MEMBER
MESSENGER Spring | Summer 2018 In each issue: Provider Updates Benefit Information Finding a Specialist
My Sanford Nurse A 24-hour Nurse Line
Connected but alone:
Health threats of loneliness
Why wait?
How preventing cancer is easier than you thought
Growing Up
Prioritizing your child’s health
Preventive Health Guideline See the latest updates
sanfordhealthplan.com
Losing pounds. Gaining life. The long-term effects of being overweight
Stop Shingles Protect yourself with a simple vaccine
In it together
Why health care is meant to be a two-way street
My Sanford Nurse, a 24-hour Nurse Line Have a health question and your doctor’s office is closed? Call My Sanford Nurse at (888) 315-0886 for after-hours help. The nurses are available to help: • Decide whether to seek care. • Decide what level of care is best for your condition. • Apply home-care prior to a doctor or hospital visit You can also submit health questions to My Sanford Nurse confidentially and securely through your member account at sanfordhealthplan.com/memberlogin. In your member account, click “Contact Us” and scroll down to "My Sanford Nurse" and click the link to send a secure message. Important: If you feel your situation is life-threatening, call 911 or contact your local emergency services immediately!
Preventive Health Guidelines If you have a grandfathered plan (which originated before March 23, 2010), your preventive care benefits may differ. Refer to your plan document(s) for specific details. Updates: • Children's Vision Screening: A vision screen is recommended at least once from ages 3-5 to ensure normal visual development. • A hearing screen is recommended at least once between ages 11-14,15-17 and 18-21 to check hearing range and sensitivity. • Depression screen is recommended when pregnant during the 1, 2, 4 and 6 month visits to ensure wellbeing of the mother. Additional Notes: • Annual services do not need to be scheduled 12 months apart. They are allowed once per calendar year. • Services performed outside of these guidelines and /or with a medical diagnosis will be applied to the member out of pocket expense (deductible and coinsurance). • If services are provided as listed, they are covered at 100% unless the plan document states otherwise. To see a complete list of preventive health guidelines and other screenings visit sanfordhealthplan.com. The references below are used to develop the Preventive Health Guidelines. Approved by Health Plan Physician Quality Committee: 1. U.S. Preventive Health Task Force: Recommendations for Primary Care Practice. U.S. Preventive Services Task Force. September 2017. Retrieved from https://www.uspreventiveservicestaskforce.org/Page/ Name/recommendations 2. Bright Futures: Recommendations for Preventive Pediatric Health Care. American Academy of Pediatrics. February 2017. Retrieved from https://www.aap.org/en-us/Documents/periodicity_schedule.pdf
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3. For further information, see the Bright Futures Guidelines, 4th Edition, Evidence and Rationale chapter: https://brightfutures.aap.org/Bright%20Futures%20Documents/BF4_Evidence_Rationale.pdf
Connected but alone: Health threats of loneliness Loneliness won’t cause a rash or zap strength like the flu, but it can still have powerful, adverse effects on a person’s health and well-being. People are now technologically connected to almost everyone, yet more than ever society struggles with loneliness. STATISTICS: Every person experiences loneliness differently. On the most basic level, it is a negative emotional response to feelings of isolation. Loneliness can make people of all ages feel restless, discontent or sad. It can result from many situations including illness, hearing loss or life changes such as retirement or the loss of a spouse. In the United States, roughly 1 in 3 people older than 65 lives alone and over half of those are older than 85. A University of California, San Francisco study published in 2012 showed that 43 percent of people over 60 felt lonely. The study also concluded that elderly who live alone are at 45 percent greater risk for death. EFFECTS: Loneliness can accelerate cognitive decline, compromise the immune system and increase the risk of heart disease. Those who are experiencing loneliness, including young children, teenagers and adults, may have a change in sleep habits and the ability to care for themselves. Emotional isolation can be especially damaging to the elderly as their social integration can decline as connections from younger years change or fade. MEDICAL LENS: Loneliness isn’t always about being alone but rather feeling alone. It can be distressing on different levels at different times. Patients can be reluctant to talk about feeling lonely. John T. Cacioppo, a professor of psychology at the University of Chicago and director of the university’s Center for Cognitive and Social Neuroscience, has been studying loneliness since the 1990s. In many of his studies, Cacioppo has found that loneliness carries a negative connotation, signaling social weakness or an inability to stand on one’s own. Health care providers can help ease these anxieties by making patients feel genuinely cared for and empowering them to be involved in their own care. Providers can ask patients about their social connections and encourage them to seek out activities that foster interaction. If you know someone who may be suffering from loneliness, simple gestures can make a big difference. Reaching out with a phone call or a plan to meet up for coffee can be all it takes to combat loneliness and protect their health.
1 in 3 people older than 65 lives alone.
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In it together. Why health care is meant to be a two-way street Your doctor wants to be your partner in your health care, and that is exactly what your relationship should be: a partnership. If you were in a three-legged race, would you expect your partner to do all the work? Of course not! To succeed you have to work together. You have to communicate. Asking questions and providing your care team with information is critical to the success of your care. Speaking with your doctor not only builds familiarity and trust, and also helps to spark discussion of health topics that may play a role in your care in the future. Get the most out of medical appointments, take some time to get prepared. Make a list of questions or topics ahead of time and be sure to write them down and bring them with you. Since time is precious in the medical world, a bit of work ahead of time will help you feel less rushed and more confident in the direction you want the appointment to go. Whether you just have general wellness questions or are worried about an upcoming procedure, asking questions will let your doctor know of your concerns and will allow them to help you understand, more prepared and in control of your health. For more information or to get your started on your questions for your next appointment, visit https://www.ahrq.gov.
It is described as one of the most painful rashes. Chickenpox on steroids. It can pop up on any part of your body and last for weeks. Shingles is not a fun experience, but now there may be an easy way to prevent it. This infection is caused by the varicella-zoster virus, which is the same virus that causes chickenpox. The virus lays dormant in your nerve tissue and could reactive after decades. It usually appears as a single stripe of blisters or a tingly, itchy rash on one side of your body.
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Shingrix is a new vaccine available that offers improved protection against shingles. The vaccine is available to healthy adults over the age of 50. If you choose to receive the vaccine, you’ll need two doses of Shingrix, two to six months apart. You can receive the new vaccine even if you’ve already had a shingles vaccine like Zostavax or if you aren’t sure if you’ve had the chickenpox or not.
Stop Shingles Protect yourself with a NEW vaccine
Talk to your provider if you have questions about Shingrix, possible side effects and to see if the vaccine is right for you.
Why wait? How preventing cancer is easier than you thought Eat vegetables. Exercise. Drink water. Don’t smoke. It’s the same advice we’ve been hearing since we were little. Do these things to be healthy. But the fact is, you could do all of these things perfectly your whole life and still develop cancer. And while that is a frustrating thought, don’t throw in the towel on your health. Taking a proactive approach to preventing cancer is worthy of your time. Many cancers are treatable if found early through screenings, and one of the most deadly can even be prevented. Colorectal cancer is one of the top leading causes of cancer death in the United States for both men and women. If you are 50 or older, getting a colorectal cancer screening test could save your life.
Colorectal cancer occurs when growths called polyps begin to form on the inside of the colon or rectum. If left alone, these polyps can become cancerous. Screening tests can find precancerous polyps, so they can be removed before they turn into cancer and can also find colorectal cancer early when treatment works best. Check with your provider for their recommendations on which screening is best for you. There is a lot we can’t control when it comes to cancer, but there are a few major things you can do that can make a big difference. Contact Sanford Health Plan to learn more about how colorectal screenings fit into your benefit coverage.
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Losing pounds. Gaining life. The long-term effects of being overweight “I’ll start the diet tomorrow.” But what happens when tomorrow becomes next week, and next week becomes next month, and before you know it, you’re writing down the same New Year’s resolution for the fifth year in a row? For many people losing weight and being fit is a life-long struggle. However, the ongoing struggle is well worth the fight. People who are overweight are at a much higher risk for a number of serious health problems. Those extra pounds put a strain on many of your body’s vital systems and also make it harder to enjoy simple day-to-day activities. When you are overweight, there is a lot of extra pressure on your joints. The hips and knees are especially strained under excess weight, which leads to pain in those areas. This pain can make it hard to move around and exercise, which in turn, makes it harder to lose weight. Extra weight also puts you at risk for heart disease (which could lead to a heart attack), high cholesterol, high blood pressure and stroke. It increases your risk for certain cancers and there’s a greater threat of emotional and mental issues as well. People who are overweight often suffer from depression, anxiety and other disorders. While it might seem like an uphill battle to bring down that number on the scale, even small changes can make a huge difference. Losing as little as 5 to 7 percent of your extra body weight can be enough to prevent type 2 diabetes. For a person weighing 300 pounds, that’s a weight loss of 15 to 20 pounds. If you are struggling to shed the weight, find the motivation to start or don’t know where to begin, talk to your provider to help you make the change that could save your life.
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Provider Update To see the most current list of providers, visit sanfordhealthplan.com/ memberlogin
Benefit Information For additional Health Plan benefit information, visit sanfordhealthplan.com/ memberlogin or call Customer Service at (800) 499-3416.
Finding a Specialist If your doctor refers you to a specialist, but the specialist is not available as soon as you would like, you have options. Ask the clinic if a similar specialist is available or call Sanford Health Plan Customer Service.
CONTACT US memberservices@ sanfordhealth.org (800) 499-3416 TTY: (877) 652-1884 Language Line: (800) 892-0675
Growing Up: Prioritizing your child’s health Your child is staying up later, studying for his driver’s test and will soon be taller than you. Welcome to the world of tweens and teenagers. And while they may be growing out of some things, a yearly well care visit shouldn’t be one of them. Many parents might think that a sports physical is enough for middle- and highschool-aged kids, but that’s not the case. A sports physical, although done by a trained medical professional, is only intended to evaluate your child’s physical ability to participate safely in sports that year. That is just the tip of the iceberg. Think about what your child is going through in those pre-teen and teen years. Thanks to puberty, your child’s body is growing and changing. Hormones are kicking in, sending some kids on an emotional roller coaster. These are large shifts in a child’s life and kids can experience stress and feel overwhelmed during this time. A well care visit gives you and your child time with your primary care provider to discuss these changes and any new developments in your child’s physical and emotional health. During the visit, the provider will review several key areas of development and cover a range of preventive health topics. Your child’s height, weight, nutrition and physical activity will be reviewed, along with a check of their vaccine history. This is also a great chance to talk about any screening recommendations that might benefit your child. This appointment is also an opportunity to encourage your child to ask questions. Encourage and help him or her become involved in their health by being an active participant. This can help make doctor’s appointments less intimidating and easier when going alone. Preventive health visits are covered by Sanford Health Plan; contact us to learn more or log in to your Member Portal at sanfordhealthplan.com/memberlogin.
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