Spring 2011
Inside
Is Your Child Due for A Well
W
ell-child visits are important, even when children
are healthy. With the help of regular checkups,
your child’s doctor can often find health problems before
they become serious. These visits are also the time to
ask questions and learn more about anything that
concerns you.
First Choice will send you a reminder before your
child is due for a well-child visit. When your child has his
or her important checkups done on time, First Choice
will thank you with a reward.
• We thank you with a $50 Wal-Mart gift card when
you take your child for 6 well-child visits by the time
he or she turns age 15 months. All 6 visits must take
place while your child is a First Choice member.
Visit?
Breast-Feeding vs. Bottle-Feeding........... 2
Know the Effects of High Blood Pressure
on Your Body...................................... 3
Healthy Recipe: Spring Vegetable Sauté.....5
With Spring Comes Allergies.................... 6
Take Control of Your Diabetes.................. 8
True or False?......................................... 10
• We thank you with a $10 Wal-Mart gift card when you
take your child for a well-child visit each year from
ages 2 to 21. To get this reward, your child must have
a checkup within 90 days of getting the “Now Due”
reminder card. Well visits during other times of the
year do not qualify for the reward.
Use this age list to help you keep up-to-date with your
child’s well-child visits:
• 2 weeks
• 9 months
• Children ages
• 1 month
• 12 months
3 to 21 should
• 2 months
• 15 months
have a well• 4 months
• 18 months
child visit
• 6 months
• 24 months
every year.
First Choice: 888.276.2020 (Toll-Free) • 888.765.9586 (TTY)
Breast-Feeding VS. Bottle-Feeding
E
xperts agree that breast-feeding
is the healthiest choice for babies
during the first year of life—and
beyond. It is healthy for mom, too.
Breast-feeding gives your new baby
the very best start. It supplies food,
comfort and love. But bottle-feeding
can supply your baby with good
nutrition and plenty of love too.
This choice is one that every
mother has to make for herself.
Please see the chart below. It may
help you make the decision that is
right for you.
If you decide to bottle-feed,
remember this safety tip for formula:
Do Not Microwave. Heat a bowl of
water in the microwave. Remove
the bowl and place the bottle in
the warm water for a few minutes.
Always test the temperature of
milk on your wrist before giving it
to your baby.
First Choice can give you a manual
breast pump if you are breastfeeding. It is free after you have had
your baby. You can also ask to see a
lactation consultant (a person that
helps with breast-feeding) while you
are in the hospital.
If you have any questions about
what choice is right for you and
your baby, call Healthy Moms
and Babies at 888.276.2020.
Please ask to talk with someone
in the prenatal group.
2
Healthy Now
Spring 2011
Breast-Feeding
Bottle-Feeding
Gentle on the baby’s stomach
F ormula can be hard for the
baby to digest
Free
Costs money
reast milk is always the right
B
temperature
F ormula must be refrigerated
once mixed and warmed to
room temperature before feeding
other is the only one who can
M
feed the baby
Anyone can feed the baby
ou do not need to clean or
Y
sterilize bottles
ottles must be washed and
B
sterilized
Pass your immunities to the baby
through milk
Needs to be mixed with the
right amount of water
Not sure how much milk your
baby has taken
an see how much milk was
C
taken from the bottle
Select Health of South Carolina
High Blood Pressure—How It Affects Your Body
H
igh blood pressure means the force of blood
pushing against the artery walls increases. This
increase in pressure can make the artery walls thicken
and fatty material build up. If blood lipids (cholesterol)
are high, they can slow blood flow and increase blood
pressure.
Often high blood pressure has no symptoms. The
only way to know if your blood pressure is high is by
having it checked. If it’s not treated, the increased
pressure can cause serious heart problems, stroke,
kidney damage or blindness.
How to Lower Your Blood Pressure
• Quit smoking.
• Eat a healthy diet that limits foods high in fat,
cholesterol and salt.
• Have regular checkups with your doctor. Make sure
to ask about your blood pressure readings.
www.selecthealthofsc.com
• Always take your medicine as directed by your doctor.
• Talk with your doctor about safe exercise. Set a goal of
30 minutes of physical activity a day for most days of
the week.
• Limit alcohol intake.
What Do Blood Pressure Readings Mean?
Blood Pressure
Systolic
(Top Number)
iastolic
D
(Bottom
Number)
Normal
Lower than 120
Lower than 80
Slightly High
120–139
80–89
High
140–159
90–99
Very High
160 and higher
100 and higher
Spring 2011
2010
Healthy Now
3
How Can We Improve?
I
mproving your satisfaction with your
healthcare and services is the main goal of
First Choice. Each year, we work with an outside
company to survey First Choice members.
Members are randomly sent a survey by the
outside company. The survey gives you a chance
to rate First Choice, your doctor and the
healthcare you have received.
Some of the questions in the survey ask you
to rate things like:
•Getting care quickly
– When you needed care right away (quickly),
how often do you think you got it as soon as
you thought you should?
– When you did not need care right away
(could be scheduled later), how often do you
think you got it as soon as you thought you
should?
•Getting the care you need
– How often do you have an easy time making
an appointment with a specialist?
– How often do you have an easy time getting
the care, tests or treatment you thought
you needed through First Choice?
•How well your doctor works
– Rate from 1 to 10 how happy you are with
your doctor with 10 being the highest.
•How well your doctors communicate
– Does the doctor explain things so you can
understand, do they listen carefully to you
and do you think the doctor shows you
respect for what you had to say?
•How well First Choice works
– Rate from 1 to 10 how happy you are with
First Choice with 10 being the highest.
A final report is sent to First Choice once all
the responses are received. This helps us learn
how we can better serve you and your family’s
healthcare needs.
A new member satisfaction survey will be
mailed out in early 2011. If you get a survey,
remember that it is important to fill it out right
away and return it.
4
Healthy Now
Spring 2011
Select Health of South Carolina
Healthy Recipe:
Spring Vegetable Sauté
Ingredients
Directions
1 tsp. olive oil
½ cup sliced sweet onion
1 finely chopped garlic clove
3 to 4 tiny quartered new potatoes
¾ cup sliced carrots
¾ cup asparagus pieces
¾ cup sugar snap peas,
or green beans
½ cup quartered radishes
¼ tsp. salt
¼ tsp. black pepper
½ tsp. dried dill
1. Heat the oil in a skillet. Cook the
onion 2 minutes, add the garlic
and cook another minute.
2. Stir in the potatoes and carrots.
Cover, turn the heat to low, and
cook until almost tender.
3. If the vegetables start to brown,
add 1 to 2 tablespoons of water.
4. Add the asparagus, peas, radishes,
salt, pepper and dill. Cook, stirring
often, until just tender—about 4
minutes more.
5. Serve immediately.
www.selecthealthofsc.com
Yield: 4 servings
Serving size: ¼ of recipe
Each serving provides
Calories: 80
Total fat: 1½ g
Saturated fat: 0 g
Cholesterol: 0 mg
Sodium: 200 mg
Fiber: 3 g
Protein: 3 g
Spring 2011
Healthy Now
5
With Spring Come
S
Allergies
pring is a time for allergies, and allergies can trigger
asthma attacks. People can be allergic to many things,
including pollen from trees and grass, animal dander,
dust mites, cockroaches, and mold.
It helps to know what causes your asthma symptoms.
Here is a list of helpful tips that can help you control
many common causes of allergies and asthma attacks:
• If animal dander is a problem for you, keep your pet
out of the house or at least out of your bedroom.
Wash your hands after touching pets.
• If pollen is a problem for you, stay indoors with the
windows closed and air conditioner on when the pollen
count is high.
• While bathing, run the exhaust fan or leave a window
open to let steam vent and avoid moisture buildup.
• Use allergy-proof filters for heating and cooling systems.
• To control dust mites, wash your sheets, blankets,
pillows and stuffed toys once a week in hot water.
Use special dust-proof covers for your mattress and
pillows. Remove as much carpet from your home
as possible.
• To keep cockroaches and other insects out of your
home, use bait, traps or insect spray when no one
is at home.
• Cover up food and clean dishes after eating.
• Remove garbage from the home every day.
• To help control mold, air out damp and humid areas
such as bathrooms, basements and closets. Clean
shower stalls and sinks weekly using products that
kill and prevent mold.
• Talk with your doctor about what causes your asthma
and how you can control it.
Also, remember:
• Use your controller medicine each day, as directed, to
help reduce flare-ups and control your symptoms.
• Quick-relief (rescue) medicine works very fast to
relieve asthma symptoms by opening the airway,
helping you breathe more easily.
• Very Important: Asthma medicine works best when
taken as directed by your doctor. If you do not have an
Asthma Action Plan, ask your doctor about creating
one at your next visit.
Breathe Easy is a free program for First
Choice members of all ages with asthma.
To learn more, call 888.559.1010.
6
Healthy Now
Spring 2011
Select Health of South Carolina
You Can Help Us Stop
Fraud and Abuse
Y
ou can help us recognize
provider fraud. To do so, please
keep track of the following:
1. When you used a healthcare
professional’s service
2. Where the service took place
3. The name of the doctor who gave
you care
4. What services were done during
the visit and any services the
doctor ordered
Make sure to let us know if you
ever think a doctor may have billed
wrong or offered an unnecessary
service. If you think someone is
abusing the Medicaid system,
you must report it. To report
suspected fraud and abuse, please
call the Corporate and Financial
Investigations Unit Fraud Hotline at
866.833.9718 or the South Carolina
Department of Health and Human
Services Fraud and Abuse Hotline at
888.364.3224.
Notice of
Privacy Practices
A
s a member of First Choice, you received a Notice of Privacy
Practices. The notice explained how we might use or disclose
medical information about you under the Health Insurance Portability
and Accountability Act of 1996 (HIPAA). By law, you have the right to
get another copy of this notice. If you would like another copy, please
contact us.
• Call Member Services at 888.276.2020.
•Write to:
Privacy Official
Select Health of South Carolina, Inc
P.O. Box 40849
Charleston, SC 29423-0849
• Or visit our website at www.selecthealthofsc.com/firstchoice.
www.selecthealthofsc.com
Spring 2011
Healthy Now
7
Tips to Take
Control Of Your Diabetes
M
aking healthy choices helps you take control of
your diabetes and feel better now. How you manage
your health today will affect your future care needs with
diabetes. Take control by putting these steps into action:
• Eat healthy.
• Stay active.
• Take medicines as ordered.
• Make and keep doctor visits.
• Test your blood sugar.
• Reduce stress.
Supplies to Help
Y
•
•
•
•
•
•
•
8
Control Your Diabetes
ou will need a doctor’s prescription to get your
diabetes supplies.
The following are covered benefits:
Alcohol wipes
Insulin pens
Lancets
Needles
Syringes
Testing strips
Here’s how to get certain supplies:
Ketone strips come from a durable medical supply
(DME) company.
Healthy Now
Spring 2011
• Learn as much as you can about diabetes.
• Get ordered lab work and yearly eye exams.
Learning is power. If you have not attended classes
about diabetes, ask your doctor to order this for you.
These classes are covered by First Choice. The staff
teaching the classes will work with you so that you can
take the best care of yourself.
Diabetes is a lifelong illness that responds well to
treatment and healthy choices. Start making your healthy
choices today!
• Alcohol wipes can also be ordered through our
personal care items program. Call First Choice Member
Services to order these.
• If you use an insulin pump, the supply company will
help you get all the items needed for it.
If you have questions about these
covered benefits, please call Member
Services at 888.276.2020.
Select Health of South Carolina
Your Medicine
Benefits
F
irst Choice members younger than age 21 have no limit on
the number of prescriptions (medicine) they can get each
month.
If you are a First Choice member and you are age 21 or older,
there are some limits to the number of prescription medicines
you can get each month. You can get 4 prescriptions or refills each
month with some exceptions. Drugs used to treat the following
do not have this 4 prescription limit:
• Acute sickle-cell disease
• End-stage renal disease
• Behavioral health disorders
• HIV/AIDS
• Cancer
• Hypertension
• Cardiac disease
• Lupus
• Diabetes
• Organ transplant
• End-stage lung disease
A maximum of 7 prescriptions will be covered
each month. Please call Member Services if you
have questions about your benefits. Call toll-free
at 888.276.2020.
Help Us
Serve You Better!
A
t First Choice, we want to make sure
that you and your family get the best
possible care. In order to do that, we need
to know more about you. The more we know
about you, the better we become at meeting
your needs.
Please do the following to help us better
serve you and your family, and you will also
be entered to win a $150 gift card:
1. Call Member Services at 888.276.2020.
2. Answer 4 questions about your cultural
background and language preferences.
If you choose to share this information
with us, it will remain private. We will only
use it to look at services you get, so that we
can meet your needs.
One member each month will be randomly
picked to win a $150 Wal-Mart gift card.
Call Member Services today for a chance to
win! Thank you for helping us improve our
services.
Tenemos empleados que hablan español y que
están listos para ayudarle.
www.selecthealthofsc.com
Spring 2011
Healthy Now
9
True or False?
1. Cervical cancer is not preventable.
False. Cervical cancer can be easily prevented. Regular
Pap tests are used to find cancer or changes that may
lead to cancer. This test looks for changes to cells caused
by HPV (human papillomavirus). It finds cell changes
early, so they can be treated before they turn into cancer.
The HPV vaccine (shot) works by preventing the most
common types of HPV that may cause cervical cancer.
2. At least 50 percent of sexually active people will get
HPV at some point in their lives.
3. Chlamydia is known as a “silent” disease.
True. Most people who have Chlamydia don’t know it
since the disease often has no symptoms. If Chlamydia
is left untreated, it can cause serious damage to a
woman’s reproductive organs.
Chlamydia screenings should be done every year if you
are a sexually active woman 24 years of age or younger.
Talk to your doctor to make sure you have had this
important screening.
Models used for illustrative purposes only.
True. HPV is one of the most common sexually
transmitted viruses. It is also the main cause of cervical
cancer in women.
The HPV vaccine is most effective when it is given
before a person’s first sexual contact. For that reason,
it is recommended for 11- and 12-year-olds to get
the vaccine during their regular checkups. Those age
26 or younger should still get the vaccine because they
may not have been infected with HPV.
10
Healthy Now
Spring 2011
Select Health of South Carolina
You Can File a Grievance or an Appeal
S
erving our members is very
important to us. However, we
realize that there may be a time when
you have a concern or do not agree
with an action taken by First Choice.
As a First Choice member, you have
the right to voice a grievance or file
an appeal when this happens.
What’s the Difference Between
a Grievance and an Appeal?
A grievance is when you are unhappy
with a provider, the plan or a benefit.
You, or a doctor acting for you, can
file a grievance at any time simply by
calling or writing Member Services.
An appeal is a request to review
an action taken by First Choice.
Examples of actions include denying
or limiting a service or denying
payment for a service. You must
file an appeal within 90 days from
the date on the denial
notice. A doctor can
also file an appeal
for you, but the
doctor must have
your written consent.
If you appeal by
phone, you must
follow up by putting
your appeal in writing
unless it is an expedited
(fast) appeal. An
expedited appeal is when
your life or health is at serious risk
if a decision is not made quickly.
To file a grievance or an
appeal, call Member Services at
888.276.2020. Or write to:
First Choice Member Services
P.O. Box 40849
Charleston, SC 29423-0849
www.selecthealthofsc.com
Spring 2011
Healthy Now
11
PrSRT Std
U.S. POSTAGE
Paid
Permit No. 372
Long Prairie, MN
P.O. Box 40849
Charleston, SC 29423-0849
de este documento en
Para obtener una copia
e al Departamento de los
español, por favor llam
al 888.276.2020.
Servicios para Miembros
SC Healthy Connections Help Line
877.552.4642
© 2011. Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date health information. But no
publication can replace the advice of medical professionals, and readers are cautioned to seek such help. Models used for illustrative purposes only. 5526M
Inside
Control your Diabetes
Making healthy choices can help you control your
diabetes and affect the future of your medical
care. On page 8 you will find tips to help you
manage your diabetes, as well as information on
the supplies you will need to control it.”