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HealthMy2015 Volume 14, Issue 3

Serving Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect

Get to know your PMP As a member, you’re assigned to a PMP.

What is a PMP? PMP stands for primary medical provider. This is your personal doctor. If you see a doctor or other health care provider who is not your PMP without an OK from us, some services may not be covered.

Do I have to be sick to see my PMP? No. In fact, it’s a good idea to schedule a checkup when you are well. This helps the doctor learn your health needs and history.

What happens at my checkup? Your PMP will discuss your medical history and the drugs you are taking. Tell your doctor about any pain or concerns you have.

How do I prepare? Bring bottles for all drugs you take. List anything you buy over the counter (weight loss, cold, cough and allergy). Include vitamins, herbs or homemade remedies since this will impact the medication or treatment.

The PMP might stop, change, or order other medications that might help you more.

Before you leave, ask: What is the drug supposed to do?

£What are the common side effects?

Call your PMP if you are having side effects or want to stop taking the drug.

What if I want to change my PMP to another doctor? You can change your PMP at any time. Just call us at the number on your Anthem ID card.

What’s a few minutes of your time worth? Fill out a health form. Earn a gift card.

It’s simple to earn a gift card! If you are a new Anthem member, please take a few minutes to fill out a special health screening online at UandIcare.com. We will send you a gift card if you fill it out within the first 90 days you are signed up with us. If you don’t have a way to fill it out online or if you prefer to speak with someone, call 1-888-849-0895. You can complete the form by phone and still get a gift card. There is only one gift card allowed per household. (Gift card offer may end at any time.)

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We can translate this free of charge. Call 1-844-284-1797; TTY 1-866-408-7188.

Podemos traducir esta información sin costo. Llame al 1-844-284-1797; TTY 1-866-408-7188.

To get this handbook in other formats, such as Braille, large print or audio CD, call our Customer Care Center at 1-844-284-1797 (TTY 1-866-408-7188).

You can learn more on our website at www.anthem.com/inmedicaid.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., independent licensee of the Blue Cross and Blue Shield Association. ANTHEM is aregistered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

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What do you want to know about us?

When you have questions about our health plan operations, your benefits, how we protect your privacy and make decisions about coverage, there are three easy ways to get the answers:

Ser ving Hoosier Care Connect

Effective 2015

Member Handbook

Anthem Blue Cross and Blue Shield

AIN-MHB-0007-15 06.15

Go online to Look in your Call us at the number www.anthem.com/ member shown on your

inmedicaid. handbook. member ID card.

Just choose one of the steps above to access information on:

Our Notice of Privacy Practices and how to get a printed copy of it, along with your rights and responsibilities as an Anthem member.

Our Quality Improvement program and what we’re doing to improve the benefits and services we offer. You can find out how we gather and use information about the quality of services that you receive.

Free case management services to help you manage a serious health condition. You or your caregiver can self-refer, or your doctor can refer you.

Finding a primary medical provider (PMP), specialist, behavioral health provider, hospital or pharmacy in the Anthem network.

The process and forms needed for filing a complaint or appealing a decision.

The professional qualifications of our network providers.

£Your benefits with a list of covered and noncovered services, including those obtained outside the health plan service area.

How to see your PMP and get care.

What to do when you are out of the plan’s service area.

How to access emergency care and 911 services.

How to get care after normal office hours.

How we stay on top of new medical treatments and procedures and update or create health policies as needed.

Your pharmacy benefits, our preferred drug list and network pharmacies.

If you do not have access to the Internet, cannot find the information you’re looking for or need a paper copy of any of our latest notices,

call us at the number shown on your member ID card.

Stay ahead of the flu

Protecting yourself from the flu is easy.

As an Anthem member, you can get a flu shot:

£ From your primary medical provider (PMP)

£ At one of our network pharmacies, if you’re age 18 or older

£ At your local health department

The Centers for Disease Control and Prevention (CDC) wants everyone six months of age and older to receive the flu vaccine each year.

How might you feel if you get the flu? What can you do to help stay healthy during flu season?

If you get the flu, you may: You can protect yourself from the flu by: £ Feel bad for several days

£ Run a high fever

£ Have aches and pains

£ Develop complications that can lead to more serious illness, hospitalization or even death

£ Pass the flu on to other family members who may be more likely to get very sick

£ Getting a flu shot each year, which is the single best way to prevent infection

£ Washing your hands often

£ Avoiding those that have the flu

£ Eating well

£ Drinking plenty of water

£ Getting enough sleep

Seasonal flu may strike anywhere at any time. You can stay ahead of the flu by protecting yourself with the flu vaccine. Children and those people age 65 or older are usually most at risk.

How can you find out how active the flu is in your state or your city? Go online to www.cdc.gov/flu or scan this image with your smartphone.

Sources: www.cdc.gov/mmwr/preview/mmwrhtml/mm6202a4.htm www.cdc.gov/flu/professionals/vaccination/effectivenessqa.htm

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Good health care starts by getting to your checkups Members of Anthem’s Hoosier Healthwise (HHW), Healthy Indiana Plan (HIP) and Hoosier Care Connect programs are covered for transportation services!

What if I need a ride to my checkup?

Being an Anthem member means we’ll get you to and from any PMP for services covered at no cost to you.

HIP Basic and Plus members: As an added benefit, Anthem covers up to 20 one-way trips under 50 miles per year. No prior approval is needed.

HIP State Plan, HIP Maternity, HHW and Hoosier Care Connect members: Anthem covers unlimited rides. You can also get trips to the following appointments:

£ Women, Infants, and Children (WIC) program

£ Division of Family Resources (DFR) to renew Medicaid benefits

£ Health education programs

Making decisions on care and services Sometimes, we need to make decisions about how we cover care and services. This is called Utilization Management (UM). Our UM process is based on the standards of the National Committee for Quality Assurance (NCQA). All UM decisions are based on medical needs and current benefits only. We do this for the best possible health outcomes for our members. We also don’t tell or encourage providers to underuse services. And we don’t create barriers to getting health care. Providers do not get any reward for limiting or denying care. And when we decide to hire, promote or fire providers or staff, we don’t base those decisions on whether we think they are likely to deny services.

To learn more about UM or an authorization request call us toll free from 8 a.m. to 5 p.m. weekdays, except holidays, at the Customer Care Center number on your member ID card. If you would like to talk to someone in a language other than English, ask for an interpreter in your language. If you have speech or hearing loss, call the TTY line. If you call at any other time, you can leave a private message. Our staff will return your call on the next business day. Or you can ask that someone call you back at a different time. Any staff members who call you about a UM issue will give you their name and the name of the company.

Please call LCP Transportation 24/7 toll free at 1-800-508-7230 (TTY 1-877-224-5785) at least 48 hours before your appointment. If you can’t reach them, call our Customer Care Center, from 8 a.m. to 8 p.m. weekdays:

Hoosier Healthwise and Healthy Indiana Plan: 1-866-408-6131(TTY 1-866-408-7188)

Hoosier Care Connect: 1-844-284-1797 (TTY 1-866-408-7188)

If you want to contact us:

Customer Care Center: 1-866-408-6131

£ Hoosier Healthwise members: press 1

£ Healthy Indiana Plan members: press 2

£ Hoosier Care Connect members: call 1-844-284-1797

TTY Line: 1-866-408-7188

24/7 NurseLine: 1-866-800-8780

24/7 NurseLine TTY: 1-800-368-4424

Care Management: 1-866-408-6131

Transportation: 1-800-508-7230

Website: www.anthem.com/inmedicaid

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Our Notice of Privacy Practices

This type of notice

explains how medical

information about you

may be used and

disclosed by Anthem.

It also tells you how to

access this information.

The notice follows the

privacy regulations set

by the Health Insurance

Portability and

Accountability Act

(HIPAA). If you would like

a copy of our Notice of

Privacy Practices, please

call our Customer Care

Center at the phone

number listed on your

ID card or go online to

www.anthem.com/

inmedicaid

.

The right care at the right time When you’re sick or injured, you can: 1. See your primary medical provider (PMP)

2. Go to an urgent care center

3. Go to the emergency room (ER)

If your condition is life-threatening and you need medical attention right away, call 911 or go to the ER. But unless you have a true emergency, a visit to the ER should be your last choice. If you are a HIP member and go to the ER for a reason that is not a true emergency, you may be charged a copayment.

Not sure if you have an emergency? You can call our 24/7 NurseLine at 1-866-800-8780 (TTY 1-800-368-4424) to speak with a nurse, day or night. Our nurses can help you get the right care, in the right place at the right time.

Urgent care centers treat conditions that should be looked at right away, but aren’t as serious as emergencies. Some of the benefits of using urgent care centers include:

You don’t need an appointment

You may have less wait time than the ER

You may have locations closer to home

You may be able to get your prescriptions there

P.O. Box 62509 Virginia Beach, VA 23466-2509

The information in this newsletter is meant to educate. It is not meant to be medical advice. Please check with your doctor for any advice about your health. Your health plan may not cover some types of care. Check your member handbook for details about what benefits your health plan covers and what it does not cover.

With the exception of www.anthem.com, the websites referred to in this newsletter are websites of independent entities and not affiliated with Anthem Blue Cross and Blue Shield.

Copies of any type of member information are made available (at no cost) upon request for translation, Braille, large print or audio format. Just call our Customer Care Center at 1-866-408-6131 (Hoosier Healthwise, Healthy Indiana Plan) or 1-844-284-1797 (Hoosier Care Connect). We can answer any of your questions about your plan. If you have a hearing or speech loss, call the TTY line at 1-866-408-7188.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., independent licensee of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

©2015

HP-C-1885-15 07.15 IN Q3