VOL. 17 ISSUE 1 2014

www.AmeriHealthCaritasPA.com

A NEWSLETTER FOR MEMBERS OF AMERIHEALTH CARITAS PENNSYLVANIA

healthynowCoverage by AmeriHealth First.

Keep Asthma Under Control 2 | Teaching Boys Respect 5 | Testing Your Child for Lead Poisoning 6

What to Do After a Visit to the Emergency Room …

Directory allows members to search for a PCP by zip code or name. You can also learn more about the doctor, such as:�� Languages spoken in the office.�� Office hours.�� Age limits.�� If the PCP is taking new patients.

No one wants to be in the hospital, but emergencies happen. When you are getting ready to leave the hospital, it is very important

to know what you are supposed to do after your visit so you do not have to go back!

To avoid having to return to the hospital, be sure to get an appointment with your primary care practitioner (PCP) as soon as possible. He or she will review your home care instructions with you and make sure you have all of the right medicines. This will help to prevent you from having another visit to the emergency room (ER).

If you do not have a PCP, we can help you find one! The AmeriHealth Caritas Pennsylvania Provider

To view the Provider Directory, please go to www.amerihealthcaritaspa.com and click on

“Find a Provider.” If you do not have access to the Internet and would like help finding a doctor, please call Member Services at 1-888-991-7200 (TTY 1-888-987-5704).

Summer 2013 • www.AmeriHealthCaritasPA.com • Verano 2013 2 Spring 2014 • www.AmeriHealthCaritasPA.com

A Time for Keeping Your Asthma Under Control

Most of us look forward to the warmer weather and bright colors of spring. But spring can be a tough time of year if you

have asthma. The pollen from plants and trees can make your asthma worse. Outdoor mold is also present this time of year.

Here are some ways to help keep your asthma under control: �� Stay indoors when pollen levels are highest —between 5:00 a.m. and 10:00 a.m. �� Keep your home and car windows closed so pollen cannot blow inside. �� Do not hang your clothing or sheets outside to dry. They may collect pollen. �� Use a dehumidifier if possible. It helps prevent mold from growing. �� Consider a special allergy filter for your air conditioner. �� Do not mow the lawn or rake leaves. These activities may stir up pollen and mold. Ask someone to help you. If you must do it yourself, wear a dust mask. The mask will keep pollen out of the air that you breathe. �� Take a shower after working outside. This washes away pollen from your hair and skin. �� Have your asthma action plan ready during this time of year.

You can also buy over-the-counter (OTC) medicine for your allergies. AmeriHealth Caritas Pennsylvania covers OTC medicine for allergies with a written prescription from your doctor. Ask your doctor which ones are best for you.

Talk with your doctor about how to control your asthma. AmeriHealth Caritas Pennsylvania has a program to help people with asthma. Call 1-877-693-8271, option 2 (TTY 711) for more information.

Spring:

Member Services • 1-888-991-7200 • Servicios para Miembros 3Member Services • 1-888-991-7200 (TTY 1-888-987-5704)

Don’t Forget! A random selection of our members will soon be receiving a bright yellow envelope in the mail that has our Annual CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey. This is a survey that measures your satisfaction with our plan. Please be sure to take the time to complete it. We strive to always provide you with the highest quality of care and service. We want to make sure that you are always satisfied with your health plan.

Look for AmeriHealth Caritas Pennsylvania in your community! AmeriHealth Caritas Pennsylvania

has many health education programs and events on preventive care, healthy behaviors and health awareness. It is our hope that these programs and events will improve the health of our members and the communities we serve.

To find out more about our upcoming events and health education sessions in your community, go to the Member section of the AmeriHealth Caritas Pennsylvania website at www.amerihealthcaritaspa.com. Then click on the “Programs” page. There you will find “Health Education Programs and Events.”

Call the Fraud Hotline at 1-866-833-9718 (TTY 711).

You have the option to remain anonymous at all times.

We Need Your Help!Members can help AmeriHealth Caritas Pennsylvania uncover provider fraud, waste and abuse.

You should keep track of the following things:�� Who provided your health care.�� What services you received during the visit and any additional tests or visits the doctor ordered.�� When you got a health care service.�� Where the service took place.

Call AmeriHealth Caritas Pennsylvania if you think the provider may have billed incorrectly or offered a service you didn’t think you needed.

Please remember, DO NOT:�� Give your ID card or numbers to anyone other than your doctor, clinic, hospital or other health care provider.�� Ask your doctor or any other health care provider for medical services or supplies that you don’t need.�� Sign your name to a blank form.�� Share your medical records with anyone other than your doctor, clinic, hospital or other health care professional.

AmeriHealth Caritas Pennsylvania has a team that works hard to identify and prevent fraud, waste and abuse. But we still need all providers and members to report possible fraud and abuse.

Community Corner

Summer 2013 • www.AmeriHealthCaritasPA.com • Verano 2013

Healthy Gums to Healthy Teeth =

At Home�� Wipe your baby’s gums with a soft cloth, or if he or she has teeth, brush them every day using a soft baby toothbrush.�� Do not let your baby go to bed with a bottle of milk, juice or formula. The sugar in these drinks will stay on the baby’s teeth all night. This can cause tooth decay and cavities.�� When teething, your baby may want something to bite or suck on. It is best to give the baby a teething ring, pacifier or a bottle filled with cold water. Never give your baby anything to suck that was dipped in juice, sweet drinks or alcoholic beverages.

At the Dentist’s Office�� You should take your baby to the dentist when the first tooth comes in or by his or her first birthday.�� A check-up at the dentist consists of:

• A cleaning at the office. • An examination of the teeth, gums and full mouth, which may include X-rays.

Your dental team can show you how to properly brush and floss your teeth and your baby’s teeth.

Good dental care now can help prevent problems in the future!

A Beautiful Smile for Life !Taking care of your teeth is a critical part of

your overall health at any age. It starts as a baby before you even have teeth! This is the

first article in a 3-part series that will give tips on how to keep a beautiful smile at any age.

Care Should Start Before Teeth DevelopHealthy teeth are important to your baby’s growth and development. They help your child eat and talk right. Baby teeth hold space for permanent teeth.

In the next edition of the 2014 newsletter: Keeping a Healthy Smile Throughout Childhood

To find a dentist in our network, please visit www.amerihealthcaritaspa.com and click on

“Find a Provider.” Then go to “Find a Dentist.” You can also call Member Services.

1PART

2PART

4 Spring 2014 • www.AmeriHealthCaritasPA.com

Member Services • 1-888-991-7200 • Servicios para Miembros

For more information on Coaching Boys Into Men, go to: www.futureswithoutviolence.org/section/our_work/men_and_boys/_coaching_leadership.

Teens who need help can call the National Teen Dating Abuse Helpline: 1-866-331-9474 1-866-331-8453 (TTY for the Deaf)

To learn the facts about and risks of teen dating abuse, go to: www.loveisrespect.org www.breakthecycle.org or www.loveisnotabuse.com.

“Eat your vegetables. Don’t play with matches. Finish your homework. Respect women.”

The above words are from a Coaching Boys Into Men program poster.

Boys get a lot of messages about how to be strong. They hear them in music, on TV and from friends. Too often these messages tell boys that they have to be tough and in control. These messages harm youth by making abusive behaviors seem normal.

Boys need advice on how to treat girls. A boy may not come out and ask how to act or talk respectfully to girls. However, boys often imitate the men around them. There are many ways that men can model positive behavior for boys.

Men can show boys:�� That abuse has no place in a relationship�� How to use respectful words in a disagreement�� How to consider a girl’s feelings

Men can also teach boys:�� How to talk things out instead of scaring or hurting someone�� Not to approve of sports figures who demean women�� Why song lyrics or jokes that put girls and women down are not OK�� How to speak up when someone is saying hurtful words to a girl�� About safe ways to help a girl who is being physically hurt

It is important for boys to develop healthy relationship skills. Be sure the boys in your life know that treating all girls with respect matters.

More Information

5Member Services • 1-888-991-7200 (TTY 1-888-987-5704)

Teaching Boys Respect

Summer 2013 • www.AmeriHealthCaritasPA.com • Verano 2013 6

Every child needs to be tested for lead poisoning. Even if your child seems healthy, he or she may have dangerously high levels of

lead. Ask your child’s primary care practitioner (PCP) about a lead screening blood test. Children should have a lead test before age 2.

If you need help finding an AmeriHealth Caritas Pennsylvania doctor, call Member Services at 1-888-991-7200 (TTY 1-888-987-5704) or visit us at www.amerihealthcaritaspa.com and click on “Find a Provider.”

What can you do to prevent lead poisoning?�� Clean your home at least once a week, especially floors, window frames and windowsills. Also, check to make sure you don’t have any peeling paint in your home.�� Have your family wash their hands before eating.�� Have everyone take off their shoes before coming into your house. This will help prevent any lead from outside coming into your home.�� Do not allow your child to put things in his or her mouth.�� Wash your child’s toys, bottles and pacifiers often.�� Make sure your child has a healthy diet full of calcium (milk, cheese and yogurt) and iron (lean red meats, chicken, leafy green vegetables and iron-fortified cereals). These foods help the body take in lead more slowly.�� Run cold water for 15 to 30 seconds before drinking it. More lead has been found in water that has been sitting.

Has Your Child Been Tested for

Lead Poisoning?

If you have questions about symptoms and your child’s PCP is not available, please call the Nurse Call

Line at 1-866-566-1513 (TTY 711). Specially trained nurses will answer 24 hours a day, 7 days a week to help you with your questions. However, please remember that the Nurse Call Line does not take the place of your child’s PCP.

Spring 2014 • www.AmeriHealthCaritasPA.com

Member Services • 1-888-991-7200 • Servicios para Miembros 7Member Services • 1-888-991-7200 (TTY 1-888-987-5704)

Are you pregnant or thinking of having a baby?The Bright Start® program helps you stay healthy

when you are pregnant and makes sure your baby has a healthy birth. The Bright Start program gives you important information about:�� Taking your prenatal vitamins.�� Eating right.�� Staying away from drugs, alcohol and smoking.�� Visiting your dentist so you can keep your teeth and gums healthy.

Call Bright Start today to learn the important steps to take to have a healthy baby. We are here to help, even if you only want a safe place to talk about your questions and concerns. We can help you through your delivery and postpartum visit to make sure you stay healthy after the baby comes.

AmeriHealth Caritas Pennsylvania encourages all pregnant members to see an obstetrician or a nurse midwife as soon as you think you are pregnant and to keep all your appointments. The healthier you are through your pregnancy, the healthier your baby will be.

Call Bright Start at 1-877-364-6797 (TTY 711) for more information.

Do You Want Your Baby to Have a Bright Start®?

The following drugs have been added to the AmeriHealth Caritas Pennsylvania formulary:

DRUG USED FOR

Auvi-Q- added with a quantity limit of 2 per 30 days

Treats allergic reactions

Benzaclin gel (generic) Treats severe acne

Tivicay 50mg tablets HIV/AIDS Therapy

Latuda- the 60mg and 120mg strengths have been added as line extensions

Treats schizophrenia

Formulary Update Your Information. Your Rights. Our Responsibilities.

The AmeriHealth Caritas Pennsylvania Notice of Privacy Practices has been updated.

This document describes how medical information about you may be used and disclosed and how you can get access to this information. To read the Notice of Privacy Practices, please go to the Member section of www.amerihealthcaritaspa.com and click on “Information for You.” If you would like a copy mailed to you, please call Member Services at 1-888-991-7200 (TTY 1-888-987-5704).

© 2014. Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date health information. But no publication can replace the advice of health care professionals, and readers are cautioned to seek medical attention any time it may be necessary. All models used for illustrative purposes only. 5520MB

A Member of the AmeriHealth Caritas Family of Companies

Ingredients3 cups water1 can (28 oz.) low-sodium tomatoes, cut up1 can (15 oz.) kidney beans, drained1 can (15 oz.) black-eyed peas, drained1 can (15 oz.) garbanzo beans, drained1 can (15 oz.) whole-kernel corn, drained1 c. carrots, chopped1 medium onion, chopped1 can (6 oz.) tomato paste

1 tbsp. Dijon mustard1½ tsp. chopped garlic1 tsp. pepper1 tsp. ground cumin1 tsp. dried oregano1 tsp. dried basil1 tsp. chili powder1 cup chopped zucchini

Hearty 3-Bean SoupDirectionsCombine all ingredients except the zucchini in a large pot. Bring to a boil. Reduce heat and simmer covered for 10 minutes. Stir in zucchini and simmer covered for 10 minutes more.

Number of servings: 12 Recipe yield: 12 cups Serving size: 1 cup

Nutrition Facts Per ServingCalories 160; Calories from fat 10

% Daily Value (DV)*Total fat 1 g 2%, Saturated fat 0 g 1%, Cholesterol 0 mg 0%, Sodium 390 mg 16%, Total carbohydrate 29 g 10%, Dietary fiber 6 g 24%, Sugars 9 g, Protein 7 g, Vitamin A 45%, Vitamin C 25%, Calcium 4%, Iron 8% * Percent Daily Values are based on a 2,000-calorie diet.

Source: Centers for Disease Control and Prevention

The following drug(s) have been removed from the AmeriHealth Caritas Pennsylvania formulary:

DRUG USED FOR

Tofranil PM (generic) Antidepressant