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MetroPlus Health Letter® is published four times a year by MetroPlus Health Plan in cooperation with Redspring Communications, Inc. © 2002 MetroPlus Health Plan. All rights reserved. MetroPlus Health Letter is a registered trademark of the New York City Health and Hospitals Corporation. Reproduction without permission is strictly prohibited. No material in this issue may be reproduced without permission from MetroPlus Health Plan. Health Letter does not promote any form of medical treatment, nor does it encourage the self-management of medical problems. It is meant to supplement, not replace, care from health care professionals.
Editor: Mari S. Gold
PLAN NEWS
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Do You Have Panic Attacks?A panic attack is scary. Your heart beats fast and you feel out of control. Some people think they are having a heart attack.
What Causes a Panic Attack?
Panic attacks often run in families. Women have more panic attacks than men do. The attacks usually start around age 25, but they can happen at any time of life.
What Should You Do?If your panic attacks happen
enough to disrupt your normal life, see your PCP. He or she will check to make sure you do not have a physical problem. Then, you may be referred to a mental health provider.
Treating Panic AttacksThe best treatment is often a combination
of medication and behavior therapy. In therapy, you learn what triggers your attacks. You can also learn special ways to breathe and other ways to calm down. These can help stop a panic attack before it starts. Doing things that you enjoy also helps. Learning a new skill, listening to music, and exercise all may help you relax.
Privacy NoticeMetroPlus Health Plan respects your privacy rights. This notice describes how we treat the nonpublic personal financial and health information (“Information”) we receive about you and what we do to keep it confidential and secure. Categories of Information We Collect and May Disclose MetroPlus collects Information about you from the following sources: ■ Information you give us on applications and other forms or that you tell us.■ Information about your dealings with us, the health care providers we work with, and others.
What We Do With Your Information We do not disclose Information about our members and former members to anyone, except as permitted by law. We do use Information as permitted by law for health plan purposes, such as the following:■ To provide the health care benefits you receive as a member of MetroPlus Health Plan; for example, to arrange for treatment that you need and to pay for services you receive.■ To communicate with you about programs and services that are available to you as a MetroPlus member.■ To manage our business and comply with legal and regulatory requirements.
How We Protect Your Privacy■ We limit access to your Information to employees and other persons who need it to conduct MetroPlus Health Plan business or comply with legal and regulatory requirements.■ Employees are subject to discipline, and may be fired, if they violate our privacy policies and procedures.■ We also use physical, electronic, and procedural safeguards to keep Information confidential and secure in accordance with state and federal regulations.
Former Members If your membership in MetroPlus Health Plan ends, your Information will remain protected in accordance with our policies and procedures for current members.
You Can Contact Us at the Address or Phone Number Below to:■ Request more information about our privacy policies and practices.■ File a privacy-related complaint with us.■ Request (in writing) to review Information about you in our records.
Member Services, MetroPlus Health Plan 11 West 42nd Street, New York, N.Y. 10036
Phone: 1-800-303-9626 (TDD 1-800-881-2812)
Attention MetroPlus Members MetroPlus Health Plan wants to be sure that you are aware of your rights to receive the services listed below as part of your MetroPlus health coverage.■ Cancer Care Second Opinion. For the diagnosis of cancer, recurrence of cancer, or a recommendation regarding cancer treatment, MetroPlus will pay for a second opinion from a cancer specialist including one affiliated with a specialty care center for the treatment of cancer, even if the specialist is not part of the MetroPlus network. A written referral from your PCP is required.■ Hospital Care with Breast Cancer Surgery. If you need a lumpectomy, lymph node dissection, or mastectomy, MetroPlus will pay for in-hospital care for as long as your doctor decides it is necessary, after discussing it with you.■ Breast Reconstruction Following Mastectomy. If you have a mastectomy, MetroPlus will pay for reconstructive surgery on either or both breasts in the manner you or your doctor deem appropriate.■ Mastectomy-Related Services. If you have a mastectomy, MetroPlus provides benefits for mastectomy-related services including recon -struc tion and surgery to achieve symmetry between the breasts, prostheses, and treatment of complications resulting from mastectomy (including lymphedema).
If you have questions about these benefits or any other aspect of your MetroPlus coverage, please call MetroPlus Member Services at 1-800-303-9626.
Dear MetroPlus Member:Like many people today, you may be wondering what happens to the personal information about you that your health plan receives. The Privacy Notice on page 4 of this newsletter tells you about the personal information MetroPlus Health Plan collects, what we do with that information, and the steps we take to keep it confidential and secure. Our company’s commitment to customer privacy is not new. MetroPlus members have trusted us with their personal information for as long as we have been in business. We value that trust and take seriously our responsibility to protect your privacy. Please read the Privacy Notice carefully. No response is required. If you have questions, however, we would be happy to answer them. Please call our Member Services Department at 1-800-303-9626 (TDD 1-800-881-2812).
Sincerely,MetroPlus Health Plan
IMPORTANT INFORMATION FOR METROPLUS MEMBERS
Introducing Family Health PlusAnother plus from MetroPlus: Family Health Plus (FHPlus)! FHPlus has no costs or co-payments. You can join if you are aged 19 to 64 with or without children; a U.S. citizen or “qualified alien”; not eligible for Medicaid; and meet certain income requirements. FHPlus has great benefits. To find our more, call 1-800-475-METRO.
Members Come FirstAt MetroPlus, the most important people are our members. We are here to help you any way we can. If you have a problem with the Plan, we want to know. Or, tell us if you have a problem with a provider. If you need us, please call Member Services at 1-800-303-9626.
MetroPlus Health Letter 4
Dealing With Teen Diabetes
Dr. Felix is a MetroPlus provider. She is a pediatric endocrinologist who works with kids who have diabetes and
other health problems at Elmhurst Hospital Center in Queens.
Many people with diabetes do not have symptoms. Sometimes doctors find diabetes in teens during a regular checkup. This is one more reason why teens need a checkup every year.
We work with teens with diabetes to help them avoid problems later on. Our team approach helps you keep
your diabetes under control. Your team is your doctor, nurse educator, and dietician, and often your school nurse. We all work together with you.
What Can You Do?■ Take your insulin or other diabetes medicine as often as you should.■ Monitor your blood sugar the way your PCP tells you to.■ Eat well, which means eating healthy foods. Eat less fried food, fatty meat, and milk products. Eat more fresh veggies and fruits. You can still enjoy fast food with
friends. Pick a plain burger with lettuce and tomato and a diet soda; skip the cheese and shakes.
■ Exercise daily. Pick an activity you like: martial arts, dancing, walking, swimming, biking, or
running. Stay with it.■ Talk to your PCP about managing your diabetes. You’ll be in control!
Site News & Notes■ Congratulations to four MetroPlus
sites! Metropolitan Hospital Center,
Gouverneur Health Care Services,
Jacobi Medical Center, and
Elmhurst Hospital Center all
scored above the national
average on their Joint
Commission on Accreditation
in Healthcare Organizations
survey.
■ Baby Express arrived at
Harlem Hospital Center, 530
West 137th Street, Manhattan.
Mothers-to-be who get Ob/Gyn
care at Harlem or Renaissance
get a voucher in their third
trimester. When labor begins,
they can phone a livery service
to take them to the hospital!
■ Kings County Hospital Center,
451 Clarkson Avenue, Brooklyn,
opened a new general care Bed
Tower. All patient rooms in the state-
of-the-art building are private or
semi-private. For more information,
call (718) 245-3910.
■ The new, modern Queens Hospital Center
opened at 82-68 164th Street, Jamaica, Queens.
For more information, call (718) 883-2214.
Preterm LaborPregnancy lasts 40 weeks. Preterm labor starts before 37 weeks. Some preterm babies are sick or die because they are born before they are ready.
What Increases Your Risk? Stress, smoking, having already had a preterm baby, being pregnant with twins or triplets, or having diabetes or hypertension. If you are at risk you may be told to:■ Change your lifestyle.■ See your Ob/Gyn more often.■ Learn how to time your contractions.
Signs of Preterm Labor These include a heavy feeling in your pelvic area; dull, low backache; the need to urinate often; cramps with or without diarrhea; an increase or change in vaginal discharge. If you notice any of these signs, call your Ob/Gyn right away.
MetroPlus Health Letter 2
By Ingrid Felix, M.D.
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Are you sneezing? Do your eyes itch? Maybe you have trouble breathing. What’s wrong? You may have allergies or asthma. You may be sensitive to plant pollen, certain foods or medicines, dust, or animals. An allergy can make you sneeze, have a runny or itchy nose, watery eyes, or hives. If you have a problem, tell your PCP. Try to avoid the “bad” substance. Asthma is a lung disease. It can’t be cured but it can be
controlled. Many children get asthma. “Triggers” can set off an asthma attack. Asthma triggers include:
■ Allergies to pets, house dust, or plants.
■ Cigarette smoke.
■ Sickness with coughing like
bronchitis. Join the MetroPlus AsthmaPlus program. We will give you lots of special
help. Call 1-800-579-9798 to learn more or to join.
It’s free!
Do You Have Asthma or Allergies?
Reminders■ Medicaid and Child Health Plus
You will get a reminder to recertify for Medicaid and Child
Health Plus. Be sure to recertify. This lets you
keep your health care coverage.
■ Do You Have a Hearing Problem?
If you can get to a TDD machine, please call
MetroPlus Member Services at 1-800-881-
2812.
■ Medicaid, Child Health Plus, and
MetroPlus Gold
You should have a yearly physical examination. This
helps you stay healthy. Call your PCP to make your
appointment now.