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Capital Health Plan Achieves Low Overhead — Again!

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

For the 20th year in a row, CHP’s administrative costs are less than 5% of its revenues. This industry-leading efficiency contributes to membership affordability.

Capital Health Plan’s mission is to help Tallahassee-area residents receive comprehensive, affordable health care services. Keeping administrative overhead low has always been an important objective. Dollars spent on management, marketing, claims processing, etc., are dollars that aren’t available for your health care needs. That’s why, as CHP tries to stretch the health-care dollar to cover as much as possible, we minimize the portion of that dollar spent on non-clinical services.

Nationally, Capital Health Plan’s administrative costs are among the lowest reported by health plans. We achieve that result in several ways: our staff’s dedicated efforts, investments in cost-saving technology, and a philosophical commitment to maximize both value and affordability of the health services and coverage for our CHP members.

Ask Dr. Nancy - Free & Low Cost Ways to Get Healthy

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Q: I want to get healthy . . . if it’s free or low cost! Any suggestions?

The answers are more plentiful than you may expect. The rest is up to you! Here are a few simple suggestions that will make a difference in your life.

Walk.

It’s the easiest, best free exercise of all. Just don’t set unrealistic goals. Start with even 10 or 15 minutes at a time, and work up to 30 minutes five days a week. Rainy day? Walk in the mall. You’ll quickly feel the mood and energy boost of walking. (Also consider a fitness center, now more affordable with a CHP $150 membership reimbursement. See page 3 for details!)

Control portion size.

If you’re not ready to change your diet drastically, begin by reducing amounts—and eat more slowly. Using smaller plates and bowls at home is a good trick. They’ll look full, and you’ll discover you still feel full with less food. Most meals cooked at home are cheaper and have fewer calories than restaurant meals. If you have leftovers, freeze them for later rather than grazing on them after hours. Avoid eating anything two to three hours before going to bed. In addition to avoiding acid reflux (heart burn), studies show eating fewer calories later in the day promotes less storage of those calories as fat.

Stop buying and eating junk food.

Break away from this unhealthy American pastime. Most fast food restaurants have healthy choices now. Make the healthy choice.

Laugh.

I’m serious. A good belly laugh actually has healthful physiological effects (also smiles and chuckles). Stress and worry can cause illness. So be open to looking on the light side, watch and read comedies, and seek out people with a good sense of humor. The doctor says: yuck it up.

Take our new online Health Survey.

This great tool yields personal health help. You answer questions that take 15–20 minutes and then receive an individualized (and updateable) report. The survey also creates forms that you can take to doctors’ visits, lets you set and track health goals, and generates a tailor-made list of information resources. The Health Survey is a terrific way to map the “big picture” of your health and decide personal goals. Do you want to lose 20 pounds, improve your strength and balance, or reduce the medications you take? CHP can help! Try this and other online services and don’t forget our 24-hour Health Coaching phone line (850-383-3400). We also have health classes and support groups through our Health Promotions department (850-383-3511) and their community partners. Live well. It’s your choice!

To Access the Health Survey

  1. Click on Members tab.
  2. Click CHP Health Coaching.
  3. Log on with your user ID and password (or register, if you are a first-time user).
  4. Click Health Tools.
  5. Click Health Survey.

$150 Reimbursement for Your Fitness Center Membership

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

What a great exercise incentive! CHP now has more help for your choice to “Live Well.” A

new program for members in 2008 is a $150 reimbursement—per calendar year—for fitness center membership.

Exercise is one of the best health steps you can take. Today, fitness centers offer many options for personal tastes and enjoyment: not only weights and equipment, but yoga, Pilates, jazzercise, swimming, and more. Please check with your physician before starting an exercise program. CHP will reimburse you directly for fees you pay to a health and fitness center. Here’s how the program works.

  • To receive a reimbursement, you must be a member of the fitness center for at least four consecutive months. Keep all documentation of your membership and fees.
  • Most centers or programs qualify. Exclusions are country or social clubs, spas, gymnastic centers, martial arts studios, tennis facilities, sports teams or leagues, and personal trainers.
  • The maximum reimbursement is $150 per calendar year, per household (CHP member or covered dependents). For Medicare members, the maximum reimbursement is $150 per member, per calendar year.
  • You file for the reimbursement once per year (no later than March 31 of the following year) and must be a current CHP member when you file. For example, for a membership occurring in 2008, you must file by March 31, 2009.
  • Go to Health & Fitness under Live Healthy on the Members tab for required documentation and how to submit it.

Any questions? Please call Member Services at 850-383-3311 or TDD 850-383-3534.

CHP Information Central

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Here are just a few of the topics you can find at the CHP website on your Members tab.

In the About Your Care section
  • Understanding Quality: Improving Services for Members
  • Confidentiality and Privacy
    • Use and disclosure of personal health information
    • Types and use of information members can enter on CHP’s secure website
  • Advance Directives and Living Wills
  • CHP’s Case Management Program
  • Disease Management
  • Clinical Practice Guidelines
  • Utilization Management: Understanding CHP’s Health Care Decision Making
    • Explanation of appeal rights, including the availability of external appeals by independent review organizations
    • CHP’s affirmation statement about incentives
    • How CHP evaluates new technology
    • How to reach CHP with specific questions about coverage issues
  • Member Rights & Responsibilities
  • Pharmaceutical Procedures: About Your Medications
In the New Members section
  • How to Obtain Care After Office Hours (CHP Urgent Care)
  • Tips for Better Laboratory Service
In the Live Healthy section
  • Recommended Screening Tests (Preventive Health Guidelines)
  • Free Local Health Education Classes

For printed copies of these documents, please contact CHP Member Services at 850-383-3311.

Give a Little of Your Sole: Walking for Community & Health

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Part of Capital Health Plan’s commitment to its members is commitment to the community. One perfect avenue is participating in the sponsored walks and runs of charitable organizations. The walks help raise funds for important causes and promote health. They are a great way for CHP to invest in the community and bring friends and family together. CHP senior management has partnered with staff to form the CHP Walking Team—employees willing to give a little of their sole.

Get in Stride Yourself.

You’re invited to join the CHP team or form a team of your own. During the past year, this walking prescription has benefited our employees while serving others. If a daily fitness walk could be put in a pill, it would be the most popular prescription in the world. Major research shows the benefits are numerous and the risks low. Walking strengthens your heart, lowers blood pressure, helps to reduce body fat, and improves blood sugar and cholesterol levels. Stop by and see us at the events listed below!

Sickle Cell Walk

www.sicklecellfoundation.org

September 13, 2008
Start: 8:30 a.m.
Jake Gaither Park

Making Strides Against Breast Cancer

www.makingstrides.acsevents.org

September 28, 2008
Registration: 12:30 p.m. Start: 3 p.m.
SouthWood Center

HIV/AIDS Walk

www.bigbendcares.org

October 12, 2008
Registration: 2 p.m. Start: 3 p.m.
Location to be announced

Heart Walk

www.bigbendheartwalk.kintera.org

October 18, 2008
Start: 9 a.m.
Tom Brown Park

Are You Facing a Tough Medical Decision?

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

At Capital Health Plan, we believe that knowledge is power—for patients as well as doctors. When you have accurate information about health and treatment options, you can work with your doctor to make the medical decisions best for you. That is shared decision making.

Free Informative DVDs and Videos.

“Shared Decision Making®” is also the name of an award-winning series of DVDs and videos available to members through CHP Health Coaching. The topics are:

  • back pain
  • enlarged prostate and prostate cancer
  • breast cancer
  • colon cancer screening
  • heart disease
  • depression
  • end-of-life issues
  • menopause
  • osteoarthritis of the hip or knee
  • uterine fibroids and abnormal uterine bleeding

When you have one of these conditions, you face treatment decisions—some that aren’t easy. Watching a DVD will help prepare you to talk with your doctor about options. The information may answer some of your questions and also help you think of others to ask your physician.

Research and Real Patients. Shared Decision Making DVDs summarize the results of medical studies about a condition; explain treatment or testing choices; and outline the possible risks and benefits of each choice. In the DVDs, real patients explain what they went through when making tough medical decisions.

Watching the DVD is step one: getting knowledge. The real decision making happens in the doctor’s office. You’ll have the power to help choose the right treatment choice for you.

How to Get the DVDs.

CHP Health Coaching is your source for Shared Decision Making DVDs and videos, as well as much more information. Call CHP Health Coaching at 850-383-3400. Health Coaches are specially trained nurses, dietitians, and respiratory therapists who are available to you by phone 24 hours a day, 7 days a week—at no out-of-pocket expense. You also can obtain additional information by following the links to CHP Health Coaching.

Advantage Prime Time

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

If Medicare Is in Your Future, Come to One of Our Regular Seminars

At this time of year, many of Capital Health Plan’s large employer groups are holding their annual open enrollments. Capital Health Plan is also preparing for its Medicare annual election and open enrollment periods. It’s time to learn what the CHP Medicare Advantage program—ranked highest in the Southeast by the National Committee for Quality Assurance—offers you. Here’s an overview, with easy ways to get more information. Note: If you are a current CHP member and you become Medicare eligible, you do not need to wait for an open enrollment or annual election period to enroll.

CHP’s Three Medicare Advantage Plans.

Two plans—CHP Advantage Plus and CHP Preferred Advantage—are direct-pay plans open to everyone who (1) has Medicare Part A and Part B; (2) lives in Leon, Gadsden, Jefferson, or Wakulla counties; and (3) does not have End Stage Renal Disease (this restriction does not apply to current CHP members). The third plan is CHP Retiree Advantage. Seventeen of Capital Health Plan’s large-employer groups offer CHP Retiree Advantage to their Medicare-eligible retirees (and their Medicare-eligible dependents). With CHP Retiree Advantage, these individuals can maintain the same CHP health care benefits they enjoyed as active employees.

The Benefits Of CHP Medicare Advantage.

All of our Medicare Advantage plans offer extra benefits, as well as covering all parts of Medicare.

  • CHP coordination of all of your Medicare coverage.
  • Automatic enrollment in a Medicare Part D (prescription drug) plan.
  • No need for enrollment in a Medicare Supplemental or Medigap plan.
  • A network of over 300 physicians who accept CHP Medicare Advantage.
  • Emergencies covered anywhere in the world so you can enjoy worry-free travel.
  • The same high-quality and cost-effective care that all CHP members receive.
  • An eyeglass benefit of up to $150 every two years.
  • Reimbursement of up to $150 yearly for health and fitness fees.
  • Annual hearing exams.
  • Personal and online services such as CHPConnect and CHP Health Coaching.

Capital Health Plan is a health plan with a Medicare contract. Benefits, formulary, pharmacy, network, premium, and copayments/coinsurance may change each contract year. Contact Capital Health Plan for details.

Find Out More about CHP Medicare Advantage FREE Seminars

CHP Advantage Plus and Preferred Advantage: Second and fourth Friday of every month
CHP Retiree Advantage: Second and fourth Wednesday of every month
Time and place: 10 a.m., Governor’s Square Health Center
Reservations: 850-523-7333
Information: Please call member services at 850-523-7441 or 1-877-247-6512 (TTY users 850-383-3534 or 1-800-955-8771), 8:00 a.m. to 8:00 p.m., seven days a week.

Important Information About Your Medication: Take It!

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Sounds obvious, doesn’t it? Not to everyone. According to the World Health Organization, almost half of Americans who are prescribed high blood pressure medication do not take it consistently. That equals very risky business—risky for debilitating strokes. Skipping or stopping medicine is an issue in many chronic or serious illnesses that require long-term, daily medication.

Taking medication consistently—sometimes different pills several times a day—can be confusing or hard to remember, but it’s important: medicine cannot work if you don’t take it. Without it, your symptoms will return or worsen, an emergency may result (perhaps irreversible), and you’ll spend more time and money under care. Here are some tips.

1. Get facts: Know exactly at what times and in what dosages to take the medicine, as well as special instructions (such as taking with food) and possible side effects. If you’re unclear, ask your physician or pharmacist.

2. Report all medications: List and report all medications you are taking to every physician and to your pharmacist. This is very important to prevent adverse drug interactions.

3. Organize in advance: Put your pills for the next day or week into a compartmented pill box. Many styles exist, some marked for time of day. You’ll know at a glance what you need to take and whether you have.

4. Remind yourself. Put the pill box where you can’t miss it, for example, by your toothbrush for a morning routine. Or put notes to yourself in obvious places: on the refrigerator, a mirror, or your telephone at work. Some people use a calendar or notebook to keep track of all medications.

5. Refill on time. Make a note to refill a prescription a week before it will run out.

Women’s Health & Cancer Rights Act, 1998

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

In compliance with this act, mastectomies and related reconstructive surgery are covered benefits for CHP members. Coverage includes reconstruction of the surgically altered breast, as well as surgery and reconstruction of the other breast for a symmetrical appearance. Coverage is also available for breast prostheses and for the physical complications of mastectomy, including lymphedemas. If you have any questions, please call Member Services at 850-383-3311.

Take This Path to a Healthier You

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

This health path isn’t a metaphor. It’s real: an outdoor trail close to your home. You’d be surprised how many trails exist and how many more the medical community and U.S. cities want to create. The reason? It’s spelled out in the theme of National Trails Day: “Take the Path to a Healthier You.”

Exercise—and More.

Excess weight, high blood pressure, heart disease, osteoporosis, back pain, stress: Walking is a proven weapon against all of these, and yet Americans today are more sedentary than earlier generations. Experts now know that trails have special properties for both exercise and motivation.

Blaze It, and They’ll Come.

Great advantages of trails are access, attractiveness, and variety. They can be designed for walking, running, biking, rollerblading, and wheelchair recreation. When well laid-out in natural settings, trails beckon people—fostering exercise as an everyday activity. That’s why blazing more trails is a nationwide urban and medical movement. Almost a decade ago, the U.S. Surgeon General created the Health and Trails Initiative. In 2006, as one example, the Medical Mile greenway opened in downtown Little Rock, Arkansas, a collaboration among Heart Clinic Arkansas and the city and national park services. A Nebraska study found that every $1 investment in trails resulted in nearly $3 in reduced health care costs (Health Promotion Practice, April 2005, pp.174–79).

Nature Deficit Disorder.

Childhood expert Richard Louv’s term “nature deficit disorder” is deliberately catchy to catch awareness. Today, kids under 13 spend only one-half hour weekly in outdoor freestyle play. Nature outings for most of us are limited. Exercising outdoors—playing, rambling . . . not directed activity—has been shown to foster more creative and cooperative play in children, says Louv.

Bottom Line Benefits.

Interestingly, data is building that city trails increase economic activity and can increase property values—in addition to the health care and insurance savings. The real end-benefit, though, is where we started: a healthier you. Trails are a stimulating, beautiful, enjoyable, and an easy way to Choose to Live Well.