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WINTER 2012

For Your FamilyHave you scheduled your

wellness exams yet?

NEWSLETTER FOR MEMBERS

one oneTO

- Do you need a case manager?

- Generics 101

- What you’ll fi nd on our site

HIKING THE SAWTOOTH MOUNTATINS, IDAHO

NEWSLETTER FOR MEMBERS

one oneTO

SPRING 2012

It’s Your TimeMake the most of your minutes

with our time saving tips

- Meet us on Facebook

- Are you sharing with your doctor?

- How to control asthma

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=TERM TO LEARN

Healthcare Fraud:Intentional, unlawful misrepresentation or deception for the purpose of gaining

unauthorized benefi ts—fi nancial or otherwise. An example is being billed for services

that you didn’t receive. If you suspect healthcare fraud, call our fraud hotline at

1-800-682-9095 or email us at fraudreporting@bcidaho.com.

Blue Cross of Idaho wants to help you get the best value in healthcare. What does this mean for you? Well, it means we are committed to helping you make cost-effective and safe decisions for your health. One way we do this is by offering money saving tips in each newsletter. Check out page 7 for fi ve ways you could cut costs—and time—when it comes to your healthcare.

Another way we support your health is with helpful courses like our population health management program, a hands-on approach to managing conditions like asthma, diabetes and heart failure. We highlight how our asthma disease management program can help sufferers on page 4.

Check out bcidaho.com for other membership perks. And ask your benefi ts administrator about any discounts available as a member of Blue Cross of Idaho.

We hope you enjoy the spring season and keep on enjoying all the benefi ts of being a member of Blue Cross of Idaho.

ONE TO ONE It Helps to ShareYour doctor can help you manage and even prevent health concerns. To do this, he or she needs a full picture of your lifestyle and habits.

So next time you visit your doctor for your annual checkup, be sure to share anything and everything—from your diet and exercise habits to travel plans and sleeping patterns. If you have a question about your body that feels embarrassing, remember that doctors are professionals who have tools and information to help you live a full, healthier life.

#BEFORE YOUR NEXT APPOINTMENT, use the following list as a starting point to explore what you may wish to bring up with your doctor. Ask yourself, “Am I… -ready to quit smoking?”-interested in becoming more active?”-having trouble sleeping?”-struggling with bladder issues?”-satisfi ed with my sexual health?”-feeling depressed or anxious?” -concerned about my alcohol consumption?”

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we’re here for your health

blue cross of idaho bcidaho.com2

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=TERM TO LEARN

Healthcare Fraud:Intentional, unlawful misrepresentation or deception for the purpose of gaining

unauthorized benefi ts—fi nancial or otherwise. An example is being billed for services

that you didn’t receive. If you suspect healthcare fraud, call our fraud hotline at

1-800-682-9095 or email us at fraudreporting@bcidaho.com.

Blue Cross of Idaho wants to help you get the best value in healthcare. What does this mean for you? Well, it means we are committed to helping you make cost-effective and safe decisions for your health. One way we do this is by offering money saving tips in each newsletter. Check out page 7 for fi ve ways you could cut costs—and time—when it comes to your healthcare.

Another way we support your health is with helpful courses like our population health management program, a hands-on approach to managing conditions like asthma, diabetes and heart failure. We highlight how our asthma disease management program can help sufferers on page 4.

Check out bcidaho.com for other membership perks. And ask your benefi ts administrator about any discounts available as a member of Blue Cross of Idaho.

We hope you enjoy the spring season and keep on enjoying all the benefi ts of being a member of Blue Cross of Idaho.

It Helps to ShareYour doctor can help you manage and even prevent health concerns. To do this, he or she needs a full picture of your lifestyle and habits.

So next time you visit your doctor for your annual checkup, be sure to share anything and everything—from your diet and exercise habits to travel plans and sleeping patterns. If you have a question about your body that feels embarrassing, remember that doctors are professionals who have tools and information to help you live a full, healthier life.

#BEFORE YOUR NEXT APPOINTMENT, use the following list as a starting point to explore what you may wish to bring up with your doctor. Ask yourself, “Am I… -ready to quit smoking?”-interested in becoming more active?”-having trouble sleeping?”-struggling with bladder issues?”-satisfi ed with my sexual health?”-feeling depressed or anxious?” -concerned about my alcohol consumption?”

THUMBS UP!For health tips, information about community events, charity giving and sweepstakes, visit our Facebook page and like us. We’ll meet you online, at facebook.com/BlueCrossofIdaho.

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we’re here for your health

Blue Cross of Idaho’s formulary may not apply to all healthcare plans. Please refer to your group’s contract provisions for more detailed information about the terms and conditions of your prescription drug benefi t.

what’s new in generic on our formularyBRAND NAME GENERIC NAME MEDICATION USE

Teveten eprosartan High blood pressure

Combivir lamivudine/zidovudine Antiviral

Ryzolt ER tramadol extended release Pain

Clobex shampoo clobetasol Topical anti-infl ammatory

Clobex lotion clobetasol Topical anti-infl ammatory

Ritalin LA 20, 30 and 40 mg

methylphenidate ER ADHD

Zanafl ex tizanidine Muscle relaxant

Lexapro escitalopram Depression

Prometrium progesterone Women’s health

Geodon ziprasidone Mental health

blue cross of idaho bcidaho.com blue cross of idaho bcidaho.com 3

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I f you have asthma, you know it’s a chronic condition that requires ongoing management. Even so, you can successfully control your asthma if you keep three things in mind:

physician support, environmental awareness and medication use.

Partner With Your DoctorYour doctor can help you understand your asthma symptoms and develop an overall strategy that works for you. If you fi nd it diffi cult to follow your doctor’s instructions or are reluctant to take a prescription medicine because of side effects, be sure to tell him or her.

To make the most of your time with your doctor during appointments, consider keeping a health diary and bringing it to your appointments. In it, record your symptoms, the medications you use, the amount of medication you use, your peak-fl ow readings and any changes in your condition.

Know Your EnvironmentSome asthma attacks can be prevented by avoiding the envi-ronmental irritants that trigger your symptoms. Common causes include tobacco smoke, pollen, animal dander and dust mites. Changes in weather, strong odors and fumes can also aggravate your asthma.

Determine which allergens or irritants set off your asthma and plan ways to avoid or anticipate them. For example, check the pollen count in your area. Use an allergy-relief mattress cover and pillowcases. Keep pets out of your bedroom. Don’t hang laundry outside to dry. Avoid exercising in cold air.

Be Med-WiseIn general, many people with asthma use a combination of both long-term control and quick-relief medications. Long-term control medications are taken every day and help manage airway infl ammation in persistent asthma. Quick-relief therapy provides short-term relief for asthma attacks.

Treatment should be fl exible and adjusted according to your changing needs. Your doctor can help you assess your condition and recommend changes to your medication use as needed.

Three steps to successfully controlling your symptoms.

Do You Understand Your Asthma?

How to Change Pharmacies Moving your prescriptions to a new phar-macy is easy. Just do one of the following:-Take your prescription bottle to your

new pharmacy; they will call your old pharmacy for you.

-Call your new pharmacy and ask them to call your old pharmacy.

-Ask your doctor to call your new pharmacy with your prescription information.

Save Time and Money on Refi llsMail-order prescription delivery lets you order refi lls online and have them delivered directly to your home. You’ll save time and gas by avoiding a trip to the pharmacy.

Also, getting maintenance drugs via home delivery may cost you less than what you pay at your local pharmacy.

Prescription PointersMedication is a critical—and often costly—aspect to maintaining good health. We’ve compiled a few tips for easily managing your refills and your spending.

#TOOLS TO USE

Think of a peak fl ow meter as a thermometer for your asthma. It helps you measure the severity and status of your condition. Properly monitoring your breathing with a peak fl ow meter can help you track, control and prevent asthma attacks. Check with your doctor about how to properly use the meter.

You may also benefi t from taking part in Blue Cross of Idaho’s asthma management program. Check your policy to see if it includes our population health management program, or call 1-800-627-6655, ext. 6924, to learn more.

blue cross of idaho bcidaho.comblue cross of idaho bcidaho.com4

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I f you have asthma, you know it’s a chronic condition that requires ongoing management. Even so, you can successfully control your asthma if you keep three things in mind:

physician support, environmental awareness and medication use.

Partner With Your DoctorYour doctor can help you understand your asthma symptoms and develop an overall strategy that works for you. If you find it difficult to follow your doctor’s instructions or are reluctant to take a prescription medicine because of side effects, be sure to tell him or her.

To make the most of your time with your doctor during appointments, consider keeping a health diary and bringing it to your appointments. In it, record your symptoms, the medications you use, the amount of medication you use, your peak-flow readings and any changes in your condition.

Know Your EnvironmentSome asthma attacks can be prevented by avoiding the envi-ronmental irritants that trigger your symptoms. Common causes include tobacco smoke, pollen, animal dander and dust mites. Changes in weather, strong odors and fumes can also aggravate your asthma.

Determine which allergens or irritants set off your asthma and plan ways to avoid or anticipate them. For example, check the pollen count in your area. Use an allergy-relief mattress cover and pillowcases. Keep pets out of your bedroom. Don’t hang laundry outside to dry. Avoid exercising in cold air.

Be Med-WiseIn general, many people with asthma use a combination of both long-term control and quick-relief medications. Long-term control medications are taken every day and help manage airway inflammation in persistent asthma. Quick-relief therapy provides short-term relief for asthma attacks.

Treatment should be flexible and adjusted according to your changing needs. Your doctor can help you assess your condition and recommend changes to your medication use as needed.

Three steps to successfully controlling your symptoms.

Do You Understand Your Asthma?

How to Change Pharmacies Moving your prescriptions to a new phar-macy is easy. Just do one of the following:-Take your prescription bottle to your

new pharmacy; they will call your old pharmacy for you.

-Call your new pharmacy and ask them to call your old pharmacy.

-Ask your doctor to call your new pharmacy with your prescription information.

Save Time and Money on RefillsMail-order prescription delivery lets you order refills online and have them delivered directly to your home. You’ll save time and gas by avoiding a trip to the pharmacy.

Also, getting maintenance drugs via home delivery may cost you less than what you pay at your local pharmacy.

If you have Blue Cross of Idaho prescrip-tion coverage, you can sign up for home delivery in one of two ways: Go to bcidaho.com and log in using your username and password. Then, on the member homepage, select Pharmacy Benefits. A new window will open with the ExpressScripts homep-age where you can select Switch to Home Delivery. Or call 1-866-265-9456. You may also call us at 1-888-494-2583 to request a home delivery enrollment form.

Check the FormularyReview our list of covered drugs to see if your prescription is available in a generic form. Generic drugs work the same as their brand-name equivalents and cost less. Go to bcidaho.com. Select Pharmacy from the bottom of the page, and then choose Search prescription drugs and formulary. Learn more by calling Customer Service at the number on the back of your ID card.

Prescription PointersMedication is a critical—and often costly—aspect to maintaining good health. We’ve compiled a few tips for easily managing your refills and your spending.

blue cross of idaho bcidaho.com 5

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D oes it feel like deciphering a new language when you try to review your health insurance information?

Save the language class for your dream trip to Italy. Here, we’ve got a list of common abbreviations and insurance terminology.

-CLAIM: An itemized statement of healthcare services and their costs provided by a hospital, physician’s office or other facility to the insurance company.

-COINSURANCE: A percentage of the allowed amount you pay for a healthcare covered service. Coinsurance applies after meeting the deductible.

-CONTRACTING PROVIDER: A provider who is part of the Blue Cross of Idaho network.

-DEDUCTIBLE: A set dollar amount you pay each benefit period for covered services before your health insurance plan begins paying benefits. Deductibles reset each year.

-EOB: An explanation of benefits—not a bill or a claim. It lists the services for which you or your provider has sent claims for coverage.

- FORMULARY: A listing of drugs, classified by therapeutic category or disease class, that are considered preferred therapy for a given population and that are to be used by an insurer’s providers in prescribing medications.

-GENERIC: Unbranded pharmaceutical drugs that meet the same standards for safety, purity, strength and quality as brand-name drugs, but typically provide substantial dollar savings versus branded counterparts.

-HMO: Health maintenance organization (HMO) plans offer coverage with affordable premiums, no deductibles and predictable costs.

- POS: A point-of-service (POS) product offers members the option to choose at the time medical services are needed whether they will go to a provider within the plan’s network or seek medical care outside the network.

-PPO: Preferred provider organization (PPO) plans cover healthcare services at lower cost-sharing amounts when patients seek care from contracting providers who agree to participate in the network.

Your cheat sheet for health insurance vocabulary.

Alphabet SOUP

5 Ways to Save Money

(and Minutes)Healthcare is expensive; we understand that. That’s why we like to share tips for safely cutting your costs.

1.

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3.

4.

5.

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- FORMULARY: A listing of drugs, classified by therapeutic category or disease class, that are considered preferred therapy for a given population and that are to be used by an insurer’s providers in prescribing medications.

-GENERIC: Unbranded pharmaceutical drugs that meet the same standards for safety, purity, strength and quality as brand-name drugs, but typically provide substantial dollar savings versus branded counterparts.

-HMO: Health maintenance organization (HMO) plans offer coverage with affordable premiums, no deductibles and predictable costs.

- POS: A point-of-service (POS) product offers members the option to choose at the time medical services are needed whether they will go to a provider within the plan’s network or seek medical care outside the network.

-PPO: Preferred provider organization (PPO) plans cover healthcare services at lower cost-sharing amounts when patients seek care from contracting providers who agree to participate in the network.

Stay in the network. Blue Cross of Idaho has contracted with providers who agree to offer their services at a specific, discounted rate. When you visit a doctor, dentist, specialist or pharmacy that’s part of this network, you will pay less. Search our provider directory online to find the right in-network option for you. Go to bcidaho.com and click Find a Provider.

See your doctor. An annual checkup can help you prevent costly, serious medical condi-tions. Your doctor will track vital signs like your cholesterol, blood pressure and weight to ensure you’re on a healthy path.

Get your screenings. Like annual checkups, preventive tests for cancer help your doctor detect problems before they become difficult to treat. Ask your doctor about screenings for colon, cervical and breast cancers.

Go to the emergency room only for emergencies. Generally, emergencies mean there’s a risk of death or losing a limb. For ailments like colds, migraines, earaches, back pain or sprains, you’ll save money and time if you visit an in-network doctor or walk-in clinic.

Take your medication as prescribed. If you don’t follow the directions or you stop taking a drug before you are due to, you may end up causing greater harm or not getting better—and that means more visits to the doctor or more sick days. If you have any questions about the medication or its side effects, ask your doctor or pharmacist.

5 Ways to Save Money

(and Minutes)Healthcare is expensive; we understand that. That’s why we like to share tips for safely cutting your costs.

1.

2.

3.

4.

5.

bcidaho.com 7 blue cross of idaho

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SMILE, we’ve got you COVERED

The new Dental GRID means more options for you.

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ID

B lue Cross of Idaho has joined forces with other Blue Cross Blue Shield Plans nationwide to develop the

Dental GRID, one of the country’s largest dental networks. By combining the dental provider networks from participating Blues Plans across the country, we are giving members broader access to contracting dentists—no matter the location—as well as the same great service they’ve come to expect from Blue Cross of Idaho.

There are no hidden fees, no premium increases, and no additional paperwork in-volved. You simply have more dentists from across the country to choose from.

To fi nd a provider, go to bcidaho.com and

use the Provider Search function at the bottom of the page. Select “Dental” as the type of provider in the top fi eld. Continue entering search criteria, then select Find Providers at the bottom of the form, and a new page displays the results.

If you get dental care, you will notice a new look for our dental explanation of benefi t (EOB) and predetermination of benefi ts forms. These forms now look more like medical EOBs. Members who participatein Blue Cross of Idaho’s electronic EOB program will not receive a dental EOB statement in the mail, only in email. To sign up for the electronic EOB program, go to bcidaho.com/electronic-eob.

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