Microsoft word - july councilinfo newsletter.docx

Fit for Life and Benefits have teamed up to provide health and benefits information monthly on a link from CouncilInfo. In this issue, you will find information on Preventive Care, the HealthPartners website, and tools to help control medical costs. Preventive Services Can Help Save Lives
One of the best and easiest ways for adults to keep themselves healthy is to make sure they get recommended clinical preventive services such as screenings and immunizations. Screenings are designed to help detect chronic diseases in their early, most treatable stages. Adult immunizations help protect against diseases such as influenza and pneumonia. Regular physical activity and refraining from tobacco use are also key prevention measures. It's time to take charge of your health! Schedule an appointment with your health care provider to discuss what preventive health services you need and when you need them. Regular health exams and screenings are important because they can identify potential problems, be a starting point in a plan to correct problems, and possibly help save your life. By getting appropriate preventive services, screenings, early diagnosis, and treatments, you are taking steps that help your chances at living a longer, healthier life. Your age, health and family history, lifestyle choices (i.e. what you eat, how much exercise you get, whether you smoke), and other important factors impact what services and screenings you need and how often you need them. These include immunizations, and for women, Pap smears to detect cervical cancer and mammograms to detect breast cancer. Make an appointment with your health care provider for a checkup on a day that is convenient for you or plan to get a health screening on the same day each year. Preventive Care Guidelines

The following Preventive Care Guidelines can be found on the HealthPartners
website (www.healthpartners.com). Your family history or personal history of risk
and conditions may change your physician's recommendations. Recommendations are evidence-based and reflect the clinical guidelines from the Institute for Clinical
Systems Improvement (ICSI).

Adult Strongly Recommended Preventive Services
19 - 39 years
40 - 65 years
Over 65 years
Talk to your doctor if you are a man age 45-79 or a woman counseling
Blood pressure
Blood pressure (BP) every 2 years if less than 120/80; every screening
Breast cancer
screening
(Mammogram)
Cervical cancer
Beginning at age 21 Every 3 years after Women 65 years screening (Pap
3 normal Pap smears in a row over 5 years. Chlamydia
Yearly for sexually active women age 25 and younger. For screening
women older than 25, talk to your doctor. Colorectal cancer
screening
African American, start at age 45. Repeat screening at intervals determined by type of screening test used. Influenza (flu)
Get a flu shot every year to lower your risk of getting the flu. Lipid screening
Fasting lipid screening for men and women every five years. Pneumococcal
Immunize high-risk groups once. Those Immunize at age 65 immunization
previously. Re-immunize once if first received more than 5 years ago and before age 65, or if doctor recommends to those with higher Problem drinking Talk to your doctor about harmful drinking and if you have
screening and
brief counseling
Tobacco use
Talk to your doctor about tobacco use, secondhand smoke screening and
exposure and ongoing smoking cessation if you use tobacco. brief intervention
Vision screening
Adult Suggested Preventive Services
Abdominal aortic aneurysm screening: Men ages 65-75 who have smoked more
than 100 cigarettes in a lifetime.
Depression screening: Talk to your doctor if you are feeling down and have
concerns about depression.
Folic acid counseling: Women of childbearing age should discuss use of folic acid
supplements to prevent birth defects.
Hearing screening: Over age 65, talk to your doctor if you think you may have
hearing loss.
Hepatitis B immunization: Immunize everyone 19-39.
Herpes zoster/shingles immunization: Immunize at age 60 or older.
Human papillomavirus (HPV) immunization: Women age 19-26, catch up if
appropriate (3-dose series)
Inactivated polio vaccine (IPV) immunization: Immunize if not previously
immunized.
Measles, mumps, rubella (MMR) immunization: Persons born during or after
1957 should have one-dose of measles; a second dose may be required in special
circumstances.
Obesity screening: Record height, weight and body mass index (BMI) annually.
Osteoporosis screening: Women age 65 and older should be screened.
Tetanus-diphtheria immunization: All adults should have completed a primary
Td series. For all adults, immunize with a booster dose of Td every 10 years.
Varicella immunization: Adults who do not have evidence of immunity to
varicella should get two doses of varicella vaccine with at least 28 days between the
first and second doses.
Vision screening: Vision test for ages 65 and older.
For child preventive care guidelines, clink on this link:
https://www.healthpartners.com/files/45343.pdf
Preventive Care Benefits On Our Medical Plans
All of the Metropolitan Council health plans offer 100% coverage of preventive care when obtained through a network provider. However, keep in mind the following: When Is A Routine Physical Not Just A Routine Physical?

Sounds like the beginning of a joke, doesn’t it? Well, if it was, the punch line would
be “When they find something wrong with you!” Our plans cover preventive
services at 100% (no deductible), when you visit a HealthPartners network provider. However, if you visit your doctor for a routine colonoscopy for example, but while they are performing the procedure, they diagnose an illness, the claim will be coded as an illness. Providers are legally required to code and bill accurately for services they provide to patients. In this case, the colonoscopy would be paid under your illness benefits, and not your preventive services benefits. HealthPartners Website
Information at Your Fingertips

Did you know that you can do more on the HealthPartners website
(www.healthpartners.com) than just find a doctor in your network? You can do
much more, such as:
• View medical and dental claims and account information • Go Green by signing up to view your Explanation of Benefits (EOB’s) online • Compare costs of health care services • Refill prescriptions from a HealthPartners pharmacy • Make appointments at a HealthPartners clinic • Check to see if your medication is covered on the HealthPartners formulary • View the online health information library • View medical and dental procedure costs • Create a health diary to track your weight, blood pressure, blood sugar; keep a medical history of allergies, immunizations and prescriptions and keep a personal health record • Get details on the Frequent fitness program • Search for doctors and dentists by name, clinic name, specialty, language, gender, hours of business, parking, wait times and more The HealthPartners website a fantastic tool and available for your use when you are a member of a HealthPartners medical or dental plan. If it’s your first time on the website you will need to create a username, password, and security question. An activation code will then be mailed to you. This process assures that your medical information and claims data is secure and accessed only by you. Controlling Medical Costs
Consumer Tips to Save Out-of-Pocket Health Care Costs

The following are practical steps consumers can take to cut their out-of-pocket
health care costs.

Get a checkup. Getting an annual physical provides an opportunity to diagnose
and treat conditions, often before symptoms of those conditions are evident.
Annual physicals have great benefits in several areas, particularly:
1. Blood pressure – probably the most easily preventable disease if detected 2. Gynecologic, pap smears and breast exams – probably the most important of regular exams for women that can lead to early detection of various forms of cancer of other diseases. 3. Cholesterol screenings to ensure supplements or prescription medicine can be recommended in time to prevent the serious effects of high cholesterol like stroke or heart disease. 4. Health habits and patient attitudes to fitness and nutrition, though moderate are still good enough reasons for an annual physical. 5. Reduction of patient worry – a significant stress-buster. Knowing you are healthy is a great feeling, but knowing your annual physical helped you catch something on time and begin treatment that can lead to a full recovery is an even better feeling! So pay your good doctor a visit at least once a year even if you are feeling perfectly healthy – they can help make sure you stay that way. Potential savings: unlimited.
Get a flu shot. According to a study published in the September 2008 issue of
Pediatrics, over 2000 hospitalizations and up to 650,000 outpatient visits are due to
the flu and could be prevented if everyone who needed one got a flu shot. Potential
savings on out of pocket copays, coinsurance or deductible: $75 to $200.
Ask about generic drugs. Generic drugs have the same active ingredients,
strength, dosage and quality as the brand version, but they can cost a lot less. Our
Distinctions III health plan has a lower copay for generics, and the Empower HRA
plan has a 20% coinsurance (after deductible) on prescription drugs. Therefore,
people enrolled in these two plans instantly save money by utilizing a generic drug. Also, people enrolled in the Open Access plan, while not receiving an instant savings because there is no copay differential between generic and brand name drugs, help lower the overall claims cost of our plan when using generics, therefore helping to control our annual premium increases. Average savings for generic drugs: $25 to $150.
Use the Web to find lower cost prescriptions. HealthPartners provides you with
the prices of prescription drugs at various pharmacies near your home. The
difference in costs between different pharmacies for the same drug can be
astounding. For example, in a search performed in July 2010, a 30 day supply of the generic heartburn medication, omeprazole, was $20.05 at one pharmacy, but the same medication was $14.94 for a 90 day supply at another pharmacy. Again, this is of particular interest to those in the HRA plan who are applying charges toward their deductible, or paying 20% of the cost, but if everyone used this option to help control prescription drug costs, we all benefit by helping to control our annual premium increases. To use the drug cost calculator and pharmacy search, go to www.healthpartners.com/pharmacy. You will need to log on to your HealthPartners account. Use the Web to find lower cost providers. HealthPartners provides you with the
prices of 83 common services and procedures for 500 primary care, radiology clinics
and hospitals in the metro area. For example, depending on where you go, an MRI
can cost between $560 and $2,100 for the same test. The coinsurance on many of
our plans for an MRI is 20% of the cost so the savings would be as high as $300. To
use the HealthPartners Cost Calculator, sign on to your HealthPartners account, and
then click this link: https://www.healthpartners.com/portal/1900.html
Review your Explanations of Benefits. Explanations of Benefits aren't bills but
rather a verification that you've received service and that HealthPartners has been charged by a provider for the service. Review your EOB carefully to make sure you've been billed correctly. If you find an error in your EOB, contact
HealthPartners Member Services at (952) 883-5000.
Get prescriptions by mail order. Through HealthPartners Mail Order pharmacy,
you can order up to three months prescription for 2 copays on our Distinctions III
and Open Access plans, and it saves you a trip to the pharmacy. Average savings:
one-third of your co-payment. Click on this link for more information:
http://www.healthpartners.com/portal/3236.html

Split pills. Some medications, like those for high cholesterol, can be prescribed in a
higher dosage, than safely be cut in half. You'll pay for a 30 day prescription, but
receive a 60-day supply. Savings: one-half of your drug copayment. Click on this
link for more information:
http://www.healthpartners.com/portal/3116.html

Use e-care or telephone visits. Some clinics, including HealthPartners Clinics,
offer e-visits and phone visits, which can save you time and gas money. Click on this
link for more information: http://www.healthpartners.com/files/32544.pdf
Use walk-in clinics. If you have a simple illness such as an ear infection or pink
eye, retail clinics can save you about one-third the cost of a traditional office visit
according to a recent HealthPartners study. If you need to see a doctor, many
doctor's offices, including HealthPartners Clinics, offer walk-in Urgent Care.
HealthPartners' study found costs at Urgent Care Clinics were more than $200 less
than a visit to the emergency room. Average savings: $50-$200 in copays,
coinsurance and/or deductibles.
Use HealthPartners’ help lines. Whether you have a middle of night question
regarding an illness, need information on a medical condition, or have questions
regarding pregnancy or mental health issues, HealthPartners has professionals
Nurse NavigatorsSM
When you need help sorting out health and insurance issues, call the nurse
navigators. You’ll talk to skilled nurses who can research and coordinate
healthcare based on your benefits and coverage. They can also guide you
through tough decisions like choosing a treatment option.
Available Monday through Friday, 7:00 a.m. – 7 p.m. CST through the
HealthPartners® Member Services line at 952-883-5000 or 800-883-2177
(TTY 952-883-5127). Ask to speak to a Nurse Navigator.
CareLineSM nurse line
Need advice or not sure if you should see a doctor? Talk to a nurse who is
trained to review your symptoms and explain your treatment options.
Available 24/7, 365 days a year. Call 612-339-3663 or 800-551-0859
(TTY 952-883-5474).
BabyLineSM phone line
BabyLine helps expectant and new parents up to six weeks after the baby is
born. Nurses can answer questions about mood swings, morning sickness,
healthy eating, safe medications and more. Nurses can also help you tell the difference between normal discomfort and signs of preterm labor. Available 24/7, 365 days a year. Call 612-333-2229 or 1-800-845-9297.

Personalized Assistance Line (PAL)
Talk to professionals who can help when you have questions about mental
and chemical health network, benefits and services.
Available Monday through Friday, 7:30 a.m. to 5 p.m., CST. Call 952-883-5811 or 1-888-638-8787.

Source: http://benefitsportal.info/benfits_%20pdf/TFLNewsletter-Jul2010.pdf