2009 - Spring

Page 1

Affordable gift idea for the graduate: Page 7

Spring 09

Heart

of Gold

from nurse to patient, Sheila Nettles experiences the other side of caregiving Sheila Nettles gets help from Baptist Health and the Blue — her remarkable story is on Page 4

A publication for the policyholders of the Arkansas Blue Cross and Blue Shield family of companies


INSIDE 3 Out of the Blue 4 Taking women’s cardiac health to heart 8 Jonesboro stays True Blue 12 Weight loss pills warning Lose weight The Healthy Weigh! 13 Don’t be a couch potato! Obesity linked to ovarian cancer 14 Pay your premium by telephone or Web Celiac disease requires lifestyle changes 15 Spring and allergies: Both in bloom 16 ABCs of stress relief Have you used a skin-numbing product? 17 Leaves of three — let them be 19 New law requires members’ SS numbers Surcharges: What and why?

on Page 10 7

Affordable gift idea for the graduate

10 Putting SilverSneakers at the top of his list

20 Fitness Challenge: On the move 21 The Doctor’s Corner 22 From the Pharmacist: Sick with the flu? Stay home! 23 Health Savings Account pharmacy benefit reminder Customer Service telephone numbers

18 Compare hospital costs online

Spring 09

is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health-care professionals and other persons interested in health care and wellness.

24 Good for you

Vice President, Communications and Product Development: Karen Raley Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer: Gio Bruno Photographer: Chip Bayer Contributors: Chip Bayer, Damona Fisher, Kristy Fleming, Jennifer Gordon, Trey Hankins, Heather Iacobacci-Miller, Ryan Kravitz, Kathy Luzietti and Mark Morehead


Out of the

Blue A message from our CEO and President, Mark White

3 As I begin my tenure as president and chief execu-

support so that our members have the information they

tive officer of Arkansas Blue Cross and Blue Shield, I

need to make good decisions in times of illness and to

am mindful of the values on which our company was

live healthier, more productive lives. Our commitment

built. Those values include operating with integrity, mak-

is visible in the service we provide, both through our

ing responsible financial decisions and serving as good

regional offices around the state and by telephone, and

custodians of our members’ trust by providing depend-

in our assurance that our members’ claims are paid

able service and valuable products. Our values have

quickly and accurately.

stood the test of time and will continue to serve our

Arkansas Blue Cross provides peace of mind in

members well in these turbulent times. Although our

difficult economic times. For more than 60 years, we’ve

leadership has changed, our mission and commitment

been part of the health care system in Arkansas. And

to the people we serve have not. We know the economy is tough, and we understand that health care is expensive. At Arkansas Blue Cross, we remain focused on providing the best value in health insurance available in the market today. We honor our commitment to being good stewards of our members’ money through working to build large and

Our values have stood the test of time and will continue to serve our members …

our desire to meet the health-care financing needs of Arkansans in affordable ways has never been stronger. We’ve built our reputation on

affordable provider networks so that our members have

dependability and trustworthiness. We care about your

access to high quality care. This commitment to value

health and your ability to pay for health care when you

drives our focus on providing health information and

need it. And we thank you for allowing us to do so. Blue & You Spring 2009


Taking women’s cardiac health to

heart

4

Sheila Nettles with her four granddaughters: (clockwise from left) Amanda, Alexia, Madison and Kristen. Photo: Cary Nettles

Blue & You Spring 2009


W

orking as a nurse, Sheila Nettles

she sat Sheila down in a wheelchair before she could

thought she was familiar with the signs and symptoms

protest. Once again, tests showed she had a blockage

of cardiac problems, but in 1994 when she arrived at

in the same vessel; this time she needed a stent.

work huffing and puffing from the short walk inside,

Sheila said she never feared for her life — as a

a friend who works in cardiology knew she was more

nurse at Baptist Health she knew she was in great

than out of breath.

hands — and after working for several years in rehabili-

“I didn’t realize I was having heart problems,”

tation, she had watched many patients recover from the

Sheila said, “but when I went in the next day for a

same procedure. She also knew that through Health

stress test, I failed.”

Advantage she had great health insurance coverage.

Sheila’s story is significant because it is so common. According to the National Women’s Health Information Center, among all U.S. women who die each year, one in four dies of heart disease. In 2004, nearly 60 percent more women died of cardiovascular disease (both from heart disease and stroke) than from all cancers combined. Sheila, who was 51 at the time, was scheduled for angioplasty in one vessel and quickly slid back into her routine. She didn’t immediately make any lifestyle changes, thinking it was a small bump in her life’s journey and that she was “probably good to go.” Sheila was working in Oklahoma when she had the angioplasty but jumped at the opportunity to move back home to Little Rock in 2002, and join the nursing team at Baptist Health Medical Center. Her sons live in central Arkansas, and she was excited to spend more time with her granddaughters. As part of her move, Sheila switched insurance to Health Advantage, one of the companies under the Arkansas Blue Cross and Blue Shield umbrella. Soon after her move however, she started having a similar, but different, feeling in her chest. “This time there was more pain,” she said, though not enough to make her panic. “It wasn’t a crushing pain, just a feeling — almost like a pinching sensation.” Sheila had become friends with a cardiology educator in the office next to hers, and she casually mentioned the strange feeling in her chest. Calmly, her friend suggested they go to the emergency room, and

And, she felt “completely at ease” with Gary Collins, M.D., the cardiologist who performed the procedure.

“Treating the heart means treating the

whole body,” Dr. Gary Collins said. “Treating the heart means treating the whole body,” Dr. Collins said, a philosophy that has gained Baptist Health the designation of a Blue Distinction Center for Cardiac Care® by Blue Cross and Blue Shield plans nationwide and the Blue Cross and Blue Shield Association. “We’re a multi-disciplinary medical center, so we have different specialists available at any given moment,” he said, adding that heart patients may need additional care for diabetes, gastrointestinal disorders or respiratory issues. The Blue Distinction Centers for Cardiac Care® program is designed to measurably improve the way health care is accessed and delivered. When Health Advantage members, like Sheila, have access to excellent health care, it means better results for her. It also gives her the information she needs when making a decision about where to have a surgery or procedure. When a hospital has been designated a Blue Distinction Center, you know they have expertise in that specialty. Cardiac, continued on Page 6

Blue & You Spring 2009

5


Sheila Nettles (left and inset) contemplates the statue in front of Baptist Health Medical Center depicting a helping hand to someone in need.

cedures. Dr. Collins said patients like Sheila are coached on their eating habits, checking their cholesterol and blood sugar, and stopping smoking. Members of Arkansas Blue Cross, Health Advantage and eligible members of BlueAdvantage Administrators of Arkansas can get help taking care of their heart through our free Cardiovascular Education Program in HealthConnect Blue accessed through My Blueprint, our self-service center on the Web. After her second procedure, Sheila joined a weightloss program through Baptist Health and changed her

“Women … tend to put off Cardiac, continued from Page 5

6

For Dr. Collins, this means Baptist Health takes cardiac patients that other hospitals turn away because those hospitals don’t have the facilities or staff available to handle the possible complications. And, he said, Baptist has a record of providing medical care faster to heart patients than many other hospitals, which is

going to the doctor when we don’t feel well … ,” Sheila said. “Don’t wait — get it checked out.”

critical to saving heart muscle tissue during and after a

eating habits. She also started sharing with her younger

heart attack.

sisters and girlfriends about the importance of heart

In order to become a Blue Distinction Center, a hospital must meet high quality standards established by an expert panel of physicians, surgeons and other

health. As her granddaughters grow, she said she will be sharing that message with them as well. “Women need to pay attention to their health be-

health-care professionals. When hospitals meet these

cause we tend to put off going to the doctor when we

standards, they demonstrate better outcomes for their

don’t feel well but can’t put a finger on what is wrong,”

patients.

Sheila said. “Don’t wait — get it checked out.”

Other medical centers designated as Blue Distinction Centers for Cardiac Care® in the Arkansas Blue Cross and Blue Shield service area include CHRISTUS St. Michael Health System in Texarkana, Texas, and St. Bernards Regional Medical Center in Jonesboro. Baptist Health Medical Center continues to follow patients as they go through rehabilitation and preventive therapy to keep their hearts healthy after their proBlue & You Spring 2009

Signs of heart trouble Common to men and women: Chest or arm discomfort, shortness of breath, dizziness, nausea, abnormal heartbeats or feeling very tired. Women may also have: Heartburn, loss of appetite and coughing.


Affordable gift idea for the graduate Your son or daughter (or maybe grandchild) is about to graduate from college and you are struggling with a practical gift idea for the new graduate. Although he or she already may have an iPhone and a laptop, he or she may soon be without health insurance. After college, many young people “age off” their parents’ insurance policy and have not yet found a job that offers

Short-Term Blue is a

account information if you want to pay for it). 4. There are only a few quick and easy eligibility questions to answer. 5. The policyholder will have access to more than 6,700 doctors and hospitals. 6. The graduate must live in Arkansas. 7. This policy will cover any unexpected illnesses, diseases or accidents. It does not cover pre-existing

group coverage. That’s where you

great idea for

come in, and we can help.

anyone who is

excluded benefits and more information can be

temporarily

found online at arkansasbluecross.com.

Arkansas Blue Cross and Blue Shield offers an individual health plan, Short-Term Blue, for anyone

uninsured.

who is temporarily uninsured. Here’s the best news about this plan — it’s very affordable! Other important information about Short-Term Blue: 1. Short-Term Blue has no monthly premium — you make one non-refundable payment for the term of the policy (if you apply online, you can use your

conditions or prescription drugs. Covered benefits,

8. If the policy ends while the covered member is hospitalized, he or she may be eligible for an extension of benefits. We know you want to make sure the new graduate has one less thing to worry about while searching for a job; this gift will show your thoughtfulness as well as give him or her some peace of mind. And, Short-Term Blue is a great idea for anyone

credit card, or have the premium drafted from your

who is temporarily uninsured -— whether you are be-

bank account).

tween jobs, working part-time, recently retired and not

2. Coverage can be for a minimum of 30 days up to a maximum of 182 days. 3. The graduate can apply online (remember, the gradu-

yet eligible for Medicare, or a new employee temporarily without coverage. For more information about Short-Term Blue, visit

ate must complete the application and provide bank

arkansasbluecross.com or call 1-800-392-2583 or your

draft or credit card information at the time of the

local independent or Farm Bureau agent.

application — although you can give him or her your Blue & You Spring 2009

7


Jonesboro stays True Blue 8

J

onesboro may be the home of the Arkansas State

The city has more than 500 full-time employees, but

University Red Wolves, but the city has been true Blue

when you add the employees at the library, airport and

since 1975 — that’s the year city employees enrolled

housing authority — who also are covered in the ac-

with Arkansas Blue Cross and Blue Shield for group

count — the membership roll is more than 600.

health insurance coverage. And, according to Jonesboro Mayor Harold Perrin, the city could not be more pleased. “Because we are a government entity, we have to bid our health insurance,” said Perrin, who served for 15

“And,” added Gloria Roark, director of Human Resources for the City of Jonesboro, “the city also offers several products through USAble [Life].” Since 2000, a big part of the customer service city

years on the city council before moving into the mayor’s

employees have come to appreciate is the Northeast

office on Jan. 1, 2009. “And over the years, Arkansas

Regional Office, located a few blocks from downtown

Blue Cross has come in with the low bid. I can’t remem-

Jonesboro.

ber them ever being outbid. In addition, the service they

“Arkansas Blue Cross has worked closely with the

provide is great. They service the account, and service

City of Jonesboro’s leadership and membership over

is something I look at closely. As mayor, I’ve got to take

our long relationship,” said Connie Meeks, M.D., medi-

care of my people.”

cal director of the Northeast Regional Office. “Since the

Blue & You Spring 2009


Gloria Roark, director of Human Resources for the City of Jonesboro, and Jonesboro Mayor Harold Perrin both cite value and superior customer service as reasons the city has been a group member with Arkansas Blue Cross and Blue Shield since 1975.

regional office was estab-

“I call programs like that an ‘extra-

lished we have been able

plus’,” said Perrin. “Providing seminars about health and wellness, and the dia-

to provide even more value with local initiatives.” Through the regional office, Arkansas Blue Cross has offered regular onsite benefit meetings at all city

betes program in particular — they don’t have to do that.” Jonesboro currently is participating in the newly or-

locations — including City Hall, Public Works, the Fire

ganized employer alliance, Community HealthCheck, the

Department and the Police Department — during and

goals of which include improving the quality of health of

after work hours.

employees and members in the community.

“We take advantage of the opportunity to help

“Having Arkansas Blue Cross here is not just good

members with any questions, but also, we are able to

for the City of Jonesboro, it’s good for our citizens as

educate them about new health information and well-

well,” said Perrin. “It helps Jonesboro, trust me. It’s a

ness tools like HealthConnect Blue.”

great selling point for economic development in Jones-

In fact, Jonesboro has been participating in the Diabetes HealthCheck program since its inception in 2005.

boro. We are the medical community in Northeast Arkansas and Arkansas Blue Cross is a big part of that.” Blue & You Spring 2009

9


Putting

SilverSneakers at the top of his list

10

After losing his footing, Aubrey Scott fell 10 feet to the ground. Blue & You Spring 2009


A

sk Aubrey Scott about

Margaret, also 86, are just enjoy-

the top of our head to the soles of

exercise and he’ll tell you, “It’s on

ing time with friends, they also are

our feet,” Aubrey said of the Sil-

the top of my list today.” But when

preventing disease, improving their

verSneakers professional fitness

he fell from the top — to the bottom

mental health and acuity, increasing

trainer at the center. Instructors in

— of a 10-foot ladder, Aubrey found

cardiovascular endurance, improving

the SilverSneakers Fitness Program

out just how important his exercise

muscle strength and gaining flexibil-

are certified and receive in-depth

regimen with the SilverSneakers

ity through greater range of motion.

training in providing exercise that

Fitness Program through Arkansas

And that can add even more years

is specific to the needs of seniors.

Blue Cross and Blue Shield really is!

to the 61 they already have enjoyed

Aubrey said Kara “provides a per-

together.

sonal touch” to the program. He and

Aubrey, 86, was referred to SilverSneakers at the Northeast

All his physical agility was put

Margaret enjoy the classes so much

Arkansas Wellness Center in Jones-

to the test recently when Aubrey

that they have asked for additional

boro, by his long-time friend and

decided to climb the ladder to his

classes to be offered. “It is a very

physician, Ray Hall, M.D., in January

son’s attic. After losing his foot-

beneficial program for maintaining a

2008. All Medi-Pak and

ing, he fell 10 feet to the

level of fitness year round, especially

Medi-Pak Advantage

ground. Shaken, Aubrey

when the weather may prevent

members are eligible

and Margaret immediately

outside activities.”

for this free exercise program.

went to the doctor to as-

To enroll in SilverSneakers,

sess his injuries, fearing the worst.

Medi-Pak and Medi-Pak Advantage

It didn’t take long before Au-

Instead, he was delighted to hear he

members can go to a participating

brey was participating in the muscle

had no injuries at all. Aubrey said he

fitness center near them and

strength and range-of-motion class

feels certain his active lifestyle and

show their ID card. Participating

and joining the free-form activities.

participation in the SilverSneakers

locations in Arkansas can be found

Even walking at the center gives him

Fitness Program made all the differ-

at silversneakers.com. The Fitness

a chance to catch up with old friends

ence in the outcome of his fall.

center staff will assist with enroll-

and make new ones. And while it may feel as if he and his wife,

“Kara Phillips does a wonderful job of keeping us very active from

ment and provide tours of the locations.

Aubrey Scott said he feels certain his active lifestyle and participation in the SilverSneakers

Fitness Program made all the difference in the outcome of his fall.

Blue & You Spring 2009

11


Weight-loss pills

g n i n r a w

The U.S. Food and Drug Admin-

12

istration (FDA) is seeking a recall on weight-loss pills that could potentially pose serious health risks to consumers. Some products being touted as “dietary supplements” claiming to be “natural” or containing “herbal” ingredients actually

Lose weight The Healthy Weigh! The Healthy Weigh! Educa-

After enrollment,

contain “undeclared, active phar-

tion Program is free for members

you will begin to receive

maceutical ingredients that may put

of Arkansas Blue Cross and Blue

information through the

consumers’ health at risk.” The FDA

Shield, Health Advantage, Blue

mail, which you can read

is urging consumers to not purchase

Cross and Blue Shield Service

in the privacy of your

or take these weight-loss pills due

Benefit Plan (Federal Employee

own home and at your

to health risks such as high blood

Program), and eligible members

own pace. The program

pressure, seizures, or even heart

of BlueAdvantage Administrators

is completely voluntary,

attack or stroke. Just one more rea-

of Arkansas.

and you may leave the

To enroll, complete the at-

program at any time. If

tached enrollment form and return

you have further ques-

it in the self-addressed, postage-

tions about the program,

ing recalled, visit the FDA’s Web

paid envelope included in this

call the Health Education

site at www.fda.gov/bbs/topics/

magazine. The program starts

Program’s toll-free num-

NEWS/2008/NEW01933.html.

when you enroll.

ber at 1-800-686-2609.

son to lose weight the natural and healthy way. For a full list of products be-

Blue & You Spring 2009

Simply complete, sign and return the attached enrollment form in the selfaddressed, postagepaid envelope.


Don’t be a couch potato! If your husband or son or father is overweight, we know he has a risk factor for heart disease. However, most people may think that just a few extra pounds is OK. Not true. A study, recently published in the medical journal, Circulation, showed that a few extra pounds along with inactivity raises the risk of heart failure in men. As much as two thirds of the adult population are overweight, if not obese. Basically, the study showed that it doesn’t matter if you are an overweight couch potato or a lean couch potato, exercise could extend your life.

Obesity linked to ovarian cancer A new study suggests a link between obesity in women and ovarian cancer, which is the fifth leading cancer of U.S. women. Researchers found that obese women were 26 percent more likely to develop ovarian cancer than those at a healthy weight, but that figure increased to 80 percent for obese postmenopausal women who never used hormone replacement therapy. The findings suggest that obesity increases the risk of ovarian cancer through hormonal effects. The major implication is a familiar one — maintaining a healthy weight is important. Source: Medline Plus Blue & You Spring 2009

13


Pay your premium over the telephone or on the Web!

Making your payment just got easier.

If you have an individual or family policy (not through an employer) with Arkansas Blue Cross and Blue Shield, we now offer two convenient and secure ways to pay your premium.

b. Visit (or register for) the member self-service

center (My Blueprint).

c. Select “Pay Premiums Online” and follow the

1. You can call Customer Service at 1-800-238-8379, and a representative can take your payment information over the telephone.

instructions. If you have any questions about either of the pre-

mium payment options, please call Customer Service

2. Or, you can pay your premium online for free:

14

a. Go to arkansasbluecross.com.

at 1-800-238-8379.

Celiac disease requires lifestyle changes

Does someone you know have an upset stomach

• Behavior changes/depression/irritability

that won’t settle down? He or she may want to get

• Vitamin K deficiency

checked for celiac disease. Celiac disease is a lifelong,

• Canker sores, tooth discoloration or loss of enamel

autoimmune disorder that causes the body to attack

Because celiac disease is chronic, the only treat-

itself when a person eats foods that contain a protein

ment is a gluten-free diet. Adapting to the gluten-free

called gluten. Gluten is found in wheat, rye, barley and

diet requires some lifestyle changes. It is essential to

many other grains. If celiac disease is left untreated, dam-

Celiac disease can

age to the small bowel can be

be chronic and

chronic and life threatening. Symptoms of celiac disease may include: • Recurring bloating, gas or

life threatening.

abdominal pain • Chronic diarrhea or constipation with pale, foul-

read labels and learn how to identify foods that are gluten free. (Potential harmful ingredients include starches, binders, fillers and malt.) Gluten also may be used as a binder in some pharma-

ceutical products. You can ask your pharmacist for help in identifying medications that contain gluten.

smelling stool • Unexplained weight loss or gain • Anemia, fatigue, weakness or lack of energy • Bone or joint pain Blue & You Spring 2009

Source: National Institutes of Health


Spring and allergies: A seasonal allergy is essentially an

allergic reaction to something that is only present for part of the year.

steps can help a great deal in reducing your exposure to pollen and its

BOTH IN BLOOM The warm winds of spring usu-

is essentially an allergic reaction

ally are a welcomed respite after a

to something that is only present

long, cold winter. But those bloom-

for part of the year — usually in

ing flowers and trees, while provid-

the spring or fall. In the spring, the

ing a colorful relief from gray skies,

culprit is almost certainly pollen — a

also bring something else.

powdery grain released from flower-

Allergies. It is estimated that almost

ing plants. In a state like Arkansas, known

40 million Americans suffer from

for its natural beauty, the potential

seasonal allergies — what we often

for large amounts of pollen in the

refer to as “hay fever.” This results

air during the spring and summer

in approximately 8 million annual

months is rather high.

visits to the doctor and billions of dollars spent on medications. U. S. companies always report higher absenteeism during the spring, as a direct result of allergies. So, what exactly causes all this fuss? It can be any number of things. But a seasonal allergy

What’s a person to do? If your allergies are severe, an allergist can help you determine which allergens affect you the most. In some cases, allergy shots are necessary to alleviate symptoms. In most people, however, some simple

ill effects. • Keep windows closed to prevent pollen from getting in your home. • Keep car windows closed while driving. • Stay indoors when the pollen count is expected to be high. • Avoid early-morning outdoor activity. Pollen is usually emitted between 5 and 10 a.m. • Take a vacation to somewhere with less pollen, like the beach, during the height of the pollen season. • Machine dry your laundry. Pollen collects on laundry that is line dried. Springtime allergens are inevitable. But you can fight back. Sources: Centers for Diseases Control and Prevention, U.S. Department of Health and Human Services

Blue & You Spring 2009

15


f e i l e r s s e r t s ABCs of avoid it. Unfortur lives. It’s impossible to We all have stress in ou alth. While we negative affect on our he a ve ha n ca s es str ch nately, too mu e s we can do to help reliev ng thi me so be y ma re can’t avoid it entirely, the ember your ABCs. stress in our lives. Just rem

A

” and cutting down e by learning to say, “no, ibl ss po en wh s es str • Avoid list. that out-of-control to-do ge ever ything. angeable – you can’t chan ch un or le ab oid av un • Accept the expectations. • Adjust unreasonable

B

16

s the stressful ep breath; then, reasses de a e tak d an op St — • Breathe lp you eathing exercises can he Br e. tiv ec rsp pe er lm ca situation from a uce your heart rate. to refocus, relax and red joy like to do something you en e tim ide as g ttin se by • Be kind to yourself end. gazine or talking with a fri ma or ok bo a g din rea taking a walk,

C

ing finding the positives or tak by de itu att d an ns tio cta • Change your expe m. a new look at the proble always expecting ddle ground rather than mi a g din fin by ise rom • Comp ers. change to come from oth d WebMD s Woman’s University an Source: Helpguide, Texa

y Bluep Relax® program behind M the t ou k ec ch s, es str at For more ways to be

rint on our Web sites.

Have you used a skin-numbing If you have used a skin-numbing product, take

coma or death. So what are they? Skin-numbing products, or topi-

note — according to the

cal anesthetics, are used to numb the surface of the

U.S. Food and Drug Admin-

skin. Trained medical professionals frequently use them

istration (FDA), they may

in medical procedures, but they also may be used in

cause serious side effects

cosmetic procedures or used to relieve pain, burning or

including irregular heartbeat,

itching due to a variety of medical conditions. They are

seizures, difficulty breathing,

available with a prescription and over the counter. They

Blue & You Spring 2009


Leaves of three let them be “I don’t know how I got poison ivy.”

Well, it’s probably easier than you think. Did you give your dog a hug after he came in from the backyard? Take a hike down a local trail? Burn some brush and sticks while on a camping trip? Poison ivy, oak or sumac can be just about anywhere, and it sticks to everything. If you have ever had a case of the infamous itch, you know you want to avoid it. Poison ivy, sumac and oak contain an oil called urushiol (you-ROO-shee-all). When this oil touches the skin, many people develop an allergic reaction that causes a rash. The best way to prevent an allergic reaction is to be able to recognize these plants — and then avoid them — when you see them in the woods or in your backyard.

Poison ivy

Poison sumac

Poison oak

17 If you accidently come in contact with one of these plants, wash your skin well with lukewarm water and soap. All clothing should be laundered, and everything else that may be contaminated with urushiol should be washed thoroughly. Urushiol can remain active for a long time. For mild cases, cool showers and an over-the-counter product that eases itching can be effective. Oatmeal baths and baking-soda mixtures also can sooth the discomfort. When a severe reaction develops, contact your physician or dermatologist. Prescription medication may be needed to reduce the swelling and itch.

product? contain anesthetic drugs such as lidocaine or benzo-

• Apply to broken or irritated skin

caine and come as creams, ointments or gels that are

• Wrap treated skin with plastic or other dressings

applied to the surface of the skin and then absorbed

• Apply heat from a heating pad to treated areas

into the blood stream. According to the FDA, with topical anesthetics, you

As with any medication, remember to use only as directed.

should not: • Apply heavily over large areas of the skin

Source: U.S. Food and Drug Administration

• Use formulas stronger than necessary

Blue & You Spring 2009


Compare

hospital costs online

18

Your husband’s doctor has recommended surgery

sites (see complete list on Page 23) and select “Com-

or a procedure that requires he spend time in the hospi-

pare hospital quality.” This will allow you to compare

tal. So you may want to compare the quality of the care

hospitals in your area. With this tool (WebMD Hospital

that different hospitals have provided for the recom-

Advisor), members may compare how the hospitals se-

mended surgery or procedure. There are differences

lected have performed when treating other members of

between hospitals, and Arkansas Blue Cross and Blue Shield can provide you with information on how hospitals perform. You may want information on how many pa-

the health plan or when treating those on Medicare. The “Cost” category represents the amount a hospital may be paid by the health plan in comparison to other hospitals in the state. This category

tients have been admitted for this surgery, or the

does not represent the amount you pay. The

number of deaths or complications related to this

hospitals are rated by the following categories —

surgery at this hospital, or how many days someone who had this surgery remained in the hospital. And now, if you are looking for cost information related to this type of surgery, it also is available online. To get this information and much more, visit the member self-service center (My Blueprint) of our Web Blue & You Spring 2009

Low Cost, Average Cost and High Cost — in comparison to other hospitals. Visit our Web site and you’ll find hospital information you need to help you make informed decisions about your health care and the health-care needs of your family.


New law requires members’

Social Security numbers

federal health coverage reporting

BlueAdvantage Administrators of

law came into effect that re-

Arkansas asking for Social Secu-

quires health insurers and third-

rity numbers for you and/or your

party administrators to provide

dependent(s). Simply write in the

Social Security numbers from

information and return the letter

members of group health plans

using the enclosed postage paid

to the Centers for Medicare and

envelope by the date requested. Arkansas Blue Cross (and its

information will allow Medicare

family of companies) is commit-

to properly coordinate payments

ted to your privacy and holds

with other health plans and/or

your information in complete

workers’ compensation benefits.

confidence. In accordance with applicable laws, including the

110-173, also known as the

Privacy Act of 1074 and the

Medicare, Medicaid and SCHIP

Health Insurance Portability and

Extension Act of 2007, requires

Accountability Act Privacy Rule,

group health plans, insurers,

CMS also maintains your confi-

third-party administrators and

dentiality.

plan administrators or fiduciaries

We appreciate your assis-

of self-insured/self-administered

tance in providing this informa-

group health plans to report infor-

tion. Please call the Customer

mation required for purposes of

Service number for your health

coordination of benefits.

plan listed on Page 23 if you

Because of this law, you may receive a letter in the mail from Arkansas Blue Cross and

If you have applied for Arkansas Blue Cross and Blue Shield individual charge” on your policy. A surcharge is

Blue Shield, Health Advantage or

Section 111 of Public Law

What and why?

coverage, you may have noticed a “sur-

On Jan. 1, 2009, a new

Medicaid Services (CMS). This

Surcharges on individual and family policies:

have any questions.

an additional cost added to your premium for a medical condition (for example, high blood pressure, high cholesterol, allergies, etc.). Offering affordable health insurance is important at Arkansas Blue Cross. One way we reduce the cost of individual health insurance is to underwrite applicants. Underwriting allows us to assess the potential for risk associated with each applicant. If an applicant is high risk, we have three options: 1. Charge a higher premium. 2. Exclude the condition that has increased the risk. 3. Decline to offer coverage. We use the first two options when necessary and only decline coverage as a last resort. Sometimes, the only way we can offer coverage is to add an additional cost (surcharge) to the premium. For more information about individual and family insurance plans (for those under age 65 and not covered by Medicare), visit arkansasbluecross. com or call 1-800-392-2583 or your local independent or Farm Bureau agent. Blue & You Spring 2009

19


The Blue & You Fitness Chal-

ernment agencies — are ranked by

Arkansas in recognition of the con-

lenge is in full swing after a record

size for the competition. At the end

test in a decree that was unveiled at

205 groups (with an eligible popula-

of the contest, winners will be an-

the contest kickoff.

tion of more than 110,000 partici-

nounced in each group size catego-

pants) from throughout the United States have pledged to “invest in fitness” for 2009. “Exercise requires only a small investment of time and movement and promises a great rate of return on your health,” said Richard Cooper, vice president of Human Resources and team champion for Arkansas Blue Cross and Blue Shield. “More than 110,000 Ameri-

20

More than

Didn’t get signed up this year? Watch groups as they progress in real time at BlueAndYouFitnessChal-

110,000

lenge-ark.com this year and plan to

eligible

Special note: Before beginning any

participants

be part of the fun in 2010.

exercise program, always consult your physician.

for 2009.

cans are eligible to make a move

ry. Groups whose participants have

toward better health by participating

the greatest participation and

in the Challenge this year.”

score the highest in

This is the sixth year for the Challenge, which is hosted by Arkansas Blue Cross, the Arkansas

four categories of measurements

Department of Health and the Ar-

will be the overall winners of the

kansas Department of Human Ser-

Blue & You Fitness Challenge.

vices. The exercise contest encour-

Governor Mike Beebe

ages participants to work toward

declared February 24 as “Fit-

the public health recommendation

ness Challenge” day in

of adult physical activity 30 minutes each day, most days of the week. Groups — representing large and small companies, banks, schools and universities, physician offices, churches, hospitals and gov-

On the move

with the Fitness Challenge

Blue & You Spring 2009


The

Doctor’s

Corner

Free drug samples come with a cost. Has your doctor ever given you a free sample of a medication? Probably. Your doctor gets those samples from the pharmaceutical companies as a way to advertise their products. However, a new study shows that these samples may not be such a good deal for you. Pharmaceutical companies usually provide samples of the most expensive medications. On average, people who receive free samples spend 50 percent more on medications than those who receive a prescription for a less expensive medication. So, go ahead and be thankful for those free samples — just remember to ask your doctor if there is a less expensive alternative when the sample runs out.

Colonoscopies and PSAs after age 75? The U.S. Preventive Services Task Force, the most respected preventive health organization in the country, recently recommended against receiving a screening colonoscopy after age 75. The Task Force also recommended that men above age 75 no longer receive the PSA (prostate-specific antigen test). The Task Force believes that the risks associated with screening and follow-up testing and treatment of abnormal results cause more harm than good after that age. In addition, the Task Force recommended that men younger than 75 ask their doctors about the potential risks and lack of evidence for PSA screening. Take your Vitamin D! Is Vitamin D the new wonder drug? According to several studies, Vitamin D seems to play an important role not only in bone formation but many other things. A recent study in the Archives of Internal Medicine has shown that Vitamin D deficiency is linked to an increased risk for coronary artery disease, several types of cancer, migraine

by Ray Bredfeldt, M.D., Regional Medical Director Northwest Region, Fayetteville

headaches, epilepsy, chronic pain, and inflammatory bowel disease.

Arthritis of the knee? Surgery may not be the best bet. Arthroscopic surgery into the knee joint to remove debris from the knee is a common procedure for people with degenerative arthritis. The hope is that knee pain will improve after the debris is removed. Each year in the United States, several hundred thousand arthroscopic surgeries are performed for this reason. However, a recent study in the New England Journal of Medicine reported that the people who had the surgery along with medication and physical therapy did not have a better outcome than those who only received medication and physical therapy. The surgery appears to add no benefit but does add unneeded risk and cost.

Blue & You Spring 2009

21


Sick with the flu? Stay home! or flu, which can be easily spread.

to infect others from the day before

this year, but don’t be fooled; chanc-

CCH is a leading provider of human

their symptoms develop, to five

es are we still will get our fair share

resources and employment law

days after becoming sick.

of sore throats, aches and fever.

information and services.

The flu season got a slow start

If you haven’t already gotten

of us the ability to work from home

one, it isn’t too late for a flu shot.

up for work, known as “presentee-

if needed. If you simply can’t stay

The Centers for Disease Control and

When sick employees show up for work, known as

away from the office, here are some

Prevention (CDC) recently said that the 2008-09 vaccine is effective in preventing or reducing the severity of illness with currently circulating flu viruses. The CDC also warned, however, that the flu virus circulating this year is resistant to the

22

When sick employees show

Technology today allows many

antiviral medication oseltamivir, also known as Tamiflu, but that other

So, as a pharmacist, what’s the

• Avoid high-traffic areas in your building where your co-workers may come in contact with you.

“presenteeism,” • Do as much communication as there is a significant and costly impact on an organization.

possible by telephone and e-mail. Shut your office door to keep out visitors. • Cover your mouth and nose when you sneeze or cough.

antiviral medications are working against the virus.

ways to stop the spread of germs:

ism,” there is a significant and costly impact on an organization, not only

• Clean your hands often and use antiseptic lotions. • Avoid touching your eyes, nose

best advice I have if that weak, achy

in terms of risking the spread of

feeling starts to hit you? Stay home!

disease, but also in terms of di-

And don’t think your boss will be

minished productivity, quality and

mad if you do. According to the

attention to safety. Overall, the CCH

Sources: The Centers for Disease

2007 CCH Unscheduled Absence

Survey found that 38 percent of em-

Control and Prevention, CCH

Survey, 87 percent of employers

ployers report presenteeism being a

report that sick employees who

problem in their organizations.

show up to work are suffering from short-term illnesses such as a cold

or mouth.

The CDC estimates that individuals who get the flu may be able

From the

Pharmacist

by Brandon Griffin, Pharm D., Arkansas Blue Cross and Blue Shield

Blue & You Spring 2009


We love to hear from you! May we help? For customer service please call:

Health Savings Account

pharmacy benefit reminder

Little Rock Number (501)

Medi-Pak members

378-3062 1-800-338-2312

Medi-Pak Advantage or Medi-Pak Rx Arkansas Blue Cross members

378-2010 1-800-238-8379 1-800-863-5561

Specialty Rx Pharmacy questions

1-866-295-2779

378-2363 1-800-843-1329

Pharmacy questions

ductible Health Plan through Health Advantage? If you do, you might not realize that you are eligible for network discounts at your pharmacy. Also be sure your pharmacy submits your claims through your insurance so that they can be applied to your deductible. There are a few pharmacies that have not submitted claims to the insurance companies because the pharmacist has stated that he/she could offer a better cash price than what the insurance company would otherwise allow. However, when a pharmacy offers a price lower than what your insurance normally charges, they still should send the cash price to the insurance company as the submitted cost. If your pharmacist informs you that your medication would cost less if you paid cash without running the claim through your insurance, please ask him/her to submit the cash price to the insurance company. If the cash price is less than what we would normally allow, then the claim system will only charge you the cash price (the lower price). Running the claim through insurance also allows the paid amount to be applied to your deductible. If your pharmacy refuses to submit their cash price to your insurance company, please contact your insurance company’s customer service department so that this situation can be remedied.

1-866-390-3369

Pharmacy questions Health Advantage members

Do you have a Health Savings Account High De-

Toll-free Number

BlueAdvantage members

1-800-863-5567

378-3600 1-888-872-2531

Pharmacy questions

1-888-293-3748

State and Public School members 378-2364 1-800-482-8416 Federal Employee members

378-2531 1-800-482-6655

Looking for health or dental insurance? We can help! For individuals, families and those age 65 or older

378-2937 1-800-392-2583

For employer groups 378-3070 1-800-421-1112 (Arkansas Blue Cross Group Services, which includes Health Advantage and BlueAdvantage Administrators of Arkansas) Prefer to speak with someone close to home? Regional Office telephone numbers: Pine Bluff/Southeast Region 1800 West 73rd St. Jonesboro/Northeast Region 707 East Matthews Ave. Hot Springs/South Central Region 100 Greenwood Ave., Suite C Texarkana/Southwest Region 1710 Arkansas Boulevard Fayetteville/Northwest Region 516 East Milsap Rd., Suite 103 Fort Smith/West Central Region 3501 Old Greenwood Rd., Suite 5 Little Rock/Central Region 320 West Capitol Ave., Suite 900

Web sites:

1-800-236-0369 1-800-299-4124 1-800-588-5733 1-800-470-9621 1-800-817-7726 1-866-254-9117 1-800-421-1112

arkansasbluecross.com healthadvantage-hmo.com blueadvantagearkansas.com blueandyoufoundationarkansas.org blueannewe-ark.com

Blue & You Spring 2009

23


At Arkansas Blue Cross and Blue Shield, we are always looking for new ways to be "Good for You." Here are some of our latest accomplishments.

24 Our news is good news

We're in your neighborhood!

Visit “Newsroom” on arkansasabluecross.com for all

Help is right around the corner when you need it. Visit

the latest news from Arkansas Blue Cross and Blue

one of our local regional offices when you need help

Shield. Plus, find company information, photos and

right away. (A complete list of addresses and telephone

bios of our executives, key statistics and information

numbers is on the inside back cover.) We’re here

about how we are good for you!

for you!

Looking for insurance?

Spring Break plans?

Visit our Web sites under “Looking for Insurance?” and

As a member of an Arkansas Blue

find insurance to meet the needs of you and your fam-

Cross and Blue Shield health plan,

ily. We have Medicare plans if you are aging into those

your ID card is your link to coverage

plans, individual plans if your company no longer offers

and doctors and hospitals through-

health insurance, and employer health plans and dental

out the United States when you are traveling. If you

plans. Call us at 1-800-421-1112 to help you find a plan

are traveling out of state and need medical care, call

that fits your needs and budget.

1-800-810-BLUE (2583) to find the name of the nearest participating hospital. (If it is an emergency, go directly to the nearest hospital’s emergency room.) OR, before you travel you can go online to our Web sites to access the BlueCard Doctor and Hospital Finder through the Provider Directory.

Blue & You Spring 2009


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