Fold and tape before mailing. Make sure the Harmony address shows on the outside. Harmony can change or cancel this program at any time. This program is for Medicaid members only. You must be a current member with Harmony to be eligible for the Healthy Rewards Program. FOLD IN HALF AND TAPE CLOSED
IL036638_CAD_BRO_ENG State Approved 02242017
©WellCare 2017 IL_01_17 IL7CADBRO80693E_0117
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HEALTHY REWARDS PROGRAM
WE WANT TO REWARD YOU FOR DOING SOMETHING HEALTHY.
WE’RE HERE FOR YOU!
We hope this brochure gives you a good idea of how the Harmony Healthy Rewards Program works. If you have questions about the program, please give us a call. You can reach us toll-free at 1-800-608-8158. TTY users may call 1-877-650-0952.
We’re here Monday–Friday from 8 a.m. to 5 p.m.
We’ll be happy to help you. You can also visit us anytime on the web at www.harmonyhpi.com.
Harmony Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-608-8158 (TTY: 1-877-650-0952).
ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-608-8158 (TTY: 1-877-650-0952).
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer1-800-608-8158 (TTY: 1-877-650-0952).
CVS SELECT GIFT CARD
You can use your Healthy Rewards CVS Select®
Gift Card to buy health-related items you use every day. Use it to buy things like vitamins, pain relief medicine, baby items and other over-the-counter items. Examples of items that you can’t purchase are alcohol, cosmetics, candy and tobacco.
ATTN: WOMEN & CHILDREN'S HEALTH TEAM HARMONY HEALTH PLAN 29 N WACKER DR STE 300 CHICAGO IL60606-9883 NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES Fold and tape before mailing. Make sure the Harmony address shows on the outside. Harmony can change or cancel this program at any time. This program is for Medicaid members only. You must be a current member with Harmony to be eligible for the Healthy Rewards Program.
B U S IN E S S R E P L Y M A IL
FIRST-CLASS MAIL PERMIT NO 9074 CHICAGO IL POSTAGE WILL BE PAID BY ADDRESSEE
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PLEASE COMPLETE THE INFORMATION BELOW WITH YOUR PROVIDER.
MemberFirstand LastName:
Subscriber ID#:
Member Mailing Address (City, State, ZIP):
Date of Appointment: Phone Number:
Provider ID# and Signature:
PLEASE COMPLETE THE INFORMATION BELOW WITH YOUR PROVIDER.
MemberFirstand LastName:
Subscriber ID#:
Member Mailing Address (City, State, ZIP):
Date of Appointment: Phone Number:
Provider ID# and Signature: PLEASE LET US KNOW WHAT SERVICE YOU HAD BY CHECKING THE BOX BELOW: 90-day PCP visit Well-child visit (birth–15 months)Child health checkup (3–6 years old)Adolescent checkup (7–21 years old)Prenatal care visit (Completed all 6 prenatal visits)Postpartum visitPap testMammogramDiabetes eye exam Diabetes blood sugar level control Diabetes LDL level control
PLEASE LET US KNOW WHAT SERVICE YOU HAD BY CHECKING THE BOX BELOW: 90-day PCP visit Well-child visit (birth–15 months)Child health checkup (3–6 years old)Adolescent checkup (7–21 years old)Prenatal care visit (Completed all 6 prenatal visits)Postpartum visitPap test Mammogram Diabetes eye exam Diabetes blood sugar level control Diabetes LDL level control
WHAT IS THE HEALTHY REWARDS PROGRAM?
The Healthy Rewards Program rewards you for taking steps that help you live a healthy life. When you complete a healthy behavior, we’ll send you a $20 CVS Select® Gift Card.
Complete another healthy behavior, and we’ll load another $20 onto your gift card.
It’s that simple.
START EARNING REWARDS NOW!
Harmony Health Plan members can start earning rewards now. When you complete your first healthy behavior, you will automatically get a
$20 CVS Select® Gift Card in the mail. Keep making the healthy choices shown on the chart.
As you do, we’ll add more rewards to your card.
Money will be automatically reloaded to your card, so please keep it in a safe place. To check the balance available on your card, please visit https://www.giftcardorder.net/cvs/mini.asp.
When You Get These
Healthy Services … … We’ll Give You
These Rewards
Healthy Rewards for New Members First Harmony PCP visit:
See your PCP within 90 days of becoming
a Harmony member Reloadable $20 CVS Select® Card
Healthy Rewards for Kids Newborn well-child visit:
Take your child to wellness visits from birth to 15 months of age (reward for each visit, up to 6 visits)
Reloadable $20 CVS Select® Card
Child health checkup:
Take your child for checkups when he or she
is between 3 and 6 years old (reward for each visit) Reloadable $20 CVS Select® Card Adolescent checkup:
Take your child for checkups when he or she is
between 7 and 21 years old (reward for each visit) Reloadable $20 CVS Select® Card Healthy Pregnancy Rewards
Prenatal care visits:
Go to 6 doctor visits before your baby is born Reloadable $20 CVS Select® Card Postpartum care visit:
Visit your doctor after your baby is born
Reloadable $20 CVS Select® Card
Go to all your doctor visits before and after your baby is born and get an extra$20 reward Well-Woman Healthy Rewards
Cervical cancer screening (Pap test):
For members between ages 21 and 64 Reloadable $20 CVS Select® Card Mammogram:
For members between ages 40 and 65 Reloadable $20 CVS Select® Card Diabetes Healthy Rewards Program
Eye exam:
For members with diabetes between ages 18 and 75 Reloadable $20 CVS Select® Card Blood sugar level control (HgbA1C):
Reach a level below 8 Reloadable $20 CVS Select® Card
LDL (“bad cholesterol”) level control:
Reach a level below 100 Reloadable $20 CVS Select® Card
