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~MEN’S Health Information Inside~

Autumn 2000

Customer Service Numbers Category

Little Rock Toll-free Number (501) Number

State/Public School Employees

378-2437 1-800-482-8416

e-mail: Medi-Pak (Medicare supplement)

378-3062 1-800-338-2312

Medicare (for beneficiaries only): Part A (hospital benefits) Part B (physician benefits)

378-3151 1-877-356-2368 378-2320 1-800-482-5525

UniqueCare, UniqueCare Blue, BlueCare PPO & PPO Plus, Blue Select® (individual products) 378-2010 1-800-238-8379 Group Services




378-2127 1-800-880-0918

Federal Employee Program (FEP)

378-2531 1-800-482-6655

Health Advantage

221-3733 1-800-843-1329

Medi-Pak HMO (Health Advantage) 954-5200 1-800-354-9904 USAble Administrators

378-3600 1-800-522-9878

For information about obtaining coverage, call: Category

Little Rock Toll-free Number (501) Number

Medi-Pak (Medicare supplement)

378-2937 1-800-392-2583

UniqueCare Blue, BlueCare PPO & PPO Plus, Blue Select® (individual products) 378-2937 1-800-392-2583 Medi-Pak HMO (Health Advantage) 378-6987 1-800-588-5706

Regional Office locations: Central Northeast Northwest South Central Southeast Southwest West Central

Little Rock Jonesboro Fayetteville Hot Springs Pine Bluff Texarkana Fort Smith

Customers who live in these regions may contact the regional offices or call the appropriate toll-free telephone numbers above.

Web sites:

is published four times a year by the Arkansas Blue Cross and Blue Shield Advertising and Communications Division for the company’s members, health care professionals and other persons interested in health care and wellness. Opinions expressed herein do not necessarily reflect the views of Arkansas Blue Cross and Blue Shield or any of its publics.



~AUTUMN 2000~

Exercise — a requirement ........................ 4-5 Get back in action ....................................... 5 Diseases of the prostate gland .................... 6 Heart Attack ................................................ 7 Parenting for dads ....................................... 8 Testicular cancer ......................................... 9 Cholesterol facts ......................................... 9 Breast cancer ............................................ 10 Living with diabetes .................................. 11 Prescription medication info ..................... 12 Focus on Men’s Health (Tips for dads, Get your shots, High blood pressure) ................................ 13 Leading the way (get to know some of Arkansas’ legislators) ....... 14-15 Health Advantage news for members ......... 16 Discounts for members .............................. 16 Health issues on the Web .......................... 17 Take a stand against domestic violence .... 18 New board members .................................. 18 Blue & Your Community ............................. 19 Clearly Blue (a terminology guide) .................... 20 E-mail Blue & You! ..................................... 20 Vice President of Advertising and Communications Patrick O’Sullivan Editor Kelly Whitehorn Designer Gio Bruno

Contributors Mark Carter, Janice Drennan, Damona Fisher and Kathy Luzietti

4 To maintain good health, however, men need three kinds of exercise: aerobic, strength training and flexibility.

Exercise — a requirement he majority of adults — male T and female alike — tend to avoid exercise. Most people are aware of the benefits of exercise. It improves your overall health, lowers your risk of disease and is essential as you age to maintain quality of life. Yet, according to the Centers for Disease Control and Prevention, more than 60 percent of adults do not achieve the recommended amount of regular physical activity. In fact, 25 percent of all adults are not active at all. Men might think they can stay in good shape if they do a little weight lifting. They do have more muscle mass than women. To maintain good health, however, men — and women — need three kinds of exercise: aerobic, strength training and flexibility.

Aerobic exercise Aerobic exercise helps to keep your lungs, heart and circulatory system healthy. Aerobic exercise increases your breathing and heart rate and builds endurance. It should be rhythmic and continuous. Walking, jogging, cycling, dancing, stair climbing, cross-country skiing, rowing and swimming are examples. To keep your heart healthy, you need at least 20 to 40 minutes of this type of exercise three times a week.

Strength Training Strength exercises build your muscles. These exercises involve the use of progressively heavier resistance in the form of weights, bands or exercise machines. Without regular strength training, you will lose muscle mass

after age 25. A study published in the Journal of Neurological Science showed that men lose approximately 40 percent of total skeletal muscle mass from age 24 to 80. With strength training, muscle cells get larger, and their demand for energy increases. This results in burning more calories. This higher metabolism helps to keep weight and blood sugar in check. If you are new to weight training, find someone professionally trained to help you get started. Using weights improperly can cause injury to muscles and joints. A community fitness center is a good place to find an advisor. Once you learn the basic techniques, you can do weight training on your own. You don’t need fancy equipment. Soup cans or milk jugs filled with water or sand will work. Your goal is to increase gradually the number of repetitions you can do and the amount of weight you can handle. About 30 to 40 minutes two to three times a week is enough to maintain muscle tone.

Flexibility Flexibility exercises involve stretching and are often overlooked, especially by men. Stretching increases your physical performance and decreases your risk of injury. It helps keep your body limber. Flexibility exercises also increase blood flow to your joints, improve balance, decrease your risk of lower back pain and reduce stress in muscles. Stretching is a good way to relax mentally and physically. You should do five to 10 minutes of


for good health, not an option stretching before and after a workout. Another important and often overlooked type of exercise is balance exercise. This type becomes more important as you age to help prevent falls. Some balance exercises build up your leg muscles; others require you to do simple activities such as briefly standing on one leg. Rather than thinking of exercise as a separate part of your life, try to incorporate it into your daily activities. Don’t park your car at the space closest to the door. Walk a little. Use the stairs instead of the elevator, if only for one or two floors. At work, use your lunch break to take a stroll. At home, do housework and yardwork. The key to any exercise program is to stay motivated. It helps to find an exercise buddy, who can encourage you and go through the exercise program with you. Once you make a habit of exercise, you will feel better physically and mentally and have a better self-image. Your body will look better too as it becomes leaner and more toned. Consult a physician before beginning an exercise program. A good place to start is by visiting, a Web site that serves as a gateway to selected consumer health and human services information resources provided by U.S. government agencies and other organizations serving the public interest. Follow the links smart choices>prevention and self-care>healthy living.


back in action

Back pain is perhaps the most tangible yet ambiguous of afflictions. Many people suffer from it or have experienced it at least once in their lifetime. Yet its origin and causes can be attributed to a multitude of factors. Most back pain is caused by trauma, spinal deformity or muscle strain and can start anywhere from the neck to lower spine. Only about 10 percent of all back pain is the result of systemic illness. Back pain can be localized or can spread across a wide area and radiate from one central spot. The exact cause of back pain can be hard to pinpoint since the source can be soft tissue, nerves, disc or bone. Risk factors for low back pain include: cigarette smoking, repetitive or heavy lifting and exposure to vibration caused by heavy vehicles or industrial machinery. Back pain has been associated with sports, such as cross-country skiing and prolonged vehicle driving. Diseases such as spinal osteoarthritis, spondylitis and compression fractures also can cause back pain. Some of these diseases are more common in the elderly, who are at a higher risk for back pain. Here are some facts about the impact of back pain: • It is the most common medical disorder in the industrialized world. • Low back pain disables 5.4 million Americans and costs the United States roughly $16 billion each year. • Seventy percent of those with back pain recover within a month. Symptoms persist for six months or longer in just four percent of cases, but this small percentage accounts for 85 percent of the money spent on treatment and compensation for low back pain. If you would like more information, see your primary care physician or chiropractic physician. Other sources include the American Chiropractic Association []; the Foundation of Chiropractic Education and Research []; American College of Rheumatology []; and the Arthritis Foundation []. — Sources: American College of Rheumatology and


hat is a prostate gland? It is a walnut-sized structure, which is located around the male urethra at the base of the bladder. It provides fluid for ejaculation. It is an essential part of the male reproductive system as it collects and produces a clear fluid that is part of a man’s semen. Benign Prostatic Hypertrophy (enlargement of the prostate gland) By age 50, more than half of all men (or 10 million Americans) have a condition called benign prostatic hypertrophy (BPH). BPH is not life threatening, but it causes uncomfortable symptoms including: difficulty starting the urine stream; a need to urinate frequently, especially at night; and a feeling of incomplete bladder emptying. Home remedies for BPH include: • Drink as little fluid as possible after 6 p.m. Cut down on fluids with caffeine. • Get up and urinate as soon as you feel the urge, then stand there a minute or more and urinate again. • Relax. • Have intercourse frequently. • Get some physical exercise. • Avoid antihistamines. • Stay warm during cold weather. • Soak in a warm bath or hot tub for 20 minutes 2 or 3 times per day. • Avoid prolonged sitting. Treatment options your physician may recommend for BPH include: watchful waiting; drug therapy; surgery; electrovaporization; needle ablation; laser therapy; balloon dilation; and stents.

That’s the bad news. The good news is that prostate cancer is treatable, if it is detected early. Usually, prostate cancer is rarely seen in men between the ages of 30 and 40. Prostate cancer becomes more common in AfricanAmerican men after age 40, and after age 50 for Caucasian men. Approximately 80 percent of prostate cancer occurs in men 65 or older. Prostate cancer, which is not related to BPH, is a more serious problem than BPH. Sometimes there are no symptoms of prostate cancer; however, some men may experience a weakening of the urinary stream or the need to urinate more often. Symptoms of advanced prostate cancer may include blood in the urine, impotence, and pain in the pelvis, spine, hip or ribs. If prostate cancer is detected, treatment options include: surgery (removal of the prostate); radiation therapy; seed implantation or prostate cancer brachytherapy; or cryosurgery.

Diseases of the prostate gland symptoms, treatment and prevention

Prostate cancer Each year, approximately 100,000 men are diagnosed with prostate cancer and more than 30,000 men die from the disease. It is the No. 1 cancer of men in the United States and the No. 2 killer, just behind lung cancer. The rates of prostate cancer are 32 percent higher in African-American men than Caucasian men.

The Prostate Specific Antigen or PSA test There is a blood test, the PSA test, which can be performed by your physician to check for the risk of prostate cancer. However, a normal reading does not mean a man does not have prostate cancer; and the reverse is true, an abnormal reading does not mean a man has prostate cancer. Many men will have an elevated PSA because they have BPH. Because BPH and prostate cancer may elevate PSA levels in the blood, the PSA test is not a true diagnostic test for prostate cancer. Rather, a PSA test combined with a rectal exam are screening examinations to determine who has a higher risk for prostate cancer. If your physician determines that you are at “high risk” for prostate cancer, he will recommend a prostate biopsy. Health Advantage Medi-Pak HMO recommends that its members receive a PSA test every 12 months. If you are a member of Medi-Pak HMO, please take advantage of this recommendation. If you are having problems with your prostate gland, please contact your physician for a diagnosis and appropriate treatment. — Sources: WebMD, and the Male Health Center (

Heart You are having trouble breathing. You have a shooting pain in your left arm. You have chest pain. Chances are, you are having a heart attack. However, sometimes the obvious signs of a heart attack may be absent. Although most people have recognizable heart attack symptoms, studies have shown that many people have heart attacks without even knowing it. According to a recent study published in the Journal of the American Medical Association, approximately onethird of heart attack victims showed up at the hospital without chest pain. Such patients were more than twice as likely to die, partly because of the delay in going to the hospital. Women, non-whites, people older than 75 and those with previous heart failure, stroke or diabetes were the most likely to have painless heart attacks. Additionally, the Journal of the American College of Cardiology published a study recently stating that more than one in five people over the age of 65 who have heart attacks have unrecognized heart attacks. Of the participants in the study, an electrocardiogram indicated that one in five of the participants had previous heart attacks. Because these silent heart attacks go undetected, they can’t be treated. This increases the chance of underlying heart disease advancing and causing another, more serious, heart attack later. Each year, approximately 1.5 million people in the United States have a heart attack — and 500,000 of them die. Heart attacks claim more lives than any other



single cause of death. There are some risk factors for a heart attack that you can’t control. Those are increasing age, gender (men are more at risk than women), race (African-Americans and other minority groups are more likely to have high blood pressure than Caucasians), diabetes and family medical history. Be sure and have regular checkups with your physician especially if you have risk factors that you can’t control. Risk factors you can control include smoking, high cholesterol, high blood pressure, obesity, physical inactivity and diet.

What is a heart attack? Heart attacks result from blood vessel disease in the heart. A heart attack occurs when the blood supply to part of the heart muscle itself is severely reduced or stopped. If the blood supply is cut off severely or for a long time, muscle cells suffer irreversible injury and die. Disability or death may result. But heart attacks may be stopped in progress and muscle damage reduced if they’re treated within a few (usually one to three) hours. To reduce your risk of a heart attack, remember the following: • Do not start smoking. If you smoke, quit. • Recognize and treat high blood pressure and diabetes. • Avoid excessive use of alcohol. • Be physically active. • Eat a healthful diet. • Have regular medical checkups. — Sources: Arkansas Chapter of the American Heart Association,, Journal of the American Medical Association and Journal of the American College of Cardiology.

Children need their father!

Dads aren’t just for discipline anymore G one are the days when Mom was the primary caregiver for the children while Dad was relegated to a secondary role — usually as the disciplinarian. Today’s Dad is ready and willing to change the diapers, carpool the kids and help with the homework. That’s good news for everyone — especially children. Numerous studies have shown that children benefit from having a caring and involved father present in their lives. Studies have indicated that: • Fatherless children are at a greater risk of suicide. (U.S. Department of Health and Human Services) • In a study involving children of divorced parents by the Children’s Psychiatric Hospital at the University of Michigan, 63 percent of the children had subjective psychological problems, 56 percent had poor grades compared to past performance, and 43 percent exhibited aggression toward their parents. • Among the teenage and adult population of females, parental divorce has been associated with lower self-esteem, precocious sexual activity, greater delinquent-like behavior and more difficulty establishing gratifying adult relationships. (Neil Kalter, Ph.D., University of Michigan, American Journal of Orthopsychiatry.) • Daughters of single parents are 53 percent more likely to marry as teenagers, 164 percent more likely to have a premarital birth and 93 percent more likely to dissolve their own marriages. The U.S. Department of Health and Human Services also reports that there were more than 1,000,000 documented child abuse cases in 1990. More than 60 percent of perpetrators were women with sole custody. Shared parenting can significantly reduce the stress associated with sole custody and reduce the isolation of children in abusive situations by allowing them to have time with both parents. • The National Fatherhood Institute reports that 18 million children live in poverty in single-parent homes.

Nearly 75 percent of American children living in single-parent homes will experience poverty. There is no doubt that having both parents in the home, or extensively involved in the children’s lives, makes happier, more well-adjusted children. That doesn’t mean that all children in single-parent homes will have academic or other problems, it just indicates that chances are greater that they might. It is the parents’ (whether married or divorced) responsibility to make sure the children benefit from what each parent has to offer. Research shows over and over again that the relationship that children have with their parents along with effective parenting (love, discipline and behavior-monitoring) are the most important factors leading to whether children will participate in “high-risk” behaviors. Raising children in today’s society is not easy, and it is not for wimps. As a reminder, focus on the following: • Relationship (creating a healthy relationship with your children) • Stewardship (providing for the physical needs) • Development (adapting to meet everchanging needs) • Ethical (teaching values and morals) • Spiritual (helping children to obtain purpose and joy) • Recreation (helping children to relax and have fun) • Mentoring (helping older children learn parenting skills). Fatherhood is probably the hardest job you will ever love. Define fatherhood in your own terms, as suitable for your children’s needs. Times have changed since you were a child, and the role of the father has changed with it. It is important to add your own values and traditions to those passed on to you from your own father. — Sources: University of Florida, Fatherwork and the National Center for Fathering.


TSE could be a lifesaver Lance Armstrong recovered

from testicular cancer and an aggressive treatment program to win the Tour de France bicycle marathon two years in a row. Testicular cancer is the most common type of cancer in men between the ages of 18 and 34. However, when detected early, it is one of the easiest to cure. If undetected at its earliest stages, it may spread throughout the lymph node system and other parts of the body. It is particularly dangerous because there are usually no symptoms associated with it. But, several predisposing factors may place some men at higher risk: past medical history of undescended testicle, mumps orchitis, inguinal hernia during childhood or previous testicular cancer. All men should perform monthly testicular selfexaminations (TSE) just as women are encouraged to do monthly breast self-examinations. The optimal time to perform the examination is while in the shower. Both hands should be used to examine each testicle with the thumbs in front and the first two fingers behind the testicle. The testicle should be rolled between the fingers


and the thumb, feeling for any lumps or bumps. Testicular cancer usually starts as a small peasized lump. It probably would not be noticed unless selfexams were routinely performed. And, finding a lump is no reason to panic (lumps or bumps in the testicle are not always cancer), but it is a reason to see your physician for an examination. Immense advances have been made in diagnosis and treatment. Besides self-exams, there are specific blood tests to screen for testicular cancer and sound waves can visualize the testicle for any abnormalities. Treatment of testicular cancer includes surgery (removal of the testicle and associated lymph nodes), radiation therapy and chemotherapy. If symptoms occur, call your physician for an appointment. If you are a male (15 or older), your physician should be performing routine testicular screenings during physical examinations.

CHOLESTEROL FACTS Why should men worry about cholesterol? The answer is simple: the higher your cholesterol, the greater your risk of getting heart disease — the No. 1 killer of men in the United States. How much cholesterol is too much? The National Heart, Lung and Blood Institute recommends that you keep your total cholesterol level at less than 200 mg/dL. A level of 200 to 239 is borderline-high, and greater than 240 is high. What exactly is cholesterol? Cholesterol is a lipid — a soft, fat-like substance. It is found in all body tissues and is critical to good health — but in reasonable quantities. Cholesterol is produced by the body (mainly, the liver) and ingested in food, especially animal products, such as meat, poultry, seafood, dairy products and eggs. Vegetables, fruit, grains and cereals contain no dietary cholesterol.

What happens when my cholesterol is too high? When you have too much cholesterol in your blood, the excess builds up along the walls of the arteries that carry blood to the heart. Called atherosclerosis or hardening of the arteries, this condition narrows the arteries, slows blood flow and reduces the amount of oxygen reaching the heart. What affects my cholesterol level? • High intake of saturated fat, dietary cholesterol and excess calories can increase blood cholesterol levels. • Being overweight. • Heredity may influence how your body makes and handles cholesterol. • Your cholesterol levels begin to rise after age 20. (Cholesterol, continued on Page 12)

Breast Cancer -- Not just for women B

reast cancer is not a disease for women only. October is National Breast Cancer Awareness Month, and it is important for men to know that they are not immune to this serious disease. Although the incidence of breast cancer in women is significantly higher than in men — an estimated 175,000 women and 1,400 men will be diagnosed with breast cancer this year — the fact is, breast cancer can occur in men. Actor Richard Roundtree, who starred in movies such as Shaft, has been seen on numerous talk shows recently discussing his experience with breast cancer. Roundtree and many others who are less famous have been sharing their stories to encourage men not to let breast cancer sneak up on them and perhaps reduce their odds for successful treatment. As with women who have breast cancer, early diagnosis and early treatment are critical to men surviving the disease. Some of the signs and symptoms of breast cancer in men include: • Breast lump or swelling (usually painless, but not always) • Nipple discharge (usually bloody) • Nipple inversion or retraction (turning inward) • Skin dimpling or puckering • Redness or scaling of the nipple or breast skin • Occasionally, local pain, itching or pulling sensation. Risk factors of breast cancer in men include: • Family history of breast cancer • Klinefelter’s Syndrome — a rare, genetic condition in males; with this syndrome men have an extra sex chromosome and do not produce enough testosterone • Gynecomastia — this is an enlargement of the male breast and may be related to Klinefelter’s syndrome, chronic diseases such as liver or heart disease, or a variety of drugs used to treat chronic diseases. Remember that most breast lumps in men are due to gynecomastia and not cancer. • Testicular Dysfunction • Radiation exposure (usually from treatment of a cancer inside the chest).

The treatment of breast cancer in men is the same as treatment for women patients and usually includes a combination of surgery, radiation, chemotherapy, and/or hormone therapy. The survival rate of men with breast cancer is comparable to women by disease stage at the time of diagnosis. However, men are usually diagnosed at a later stage, after the cancer has spread, because they are less likely to report any symptoms. In addition, among some men, there’s an embarrassment factor with a diagnosis of breast cancer and a worry that someone might question their masculinity. Cancer is no respecter of persons. Although physiology in men and women are different, all people have breast tissue. Like all cells of the body, a man’s breast duct cells can undergo cancerous changes. Many men’s breast cancers can be found early by their health care professional if they simply have regular checkups, but men who have any changes in their chest/ breast area should report them to a medical professional immediately. And don’t leave it to a health care professional to guess where the change is; be specific about suspicions or locations of lumps. Some people visit their doctor with the idea that if the doctor doesn’t find it, there’s nothing there. If you find a lump or know there’s a discharge or other symptom, show it to your doctor. Even if a man never develops breast cancer himself, chances are high that he will experience the disease through a diagnosis in his wife, mother, daughter, sister, aunt, niece, co-worker, friend or neighbor. Many men actually discover lumps in their partner’s breasts. And like other diseases, breast cancer impacts all of those around the person who has the illness and fights the battle to survive. History has a way of teaching future generations if people will listen and learn from the past. It hasn’t been too many years ago that women feared saying the words “breast cancer,” let alone considered discussing it with anyone ... and many women perhaps died unnecessarily. Men should not ignore the reality that they can develop breast cancer and certainly should not ignore the warning signs. — Sources: Susan G. Komen Breast Cancer Foundation and the American Cancer Society.

Living with diabetes D

iabetes is a killer. About that, make no mistake. Those who suffer from the disease and are in control of it can lead relatively normal lives. But diabetes will not be taken lightly. Diabetes and its complications kill someone in the United States every three minutes — the equivalent to a jumbo jet plane crashing every day with no survivors. Even diabetics who maintain good control of their blood glucose levels are likely to experience some sort of complication related to the disease because of damage to large and small blood vessels affecting the kidneys, heart, eyes, nerves and gums. Diabetes is a leading cause of kidney disease, blindness, heart disease, gum disease, stroke and amputations. Just what is diabetes? Diabetes is a series of conditions in which blood glucose (sugar) levels are abnormally high. It occurs because the immune systems of those affected attack and destroy the body’s insulinproducing cells. It is not known why this happens, but scientists speculate a combination of factors could be involved, such as exposure to common viruses at a young age and genetics. Diabetes entails two main types: type 1, or juvenileonset diabetes; and type 2, or adult-onset diabetes. Anyone is susceptible, regardless of age, race or gender, although type 1 diabetes generally strikes infants, children and young adults. Until a cure is found, it remains with its victims for a lifetime. Type 1 diabetics require insulin injections to live. Insulin is not a cure. In type 1 diabetics, the pancreas stops producing insulin — the hormone necessary for the proper metabolism to digest foods (the process by which glucose is allowed to enter body cells) — or doesn’t produce enough insulin. In people without diabetes, the pancreas produces just enough insulin necessary to break down the intake of blood glucose. In type 2 diabetics, the pancreas continues to produce insulin, but the insulin is unable to break down the blood glucose. Type 2 diabetics generally are able to treat their condition with oral medication, diet and exercise. Some still require insulin injections. Symptoms of diabetes are not hard to detect. They include: • Frequent urination. • Increased thirst.


• Increased hunger. • Unexplained weight loss. • Extreme fatigue, lethargy. If you have family members who have diabetes, be aware of these symptoms. It is believed genetics plays a factor in the contraction of the disease. If you have diabetes, remember that keeping your blood sugar levels as close to normal is the only way to help reduce the risk of long-term effects from the disease. Questions diabetics may want to ask their doctor include: • What is my glycosylated hemoglobin (a test that measures blood sugar levels over a two-to-three month period). What is a normal glycosylated hemoglobin reading? • How can I get my glycosylated hemoglobin in the normal range? • How often and under what conditions should I test my blood sugar? What should I do with the results, and what patterns should I try to achieve? • Do I have microalbuminuria (detection of tiny amounts of albumin in urine indicating early diabetic kidney disease)? • What effect has diabetes had on my eyes and kidneys? (Diabetics should visit their eye doctor for a diabetic checkup at least twice a year.) • When should I consult a dietician to review my diet? • What exercises are best for me and what adjustments to my food or insulin intake should I make if I plan to exercise? • What should my family and friends do if my blood sugar goes so low that I need their help? • How should I take care of my feet? • Are there any diabetes group meetings I could attend in my area? A cure for this disease is believed to be right around the corner. In the meantime, diabetes can be controlled. But each individual affected by the disease must decide how tight that control will be. — Sources: National Diabetes Information Clearinghouse and

12 FYI

For your information prescription medication formulary changes

Changes to the three-tier formulary Many employee groups covered by Arkansas Blue Cross and Blue Shield and Health Advantage utilize a three-tier co-payment benefit plan for prescription medications: Tier 3 is for brand-name prescription medications, which have the highest co-payment; Tier 2 is for brand-name prescription medications with the midrange co-payment; and Tier 1 is for generic prescription medications, which have the lowest co-payment. Changes to the tiers are made (usually two times per year) based on the safety, effectiveness and cost efficiency of medications in the same category. Effectiveness and safety are always the first considerations. If a less expensive medication becomes available that is just as safe and effective as a more expensive medication, the more expensive medication may move to a higher tier. How changes will affect members Effective Oct. 1, 2000, some medications will be moved to Tier 3. Members using one of the medications being moved may continue to use these medications at a higher co-payment. Or, the member may request from their physician a generic medication or a medication in the second tier. (Cholesterol, continued from Page 9) What is the difference between good cholesterol and bad cholesterol? LDL (low-density lipoprotein) and HDL (highdensity lipoprotein) are the two cholesterol carriers. Too much LDL-cholesterol causes buildup, so LDL is known as the bad cholesterol. The buildup, which becomes thick and hard, is called plaque. HDL-cholesterol, or good cholesterol, helps remove cholesterol from the blood and helps prevent fatty buildup. How can I lower my cholesterol level? The first step is to watch your diet. Eat foods that are: • Low in saturated fat. Saturated fat raises your cholesterol levels more than anything else you eat. Read food labels to determine which foods have saturated fat and which have unsaturated fat (monounsaturated and polyunsaturated). • Low in total fat. These foods have less saturated fat and fewer calories.

Three-Tier Formulary Changes Medications moving from Tier 2 to Tier 3 1. Accutane for treatment of acne 2. Arava for treatment of rheumatoid arthritis 3. Cardizem CD to treat high blood pressure 4. Cleocin T for treatment of acne 5. Corgard for treatment of high blood pressure 6. Diabeta for treatment of type 2 diabetes 7. Enbrel for treatment of rheumatoid arthritis 8. Equagesic for pain relief 9. Glynase for treatment of type 2 diabetes 10. Infertility medications 11. Injectable medications 12. Lamisil for treatment of fungus infections 13. Librax for relief of gastrointestinal disorders 14. Lupron Depot hormone injection 15. Micronase for treatment of type 2 diabetes 16. Relenza for treatment of viral infections 17. Sporanox for treatment of fungus infections 18. Tamiflu for treatment of viral infections 19. Ticlid for stroke prevention

• High in starch and fiber. Breads, cereals, pastas, grains, fruits and vegetables are examples. They are low in fat and calories and high in vitamins and minerals. • Low in cholesterol. Dietary cholesterol, which is present only in foods that come from animals, raises blood cholesterol, but not as much as saturated fat. Liver and egg yolks are low in saturated fat but high in cholesterol. Egg whites, vegetables and fruits have no dietary cholesterol. One good source of information about cholesterol is the American Heart Association. Visit their Web site at http://

Did you know . . E


10 things for Dad to do with the kids 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Fly a kite. Read a book. Have a picnic. Go swimming, fishing or hiking. Visit a museum. Ride bikes. Enjoy a movie. Go bowling or skating. Play board games or charades at home. Snuggle.

Get your shots Influenza (better known as the flu) and pneumonia are no fun. To ensure a healthy fall and winter, take preventive measures and get your vaccines. You may be at risk if you are in one of the following categories: • Persons aged 65 or older. • Persons aged 2 to 64 who have chronic illnesses such as cardiovascular disease including congestive heart failure (CHF), cardiomyopathies and chronic obstructive pulmonary disease (COPD), recurrent bronchitis, emphysema, diabetes mellitus, alcoholism, chronic liver disease, cirrhosis, cystic fibrosis, functional or anatomic asplenia, or sickle cell disease. • Persons who are smokers. • Persons aged 2 to 64 who are in special environments such as nursing homes or other long-term care facilities. • Persons 2 and older who have functional or anatomic asplenia (including sickle cell disease), Hodgkin’s disease, lymphoma, leukemia, multiple myeloma, chronic renal failure and other conditions such as organ transplantation, cancer treatments and drug regimens causing immunosuppression and HIV infection. If you appear at risk, you will be receiving a reminder card from Health Advantage encouraging you to get your vaccines. Both vaccines may be taken at the same time at the onset of the flu season (early October). Most people only need one pneumonia vaccination to immunize them for the rest of their lives. Others may need another shot every five years. See your primary care physician with questions or for more information.

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Men live, on the average, about 7 years less than women in the United States. Some believe it is because women visit their doctors more often.

High blood pressure: Do you have it?

According to utilization statistics from Arkansas Blue Cross and Blue Shield, high blood pressure is the No. 1 reason that our male members visit their physician. High blood pressure is called the “silent killer” because there are no symptoms. You may look and feel fine while your blood pressure is soaring to dangerous levels. So what can you do? Learn what causes high blood pressure and what you can do to decrease your risk of having high blood pressure. What is high blood pressure? Two numbers are being measured when you have your blood pressure checked by a medical professional. The first number (systolic pressure) measures the pressure in your arteries while your heart beats. The second number (diastolic pressure) measures the pressure while your heart rests between beats. Normal blood pressure falls within a range; it’s not one set of numbers. It should be less than 140/90 if you are an adult. If your blood pressure goes above this threshold and stays there, you have high blood pressure. What causes high blood pressure? In 90 to 95 percent of high blood pressure cases, the cause is unknown. You could have it for years without knowing it. In the other five percent of cases, there is usually an underlying problem such as a kidney abnormality or congenital heart defect. What can you do about high blood pressure? • Maintain a normal, healthy weight. • Decrease salt intake. • Take medications as prescribed by your physician. • Do not start smoking and if you are a smoker, quit. If you are experiencing symptoms of high blood pressure, please visit your physician for diagnosis and treatment. — Source: American Heart Association.


Leading T

his issue of Blue & You continues our mission to introduce our state senators and representatives of the Arkansas General Assembly to our customers.

Rep. Jo Carson (D) (Dist. 13) Fort Smith Aging, Children & Youth, Legislative and Military Affairs; Judiciary (O) 501-785-2326 (H) 501-646-2111 Rep. Keith Davis (D) (Dist. 89) Weiner Agriculture & Economic Development; Joint performance Review; Judiciary (O) 870-252-3283 (H) 870-684-7558 Rep. George French (D) (Dist. 82) Monticello Vice-Chairman, Rules; Agriculture & Economic Development; Education; House Management; Joint Budget (O/H) 870-367-2804 Rep. Phillip Jacobs (D) (Dist. 25) Clarksville Vice-Chairman, Joint Performance Review; City, County & Local Affairs; Public Transportation (O) 501-754-2924 (H) 501-754-3036

Rep. Gene Jeffress (D) (Dist. 38) Louann Agriculture & Economic Development; Joint Retirement & Social Security; Public Transportation (O) 870-837-1300 (H) 870-689-3537 Rep. Steve Jones (D) (Dist. 95) West Memphis Aging, Children & Youth, Legislative and Military Affairs; Public Transportation; Rules (O/H) 870-739-2137

Rep. Janice Judy (D) (Dist. 7) Fayetteville Aging, Children & Youth, Legislative and Military Affairs; Public Transportation (O)501-643-3500 (H) 501-521-4194 Rep. Jim Milligan (D) (Dist. 39) Yellville Agriculture & Economic Development; Energy; Judiciary (O/H) 870-449-6775

Rep. Andrew Morris (R) (Dist. 5) Siloam Springs Agriculture & Economic Development; Education; Joint Advanced Communications & Information Technology (O) 501-549-6351 (H) 501-750-1845

the Way These elected officials spend numerous hours working on health care issues that affect you. (Upcoming issues of Blue & You will feature additional profiles of our legislators.) Rep. Larry Prater (D) (Dist. 10) Rudy City, County & Local Affairs; Joint Performance Review; Judiciary (O/H) 501-474-6246

Rep. Paul Weaver (D) (Dist 67) Violet Hill City, County & Local Affairs; Education; Joint Retirement & Social Security (O/H) 870-322-7338

Rep. Robert White (D) (Dist. 37) Camden Agriculture & Economic Development; Judiciary (O) 870-574-4500 (H) 870231-4285

Rep. Henry Wilkins (D) (Dist. 73) Pine Bluff Aging, Children & Youth, Legislative and Military Affairs; Joint Retirement & Social Security; Public Transportation (O/H) 870-535-4488

15 Rep. Arnell Willis (D) (Dist. 99) West Helena Aging, Children & Youth, Legislative and Military Affairs; Education; Join Retirement & Social Security (O) 870-572-7700 (H) 870-572-7717

Sen. John Riggs (D) (Dist. 16) Little Rock City, County & Local Affairs; Committee on Committees; Education; Joint Advanced Communications & Information Technology;Transportation, Aging & Legislative Affairs (O) 501-570-3100 (H) 501-223-8916 Sen. Tim Wooldridge (D) (Dist. 30) Paragould Vice-Chairman, Agriculture, Economic & Industrial Development; Committee on Committees;Transportation, Aging & Legislative Affairs (O) 870-236-6901 (H) 870-239-8763


TO ALL HEALTH ADVANTAGE MEMBERS: Do you have a primary care physician listed on your Health Advantage ID card? Check your card right now! If your answer is no, call us immediately at (501) 221-3733 or toll-free 1-800-843-1329. When enrolling with Health Advantage, all members (this includes the contract holder, spouse and all dependents as applicable) must select a Primary Care Physi-

ge Health Advanta members —

take note!

cian (PCP) from the list of participating providers. You will receive an ID card within 5-7 days with the PCP’s name on it. This card must be presented when seeking medical care in order to have claims paid promptly and correctly. Participating status of a provider may be verified by contacting

the Health Advantage Customer Service Department or visiting our Web site Failure to choose a PCP may result in denied services. Also, the PCP is under no obligation to provide services to Health Advantage members if they have not selected him or her as their PCP. Therefore, this could cause delays in getting appointments and additional paper work when you try to schedule a visit. Please call our customer service department at (501) 221-3733 or toll-free 1-800-843-1329 for assistance. Hours of operation are 8 a.m.–5 p.m, Monday-Friday.

Have we got a discount for you! $ ➘ $ ➘ $ ➘ $ A rkansas Blue Cross and

Blue Shield, Health Advantage and USAble Administrators are now offering a “wellness program” to all members. The wellness program provides discounts at local health clubs, sporting good stores and fitness equipment vendors statewide. Those participating and their discounted services are listed on our Web sites by name and location (with phone numbers). See Web addresses on Page 3. Current participants are: Carr’s Chain Reaction Bicycle (Russellville) Country Squire Sports (West Memphis) Curves for Women (36 locations statewide) Fitness Concepts, Inc. (Little Rock) Hot Springs Athletics and Racquet Club Jazzercise of Conway Jean-Paul Fitness Specialists (Little Rock) Minton’s SportsPlex (Texarkana)

New Attitudes Wellness Center (Atlanta, Texas) New Body Fitness (Heber Springs) Physiques Health and Fitness (Magnolia) QuailTree Health & Racquet (Harrison) Sports Depot, Inc. (Morrilton) Ultimate Fitness (Cabot and Jacksonville) Xtreme Fitness (Conway and Sherwood) Bess Chisum Stephens YWCA (Little Rock) YMCA of El Dorado Getting the discount is easy. Members simply show their individual or family health insurance ID card at the time of purchase. New venues will be added to the Web site directory as the network develops, so check the site periodically for your favorite health club or sporting goods store. To find out more about available services and product discounts, call the program participants directly.

Disclaimer Notice This discount program is not an endorsement of any services, products or businesses. You are responsible for selecting your own fitness or wellness vendors and products and should not rely on this discount program to select or recommend any vendor or product for you. You should always consult your own physician before engaging in any exercise or fitness routine or before using any fitness products, dietary supplements or other products or services offered by fitness vendors. We have not inspected or evaluated the facilities, products or services of any of the businesses participating in this discount program for safety, quality or appropriateness; you will need to inspect, evaluate and make your own independent judgment in each case before selecting a fitness vendor or product.

Northwest Regional ➔ Office Moving Arkansas Blue Cross and Blue Shield’s Northwest Regional Office, headquartered in Fayetteville, is on the move. On Thursday, Nov. 30, 2000, the office will close at noon to move to its new location at 516 East Millsap Road, Fayetteville, AR 72703. The office will reopen on Monday, Dec. 4. Office telephone numbers will remain the same.

he national Blue Cross Blue Shield Association T (BCBSA) has launched a new public policy Web site: The site, which is accessible to the public, provides balanced, credible information, reflecting different viewpoints on publicpolicy issues that affect health care coverage. Site visitors may register on two levels. If they choose to register on the first level (news registration), they will receive news and information via e-mail and have access to a more comprehensive “Health Care Headlines” section. The second level (activist registration) encourages users to “Take Action,” which leads them to the “Action Center.” This center allows them to speak out and voice their stand on the issues. Registration on this level automatically matches users to their congressional and state legislative districts and enables them to send faxes to their congressional

Key Issues • “Key Issues” features a pull-down menu of links: “Doctors Collective Bargaining,” “Right to Sue,” “Coverage for Small Business,” “Patients’ Bill of Rights,” “Prescription Drug Costs for Seniors,” “The Uninsured,” and “Rising Drug Prices.” An overview, “Some Say,” “Others Say,” “BCBSA Position” and “Other Links” to supporting and opposing views are provided. Political Information By clicking on “Congress and State Legislatures,” viewers may access political information, including a link that assists them in registering to vote. Pull-downs are: • “Guide to Congress” contains information, such as voting history, about every U.S. representative and senator. • “Congressional Schedule” gives daily House and Senate schedules and weekly schedules for committee hearings. • “Congressional Bill Status/Tracking” lists the priority federal bills that the association is tracking. • “Guide to the 2000 Election” examines this year’s federal and state election races, including information on the candidates and links to their Web sites. • “State Capitol Watch” indexes major health legislation enacted in 1999 and identifies the most significant issue trends for 2000. • “Guide to State Legislatures” provides information on state legislators. • “National Conference of State Legislatures” links to the National Conference of State Legislatures site.

Health Issues Web Site provides public with information, avenues for action

representatives from the site. Activist users also will receive “action alerts” and e-mail updates on key issues. Site Features The major features of the health issues site are: • “Top Story” is a key message, which will change frequently and link to additional information. • “BCBS Top News” lists important breaking news. • “Today’s Health Care Headlines” is a news monitoring service that searches more than 1,000 sources — including Associated Press, Internet Wires, UPI, Knight-Ridder, US Newswire and PR Newswire — for topics associated with health insurance, managed care, Medicaid/Medicare, and health care legislation. Information is updated throughout the day. • “Search” engines appear on every page. Users can search the entire site or may choose to search more than 5,000 other public-policy and political Web sites. In addition, users can search federal legislation (via a link to the THOMAS site at and regulatory information (via the National Archives site at • “Sound Off” allows visitors a place to speak their minds while remaining anonymous. Three major menu items are accessible at the top of every page on the Web site: “Key Issues,” “Congress and State Legislatures” and “News and Research.”

News and Research The “News and Research” menu item at the top of each page features a drop-down menu, where the facts and news stories about health care can be found. The links include: • “Top Stories” • “Health Care Headlines” • “BCBS Newsroom” • “Understanding Health Insurance” • “Featured Research” • “Politics of Health Care” • “Presidential Candidates on Health Care” • “Health Care Polling Report.”


Take a stand against domestic violence

Approximately 95 percent of the victims of domes-

tic violence are women. The sad fact is that someone you know — a coworker, sister or friend — may have been a victim of domestic violence at some point. According to the Federal Bureau of Investigation, approximately one out of every four women will become a victim of domestic violence in her lifetime. Arkansas Blue Cross and Blue Shield and the Little Rock Commission on Domestic Violence have joined forces in a campaign to increase awareness in the Little Rock community about domestic violence. The campaign, which features the slogan “Raise Your Hand Against Abuse,” will be funded in part by the city of Little Rock and will feature advertising in local newspapers and on local radio and television stations. A 24hour toll-free telephone number is included in each advertisement for confidential assistance and referrals. The call center will serve as an outsourcing center, giving referrals to both victims and perpetrators. “Domestic violence has been a ‘hidden’ problem in our communities,” said Bob Cabe, chief legal counsel and executive vice president of Arkansas Blue Cross. “Every 15 seconds a woman is beaten in our

country. This means that domestic violence is not only a serious social problem, but also a significant health risk for many of our citizens. “Arkansas Blue Cross is very proud to take part in a program that will help Arkansans learn more about this issue and let them know there is confidential help available and a place for victims and their children to stay if needed,” added Cabe. The Commission currently oversees two intervention and education programs in Little Rock. The Domestic Violence Intervention Program, which offers a 33-week course for domestic violence offenders, served 846 clients in 1999. After completion of the course, only 18 offenders were re-arrested for domestic violence. The Domestic Violence Outreach Program, a program for domestic violence victims, served 1,035 survivors in 1999. For more information on how to stop the cycle of domestic violence, or for confidential help, call (501) 376-3219.

New Board Members Elected Robert V. Brothers of Rogers, James V. Kelley of El Dorado, and Patty Fulbright Smith of Texarkana have been elected to the Arkansas Blue Cross and Blue Shield Board of Directors, according to Hayes McClerkin, chairman of the board. “These three individuals bring to the Arkansas Blue Cross board of directors added expertise in the areas of financial management and community outreach,” McClerkin said. “Their skills will greatly enhance the ability of Arkansas Blue Cross to assess and serve the health care financing needs of our members and the state.”




Brothers is president and chief executive officer of ARVEST Bank (formerly First National Bank and Trust) in Rogers; Kelley is chairman, president and CEO of First United Bancshares, Inc., in El Dorado; and Smith is administrative director of Opportunities, Inc. in Texarkana.

19 rkansas Blue Cross and Blue Shield strives to be a A good corporate citizen. Our employees raise money and spend many hours helping those causes near and dear to the hearts of Arkansans. Drug Prevention Walk BlueAnn Ewe was one of many celebrities on hand to lead the fight against drugs at the 13th Annual “Just Say No” drug prevention walk hosted by Perritt Primary School in Arkadelphia on April 21. To help lead the walk, BlueAnn joined such famous folks as Fitz Hill, Arkansas Razorback assistant football coach and Arkadelphia native; Rick Dial, character actor; Roxie Hannah, Miss Henderson State University; Lisa Akins, Miss Southwest Arkansas; Arkadelphia Mayor Chuck Hollingshead, Eric Drost from Governor Mike Huckabee’s office; Perritt Elementary students and Barney Badger, get ready to march against Arkadelphia High School drugs in Arkadelphia. mascot. But the special stars were the hundreds of elementary students, high school mentors, teachers and administration staff, and community supporters who marched against drugs. To top off a great event, Dial performed the song, “I’m Proud to be an American” made famous by country recording artist Lee Greenwood. “Build a Healthy Sundae” Parties Elementary school students in five lucky classrooms in Arkansas constructed creamy creations recently with the assistance of BlueAnn Ewe. The students, who were members of the BlueAnn Class Club, completed a Healthy Habits Activity Calendar under the direction of their teachers, and thus became eligible for a “Build a Healthy Sundae” party with BlueAnn in their classrooms. To complete the Healthy Habits Activity Calendar, students practiced at least one healthy habit each day — brushed their teeth, got a good night’s sleep, exercised,

Students at Riverside East buckled their seat belt, ate healthy foods, Elementary in Caraway enjoy sundaes with BlueAnn Ewe. etc. — and recorded their habits with a sticker on a calendar for 20 school days. As a reward for their efforts, BlueAnn Ewe paid a personal visit to the classroom and served the students bowls of frozen vanilla yogurt, which they topped off with granola, fresh bananas, multi-grain cereal, strawberries, cherries, nuts, sprinkles and fat-free whipped topping. Students also enjoyed low-fat animal crackers, juice and water with their treats. Following their cool refreshments, the students played games with BlueAnn, and watched and learned the words to BlueAnn’s new musical health videos. Each student and the teacher received a party favor during the festivities. Winners of the sundae parties were: Mrs. Sonya Launius’ secondgrade class at Bearden Elementary School; Ms. Diane Payton’s kindergarten class at Cotter Elementary School; Mrs. Sherry Bland’s kindergarten class at Caddo Hills Elementary School; Mrs. Debbie Dunigan’s third-grade class at Riverside East Elementary School in Caraway; and Mrs. Linda Semelka’s kindergarten class at Sheridan Elementary School.

Thousands visit Olympic Village Although the rain kept the largest crowds away from Riverfest on Saturday, May 27, more than 75,000 turned out in the sunshine on Sunday to partake of the festivities ... and thousands of those festival-goers paid a visit to the “Caring for the Human Spirit”™ mini Olympic Village hosted by Arkansas Blue Cross and Blue Shield. Baptist Health nurses took blood pressure readings and measured body fat for interested visitors of the Village. Kids of all ages enjoyed the mini-decathlon, health fair and nutrition center — all in the spirit and excitement of the Olympic Games. Sports fans shot hoops, pitched baseballs, shot hockey pucks and sprinted against resistance in the bungee sprint for fun and friendly competition. Everyone had a blast ... rain and shine.

— a guide to health insurance terminology


f health care terminology (including abbreviations and acronyms) leaves your head spinning … Arkansas Blue Cross and Blue Shield would like to help you make sense out of all the jargon. We want you to be an informed customer, so in each issue of Blue & You we will explain the meaning behind those health insurance words, acronyms and abbreviations that you may encounter when reading health care-related materials. Beneficiary — A person who is eligible to receive, or is receiving, benefits through health care coverage (a term usually used in regard to federal programs). Benefit period — The period of time for which payments for benefits covered by an insurance policy or health care service contract are available. Benefit period is usually defined by a set unit of time (for example, one year). Coverage — Specific benefits against specific losses provided under an insurance policy (or evidence of coverage of the health plan or employer, if self-insured), to the insured member who meets eligibility requirements and for whom premium payments are paid. Dependent eligibility — Requiring our members to list their dependents at the time of enrollment (as opposed to when claims are filed on their behalf). This cost-saving measure also includes periodic dependent verification. Group insurance — Any insurance or health services contract by which groups of employees (and often their dependents) are covered under a single policy or contract issued to their employer or other group entity. Individual health insurance — Health services contract or insurance policy which is purchased by an individual and which covers the individual (and usually the person’s dependents) in contrast to group insurance. Open enrollment — A period of time during which eligible subscribers may elect to enroll in, or transfer between, available programs providing health care coverage.

Pre-existing condition — A physical condition or disease which existed prior to the issuance of a health insurance policy or health care services contract and for which treatment under the contract or policy may be limited or excluded for a set period of time. Reserves — Monies earmarked to cover anticipated claims and operating expenses for a set period of time. Reserves are an obligated amount and have three principal components: reserves for known liabilities not yet paid; reserves for losses incurred but unreported; and other reserves for various special purposes, including contingency reserves for unforeseen circumstances.

We’d like to hear from you! Do you have a comment about this publication? Do you have suggestions for articles or issues you would like to have included in Blue & You? If you do, please feel free to e-mail all comments or suggestions to We look forward to hearing from you, and we will do our best to respond to all e-mails. Remember if you have a question about a claim or your health insurance policy, turn to Page 2 in this publication to find the appropriate telephone number to call to have your question answered.

Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181

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