flu shot; and Chlamydia screening. Need a ride to your appointment? Call Member Services at least three days before your appointment. The number is on the back page. Call to see if you are eligible. There is no cost to members eligible for transportation benefits. Talk with your adolescent s physician to make sure he or she gets the right tests and care. Source: NCQA HEDIS Volume 2: Technical Specifications, www.ncqa.org Member Newsletter 5
When Should Dental Care Start? Dental Care Tips for Your Child Run a damp washcloth over your baby s gums following feedings. Brush with just water and a soft toothbrush for children younger than age 2. Use a pea-sized amount of toothpaste with fluoride for children ages 2 and older. Begin using floss after your child has two teeth that touch. Ask About Fluoride Varnish Fluoride varnish is a coating that is painted on a child s teeth. It s safe. It makes teeth stronger and helps prevent or stop cavities. Ask your child s health care provider or dentist about fluoride varnish. Source: MedlinePlus, www.nlm.nih.gov/medlineplus CAHPS : Health Care Quality From Your Point of View What is CAHPS? It stands for Consumer Assessment of Healthcare Providers and Systems. It s a survey that asks members what they think about the quality of care their children get. You may get a CAHPS survey by mail or over the phone. If you do, please complete it. It can help us improve our services. It also tells providers how they re doing. The survey asks about your child s providers and health plan. Topics may include: Access to the care your child needs; Providers communications with you; Our customer service; and Your child s primary care provider s (PCP) knowledge of care received from other providers. Your PCP s name and phone number are on your member ID card. Do you have questions? Call Member Services at 1-800-322-6027. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality. To learn more about CAHPS, its products and services, visit www.cahps.ahrq.gov. 6 Member Newsletter
Extra Benefits for Children Missouri Care knows how important it is for kids to have a safe place to go after school or to join a club to help them build character. We support this by covering the yearly membership cost for your choice of one of the following programs in your area: Boy Scouts: The Boy Scouts is one of the nation s largest youth organizations for boys ages 7 20. Girl Scouts: For girls ages 5 17, the Girl Scouts can hike and camp, engage in the cookie program and more. 4-H: Youth in 4-H can engage in hands-on education in science, healthy living and more. Boys & Girls Club: The Boys & Girls Club offers education and career programs, health and life skills, arts and more. Diabetes camp: Kids can learn self-confidence while being with other kids who have diabetes, all while having a good time. Vision camp: Vision camp is for kids who have vision issues. The day camp lets kids try a number of typical outdoor camp activities. Camp helps kids be independent. It also teaches social skills. To learn more, call Member Services. The number is on the back page. Member Newsletter 7
P.O. Box 31531 Tampa, FL 33631-3531 PRSRT STD U.S. Postage Paid Wellcare Health Plans Para solicitar este documento en Español, llame al Servicios para Miembros al 1-800-322-6027 (TTY 1-800-735-2966). MO027901_CAD_NEW_ENG State Approved 02182015 WellCare 2015 MO_10_14 63129 In This Issue We re pleased to deliver another newsletter issue. It s full of helpful ideas about ways to live healthier. Here s what you ll find inside: Tips on child dental care; Information on preventing heart disease; and Childhood checkups. There s much more inside, so please take a moment to explore. As always, we wish you good health. Numbers to Know We re just a phone call (or click) away! Call Member Services: 1-800-322-6027 TTY 1-800-735-2966 Monday Friday, 8 a.m. to 5 p.m. Or visit www.missouricare.com Nurse Advice Line: 1-800-919-8807 (TTY 711) 24 hours a day/7 days a week 10867MC