Balance winter 2015

A PUBLICATION OF

W I N T E R

2 0 1 5

L I F E , H E A LT H & W E L L N E S S

I am making my health my job so

I can beat this.

How self-advocacy and perseverance helped Network Health member Karen Schmidt get one step closer to a cure.

life 3 Test Your Home and Protect Your Health

Radon testing is easy and could save your life

3 Network Health Rates High on Quality

Learn more about our national rankings

03

4 Clinical Practice Guidelines

Appropriate care for specific clinical circumstances

4 We’re Here to Help Overcoming obstacles in your treatment plan

health

Respiratory Medication

Rescue inhalers vs. controller medicine Tips for living a heart healthy life

Lead Designer Debra Sutton

E DITORIAL

BOARD

© 2015 Network Health. No portion of this newsletter may be reproduced without written permission from Network Health.

7 Feeling Down?

Marketing Jessica Coordinator Thomaschefsky

Balance is published quarterly by Network Health. The health information contained in Balance is meant to supplement, not replace, the advice of health care professionals.

6 Show Yourself Some Love

Chief Administrative Penny Ransom

Officer

Dawn Rady, Mark Geiger, Renee Corral, Teri Koepke, Darren Brzozowski, Melanie Draheim, Gary Melis, Carisa Satorius, Stacy Schwander, Joan Merwin, Jessica Fischer

06

5 Understanding Your

E DITORIAL STAFF President and CEO Sheila Jenkins

How to know when it’s more than just the blues S T O C O V E R Y

08

staying calm in the face of

If you have questions or suggestions or

How self-advocacy and perseverance helped Network Health member Karen Schmidt get one step closer to a cure

balance@networkhealth.com.

ADVERSITY

wellness Beauty Sleep

Learn about the benefits of sleep to your overall health

PLANS THROUGH AN EMPLOYER 800-826-0940

14 Preventive Services and

PLANS FOR INDIVIDUALS AND FAMILIES 855-275-1400

Immunizations

Helping you live the healthiest life possible

19 A New Look

Network Health to launch new wellness websites in January of 2016

2 | balance • W i n t e r 2 01 5

Network Health Attention: Jessica Thomaschefsky 1570 Midway Pl. Menasha, WI 54952

HOURS Mon., Wed. - Fri.: 8 a.m. to 5 p.m.

Tuesday: 8 a.m. to 4 p.m.

13 Keep Calm and Get Your

You can also write to us at:

Call our award-winning customer service team.

Control your risk factors for high blood pressure

would like to tell us how Network Health improved your life, send us an email at

HAVE A QUESTION?

12 Don’t Be the One in Three

TELL US WHAT YOU THINK

WANT MORE HEALTH TIPS?

12

Check out our blog at copilotwi.com.

We add helpful information about health and well-being every week, so be sure to visit often.

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life

Information to help you get the most out of your coverage

Test Your Home and Protect Your Health A

ccording to The U.S. Environmental Protection Agency (EPA), as many as 20,000 lung cancer deaths are caused by radon each year. In fact, radon is the second leading cause of lung cancer behind smoking. If you smoke and your home has a high radon level, you’re at an even greater risk. Radon-induced lung cancer costs the U.S. over $2 billion per year in health care costs and it could cost you your life.

What is radon?

Radon is a naturally occurring cancer-causing gas that you cannot see, smell or taste. Radon can build up to dangerous levels inside homes and buildings where people are exposed through inhalation and ingestion. Radon in the ground, groundwater or building materials enters living spaces and turns into something scientists call decay products. Those decay products are radioactive byproducts that are inhaled and cause lung cancer.

are usually highest in the basement because it’s closest to the source.

If you spend a lot of time in your basement, it’s a good idea to have your home tested. Without testing, you have no way of knowing how much radon is present in your home.

What should I do if radon levels in my home are high?

The EPA estimates that roughly one out of every fifteen homes has unsafe radon levels. If a radon test determines that your levels are high, it’s recommended you take action to reduce the level. Sealing cracks in floors and walls can help protect your family. However, to decrease the radon level, you must have a licensed professional install a radon mitigation system.

How does radon gas get released into my home?

Radon gas is emitted from the ground and enters a home through cracks in the basement floor, walls or gaps in the foundation. Levels

Take action today. Radon testing is easy, inexpensive and might just save your life.

3 n e t w o r k h e a l t h . c o m

Network Health Rates High on Quality

Network Health evaluates the quality of care and services provided to members using two nationally recognized tools, the Healthcare Effectiveness and Data Information Set (HEDIS®) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®). Each tool scores our service in a different way. To view Network Health’s results, visit networkhealth.com and search for HEDIS and CAHPS. If you would like a hard copy, or for more information about Network Health’s Quality Improvement Program and national rankings, call 920-720-1229 or 800-826-0940, ext. 01229.

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life { YOUR CARE }

Clinical Practice Guidelines

N

etwork Health provides clinical practice guidelines to help you and your health care team make decisions regarding appropriate care for specific clinical circumstances. These circumstances may be medically acute or chronic in nature such as low back pain or diabetes, or behavioral health such as depression. These evidence based guidelines are available to both you and your provider on Network Health’s website. Go to networkhealth.com and access the guidelines by selecting Member’s Corner. Select Resources and click on the Learn More button. Here you will find a link for Clinical and Preventive Guidelines. If you would prefer a printed copy of these guidelines, call our customer service department at the number listed on page two.

S AY W H AT ?

Acute – Symptoms appear, change or worsen suddenly.

Chronic – Symptoms develop and worsen over time.

We’re Here to Help We understand there may be religious, financial or cultural obstacles that keep you from following or understanding a treatment plan prescribed by your primary care physician. These obstacles may include the following. >> Beliefs and concerns about the condition and treatment >> Perceived barriers to meeting treatment requirements >> Access, transportation and financial barriers to obtaining treatment >> Cultural, religious and ethnic beliefs All of these factors play into a person’s ability to follow their doctor’s treatment plan. If you are unable to follow your treatment plan because of one or more of these barriers, and need additional support, call our care management department at 920-720-1600 or 800-236-0208. A nurse will assist you with finding ways to work through these barriers.

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health

News and tips to help you maintain a healthy and happy life

Understanding Your Respiratory Medication O

ne of the best ways to control your respiratory condition is to understand and follow your doctor’s instructions for medication.

Medications play an important role in managing the severity of your symptoms, so it’s important to understand how they work.

There are two kinds of asthma medications your health care provider may prescribe, a rescue inhaler or a controller medicine.

Rescue inhaler

Use this when quick relief is needed from symptoms such as wheezing or tightness in your chest. The medicine quickly relaxes the muscles around your airways and lets air through to your lungs. An inhaler delivers a measured dose of medication into your lungs. It’s important to use your inhaler correctly to ensure all the needed medication reaches your lungs. If you need to use your rescue inhaler more than two days a week, talk to your doctor because it may mean your asthma is not under control.

Controller medicine

These long-term medications are taken on a daily basis, even when you don’t have symptoms. Controller medications prevent attacks by gradually keeping your symptoms under control for a longer period of time. Think of controller medications as routine maintenance of your symptoms.

That means if you take them every day, you will prevent flare-ups. They help control swelling in your airways and make them less sensitive.

Network Health has a new asthma/chronic obstructive pulmonary disease (COPD) medication management program that offers individualized education with a Network Health pharmacist at no additional cost. You and the pharmacist can talk about the following topics. >> Ensure you are receiving your medications at the lowest cost >> Differences between daily controller and rescue medications >> Importance of taking medication as directed by your doctor >> Best times to take your medications and why >> How to properly take and clean inhaled medications >> Discuss medication questions or concerns Network Health pharmacists are here to help you manage your asthma or breathing condition. Individuals who talked with a pharmacist saw average savings on their monthly cost ranging from $25 to $253 per month. For more information about this program and to be referred to a Network Health pharmacist, call Jan Cobia, RN, at 920-628-7155 or 800-769-3186. n e t w o r k h e a l t h . c o m

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health

Show Yourself

some love L

ove will be in the air this February with the arrival of Valentine’s Day. How fitting that February is American Heart Month. With heart disease being the leading cause of death for men and women in the U.S., it’s important to focus on your health, spread the word about prevention and encourage those around you to live heart healthy lives.

Here are a few easy ways to show yourself some love.

Eat a healthy diet

Include more fruits and vegetables, whole-grain foods, poultry, fish and low-fat dairy products in your diet. Reduce the amount of red meat, sweets, saturated fat, trans fat and cholesterol.

Get moving

Get at least 30 minutes of moderate physical activity each day. You’ll feel better and lower your risk of heart disease, stroke and diabetes.

Manage your blood pressure

If the blood running through your arteries flows with too much force and pressure, you can end up with tiny tears in the vessels. Your body heals these tears by creating scar tissue. Unfortunately, that scar tissue traps plaque and white blood cells which then form blockages and blood clots. Eating a healthy diet and getting regular exercise are two ways to keep your blood pressure under control.

Keep your cholesterol under control

When you have too much bad cholesterol (LDL), it combines with white blood cells and creates plaque in your veins and arteries. These blockages lead to heart disease and stroke.

To keep your cholesterol in check, once again, eat a healthy diet and get daily exercise.

Reduce your blood sugar

If your fasting blood sugar level is over 100, it could indicate diabetes or prediabetes. Even though diabetes is a treatable condition, it increases your risk of heart disease and stroke. Reduce your consumption of sugary desserts, soda and candy. Get your daily exercise and if you have diabetes, make sure you take your medications as prescribed.

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networkhealth.com

?

For a complete list of recent changes to our provider network, go to networkhealth.com/providerchanges.

Feeling

Down T

he cold days and dark nights of winter in Wisconsin can make us feel like we’ve caught a case of the blues. While slight mood changes can be normal, it’s important to know when it might be something more serious.

UNDERSTAND DEPRESSION

Depression can be caused by a combination of genetic, biological, environmental and psychological factors. According to genetic research, depression can result from genes acting together with environmental factors.

Some types of depression run in families and in other cases, trauma can cause depression. Loss of a loved one, career or any other stress can also trigger depression. Seasonal depression, called seasonal affective disorder (SAD), occurs each year at the same time.

It’s believed to be related to seasonal variations of light. In some instances, depression can occur without any obvious triggers.

You shouldn’t feel ashamed or embarrassed if you think you’re experiencing depression. It’s a medical condition, not a mood or character flaw. Instead, take steps to understand it and know when you should talk to your doctor.

How to know when it’s more than just the blues

KNOW YOUR RISK FACTORS

According to the National Institute of Mental Health, each year about 6.7 percent of U.S. adults experience major depression. Women are 70 percent more likely than men to experience depression during their lifetime.

Fortunately, even in severe cases, depression can be effectively treated. In fact, the earlier treatment begins, the more effective it is.

The first step to getting appropriate treatment is to visit your doctor or a mental health specialist. If an antidepressant is prescribed, be sure not to skip doses or quit treatment early. It can take up to eight weeks before an antidepressant takes full effect. Give your medication a fair chance by taking it as prescribed and giving it time to work.

RECOGNIZE THE SYMPTOMS >> >> >> >> >> >> >>

>> >> >> >>

Persistent sad, anxious or empty feelings Feelings of hopelessness or pessimism Feelings of guilt, worthlessness or helplessness Irritability or restlessness Loss of interest in activities or hobbies you used to enjoy Fatigue and decreased energy Difficulty concentrating, remembering details and making decisions Insomnia or excessive sleeping Overeating or appetite loss Thoughts of suicide or suicide attempts Aches, pains, headaches, cramps or digestive problems that don’t get better with treatment

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You know your body, so you need to advocate for yourself. Having another advocate, like Jenni, in my corner is great because

I can’t do this on my own.

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networkhealth.com

S T O C O V E R Y

staying calm in the

FACE OF

ADVERSITY Karen Schmidt is thankful for many things including Network Health and her care management coordinator, Jenni Topel. > > >

By Jessica Thomaschefsky P h o t o g r a p h s b y B e t h D e s J a r d i n , Tr ove P h o t o g r a p hy

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Stress really kills with this one, and

I am making my health my job so I can beat this.

F

or the last several years, Karen has had an unhealthy reaction to stress. Whether it was the holidays or renting out her house for EAA, she would experience odd symptoms whenever she would get stressed. “I was like a cat on a hot tin roof,” Karen said.

Her back would go out, and she would become extremely irritable.

Everyone reacts differently to stress, so she wasn’t too concerned.

After graduating with a master’s degree in mental health counseling in 2008, she began her own private practice. Seeing patients and working with them was the easy part. However, she had a difficult time keeping up with the details and deadlines involved in owning a private practice. She couldn’t understand why she was having such a difficult time, and the brain fog she had been experiencing for years was getting worse. She knew there was something wrong, but couldn’t pinpoint the source.

Karen decided to see her doctor to talk about her cognitive function and her unhealthy reaction to stress. It was passed off as high anxiety, however, she knew it had to be something more.

In 2010, she developed kidney stones. Then a few months later, she went into menopause, seemingly overnight. A blood panel showed she was post-menopausal even though she never had any other symptoms. This was her first indicator that something wasn’t right, and she needed to take action.

In 2012, Karen gave up her private practice and took a position at UW-Oshkosh. Unfortunately, going from a flexible private practice where you make your own hours to being responsible for 350 students increased her stress level. A few months into her 10 | balance • W i n t e r 2 014

new position, she suffered from hearing loss, multiple urinary tract infections and ever-increasing back pain. The pain was so bad she couldn’t sit down in meetings, had to switch to a stand-up desk and even taught class lying on the ground. Karen muddled through life like this for over a year and a half while seeing numerous doctors and specialists. Symptoms would flare up but by the time she had a chance to see her doctor, they would disappear.

In 2014, after years of suffering and numerous doctor visits, Karen finally took some time off from work to figure out what was going on with her health. She decided to try an integrative and holistic approach. A Western blot test confirmed that Karen had Lyme disease. She finally had an explanation for all of her symptoms. Once the prescribed antibiotics started working, some of the back pain was alleviated, and the aches and pains in her joints seemed to disappear.

She no longer felt like she had brain fog and was looking forward to getting her life back.

Unfortunately, the kidney stones came back. A CT scan confirmed that she had bilateral kidney stones, which was no surprise as she had them in the past. After speaking with her urologist, she decided to read through the radiology report online. The report mentioned multiple lesions on her liver which is associated with metastatic disease. A follow-up biopsy was recommended. At first, she attributed the lesions to the amount of antibiotics she had taken for Lyme disease, thinking it was a side effect. To be sure, she followed up with her urologist about the lesions. The report also mentioned a thickened uterus, which is normal with being post-menopausal. Her networkhealth.com

urologist then referred Karen to a gynecologist.

The gynecologist agreed to do a biopsy on her liver. Assuming it was just the Lyme disease, she was surprised with the results of the biopsy.

Karen had a neuroendocrine tumor.

A neuroendocrine tumor is a mass that begins in parts of the body which produce and release hormones. Because an endocrine tumor develops from cells that produce hormones, the mass itself produces additional hormones and causes serious illness. One of the trademarks of this type of cancer is dementia, which explained the brain fog and struggling with details. A very small percentage of people with this type of cancer show the symptoms like Karen had, which explains why it went undetected for so long.

Karen asked to have the results checked again because she didn’t believe it. According to the scan, the cancer was all over her liver.

A week later, she ended up in the hospital with a small bowel obstruction. Even though this was very painful, it ended up being a blessing in disguise, because that’s how her doctor found the primary source of her cancer, two tumors in her small intestine. Karen searched through her health insurance packet from Network Health and found information offering help to those with a chronic illness.

“I couldn’t dial that number fast enough,” Karen said. “I couldn’t think straight, I didn’t understand insurance and I needed help.”

She was put in touch with a care management coordinator at Network Health, Jenni Topel, who was able to work with her and set up an appointment to get a second opinion. Within a month of finding the tumors, Karen was in Madison having surgery. A 45-minute surgery removed 15 inches of her small intestine, her gall bladder and 13 lymph nodes, one of which was cancerous. “Now, looking back, we put all the symptoms together with the diagnosis and it all makes sense,” Karen said.

After her surgery she was in no position to be making phone calls and important decisions about her care. That’s where Jenni came in.

“As a patient, I’ve learned to trust my gut,” Karen said, “and Jenni has been instrumental in helping me do that.” While in Madison recovering from surgery, Karen was told about a clinical trial in Iowa.

Her doctor thought she would be a great candidate because of her age and how well she did in surgery. Karen’s doctors want to do more than just provide her with ways to cope with the cancer. They want to help her find a cure.

“There really are not that many options for me,” Karen said.

After she has six injections of Sandostatin, a drug that brings down hormone levels to alleviate symptoms, she will travel to the University of Iowa to see if she is still a candidate for the clinical trial. Because neuroendocrine cancers cannot be treated with chemotherapy, she would receive a new injection consisting of Sandostatin and radiation in hopes the treatment goes straight to the lesions on her liver. If all goes well, it could be a potential cure.

“People see me and think that I don’t look sick because I don’t have the traditional face of cancer,” Karen said. “I can’t allow myself to get under too much stress.” Karen decided to go online and research how other people living with neuroendocrine tumors are staying as healthy as possible. She learned how to change her diet to be low in sugar and meat-free. “Stress really kills with this one, and I am making my health my job so I can beat this.” Karen said. net workhealth.com

– Jenni Topel, Network Health Care Management Coordinator

Karen has had a positive attitude the entire time that I’ve worked with her. She has shown perseverance by advocating for her own health care needs.

We have worked well as a team, talking about her care and the status of her appointments and treatment.

SAY WHAT? Cognitive function – This involves all aspects of thinking, perception, reasoning and remembering.

Western blot test – This is a lab test that uses electricity to separate proteins in your blood into bands. The reading from the test looks like a bar code. It compares the pattern produced by your blood with a template pattern representing positive cases of Lyme disease.

Metastatic disease – The spread of a cancer or other disease from one organ or part of the body to another.

She is amazed at how her circumstances have lined up to get her where she is today. She has supportive coworkers, great doctors and a comprehensive health insurance plan. “I can’t tell you how blessed I am to be in this position,” Karen said.

“Had all this happened while I was in my private practice, it would have been horrible. I had no one to cover for me and limited choices when it came to health insurance.”

“When you know something is wrong and doctors can’t find what it is, you feel crazy. You know your body, so you need to advocate for yourself.” Karen said. “Having another advocate, like Jenni, in my corner is great because I can’t do this on my own.”

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wellness

Tools to empower your personal health

Don’t Be the One in Three Understanding Blood Pressure

H

igh blood pressure is common among Americans—nearly one in three has high blood pressure, according to the American Heart Association.

Unfortunately, this leads to an increased risk for developing serious health conditions such as heart disease and stroke.

U.S. adults

What should I do if I have high blood pressure?

Talk to your doctor. Together, you can decide what steps you need to take to achieve what’s healthy for you. If your initial blood pressure taken at your doctor’s office is higher than usual, be sure to have it rechecked before you leave.

Control your risk factors

Knowing your numbers and being informed can help you manage risk factors and get your blood pressure under control. Here are a few other ways to control your risk factors.

>> Lose weight. If you’re overweight, losing even five pounds can help lower your blood pressure. >> Get active. Regular physical activity can help lower your blood pressure and keep your weight under control. >> Don’t use tobacco and limit alcohol. Smoking or chewing tobacco can raise blood pressure. If you smoke, quit. And, only consume

alcohol in moderation. Too much alcohol is a contributing factor of high blood pressure.

>> Eat a healthy diet. A diet rich in whole grains, fruits, vegetables, low-fat dairy and low in sodium has been shown to help lower

blood pressure.

>> Reduce stress. Stress can raise blood pressure temporarily and may lead to overeating and tobacco or alcohol use. If you often feel

overwhelmed or stressed, it’s important to identify and take steps to reduce it.

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KEEPANDCALM GET YOUR BEAUTY SLEEP I

t’s called beauty sleep for a reason. You need sleep just as much as food and oxygen. While you are asleep, your body is busy taking care of your physical and mental health, getting you ready for another day of hectic schedules, deadlines and other daily commitments.

When you’re deprived of sleep, your brain can’t function properly and that affects your physical and mental health. Not only is this dangerous, but it can significantly lower your quality of life. Sleep deprivation can cause damage to your body, and over time, can lead to chronic illnesses such as high blood pressure, heart failure, stroke and obesity.

What you eat, drink, the medications you take and how you schedule your days and evenings all play a role in your quality of sleep. Follow these healthy sleep habits and you’ll be more productive, healthier and functioning at your best. >> Keep a consistent schedule. Get up at the same time every day, even on weekends. >> Get at least seven hours of sleep. >> Make your bedroom a quiet and relaxing place. >> Don’t eat a large meal before bedtime. >> Avoid caffeine and alcohol before bedtime. >> Don’t go to bed unless you are tired. If you can’t fall asleep after 20 minutes, get out of bed.

Find out how much sleep you need. While sleep requirements differ from person to person, most healthy adults need at least eight hours of sleep each night to function at their best. By improving the quality of your sleep, you’ll also improve your overall health and quality of life.

Breathe at ease Breathe at ease

If you’ve been diagnosed with chronic obstructive pulmonary disease (COPD), this program can help. Breathe at Ease is available to Network Health members at no cost. It’s held in the outpatient pulmonary rehabilitation department at St. Elizabeth Hospital, Mercy Medical Center, Affinity Medical Group New London and Calumet Medical Center.

To join Breathe at Ease at St. Elizabeth’s Hospital, Affinity Medical Group New London or Mercy Medical Center, call Robyn West, RRT, at 920-831-1498 or 920-738-2558. To join at Calumet Medical Center, call Peggy Nolan, RRT, at 920-849-1816.

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wellness

Preventive Services and Immunizations To help you live the healthiest life possible, Network Health offers preventive services at no cost.

Your annual wellness visit, which consists of a general review of your health and well-being, is considered preventive, and covered by Network Health at no charge when you visit a doctor in our provider network.

The services listed in bold and orange may be covered at 100 percent if billed as preventive. If they are billed as a diagnostic, there may be a cost. *Network Health follows the recommendations of the United States Preventive Services Task Force (USPSTF).

USPSTF recommendations are posted on networkhealth.com.

Services offered once a year unless otherwise noted.

PREVENTIVE SERVICES FOR ADULTS SERVICE

RECOMMENDATION

Abdominal Aortic Aneurysm

Screening, one screening per lifetime for men age 65-75

Alcohol Misuse

Three counseling sessions annually and one screening

Aspirin

Counseling for daily use for adults who are higher risk

Blood Pressure

Screening

Cholesterol (lipid disorder)

Screening

Colorectal Cancer (Colonoscopy)

Screening for adults over 50

Depression

Screening

Diabetes

Screening for adults with high blood pressure or who are at risk

Healthy Diet

Six counseling sessions annually and one screening for adults at higher risk for chronic disease

Hepatitis A, B and C Virus

Screening for adults at higher risk

Human Immune-Deficiency Virus (HIV)

Screening for sexually-active adolescents and adults

Human Papillomavirus (HPV)

Screening for sexually-active adolescents and adults

Immunizations, (vaccines, doses, recommended ages and populations vary)*

Hepatitis A and B, (Hemophilus Influenza b); Herpes Zoster (Shingles); Human Papillomavirus (HPV); Influenza (Flu); Measles, Mumps, Rubella (MMR); Meningococcal (Meningitis); Pneumococcal (Pneumonia); Diphtheria, Pertussis, Tetanus (DPT); Varicella (Chicken pox)

Metabolic Panel

Screening

Obesity

Six counseling sessions and one screening annually

Preventive Care Visits

Wellness/physical exam, including office visit when performed during the same visit

Sexually Transmitted Infections (STI)

Counseling and screening for adults at higher risk

Sigmoidoscopy

Screening for adults age 50 and older, one per five years

Stool Blood Occult

Screening for adults age 50 and older

Syphilis

Screening

Tobacco Use

One screening annually and two tobacco cessation attempts per year. Each cessation attempt includes coverage for up to four tobacco cessation counseling sessions

Vision

Screening

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PREVENTIVE SERVICES FOR WOMEN (INCLUDING PREGNANT WOMEN) SERVICE Anemia Bacteriuria BRCA Breast Cancer Mammography Breast Cancer Chemoprevention Breast-Feeding Support Cervical Cancer Chlamydia Infection Contraceptive Methods Contraceptive Sterilization Domestic Violence Gestational Diabetes Gonorrhea Human Immune-Deficiency Virus (HIV) Osteoporosis RH Incompatibility Rubella Screening Well-Women Care Preventive Visit

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RECOMMENDATION Screening for pregnant women Screening for urinary tract infection in pregnant women Counseling about genetic testing for women at higher risk Screening Counseling for women at higher risk and approved medication (see your Preferred Drug List) Supplies and counseling in conjunction with each birth of a child Screening for sexually-active women Screening for younger women and women at higher risk Approved contraceptive methods (implantable and injectable) and patient education and counseling Procedures, one per lifetime Counseling and screening Screening for pregnant women Screening for pregnant women Screening for sexually active women Screening for women over age 60 or who are at higher risk, one per three years Screening for all pregnant women Women of child-bearing age Wellness/physical exam, Including office visit when performed during the same visit

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wellness PREVENTIVE SERVICES FOR CHILDREN (BIRTH TO AGE 18) SERVICE

RECOMMENDATION

Alcohol and Drug Use Autism Behavioral Assessment Blood Pressure Congenital Hypothyroidism Depression Developmental Hearing Tests Height, Weight and Body Mass Index Measurements Hematocrit or Hemoglobin Hemoglobinopathies or Sickle Cell Human Immune-Deficiency Virus (HIV) Iron Deficiency

Assessment for adolescents Screening Assessment for adolescents Screening Screening for newborns Screening for adolescents Screening Screening

Immunizations (vaccines, doses, recommended ages and populations vary)* Lipid Disorder Lead Screening Medical History Metabolic Panel Obesity/Healthy Diet Oral Health, risk assessment for young children Phenylketonuria (PKU) Tuberculin (TB) Testing Vision Well-Baby/Child Preventive Visit

Included in well-baby/child preventive visit Screening Screening for all newborns Screening for adolescents at higher risk Screening Diphtheria, Pertussis, Tetanus (DPT); Haemophilus Influenzae type b; Hepatitis A and B (Hemophilus Influenza b); Herpes Zoster (Shingles); Human Papillomavirus (HPV); Influenza (Flu); Measles, Mumps, Rubella (MMR); Meningococcal (Meningitis); Pneumococcal (Pneumonia); Poliovirus; Rotavirus; Varicella/Zostavax (Chicken pox) Dyslipidemia screening for children at higher risk Recommended ages for children at risk of exposure For all children throughout development, included in well-baby/child preventive visit Screening Six counseling sessions and one screening annually Included in well-baby/child preventive visit Screening genetic disorder in newborns up to one month of age Screening for children at higher risk of tuberculosis Screening Wellness/physical exam, including office visit when performed during the same visit

IMMUNIZATIONS FOR CHILDREN (NEWBORNS THROUGH AGE 18) (doses, ages and recommendations vary) VACCINE

RECOMMENDATION

Chicken Pox (varicella)

One dose between 12-18 months old. Children between 12 months and 12 years can get one dose if they have no history of chicken pox. A second dose is given between ages four to six. Two doses for children between 7-18 years if no history of chicken pox and no previous vaccination.

Diphtheria, Tetanus, Whooping Cough (pertussis)

One dose of DTaP at two, four, six and 18 months old. One dose of Tdap between 11 and 12 years with a Td booster every 10 years after. Children over seven years old and not previously immunized can get a single dose of TdaP.

Flu

Two doses for healthy children between six months and eight years old the first time they get it. There should be four weeks between the first and second dose. After age two, children who previously received the shot can get one dose annually.

Haemophilus Influenza Type B

One dose at two, four and six months and once between 12 and 18 months old

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IMMUNIZATIONS FOR CHILDREN (NEWBORNS THROUGH AGE 18) continued VACCINE

RECOMMENDATION

Hepatitis A

Two doses at least six months apart between 12-23 months old.

For children not previously immunized, two doses can be given at least six months apart at the doctor’s discretion.

Hepatitis B

One dose to all newborns before leaving the hospital, a second dose between one and two months and a third dose between six and 18 months. May begin between two to 18 years old if not immunized as a baby.

HPV (human papillomavirus)

Three doses over a 24-week period starting at age 11. Your doctor may give the vaccine as early as age nine if the child is at high risk.

Polio (inactivated poliovirus)

One dose at two and four months old and between 16 and 18 months (three doses total). Then, one dose between ages four and six.

Measles, Mumps, Rubella (MMR)

One dose between 12 and 15 months and a second between four and six years. Can be given to older children if no history of vaccination or disease.

Meningitis (meningococcal)

One dose between 11 and 12 years. Doctors may give vaccine as early as age two if the child is at high risk.

Pneumonia (pneumococcal)

One dose at two, four and six months and again at 12 to 15 months. Children over age two can get a single dose if not previously immunized. Children with an underlying medical condition can receive an additional dose. Children at high risk can be vaccinated after age seven.

Rotavirus

One dose at two, four and six months old

If you would like to print these guidelines, visit networkhealth.com/members.

Select the Resources button on the right side of the page and then click Learn More.

n e t w o r k h e a l t h . c o m

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wellness Network Health’s Self-Management Workshops

We connect you and your caregivers with workshops that provide the tools needed to manage your condition. For more information or to sign up for a workshop, call us at 800-769-3186, extension 87160. Or, visit us at networkhealth.com/workshops. Click Learn More for details about each workshop.

Living Well with Chronic Conditions

This six-week workshop is for anyone living with a chronic condition such as COPD, arthritis, heart disease, anxiety, migraines, depression, asthma and more. This workshop teaches self-management skills including goal setting, reducing stress and fatigue, physical activities, healthy eating and more. This class meets once a week for two and a half hours and caregivers are welcome to attend.

Healthy Living with Diabetes

VACCINE

RECOMMENDATION

Chicken Pox (varicella)

Two doses four weeks apart for those with no history of vaccination or disease

For any adult living with type 2 diabetes and their caregivers, this six-week workshop helps people better manage their condition and related challenges. Each session is designed to help you learn practical ways to deal with your diabetes, discover better nutrition and physical activities, meal planning, label reading, monitoring and preventing low blood sugar and talking with your health care provider. This workshop meets once a week for two and a half hours.

Flu

One dose yearly

Stepping On

Hepatitis A

Two doses for those at high risk

Hepatitis B

Three doses for those at high risk

HPV (human papillomavirus)

Three doses over a 24-week period up to age 26

Measles, Mumps, Rubella (MMR)

One to two doses if no history of vaccination or disease. Can be given after age 40 if at high risk

Pneumonia (pneumococcal)

One dose for 65 and older. Those at high risk or with a history of asthma or smoking should have one dose between ages 19 and 64 with a booster every five years.

Shingles (herpes zoster)

One dose for those 50 and older

Tetanus, Diphtheria and Whooping Cough (pertussis) (Tdap/Td)

One dose if no history of pertussis vaccine regardless of interval since last tetanus vaccine, followed by Td every 10 years. This vaccine is recommended especially if the patient has contact with children under age one.

IMMUNIZATIONS FOR ADULTS (doses, ages and recommendations vary)

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A program for older adults living independently who may have fallen, worry about falling or are at risk of falling. This program promotes confidence and awareness by teaching strength and balance exercises, as well as how medication, nutrition, footwear and vision play important roles in the risk of falls and injury. This seven-week workshop meets once a week for two hours and caregivers are welcome to attend.

Additional Local Support Groups Better Breathers A community-wide support group for people with COPD and other chronic lung diseases. For more information, call 920-738-2558.

Fox Valley Diabetic Education and Support Group

Open to people with type 1 or type 2 diabetes and/or their loved ones. Classes are free and no registration is needed.

networkhealth.com

A New Look

Personalized. Simplified. Gamified.

N

etwork Health has redesigned its wellness websites to be more engaging, easy-to-use and mobile friendly. The website will be launched to Millennium and Strive participants in January of 2016.

Through extensive website analytics, usability testing and feedback from real users, the revamped wellness websites should be even more enjoyable to use. The new look translates to a powerful wellness tool that is personalized, simplified and gamified.

Personalized

A new dashboard view is personalized for each user. A snapshot of progress in the five wellness categories allows a quick and clear view of what paths you can take to complete activities and earn more points.

Simplified

After analyzing page visit statistics and observing real users interacting with the existing site, we tailored the navigation and site structure to create an intuitive experience for users. Simple navigation and improved ease-of-use means you’ll spend more time on the site completing activities and less time searching for what you need.

Gamified

Focusing on your health already makes you a winner and now you can see it. You’ll earn badges on your way to rewards, motivating you to keep taking steps towards better health.

While the wellness programs remain the same, the new design will be more satisfying and feel more engaging. Discover how a captivating wellness website can lead to lasting health benefits starting in 2016.

The Millennium and Strive wellness programs are available for purchase by employer groups. If your employer does not participate, have them inquire by calling 800-276-8004. n e t w o r k h e a l t h . c o m

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1570 Midway Pl. Menasha, WI 54952

MAILED ON 12/30/15

ENSURING YOUR HEALTH

AT NETWORK HEALTH, WELLNESS IS THE GOAL. By engaging our customers and listening to what they want, we can design unique programs that empower and reward. The results?

Better health and lower costs. Maybe that’s why most Network Health customers actually use our wellness programs. That’s what a health insurance plan should do, help ensure your health.

MeetNetworkHealth.com 800-276-8004 HMO plans underwritten by Network Health Plan. POS plans underwritten by Network Health Insurance Corporation, or Network Health Insurance Corporation and Network Health Plan. Self-funded plans administered by Network Health Administrative Services, LLC. SAL-171-01-5/13