The Mix - March 2016 - Family Health Plan Edition

MARCH-APRIL

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A Blend of Tips So You Can Be Your Best

Spring into

Healthcare Coverage

Stay up to date on pharmacy news Find out if you qualify for free rides to the doctor Get to know a fellow member

Mix in Some Healthcare Coverage Knowledge The Mix, our newsletter for Health Alliance Connect Medicaid members, reminds you it’s always a great time to connect to the care you need and use your benefits to their fullest.

Spring into The Mix with: Reminders and updates about your pharmacy coverage

Ride eligibility basics

Health tips for your kids

A touching story from a fellow member

Mix in Health

1

Health Alliance Connect helps make sure you get the care you need from start to finish. That means you’ll have a primary care physician (main doctor, also called PCP) who focuses on all your health needs. And you might be eligible for other services and support to help you meet your goals. Plus, all your health records stay in one place.

Have a Question?

Question?

Call Us. Us. Have a Question?

Have a Call • Hours: Monday through Friday, 8 a.m. to 8 p.m.

• 1-877-633-2526, Monday through • Hours: Monday through Friday, 8 a.m. Friday, to 8 p.m.

• ICP-Medicaid: 1-877-933-8480 8:30 a.m. to 5 p.m. TTY: 711 • ICP-Medicaid: 1-877-933-8480 • MMAI-Medicaid and Medicare (Duals): 1-866-951-0264 • HealthAllianceConnect.org • MMAI-Medicaid and Medicare (Duals): 1-866-951-0264 • Both: TTY users call 711 or 1-800-526-0844 (Illinois Relay).

• Both: TTY users call 711 or 1-800-526-0844 (Illinois Relay).

Pharmacy Updates and Reminders Check out the update and reminders below for helpful pharmacy info.

If you have any questions, call the number on the back of your ID card.

Update:

These brands of birth control are no longer covered. If you have a prescription for one of these, talk to your doctor about switching to a covered brand.

Beyaz®

Depo-SubQ Provera 104®

Safyral® Ortho Tri-Cyclen® Lo

Natazia®

Lo Loestrin® Fe

Reminders: Your doctor must get preauthorization from Health Alliance Connect before you can fill a prescription for an insulin pen and have it covered by your health plan.

If you have diabetes, there is a limit on how many test strips you can get, depending on if you use insulin or not.

People who take insulin usually have to test more often than people who don’t.

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Need Help Getting to Your Doctor’s Office?

Going to the doctor can be tough sometimes, but we can help you get there and take you to the pharmacy after your visit if these points apply to you.

Your appointment is for medical reasons and is not court-ordered or court-appointed.

You are going to an in-network facility or provider. If not in-network, you have correct preauthorization.

You don’t have a car or another way to get to your appointment, like a friend, family member or access to public transportation.

Next time you set up a visit with your doctor, call us as soon as you know the date and time you’ll need a ride. We’ll check if you qualify by going through the points above.

Call three business days before the visit if you can and tell us about any special requirements, like if you’ll need a van for a wheelchair.

For questions or to set up a ride, call 1-877-633-2526 (TTY 711).

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You ca n’t affo rd the tri p.

Your health makes traveling difficult.

We have info about public transportation at HealthAllianceConnect.org. Just go to “Need a Ride.” Do not call an ambulance for a doctor’s visit. Ambulances are only for emergencies. If you have a life-threatening emergency, call 911.

Have a Question?

Question?

Call Us. Us. Have a Question?

Have a Call • Hours: Monday through Friday, 8 a.m. to 8 p.m.

• 1-877-633-2526, Monday through • Hours: Monday through Friday, 8 a.m. Friday, to 8 p.m.

• ICP-Medicaid: 1-877-933-8480 8:30 a.m. to 5 p.m. TTY: 711 • ICP-Medicaid: 1-877-933-8480 • MMAI-Medicaid and Medicare (Duals): 1-866-951-0264 • HealthAllianceConnect.org • MMAI-Medicaid and Medicare (Duals): 1-866-951-0264 • Both: TTY users call 711 or 1-800-526-0844 (Illinois Relay).

• Both: TTY users call 711 or 1-800-526-0844 (Illinois Relay).

Your Child’s PCP is Key Your child’s main doctor (primary care provider or PCP) knows the full picture of your child’s health. You should set up a visit with your child’s PCP when he or she needs non-emergency care.

Your son or daughter should visit his or her PCP: • • •

Six times in the first 15 months after birth Yearly, ages 3–6 Within 14 days after getting out of the hospital (any age)

During the office visit, ask for tips on how the whole family can eat healthier and move more. Healthy foods and plenty of physical activity are key to your child’s development. Also ask if your child is due for any immunizations.

Check out the lists below for some examples of when to set up a PCP visit or when to go to the emergency room.

In addition to regular checkups, call your child’s PCP for: • Cough or other signs of a cold • Muscle sprain or possible broken bone • Sore throat or earache

• Fever of 102 degrees or higher in kids older than 3 months

If you need same-day care and the doctor can’t fit you in or the office is closed, go to an urgent care clinic.

Go to the emergency room (ER) for: • Injury to head, neck, back or eyes • Bad cuts or burns • Heavy bleeding

• Badly broken bone • Fever of 100.4 degrees or higher in babies younger than 3 months

The ER is only for true emergencies.

These are examples, not complete lists.

If you have trouble getting an appointment with your PCP, call Member Services at 1-877-633-2526 (TTY 711). For health questions, call the 24-hour Anytime Nurse Line at 1-855-802-4612.

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Member Gains Heroic Buddy after Accident When Health Alliance Connect member Phillip Wright married the love of his life 23 years ago, he didn’t know a skill she’d started as a childhood 4-H project would play a role in helping to save him someday.

Phillip, who lives in Decatur, fell last May while trimming a tree and landed on concrete 28 feet below. He had 20 fractures from his forehead to his chin and damaged his eyes, eardrum, ribs and backbone. He barely survived.

Six days after his fall, Phillip had another scare. His wife, Juli Ward-Wright, was in his hospital room when it happened. She had her service dog, Nala (a fluffy Black Russian Terrier), by her side.

Phillip says the dog started pacing back and forth, to and from his bed. Confused

by Nala’s pacing, Juli glanced at Phillip. It looked like he was having a stroke, so Juli got the doctor right away.

Phillip had a small stroke. The couple thinks if Nala hadn’t noticed Phillip’s strange behavior, Juli may not have acted as quickly.

And time is important during a stroke.

“If it weren’t for the dog, it might have been worse than what it was,” Phillip says.

Nala is now Phillip’s service dog and helps him deal with eyesight problems from his fall.

The couple got another Black Russian Terrier for him, but Nala latched onto Phillip. The new dog, Bear, preferred Juli.

“They both picked their people,” Juli says, laughing.

Juli has used service dogs for nearly two decades to help with problems from her inner ear disorder and pancreatic cancer. But her connection to service dogs goes back even further.

She started training dogs when she was 11 years old after bringing a dog to a 4-H class.

The instructor told her she had a talent for training and should learn the skill. Today, she

Have a Question?

Question?

Call Us. Us. Have a Question?

Have a Call • Hours: Monday through Friday, 8 a.m. to 8 p.m.

• 1-877-633-2526, Monday through • Hours: Monday through Friday, 8 a.m. Friday, to 8 p.m.

• ICP-Medicaid: 1-877-933-8480 8:30 a.m. to 5 p.m. TTY: 711 • ICP-Medicaid: 1-877-933-8480 • MMAI-Medicaid and Medicare (Duals): 1-866-951-0264 • HealthAllianceConnect.org • MMAI-Medicaid and Medicare (Duals): 1-866-951-0264 • Both: TTY users call 711 or 1-800-526-0844 (Illinois Relay).

• Both: TTY users call 711 or 1-800-526-0844 (Illinois Relay).

The couple is thankful to have gotten Nala before the accident so that she could be in the right place at the right time to help Juli get quick medical help during Phillip’s stroke.

To Phillip and Juli, Nala and Bear are more than service dogs. They are family. Phillip’s hero is now a buddy who helps him cope every day.

“Service dogs are wonderful,” Juli says. “Not only are they a working dog, but they are also your constant companion.”

Act FAST, Help Stroke Victims Call 911 immediately if you think someone is having a stroke (lessening of blood supply to the brain). Waiting raises the risk of permanent brain damage. says she has trained too many dogs to count in the nearly 46 years she’s been doing it.

Phillip and Juli have owned dogs from lots of different breeds and recently fell in love with Black Russian Terriers, which they’ve gone to great lengths to get.

Nala traveled about 5,000 miles from the Ukraine to be with Phillip and Juli.

She joined the pair in April 2015, less than a month before Phillip’s fall.

Face: Check if one side of the face droops and if the person can move it.

Arms: Make sure the person can raise both arms equally.

Speech: Make sure the person can repeat simple phrases and is not slurring words.

Time: If you see any sign of stroke, call 911 right away.

Some other symptoms are numbness, confusion, vision problems, bad headache and dizziness. Go to stroke.org for more info.

301 S. Vine St. Urbana, IL 61801

2016

EV ENT

CALENDAR For more community events, visit our website, HealthAllianceConnect.org.

Give a Gold Star Have you had a great experience with somebody at Health Alliance Connect?

If so, you can give that person a Gold Star as a special way to say thanks.

We’ll share your story with that person and his or her manager and peers.

You can thank someone today at HealthAlliance.org/GoldStar.

Bingo Normal Activity and Recreation Center 600 E. Willow St. | Normal, IL March 29 | 11 a.m.–noon Illinois Heart & Lung Foundation’s Women’s Health Night Illinois State University Bone Student Center 100 N. University St. | Normal, IL April 5 | 3–7 p.m. | June 20 | 4 p.m. to 8:30 p.m.

Christie Clinic Illinois Marathon Health & Fitness Expo University of Illinois Activities & Recreation Center 201 E. Peabody Dr. | Champaign, IL April 28, 4–8 p.m. | April 29, 10 a.m.–7 p.m.

Batman v Superman Day Activity Hour Barnes and Nobel |65 E. Marketview Dr. Champaign, IL | March 19, 12–1 p.m.

April 29, 10 a.m.–7 p.m.

Goodnight Storytime Champaign Public Library | 200 W. Green St. Champaign, IL | Tuesdays | 6:30–7 p.m.

Don’t forget to stay in touch!

Just like your friends and family, we need to know if you move or get a new phone number. That way, we can keep in touch, send you important info about your plan and make sure you get your copy of The Mix. You can also connect with us on social media. We’ll keep you in the loop on news and events, plus give you healthy living tips and info.

Facebook.com/HealthAlliance

Twitter: @Health_Alliance

Pinterest.com/HealthAlliance

Please call 1-877-633-2526 and tell us what changed (TTY users call 711). Or send an email with your name, address and phone number to connect@healthalliance.org.

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