Teachers Health Trust Health Traxx: Volume 17 | Issue 4 | Fall 2018

Health

A Publication for Teachers Health Trust Participants

raxx Fall 2018│Volume 17, Issue 4

For Teachers by Teachers

EMOTIONAL HEALTH VOLUME 17, ISSUE 4

Depression and Suicide

MYTHS AND TRUTHS Birth Control

ALLERGY SEASON For Children

“It’s What’s Inside That Counts.”

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contents Fall 2018 VOLUME 17, ISSUE 4

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"Myth: everyone who gets the implant that goes under the skin gains weight"

Birth Control:

Myths and Truths

8

16

in this issue 5 FREQUENTLY ASKED QUESTIONS

Your questions answered

7H OW CAN A HEALTHCARE ADVOCATE HELP YOU? Work hand-in-hand with your advocate

8A LLERGY SEASON FOR CHILDREN

elp your kids stay healthy H this season

13 EMOTIONAL HEALTH

anaging depression and M suicide prevention

16 BIRTH CONTROL:

MYTHS AND TRUTHS

Separating fact from fiction for each type of birth control

20 IMPORTANCE OF REGULAR

PRIMARY CARE CHECKUPS

Staying ahead of health care curve

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98.6 f 98.6 f

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FA Q

Your Questions Answered Q: Where can I locate the complete Plan Document?

A: Find the complete Plan Document at https://www.teachershealthtrust.org/participants/benefits Q: If I have a true emergency, will I be penalized for not obtaining a referral from my PCP? A: In the event of a true emergency, no referral is required for medical care.

Q: If the doctor I need is not in Clark County, will I be covered going outside of the county or state?

A: Yes, you may visit a doctor outside of the county or state, but your out-of-pocket costs will be calculated under the out-of-network benefits (see page 89 of the Performance Plus Plan Document). If your physician believes that a service you need requires you to go out of state because it is unavailable in-network, authorization of the Extended Network Benefit may lower your out-of-pocket costs.

Q: I need to have a minor outpatient surgery. What are some of the costs that will be associated with this, and who should I reach out to in order to determine exact costs?

A: Outpatient surgery in the physician’s office, with a referral, has a coinsurance of 20 percent (deductible does not apply). Outpatient surgery in a facility has a co-payment of $400 (deductible does not apply). The surgeon and the anesthesiologist each have a 20 percent co-insurance after the deductible is met. The calendar year out-of-pocket maximum for an individual participant is $6,850.

While the above provides the portion of the cost you are responsible for an outpatient surgery, the Trust cannot predict your total costs. The final cost will depend upon what services, procedures, etc. are billed in respect to your surgery. The Trust highly encourages you to speak to your provider prior to surgery to assist in determining what services and procedures will be included in your case.

Q: What is telemedicine?

A: Telemedicine refers to clinical diagnosis and monitoring that is delivered by technology. It is the use of telecommunication and information technology (i.e., smart phones, computers, tablets) to provide health care remotely. Telemedicine aims to provide an added benefit for non-emergent and non-life-threatening symptoms that would otherwise be addressed through urgent care. To access telemedicine, download the WellHealth Quality Care app or visit WellHealthOnline.com.

Q: How do I register for telemedicine?

A: Visit WellHealthOnline.com and follow the instructions to register. You will need to add two additional zeros (00) to the end of your participant ID number.

Q: When should I use telemedicine?

• A: Instead of going to the ER or an urgent care center for a non-emergency issue • During or after normal business hours, nights, weekends and even holidays • If your primary care doctor is not available • If you're traveling and in need of medical care Q: What can telemedicine treat?

A: Allergies • Asthma

• Insect bites

• Bronchitis

• Joint aches

• Cold & flu

• Rashes

• Diarrhea

• Respiratory infections

• Ear infection

• Sinus infections

• Fever

• Skin infections

• Headache

• Sore throat

• Infections

• Urinary tract infections

Q: What kinds of problems can I access teletherapy for?

A: You can access the behavioral health portion of telemedicine for issues such as: • Marital problems

• Parenting counseling

• Child behavior

• Problems at work • Stress • Life challenges

• Child learning issues • Financial hardship • Coping with loss & grief

More questions?

We’re here to help!

Member Services can answer your questions about benefits, claims, billing and more.

Contact the team by email at serviceteam@teachershealthtrust.org, or by phone at (702) 794-0272.

Who should I call?

WE’RE HERE TO HELP

HEALTHCARE ADVOCATE

When you have questions about in-network providers, scheduling appointments, claims status, adding or removing dependents and more, do you know who to call?

SERVICE TEAM

At Teachers Health Trust, we have two teams dedicated to getting all of your questions answered quickly and clearly— the Healthcare Advocates and the Service Team. Both teams share a common goal of helping you navigate your health care and live your healthiest life.

Contact a

Contact the

if you need to...

if you need...

HEALTHCARE ADVOCATE

SERVICE TEAM

• Find an in-network provider

• To ask in-depth benefit questions

• Confirm your primary care provider

• Information about eligibility

• Schedule appointments for complex care medical conditions

• Answers about prescription refills

• Get help with referral management and coordination

• To add or remove dependents from a policy

• Find or file a Provider Change Request form

• Policy payment or reimbursement information

• Request, obtain or send medical records

• Answers about claims or details about an explanation of benefits

• Discuss or enroll in Here’s to Health programs (diabetes, heart health, high risk pregnancy and asthma/COPD)

• Information about prescription costs or co-pays

• To ask billing questions

• Ask questions regarding telemedicine or teletherapy

Contact Healthcare Advocates

P: (855) 404-9355 | E: advocates@wellhealthqc.com

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Contact the Service Team

P: (702) 794-0272 | E: serviceteam@teachershealthtrust.org

F E AT U R E S

How can a Healthcare Advocate help you?

Every participant has access to a Healthcare Advocate who will work hand-in-hand with you to address a wide range of health care needs, including selecting and gaining access to an in-network primary care physician (PCP), PCP change requests per quarter, referral management and coordination and much more.

Healthcare Advocates also help to coordinate your care in order to ensure that you do not experience repetitive or excessive testing or incur unnecessary out-of-network costs.

They can also help participants who live with conditions such as diabetes, asthma, COPD, hypertension and more to enroll in a specialty care program.

You may reach an Advocate via phone at 855-404-9355, by email at WH_Advocates@hcpnv.com or in person at the Trust during business hours. (located at 2950 Rochelle Ave., Las Vegas, Nevada, 89121)

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F E AT U R E S

Allergy Season for Children 8

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F E AT U R E S

With the summer season warming up, trees and flower in full bloom, allergy season is on the rise.

Defined by the Joint Task Force on Practice Parameters in Allergy, Asthma, and Immunology, allergic rhinitis (AR) is “inflammation of the membrane lining the nose, characterized by nasal congestion, rhinorrhea, sneezing, itching of the nose and/or postnasal drainage.” Up to 40 percent of children are affected by AR by age 6, some yearround and some seasonal.

Patients who are affected experience a variety of signs and symptoms. Parents often report sneezing, watery eyes, itchy nose, sniffing, nasal congestion, postnasal drip and coughing. AR symptoms can also affect the eyes and throat or cause sensory changes of the palate. Overall, long-term symptoms of AR can cause fatigue due to disrupted sleep, headache, impaired concentration and decreased emotional well-being. Risk factors for developing childhood AR include asthma, maternal smoking in the child’s first year of life, parental allergies and family history of asthma. In addition, children who have AR often have co-existing conditions related to the upper and lower airways. Studies have shown strong correlation between children with AR and asthma being more susceptible to viral infections, chronically increased mucus and nasal congestion leading to sinusitis and inner ear infections.

Pediatricians will take an inclusive history and examine the affected child to assess the severity of symptoms. On the physical exam, particular attention is directed toward looking for intranasal obstruction and swelling, darkening of the lower eyelids due to nasal congestion and facial lines and creases from chronic rubbing of the nose and mouth area.

Some additional clinical labs and adjunctive tests can confirm suspected allergens to aid in management of symptoms.

By Eileen Shi, MD, FAAP Durango Pediatrics

Once the diagnosis is made, the primary mode of managing the symptoms of AR is prevention and allergen avoidance.

Some strategies include: • Staying indoors during high pollen times (5–10 AM) • Keeping air conditioning on during spring and fall pollen season • Changing out of clothes after being outdoors • Using special pillow and mattress covers to prevent accumulation of dust mites • Washing bedding weekly in hot water and drying in high heat • Keeping humidity low by using a dehumidifier • Keeping pets outdoors if your child’s allergy is severe, vacuuming weekly • Fixing leaks to avoid mold In addition to these preventative measures, the mainstays of pharmacologic options for treating AR are intranasal corticosteroids, oral antihistamines, and oral modifiers of allergen receptors. Allergy immunotherapy is reserved for children with severe AR and co-existing conditions such as asthma.

The American Academy of Pediatrics advises parents to talk with their pediatrician if a child shows symptoms of an allergy. As pervasive as allergies may be, managing your child’s allergy symptoms is possible and doing so improves overall health so that allergy season, like any other season, is a time for adventures, growth and play.

" Once the diagnosis is made, the primary mode of managing the symptoms of AR is prevention and allergen avoidance."

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E M P L O Y E R B E N E F I T S O L U T I O N S F O R E D U C AT I O N

Running for the greater good.

Hustle. Bustle. On the go. As a dedicated education employee, you’re on point each day to help keep the system running. Always racing to beat the clock.

Checking off your to-do list—all for the greater good.

Students depend on you each day and you help show them the way.

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Your emotional health affects your physical health.

How you manage stress, cope with problems, handle difficult people or deal with day-to-day issues are keys to good emotional health.

Individuals who are emotionally healthy are aware of their feelings and their behaviors. Many studies show that poor emotional health can have an impact on your physical health.

Everyone feels sad or down sometimes. If you or a loved one has overwhelming feelings of despair that last more than a few weeks, depression may be the cause. When people face serious problems, like mental illness, chronic disease, divorce, death of a love one or financial hardships, they can experience severe depression and thoughts of suicide. It’s important for everyone to know there are many treatment options for depression. For those that are feeling overwhelmed or hopeless, there are solutions and professionals to help in a matter of minutes.

Here are a few resources to call for

HELP 12

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Crisis Hotline For LGBT Youth (866) 488-7386

Crisis Text Line Text 741-741

Suicide Prevention Hotline (800) 273-8255

Crisis Call Center (775) 784-8090 (800) 992-5757

A Trained Counselor will respond.

F E AT U R E S

WHAT WE ALL CAN DO THAT MAY SAVE A LIFE:

Many people are uncomfortable with the topic of suicide. As a result, people rarely communicate openly about suicide. Friends, family and even co-workers can make a difference. If you think someone is suicidal, take it seriously. The statistic below represent real people, not just numbers on paper. Many lives are impacted when a person intentionally takes their own life.

• Talk about your feelings • Listen without judgment • Let them know you care, show concern

In 2015, in the United States, there were an estimated 505,507 suicide attempts that received medical care for self-inflicted injuries. However, over 1.4 million adults self-reported a suicide attempt, and over 9.7 million adults self-reported having serious thoughts of suicide. Sadly, an estimated 300,000 individuals commit suicide every year. In 2016, Nevada ranked fifth in the nation for suicides, with 650 individuals intentionally ending their lives.

• Ask the question, "are you thinking about harming yourself?

Have you made a plan?"

• Encourage them to seek help by saying, "I know where we can get some help. Let's call a crisis line now. I'll stay here with you."

• Remove accessible stockpiled pills or weapons

References: Centers for Disease Control and Prevention (2017). Preventing Suicide. Southern Nevada Health District.

American Foundation for Suicide Prevention. National Institute of Mental Health. Transforming the Understanding and Treatment of Mental Illnesses. Suicide in America

• Alert a trusted and important people in your friend's life

“

In 2016, Nevada ranked

fifth in the nation for suicides, with 650 individuals intentionally ending their lives.

”

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Birth Control:

Myths and Truths Myths

By DAVID HOWARD

Many common myths and truths around various methods of birth control exist. We will discuss each type of both male and female options for birth control.

Let's start off with the pill. One common myth is that the pill can cause birth defects. In fact, there are no studies that show that taking the pill causes birth defects or will harm the baby if you become pregnant.

Myths

Some believe that the pill accumulates in your body and could cause disease or cancer later in life, but the truth is that the effects of the pill only last about 26 hours. The pill can actually protect you from ovary and uterine cancers.

Myths Myths Myths

Myths Myths

Myths

Next, we'll talk about the shot, known as the Depot shot. Some people believe that changes in your periods while getting the Depo shot are harmful. In fact, these bleeding changes are temporary and not harmful. Your periods will usually return to baseline a few months after stopping the Depo shot.

It is also a myth that the Depo shot can cause cancer. The progesterone in the Depo shot actually protects you from uterine cancer.

Next, we'll talk about the patch. It is a myth that the patch puts you at higher risk for blood clots than the pill. In fact, the most recent postmarketing data shows similar risk of blood clots between women age 39 years or younger who use the patch versus the pill. Less than five out of every 1,000 women develop clots while using the patch, which is still significantly less than the risk of blood clots during pregnancy.

The next method we'll talk about is the ring, specifically the NuvaRing.

Some people believe that the ring cannot be reused if it falls out. This is not true. Even if the ring falls out, it can be washed and replaced. You should use backup birth control for one week if the ring has fallen out for more than 48 hours.

The next category that we'll talk about is long-acting birth control methods.

With implants that go under the skin, one myth is that the implant can move to another part of the body. In reality, the implants rarely shift, and if they do, they shift no more than an inch.

Another myth is that the implant causes weight gain. In reality, only about two to three percent of patients experience weight gain due to increased appetite while on the implant.

A common myth is that IUDs can cause infections and infertility. Many studies have shown that there's no increase in the risk of infections or infertility among IUD users.

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F E AT U R E S

Another myth is that IUDs are only for women who already have kids. On the contrary, young patients who have never been pregnant are also candidates for IUDs. In fact, one of the IUDs on the market, Kyleena, is specifically for women who have never had kids.

"Myth: everyone who gets the implant that goes under the skin gains weight"

Finally, in terms of female methods, we'll talk about sterilization or permanent birth control. A common myth is that having your tubes tied can cause menopause or heavy periods. The truth is, studies have found no major changes in menstrual bleeding patterns after permanent birth control procedures.

It is also a myth that permanent birth control, or tying your tubes, can affect sexual desire or sexual function. In reality, no such effect has been found in studies.

There are two methods of male birth control: barrier method, or the condom, and permanent method, or vasectomy.

In terms of the condom, it is a myth that using spermicide can make them work better. In fact, using certain spermicides with the condom can cause irritation and increased risk of transmitting HIV. It is also a myth that males cannot get an erection or orgasm after a vasectomy. This procedure will not effect the sex drive or penis function during sex.

Some believe that a vasectomy can cause prostate cancer in men, but the American Neurological Association has issued an official statement denying the link between a vasectomy and prostate cancer in men.

In summary, we hope that you have learned something about birth control and are now better able to separate myths from truths with regard to contraception.

Myth: Vasectomy can cause prostate cancers in men

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Member Materials

PRESCRIPTION DELIVERY SERVICE Prescription Delivery Service offers free delivery of medications to a convenient place – home, work, or doctor’s office. We recommend this service if you take a medication on an ongoing basis. Here’s what you need to know: Registering: Get started by registering for Prescription Delivery Service. You’ll need to provide insurance, contact, payment, and health information for you and your covered dependents.

Online: For 24/7 access to your benefit and prescription information, go to www.WellDyneRx.com and click “Members.” Select “Member Registration” to set up your account profile.

Sending Prescriptions: Your doctor must write your prescription for a 90-day supply (or the number of days your plan allows for mail service). There may be limitations on some medications, such as controlled medications, due to state and federal laws. Send your prescriptions to WellDyneRx: Electronically: This is the quickest way to fill your prescription. Ask your doctor to electronically send your prescription to WellDyneRx Prescription Delivery Service.

By Fax: 1-888-830-3608 or 1-877-221-1259.

Onlyprescribers may fax prescriptions to a pharmacy.

By Mail: Write your Member ID and date of birth on the prescriptions and mail them to WellDyneRx. Ordering Prescriptions: WellDyneRx offers several easy ways to order your prescriptions. We will send a reminder when it’s time to refill your prescription. The best time to order refills is when you have a 14-day supply of your medicine left.

Online: Order refills by going to www.WellDyneRx.com, click on the “Members” link, and then sign into your member portal.

By Mail: Mail your original prescriptions, with your Member ID and date of birth written on them, to WellDyneRx.

By Phone: Order through the WellDyneRx automated phone system at 1-888-635-7351, press 2. To access your account, you will be prompted to enter your date of birth, zip code and phone number.

By Mobile App: Order refills from the WellDyneRx mobile application. Go to mobileapp.welldynerx.com, or search for “WellDyneRx” in the iTunes App Store or Google Play Store.

Payment: Payment is required with every prescription order. WellDyneRx accepts Visa, MasterCard, American Express, Discover, check, check by phone, or money order. We also accept payment cards for flexible spending and health savings accounts. Once you have registered, you can add or update your payment cards online or through our automated phone system.

Medication Preference: WellDyneRx substitutes FDA-approved generic equivalent drugs for any brand name medications ordered, if available and permitted by your doctor. A generic drug is a variation of a brand name that has the same effectiveness, quality, safety, and strength, as confirmed by the FDA. If you prefer to receive only brand medications and pay the additional cost, please contact Member Services.

Prescription Order Status: Check the status of your prescription order online or through the WellDyneRx automated phone system. We also send email alerts that include order information, refill reminders, and shipment notifications. Automated phone messages are available for select order statuses and refill reminders.

Member Services: Member Services representatives are available 24 hours a day, 7 days a week to answer questions and help with prescription orders.

Pharmacists are available for consultations 24 hours a day, 7 days a week if you have questions about your medication, including how to take it, what to do if you miss a dose, side effects or drug interactions. For medical emergencies, please call 911.

By Phone: 1-844-635-7351 1-800-900-6570 TT

Mailing Address: WellDyneRx P.O. Box 90369 Lakeland, FL 33804

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The Importance of Regular Primary Care Checkups Staying Ahead of the Health Care Curve

by Gina Gardner, Staff Writer

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F E AT U R E S

Just as when a teacher meets with a new student to determine curriculum levels and learning goals, perhaps the most important checkup you schedule with your primary care provider is your initial exam.

Your initial 20-minute well exam provides your primary care team time to gather important details about your health history, current medications and any other concerns or goals you may have. It is during this appointment your primary care physician can ensure appropriate health screenings are ordered and recommendations for ongoing regular exams can be determined.

According to the Centers for Disease Control (CDC), regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. By getting the right health services, screenings and treatments, you are taking steps that help your chances for living a longer,

!

healthier life. Your age, health and family history, lifestyle choices (i.e. what you eat, how active you are, whether you smoke), and other important factors impact what and how often you need health care.

Regularly seeing your primary care team allows them to educate you about how to prevent or manage chronic illness and identify important resources to manage stress or other behavioral health concerns you may have. Your team can also build a personalized profile about your health needs so reminders can be sent to you about upcoming appointments or important immunizations or screenings your physician recommends.

As teachers work with new students to create individual plans to stay ahead of the curve in education, you deserve the same opportunity for the best health care outcomes possible by partnering with your primary care team.

If you cannot remember who your primary care physician is or need to request a new one, contact Healthcare Advocates by phone at

(855) 404-9355 or email at WH_Advocates@hcpnv.com.

Every Appointment, Every Time It is always good practice to create a list of complaints and questions to bring with you. Below are suggestions for what to consider when creating your list.

• Review any existing health problems and note any changes.

• Have you noticed any body changes, including lumps or skin changes?

• Are you having pain, dizziness, fatigue, problems with urine or stool, or menstrual cycle changes?

• Have your eating habits changed?

• Are you experiencing depression, anxiety, trauma, distress or sleeping problems?

For each item, note when the change began, how it’s different from before and any other observation that you think might be helpful.

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