How Care Management Can Help You

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kentucky | 2015 | ISSue II

How Care Management Can Help You

Got a question or concern about your health? care Management helps members with special needs. It pairs a member with a care manager. the care manager is a nurse.

He or she can help the member with issues.

these include:

• complex medical needs;

• Solid organ and tissue transplants;

• children with special health care needs; and

• Lead poisoning.

We’re here to help you! call us for more information. the number is on the back page. Ask for the care Management Department. this service is available at no cost to you.

Disease Management Program

Disease Management is similar to care Management. the program supports members with health problems. these may include, but are not limited to:

• Asthma;

• Diabetes;

• Hypertension;

• Heart disease; and

• HIV/AIDS.

Do you have any of these conditions? Are you interested in this program? Please call customer Service. the number is on the back page.

you can get educational materials. In some cases, you may get coaching from a registered nurse.

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Boosting Your Future With Our GED

^®

Test Benefit Program

When you sign up to take the GeD test,

you’re taking a big step toward improving your future. Wellcare wants to help you achieve this important goal. that’s why we’ll pay the GeD testing fee for our eligible health plan members.

How to Qualify

to be eligible for Wellcare’s benefit program for the GeD test, you must:

• Be at least 16 years old;

• not have graduated from an accredited high school;

• not have received a high school equivalency certificate or diploma;

• not be enrolled now in a regular high school; and

• Have a valid ID card, driver’s license or state ID.

What You Need to Do

certain tasks can help you pass the GeD test the first time you take it. Studies show this.

the tasks listed below can help. they need to be done at an adult testing center.

• Spend at least 40 hours in state- approved adult education classes.

• complete the GeD Ready™ practice test.

• Score at least 150 on the GeD Ready™

practice test.

After you complete these tasks, Wellcare will send you a letter. It will have a voucher number. When you’re ready to take the GeD test, bring your voucher number to the testing center. you should also bring your state ID card and Wellcare ID card.

need a complete list of computer- based testing centers? Please visit www.gedtestingservice.com/testers/

locate-a-testing-center.

GED® is a registered trademark of the American Council on Education (ACE) and administered exclusively by GED Testing Service LLC under license. This content is not endorsed or approved by ACE or GED Testing Service.

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Take Control of Your Asthma and Breathe Easier

Asthma is a chronic lung disease. It’s a

long-term issue. It causes the airways in the lungs to become sore and swollen.

When the airways react to irritants like dust or smoke, they get narrower. that can make breathing difficult.

You Can Control Asthma

there are two main medicines to help control asthma. the first is long-term control medicine. It will stop symptoms and control asthma. It may take a few weeks before you notice it’s helping.

the second is for quick relief. An inhaler is an example of this type. It relaxes and opens the airways. this can help control asthma attacks. these attacks block airways. this makes breathing difficult.

you can also control your asthma by avoiding the things that cause your attacks. these are called triggers.

common triggers include:

• tobacco smoke;

• Dust mites;

• Outdoor pollution;

• cockroach allergens;

• Mice droppings;

• Pets;

• Mold; and

• Added activity like running or playing sports.

Manage Your Asthma With a Good Action Plan

A good asthma action plan can help. It can lessen your symptoms and prevent attacks. Asthma changes over time. So your plan may need updates. Work with your health care provider on an asthma action plan that’s right for you.

Do you have concerns or questions about your health? Remember, the nurse Advice Line is there for you.

you can talk to a nurse 24/7. It’s no cost to you. the number is 1-800-919-8807 (tty 711).

Sources:

• Centers for Disease Control and Prevention, “Learn How to Control Asthma,”

retrieved from www.cdc.gov/asthma/faqs.htm

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Start Your Tobacco-Free Life With a Successful Quit Day

Have you decided to finally quit tobacco?

If so, congratulations! cigarettes, pipes, hookahs and smokeless tobacco are all bad for you. Quitting is one of the best things you can do for your health.

now you can focus on that first step – your Quit Day. this is the day you begin a

tobacco-free life. Here are some tips for getting through your Quit Day. they come from www.smokefree.gov.

Reach Out for Support

• use a support program. call

1-800-QUIT-NOW (1-800-784-8669) to learn more.

• Are you using medications like gums or patches to help you? use them as directed.

• Our Disease Management Department can help. Get educational materials and advice on how to quit. call customer Service. the number is on the back page. Ask for the Disease Management Department.

Keep Busy

• Stay as busy as possible on your Quit Day. Go to a movie or take long walks.

• Spend time in places where smoking isn’t allowed.

• Do you miss having a cigarette in your hand? Hold something else. try a pencil.

• Have a craving? try chewing on gum, hard candies, toothpicks, or carrot or celery sticks.

• Drink plenty of water or fruit juice. But avoid drinks that may be triggers. this could be alcohol or coffee.

Source: “Steps to Take on Your Quit Day,”

retrieved from www.smokefree.gov

Source: Centers for Disease Control and Prevention, “Health Effects of Cigarette Smoking,” retrieved from www.cdc.gov

Heart and circulation

improve Easier to

breathe

Stroke, heart attack and lung disease

risks drop

Cancer risk cut in half 1 MINUTE

3-6 MONTHS

1 Y

EA

R

10 Y EARS

The Health Benefits of Quitting

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WellCare Plans Now Offered on State Exchange

As a Wellcare Medicaid health plan

member, you have access to all the quality health coverage Wellcare offers. But what if you become ineligible for Medicaid? can you continue to be a Wellcare member?

As of november 2014, the answer is yes.

that’s when Wellcare joined kentucky’s health insurance exchange program, kynect. the marketplace helps people without health coverage enroll in an affordable, high-quality plan. If you lose eligibility for Medicaid, you have 60 days to apply for health coverage on the

exchange and take advantage of premium tax credits. After that, you can’t get 2015 coverage until the following year.

Wellcare offers multiple types of plans on the exchange. these include both single and family benefit plans. there are

Wellcare plans offered at both the silver and gold metal levels on the exchange. All plans cover the 10 essential health care benefits, pre-existing conditions and preventive care. they also include such

perks as no co-pays for the first three office visits of the year.

Wellcare plans are currently available in 12 counties: Bullitt, Jefferson, Warren, Fayette, Jessamine, Boone, campbell, kenton, clay, Harlan, Laurel and Leslie.

For more information, go to www.

wellcareplans.com or kynect.ky.gov. you can also call 1-855-582-6175. tty users call 1-855-582-6171. Representatives are

available Monday–Friday, 8 a.m.–8 p.m.

Click or Call for the Latest Drug Coverage Updates

Want to find the latest about the drugs we cover?

Stop by our website. you’ll find our Preferred Drug List (PDL). Just go to kentucky.wellcare.com. click on

“For Members.” next, click on the “Pharmacy” tab at

the top. you can also call us for updates. the number is on the back page.

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WellCare’s Commitment to Quality

Quality is one of our most important goals. We want to make sure you are getting the right care for your health. In 2014, the Wellcare Quality Program did many things to improve the quality of your health care.

the program:

• Responded to reported quality concerns;

• encouraged you to go to well visits, including mammograms, eye exams for those with diabetes, immunizations and more;

• Met your language, cultural and ethnic needs;

• Made sure you can reach doctors by phone, get a timely appointment and find a doctor near your home;

• Made sure we answered your calls quickly; and

• ensured that claims were paid accurately.

Here are some of our goals for 2015:

• We will continue to measure the quality of the care and services you receive.

• We will continue working with you and your doctor(s). together, we can meet your health care needs. We can also coordinate your health care. this improves the quality of service.

• We will continue to ask if you are satisfied. this helps us make sure you are pleased with us and your doctors.

• We will ask what your doctor(s) think of our service. We’ll use that feedback to improve.

• We will continue to review and update our guidelines. this will help us keep a safe and healthy environment for your care.

Want to receive a copy of our Quality Improvement Program description? call customer Service. the number is on the back page.

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Help Is Available for Substance Abuse Problems

Anyone at any age can get into trouble

with drugs and/or drinking. People often use drugs and/or alcohol to relieve stress or deal with emotional pain. Drugs and/or alcohol may seem to work for a while. But they only make things worse in the end.

What is a substance abuse problem? It is any drinking and/or drug use that harms the user or puts others at risk. the good news is substance abuse can be treated.

you can talk with your doctor or a

substance abuse counselor. Ask him or her for help to quit. Be honest. talk about what you use, how much and how often.

Anything you say will be kept confidential.

Helpful resources:

• Substance Abuse and Mental Health Services Administration:

www.samhsa.gov

◊ SAMHSA 24/7 treatment Referral Line: 1-800-662-HELP (4357)

• Partnership for a Drug-Free America:

www.drugfree.org

• narcotics Anonymous: www.na.org

• cocaine Anonymous: www.ca.org

• Alcoholics Anonymous: www.aa.org

• kentucky cabinet for Health and Family Services, Department for

Behavioral Health, Developmental and Intellectual Disabilities:

http://dbhdid.ky.gov/dbh/sa.aspx Sources: Substance Abuse Consumer Fact Sheet, NC Division of Mental Health, Developmental Disabilities and Substance Abuse; Health Bulletin #61, New York City Department of Health and Mental Hygiene

Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. It is based on third party sources. We are presenting it for your information only. It does not imply that these are benefits covered by WellCare. Also, WellCare does not guarantee any health results. You should review your plan or call Customer Service to find out if a service is covered.

Call 911 or your doctor right away in a health emergency.

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Numbers to Know

P.O. Box 438000

Louisville, ky 40253

We’re just a phone call (or click) away!

call customer Service:

1-877-389-9457 tty 1-877-247-6272 Monday–Friday, 7 a.m.–7 p.m.

Or visit

kentucky.wellcare.com

nurse Advice Line:

1-800-919-8807 (tty 711) 24 hours a day/7 days a week

In This Issue Numbers to Know

We’re pleased to deliver another newsletter issue. It’s full of helpful ideas about ways to live healthier. Here’s what you’ll find inside:

• tips on how to better manage asthma;

• How to start a tobacco-free life; and

• Information on our care and Disease Management programs.

there’s much more inside. Please take a moment to explore. As always, we wish you good health.

ky028540_cAD_neW_enG State Approved 05222015

Para solicitar este documento en español, llame al Servicio al cliente al 1-877-389-9457 (tty 1-877-247-6272).

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