Fall 2014 Your Starting Point Our Wellness Portal is the perfect place to begin your path to health - Time for a yearly check-up - Is sleep apnea hurting your health? - Cholesterol by the numbers
ONE TO ONE Health In Your Hands For almost 70 years, Blue Cross of Idaho has provided much more than just health insurance. We believe in giving our 700,000 members the tools to help them make informed healthcare decisions. Today, those tools look a lot different than they did in the 1940s. Our newly refreshed online wellness portal is a great example. With symptom checkers, food trackers and personalized health assessments, it s a convenient and secure way to boost your health and get medical information whether you re on the go or at home. Turn to page 4 to check out all the details. We thank you for being a member and hope you re enjoying all that Blue Cross of Idaho insurance offers you and your family from the freedom to travel with access to reliable coverage to the ability to take control of your own health choices. = term to learn Deductible: A set dollar amount you pay each benefit period (typically 12 months) for covered services before your health coverage begins paying benefits. Deductibles are reset each year. Benefits described in this publication are not a guarantee of coverage. Always check your Blue Cross of Idaho plan description for a list of covered services and costs for your health insurance plan. blue cross of idaho 2
concerned about cholesterol? H igh cholesterol levels cause fatty deposits in your blood. Eventually, these deposits make it difficult for enough blood to flow through your arteries, and that results in your heart not getting enough oxygen. That in turn can increase your risk of coronary heart disease, heart attack, stroke or even death. What are your numbers? A simple blood test is all it takes to check your cholesterol levels. Discuss your test results with your doctor and learn what your numbers mean. You and your doctor can determine the right treatment for you. just the facts on flu Ideal numbers - Total cholesterol: Less than 200 mg/dl - HDL ( good or healthy ) cholesterol: 60 mg/dl or above - LDL ( bad or lousy ) cholesterol: Less than 100 mg/dl - Triglycerides: Less than 150 mg/dl 1. an annual flu vaccine is the best way to help you avoid getting this year s flu. 2. The flu shot cannot give you the flu though some people will experience mild flu-like symptoms. 3. The flu shot is available for free. Call your doctor to schedule a visit. 4. The flu vaccine is available as a shot or as a nasal spray at many locations. medication update The brand-name drugs below have recently been released in a generic form. Generics are a safe and effective way to lower the cost of your medications. Ask your doctor or pharmacist if a generic medicine is right for you. Brand Name Generic Name Medication Use Kapvay ER Clonidine Attention deficit hyperactivity disorder Aciphex Rabeprazole Gastroesophageal reflux disease (GERD) and other stomach conditions Tobi Tobramycin Bacterial lung infections Focalin XR Dexmethylphenidate Attention deficit hyperactivity disorder Solaraze 3% Gel Diclofenac Osteoarthritis Locoid Lipocream Hydrocortisone Skin inflammation Cymbalta Duloxetine Major depressive disorder blue cross of idaho 3
Better Health At Your Fingertips 4 reasons to check out the new and improved online WellConnected wellness portal. W e all strive for good health. Having an active mind and body enables us to enjoy a long and productive life. But sometimes we need a little help along the way. And that s where the online wellness portal can help. Check out four reasons you should visit members. today. 1 WellConnected is a covered service with your insurance. (Yes, that means free!) The wellness portal is available to all of our members at no cost. A health assessment, online workshops, daily health tips and food trackers all for free. 2 WellConnected is personalized. Once you complete a health assessment in the WellConnected wellness portal, you ll get an extensive health summary report as well as wellness score. You ll even get personalized recommendations for improving your health. blue cross of idaho 4
3 WellConnected is convenient. With a variety of online tools and resources and even a mobile app the wellness portal is easy to incorporate into your daily life. Track your health with logs for blood pressure, blood sugar and weight. Log your daily activity or food consumption. It s easy to make the portal a habit when you re on the go or at the office. 4 WellConnected goes beyond the basics. Even if you already have a good handle on your healthy lifestyle, you ll find resources to help you make informed healthcare decisions. The WellConnected health library includes information on prevention, home treatment and when to call a doctor for thousands of symptoms. You ll can also watch health videos and review decision tools about surgeries and medical tests. Get Started with a Health Assessment 1. Go to. 2. select Individual & Family from the drop-down menu under Members. 3. select Log in and enter your username or email address and password. If you re not yet registered, follow the prompts to set up your secure account. 4. From your member home page, find Health & Wellness and select Health Assessment under WellConnected Tools in the dropdown menu. You will be securely linked to the WellConnected wellness portal. To get the most from your health assessment, first visit your doctor and get your biometric measures blood pressure, cholesterol, blood sugar, height and weight. blue cross of idaho 5
sleep, interrupted What you need to know about sleep studies. A new program designed to manage testing and therapy for sleep disorders like sleep apnea supports our commitment to providing the best quality healthcare at the lowest possible cost. Sleep studies range in cost from $2,000 at an outpatient clinic to $500 for a home study. Not all sleep studies are necessary and many members can benefit from convenient and cost-effective home testing instead of a sleep study done in a clinical setting. Beginning Nov. 1, 2014 physicians who order sleep studies must first obtain prior authorization for the services in order to be reimbursed by Blue Cross of Idaho. Services managed under the new sleep testing and therapy program will include: - Home sleep testing (HST) - In-lab sleep study (Polysomnography or PSG) - Positive airway pressure titration study - Initial treatment order automatic positive airway pressure (APAP), continuous positive airway pressure (CPAP), bilevel positive airway pressure (BPAP) - Ongoing treatment order (APAP, CPAP, BPAP) - Oral appliances for sleep therapy The program is administered by AIM Specialty Health, a specialty benefits management company that considers the medical necessity of a sleep study as well as the clinical appropriateness of a facility test or a test done in the home. Prior authorization is required for both sleep testing and subsequent therapy services. The program also monitors treatment to make sure prescribed equipment is used correctly so therapy can be safe and effective. Is Troubled Sleep Putting Your Heath at Risk? Do you awaken throughout the night choking or gasping? You might be suffering from sleep apnea. If you have this condition, your breathing pauses or becomes shallow throughout the night. It leaves you feeling tired and can also increase your risk for obesity, high blood pressure, stroke, diabetes and heart attack. The best way to find out if you have sleep apnea is by talking with your doctor, who may recommend a sleep study. A sleep study is a test that measures how your body responds to changes in your sleep. If your doctor suggests a sleep study, you may be able to have your test at home as long as you don t have a condition that requires it be done in a sleep lab. There are many options for treating sleep apnea. Work with your doctor to figure out the best option for you. blue cross of idaho 6
The Doctor Will See You Now You asked, we answer. Q: Do I really need to see the doctor for a wellness exam once a year? A: Yes. In fact, going to the doctor for a wellness exam might just save your life. Here s why. Many serious diseases can be prevented with early detection and treatment. And early detection starts with preventive care including screenings and tests your doctor will conduct at an annual check-up. Plus, many life-threatening diseases can develop without you knowing it. For example, heart disease can begin with high blood pressure or high cholesterol. But those are not conditions with obvious symptoms. At a wellness exam, your doctor can test your blood cholesterol level and your blood pressure. Here s another good reason for a wellness exam: It s affordable (and much cheaper than a serious illness). A yearly wellness exam is available at no cost to members. Q: What are some questions I should ask my doctor at a wellness exam? - What preventive tests do I need given my age and my personal risk factors? - How often should I get these tests? - When and how (letter, call, email) can I expect my test results? - Who can I talk to about my test results? Q: What is a wellness exam? A: A wellness exam is an appointment with your medical practitioner to discuss your health and go over your current medications. A wellness exam usually involves preventive testing such as cholesterol screening, diabetes screening or a mammogram, to name a few. The best way to stay healthy is to stop illness before it happens, so schedule a check-up with your doctor today. If you need to find a doctor, visit /findaprovider. blue cross of idaho 7
how can we help you today? Here s how to reach us with your questions. We understand that health insurance can seem complicated, and our customer service is happy to answer any questions that come up. Call if you have questions about a claim or your benefits. Or let us know if you want more information about our products or services. Call the number on the back of your member ID to reach Customer Service. If you re a member of a group or individual product, you can reach us between 7 a.m. and 8 p.m. Monday to Friday (except Wednesday mornings when we close 8 8:30 a.m.) and 8 a.m. to noon on Saturday. Blue Cross of Idaho employees can reach us: - 8 a.m. to 6 p.m. on Monday, Tuesday, Thursday and Friday - 8:30 a.m. to 6 p.m. Wednesday All other Individual and Group members can reach us: - 7 a.m. to 8 p.m. on Monday through Friday (closed Wednesday from 8 8:30 a.m.) - 8 a.m. to noon on Saturday 3000 E. Pine Ave. Meridian, ID 83642 PRSRT STD U.S. POSTAGE PAID One to One ID Published by McMurry/TMG, LLC. 2014. 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 healthcare provider. Consult your physician before making major changes in your lifestyle or healthcare regimen. McMurry/TMG, LLC makes no endorsements or warranties regarding any of the products and services included in this publication or its articles. cover: Glenn Oakley/idaho stock images