healthjournal The Priority Health magazine for healthy living Winter 2017 Virtual Care. Convenient 24/7 care, when you need it. Page 2 Don t forget your yearly medication checkup. Page 7
Virtual care. Get care when you need it. Virtual care is a convenient way to get care for a variety of common illnesses without having to go to the emergency room or urgent care center. Connect with a doctor 24/7 through your phone or computer to receive care where you are, when you need it. Virtual care saves you time and hassle. It s a convenient option when your doctor isn t available for non-emergency conditions like the following: Allergies Back pain Bites and stings Bronchitis Cold, cough and flu Diarrhea Ear ache Fever Headache Heartburn Pink eye Rashes/hives Sinus infection Sore throat Sprains and strains Smoking cessation Urinary tract infection How to schedule a virtual care visit Check with your doctor s office to see if they provide virtual care. OR Use MedNow.* Schedule a visit by calling toll-free 844.322.7374 or log in to your MyHealth account. *MedNow is staffed by Spectrum Health providers. 2 Health Journal Winter 2017
Free lead poisoning screenings Screening for lead poisoning is important for two reasons. First, babies and toddlers put toys and other objects that could have lead paint on them into their mouths. Second, lead poisoning often doesn t have any symptoms, so kids with lead poisoning may not look or act sick. Only a simple blood test can tell for sure. Children should be tested for lead poisoning at 12 and 24 months, and once a year from ages 3 6. Now you can get a $10 prepaid Visa card just for taking your toddler to the doctor for a free lead poisoning screening. Simply call your child s doctor, schedule an appointment and go to the appointment before your toddlers second birthday and we will mail you a $10 prepaid Visa card. It s our way of saying thanks for being healthy! Help protect your child against lead poisoning. Call your child s doctor to set up a visit for a free lead poisoning screening test. Don t lose your Medicaid coverage. Take action. Medicaid members need to renew their eligibility in order to keep their coverage. The Michigan Department of Health and Human Services (MDHHS) will send you a form when it s time to renew your Medicaid coverage. It s important to know you could lose your Medicaid health care coverage if you don t take action. There are three ways to renew your coverage: Keep us updated Contact your caseworker and Priority Health Customer Service at 888.975.8102 with any of the following changes that may affect your Medicaid coverage: Address changes Enrollment, disenrollment or coverage by any other insurance or health plan Phone: Call your MDHHS caseworker at the scheduled time on your renewal form. Mail: Complete the renewal form and mail it to the address provided. Online: Go to mibridges.michigan.gov/access Please note that Priority Health cannot process your renewal. Call your MDHHS caseworker to verify your renewal date and with any questions. Health Journal Winter 2017 3
Customer Service is here to help When you have questions about your health care benefits, contact us! You can also call us when you need help with the following: You want to change your doctor You need a new ID card Need a ride? You get a medical bill by mistake You want to know how to get care We will help you get a ride to your medical appointments. Call us for help if: You do not have a way to get to and from a doctor visit. You do not have a way to get medical items or services covered by us. Remember: Rides must be approved in advance. For routine appointments, such as a doctor s appointment that is not an emergency, you must ask for a ride at least 3 days before your appointment date. To use our transportation, you must have no other way to get to your medical appointment. Call 888.975.8102 or 616.464.8102 for more information or help arranging a ride. Call us The Customer Service number is 888.975.8102 (TTY users should call 711). Hours: Monday Thursday 7:30 a.m. 7 p.m. Friday 9 a.m. 5 p.m. Saturday 8:30 a.m. 12:00 p.m. If you speak little or no English, we ll work with a translator so we can talk to you. Email us Go to priorityhealth.com and click on Contact Us at the top right of the page. Know your BMI Your body mass index (BMI) tells you how much body fat you have. It is a quick and painless way of screening for potential health problems. A BMI between 18.5 and 24.9 is healthy for adults. If your BMI is 25 or over, you re at risk for diabetes, high blood pressure and more. For children, having too much or too little body fat can also lead to various diseases and health risks. Ask about your child s BMI percentile at their next doctor s appointment. 4 Health Journal Winter 2017
Keep your child healthy with well-child visits As a Priority Health member, you can get great care for your child from birth through young adulthood with free well-child visits. It is recommended that children have six well-child visits within the first 15 months of life. Kids also need a checkup once a year from ages 3-6, at least every two years ages 7-10 and one visit each year at ages 11-18. At well-child checkups, your doctor can: Give a lead poisoning test and vaccines Measure your child s height, weight and body mass index (BMI) Find health and learning problems early At the 9-, 18- and 30-month checkups, your doctor will see if your child is developing normally by checking how your child speaks, plays and acts. This will tell your doctor if your child is learning age-related skills or if there may be a problem. Stay eligible If you have a child covered under the Children s Special Health Care Services program, they need to be seen by a specialist more than once per year. If you need help with renewing coverage, email or call your case manager at 800.998.1037 and press 1 to enter their extension or select from a directory. Health Journal Winter 2017 5
Pregnancy and vaccinations When you re pregnant, you share everything with your baby. This means when you get a vaccination you aren t just protecting yourself, you are protecting your baby as well. Pregnant women and infants are also more likely to get sick from illnesses like flu and whooping cough. Flu and whooping cough vaccines are recommended for women during each pregnancy to protect you and your baby from these serious diseases. Flu vaccine Pregnant women should receive a flu vaccine once a year as early as possible in the flu season (October May), during any trimester of each pregnancy. Whooping cough vaccine Women should get the whooping cough vaccine (Tdap) in the third trimester (between 27 & 36 weeks) of every pregnancy. This vaccine provides protection against whooping cough, as well as tetanus and diphtheria. Maternal Infant Health Program A new option for prenatal care Now you can ask questions and learn about pregnancy in a comfortable group setting. Centering Pregnancy brings a small group of women, who are due at the same time, together with a provider for their prenatal care. This allows women to discuss common pregnancy concerns, breastfeeding and infant care as a group with a provider. Learn from other pregnant women and be better prepared for all stages of your pregnancy. Ask your doctor how you can sign up for this new option today. The Maternal Infant Health Program (MIHP) is a program for pregnant women and infants with Medicaid. Through this program, a MIHP nurse provides in-home support to women and parents so they have healthy pregnancies and healthy infants. MIHP services include: Free transportation to doctor s appointments, WIC, and childbirth/parent education classes Help getting prenatal care Answers to your questions about pregnancy and caring for your baby Help with health problems that could affect your pregnancy And much more To learn more, visit michigan.gov/mihp 6 Health Journal Winter 2017
Chlamydia screenings Chlamydia is a sexually transmitted disease (STD) that affects both men and women. It is caused by having unprotected sex with someone who is infected with the disease. Chlamydia can cause serious health issues, including infertility in both men and women, and problems during pregnancy. It can also be passed on to infants during childbirth. Chlamydia can be treated with antibiotics and will need to be retreated if repeat infections occur. When should I (and my partner) be tested? If you are sexually active If you or your partner have symptoms, including unusual discharge or painful urination If you or your partner have had Chlamydia in the past Treatment options Antibiotics can cure Chlamydia if taken as directed You can also receive medication for your partner To get tested and learn about treatment options, ask your health care provider or call the Michigan Department of Health and Human Services STD program at 517.241.0870. Additional information is available at michigan.gov/hivstd. A yearly checkup for your medications Immunization reminders Immunizations (shots) help you and your family from getting and spreading serious diseases. Ask your doctor if you and your family are up to date on these shots. Influenza helps protect against the flu, which can be serious for people with chronic illness or for young children. Hepatitis B protects against a liver disease that could be deadly. Human papillomavirus (HPV) protects against HPV, a very common virus that is spread through sexual contact. Some types of HPV can cause cervical cancer. Measles-mumps-rubella (MMR) protects against measles, mumps and rubella. Just as your health can change every year, so can your medication needs. That s why it s important to review your medications each year. With our Medication Therapy Management program, you can meet with a certified pharmacist each year for a comprehensive medication review. During this review, your personal pharmacist will discuss your current medications, make any necessary changes and go over any questions you may have. There is no cost to you and you won t need to switch pharmacies. Plus, you can continue to use any Priority Health participating pharmacy to fill your prescriptions. Signing up is easy. Call your pharmacy and see if they participate with Priority Health. If they do, simply ask them to schedule your review. You can also call the Customer Service phone number on the back of your Priority Health membership ID card. We will help you find a participating pharmacy that is convenient for you. Pneumococcal protects against pneumococcal pneumonia, a lung infection that can be fatal. Tetanus-diphtheria-pertussis booster protects against diphtheria, a bacterial infection that can be fatal. It also protects against lockjaw, a jaw disorder, and whooping cough. Varicella protects against chickenpox, which can be fatal in adults. Health Journal Winter 2017 7
Protecting your privacy Priority Health is committed to protecting the privacy, confidentiality and security of your information. In general, this means your personal information is safe. We will not sell or share your email address, phone number, or any other information about you without your permission. Your health information is safe. If you are a member of one of our plans, we will not discuss your health with anyone online or over the phone unless you give us permission. Learn more about how we protect your privacy at priorityhealth.com/privacy. For questions or concerns, please contact the Priority Health Privacy Department at patient.privacy@ spectrumhealth.org. Protect yourself and your family Some people look for illegal ways to get money from health insurance companies. That s called health care fraud and abuse. Experts estimate that it costs you and all U.S. taxpayers as much as $175 billion dollars each year. Know the signs of fraud and abuse. Fraud Health care fraud is when someone lies to get money they aren t entitled to. Examples include: A doctor bills the insurance company for a service that the doctor did not provide A person receives health care services under someone else s name Abuse Health care abuse is when a doctor provides unnecessary care or patients try to avoid paying their share of the costs. Health care abuse happens when, for example: A person goes to the emergency room for non-emergency services A doctor orders tests or services you don t need Report fraud and abuse If you think you know of this kind of activity, you should report it by doing one of the following. You will not have to give your name, address or phone number. 8 Health Journal Winter 2017
If you suspect fraud, waste or abuse, please contact us in the way that s most convenient for you: Contact Priority Health Call Customer Service at 616.464.8102 or 888.975.8102. Monday Thursday 7:30 a.m. 7 p.m. Friday 9 a.m. 5 p.m. Saturday 8:30 a.m. noon Write: Priority Health Fraud and Abuse Program MS 3175, 1231 E. Beltline NE Grand Rapids, MI 49525 Send email to SIU@priorityhealth.com Call the Compliance Helpline Call 800.560.7013. This thirdparty organization is open 24 hours a day, and they ll report your concern to us. Contact the State of Michigan Call 855.MI.FRAUD (855.643.7283) Visit michigan.gov/fraud and click on Submit an online complaint. Write: Office of Inspector General P.O. Box 30062 Lansing, MI 48909 Health Journal Winter 2017 9
Priority Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Priority Health does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. Priority Health: Provides free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages If you need these services, contact Priority Health customer service by calling the number at the back of your membership ID card (TTY users call 711). If you believe that Priority Health has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex you can file a grievance with: Priority Health Compliance Department Attention: Civil Rights Coordinator 1231 East Beltline Ave NE Grand Rapids, MI 49525-4501 Toll free: 866.807.1931 (TTY users call 711) Fax: 616.975.8850 PH-compliance@priorityhealth.com You can file a grievance in person or by mail, fax or email. If you need help filing a grievance the Priority Health Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at ocrportal.hhs.gov or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 800.368.1019, 800.537.7697 (TDD) Complaint forms are available at hhs.gov/ocr/office/file/index.html 10 Health Journal Winter 2017
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia en su idioma. Consulte al número de Servicio al Cliente que está en la parte de atrás de su tarjeta de identificación de miembro. (TTY: 711). مالحظة: إذا كنت تتحدث العربية فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. يرجى االتصال برقم خدمة العمالء على الجانب الخلفي من بطاقة عضويتك الشخصية. )رقم هاتف الصم والبكم: 711 (. 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請撥打會員卡背面的客服電話 (TTY: 711) ܝ ܐ ) ܡ ܨܝ ܬܘ ܢ ܢܘ ܗ ܪ ܐ: ܐ ܢ ܐ ܚܬܘ ܢ ܟ ܐ ܗ ܡܙ ܡܝ ܬܘ ܢ ܠ ܫ ܢ ܐ ܣܘ ܪܝ ܝ ܐ ( ܐ ܬܘܪ ܩ ܒܠܝ ܬܘ ܢ ܚ ܠܡ ܬ ܐ ܕܗ ܝ ܪܬ ܐ ܒܠ ܫ ܢ ܐ ܡ ܓ ܢ ܐܝ ܬ. ܐ ܢ ܒ ܣܡ ܠܘܟ ܘ ܢ ܩܪܘ ܢ ܠܚ ܖ ܡ ܢ ܢ ܐ ܖܚ ܠܡ ܬ ܐ ܥ ܠ ܡ ܢܝ ܢ ܐ ܖܐܝ ܠ ܗ ܟܬܝ ܒ ܐ ܠܚ ܨ ܐ ܖܦ ܬܩ ܐ ܖܗܝ ܝܘ ܬ ܐ ܡ ܐ ܡܗ ܝ ܪ ܗ ܖ ܡܘ ܬܐ 711). (TTY: ܖܗ ܖ CHÚ Ý: Nếu quý vị nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho quý vị. Xin hãy gọi tới số điện thoại của bộ phận dịch vụ khách hàng có ở mặt sau thẻ ID thành viên của quý vị. (TTY: 711). KUJDES: Nëse flisni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pagesë. Ju lutem kontaktoni qendrën e shërbimit për klient në pjesën e pasme të ID kartës tuaj të anëtaresimit (TTY: 711). 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다. 멤버쉽 ID 카드의뒷면에있는고객서비스번호로전화해주십시오. (TTY: 711) লক ষ য কর ন আপনন ব ল য় কথ বলত প রতল আপন র জনয নন খরচ য় ভ ষ সহ য় সসব স লভ রতয়ত অন গ রহ কতর আপন র সদসযপদ আইন ক ত র সপ তন থ ক গ র হক সসব নম বতর কল কর ন (TTY: 711) UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer telefonicznej obsługi klienta wskazany na odwrocie Twojej legitymacji członkowskiej (TTY: 711). ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienste zur Verfügung. Bitte rufen Sie die Kundendienstnummer auf der Rückseite Ihrer Mitgliedskarte an. (TTY: 711). ATTENZIONE: se parla italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero sul retro della tessera identificativa di membro. (TTY: 711). 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます メンバーシップIDカードの裏面にあるお客様サービスセンターの番号までお電話にてご連絡ください (TTY: 711). ВНИМАНИЕ! Если Вы говорите на русском языке, то Вам доступны услуги бесплатной языковой поддержки. Пожалуйста, позвоните в службу поддержки клиентов по номеру, указанному на обратной стороне Вашей идентификационной карточки участника (телетайп (TTY: 711). OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Molimo nazovite broj službe za korisnike na pozadini vaše članske iskaznice (TTY: 711). Kung nagsasalita ka ng Tagalog,mga serbisyo ng tulong sa wika, ng libre, ay available para sa iyo. Pakitawan ang numero ng customer service sa likod ng iyong ID card ng pagiging miyembro. (TTY: 711). Health Journal Winter 2017 11
1231 East Beltline Ave. NE Grand Rapids, MI 49525 Get the latest news, tips and information. Like us on Facebook or follow @PriorityHealth on Twitter and Pinterest. Get big savings with Member Perks With Priority Health Member Perks, powered by the Benefit Mobile app, we offer our members an easy way to save on national and local brand-name favorites like Target, Amazon, Banana Republic, Groupon, Nike, Starbucks, Whole Foods, Athleta and more, through the purchase of digital gift cards that earn cash back rewards. Every dollar spent within the Benefit Mobile app results in money back in your pocket. Once you earn $10 within a month, you ll get cash back in the form of a check. You can then use that money on your monthly premium, health care expenses or other everyday purchases. You can access information about Member Perks through your MyHealth account or download the Benefit Mobile app. 3001-12 Approved MH12142016 2017 Priority Health 9292B 01/17