US Family Health Plan eNews 2022: Issue 3
Posted 07/12/22
For more of eNews Member Newsletter
IN THIS EDITION:
5 Steps to Control Your Blood Pressure
1. Know Your Numbers
Most people should strive for a blood pressure below 130/80 mmHg; speak with your health care provider to determine what your target blood pressure should be. Also ask what blood pressure level you should contact their office or seek immediate care for.
2. Work with Your Doctor
Your health care provider will create a plan with you to lower your blood pressure. This plan should include a follow-up call or appointment to see how your blood pressure is responding.
3. Make Lifestyle Changes
- Maintain a healthy weight. Strive for a body mass index (BMI) between 18.5 and 24.9.
- Reduce salt. Most people should stay under 1500mg of salt (sodium) but speak to your doctor to confirm this is right for you.
- Get active. Aim for 90-150 minutes of exercise per week.
- Limit alcohol. Women should drink no more than 1 drink a day and men no more than 2.
4. Check Your Blood Pressure at Home
Sharing multiple blood pressure readings that you’ve taken at home with your health care provider can give a better picture of your health than a one-time spot check in the office.d
5. Take Your Medications
If you are prescribed medications for your blood pressure, take them as directed. Let your doctor know if you have trouble affording medications, remembering to take them, or if you have any new symptoms.
August is National Immunization Awareness Monthd
National Immunization Awareness Month highlights the importance of vaccination in protecting the health of people of all ages. The Centers for Disease Control and Prevention (CDC) provides important guidance about immunization schedules recommended for different age groups.
Check out our convenient list of these recommended immunization schedules on our website today and make sure you and your family are up-to-date with your vaccines!
Do you have kids heading back to school? Make sure to check your school’s vaccination requirements to ensure your child is ready to head back this fall.
TRICARE® Ends COVID Pandemic National Emergency Telehealth Cost Share Waivers
In accordance with TRICARE regulation, member cost shares and copayments (including deductibles) were waived for in-network telehealth services during the national emergency for the global coronavirus 2019 (COVID-19) pandemic. This temporary waiver provision terminated July 1, 2022, in accordance with the final rule, "TRICARE Coverage and Reimbursement of Certain Services Resulting from Temporary Program Changes in Response to the COVID-19 Pandemic.”
Please be aware that Martin’s Point US Family Health Plan members receiving eligible telehealth services will be allowed a waiver of cost shares/copays during a grace period of 45 days from the TRICARE benefit termination date. As of August 15, 2022, member cost shares/copays for telehealth services provided by contracted providers will no longer be waived by the Plan. Please note that active-duty family members do not have copays/cost shares for these services.
Please contact Member Services at 1-888-674-8734 (TTY: 711) if you have questions about this.
Lower Back Pain: Don’t Rush to Imaging
Did you know that four out of five people will experience lower back pain in their lifetime and it’s one of the most common reasons for a physician visit?
Many people with lower back pain may think it’s important for their provider to order “imaging”—an X-ray, MRI, or CT scan—of their back right away to help in diagnosing or treating their pain. The good news is that most people recover from lower back pain within several weeks whether they have imaging or not. The recommendation is to hold off on imaging for six weeks to give your body a chance to recover.
Why wait? Imaging can expose you to unnecessary radiation and be expensive. Imaging can also identify abnormalities that may have been present all along and are not the cause of your pain; this could result in unnecessary surgeries. People who undergo surgery put themselves at risk of complications like infections and can have similar outcomes to those who used conservative measures.
Examples of conservative treatment are:
- Heat or ice packs
- Exercises like walking or gentle stretching
- Medications
- Acupuncture
- Physical Therapy
- Transcutaneous electrical nerve stimulation (TENS)
In some situations, having imaging done sooner than six weeks may be appropriate. Some of the symptoms that may influence your health care provider to order imaging sooner are:
- Unexplained weight loss
- Fever over 102
- Loss of bowel or bladder control
- Loss of feeling or strength in your legs
- Problems with reflexes
- A history of cancerd
Spotlight on Mental Health
We’ve recently updated our Mental Health section on our website to highlight support for you and your family. Check it out here to learn more about mental health in adults and children and find resources available to you.
Sore Throats: Antibiotics Aren’t Always the Right Treatment
There are many causes for a sore throat—including allergies, smoke exposure, strep throat, and viruses. Viral infections are the most common cause.
There is only one cause that can benefit from using an antibiotic—that is strep throat—which is a bacterial infection. Taking antibiotics when your sore throat is not caused by strep throat will not help your throat and could cause more harm than good. One of the biggest concerns with taking antibiotics when not needed is creating antibiotic-resistant bacteria. These are germs that are no longer killed by antibiotics that were designed to kill them. Another risk is developing C. diff—a bacteria that can cause severe and sometimes deadly diarrhea.
Symptoms of Strep Throat
(Bacterial Cause)
- Sore throat starts very quickly
- Fever
- Red and swollen tonsils, sometimes with streaks of pus
- Tiny red spots on roof of mouth
- Swollen lymph nodes in neck
Symptoms of Sore Throat
(Viral or Other Cause)
- Cough
- Runny nose
- Hoarseness
- Conjunctivitis (pink eye)
Although there may be some symptom differences between a viral sore throat and strep throat, the only way a doctor can determine that you have strep throat is by doing a strep test. If you are not diagnosed with strep, your viral sore throat should go away within one week.d
Here are some things you can do to help you feel better:
- Suck on ice chips, popsicles, or lozenges (don’t use lozenges or ice chips in children under 2 yrs old).
- Use a clean humidifier or cool mist.
- Gargle with salt water.
- Drink warm beverages and lots of fluids.
- Use honey to relieve cough if over the age of 1 yr.
- Ask your doctor or pharmacist about over-the-counter medicines that can help you feel better.
Source: https://www.cdc.gov/antibiotic-use/sore-throat.htmld
TRICARE Has Added a New Option for Continuous Glucose Monitors!
TRICARE is now covering the Continuous Glucose Monitors (CGMs) two ways: From a Durable Medical Equipment Supplier and from our Mail Order Pharmacy! If you have diabetes and are insulin dependent, talk to your provider about whether a CGM may be right for you. If so, they can request a prior authorization to receive your CGM and supplies through the Martin’s Point Mail-Order Pharmacy.
For eligibility and cost sharing information, please contact Member Services.
Is Your Dependent Aged 21 to 26 Years Old? College or not, we’ve got them covered!
Is your student hitting the books at college this fall? For many eligible, young adult military dependents, their US Family Health Plan coverage can follow them to college. Military Dependents are generally eligible for TRICARE® benefits until their 21st birthday. Beneficiaries with full-time student status can even have their benefits extend as far as their 23rd birthday, or graduation, whichever comes first.
What you’ll need to do to extend benefits past your student’s 21st birthday:
- Get proof of enrollment from the school registrar’s office stating that your dependent is enrolled full time in an accredited college in pursuit of an associate degree or higher. Provide this documentation to DEERS.
- To avoid automatic disenrollment when your dependent turns 21, you should update DEERS information before their 21st birthday. Find instructions on updating DEERs information here.
- Be sure to call Member Services after your DEERS update to verify the extension of enrollment. You can reach them Monday through Friday, 8 am–5 pm, at 1-888-674-8734.
Please note that, depending on where your child is going to school, it may be beneficial to transfer (“port”) their coverage from one TRICARE contractor to another. This would prevent them from having to use the POS benefit with higher cost shares if their school is out of the area of their current TRICARE plan. We encourage you to call Member Services to discuss your child’s college situation to discuss the best options.
Is your dependent between the ages of 21-26 and NOT a full-time student?
They may be eligible for coverage through the TRICARE Young Adult (TYA) program. The TYA program is a premium-based health plan available for purchase by qualified dependents through the Martin’s Point US Family Health Plan. TYA medical and pharmacy benefits are the same as US Family Health Plan retirees, the only difference is the premium and the dependent becomes their own sponsor.
Tricare Young Adult (TYA) Coverage can extend up to age 26 for unmarried dependents of TRICARE-eligible sponsors if both:
- The beneficiary is a student enrolled in a full-time course of study at an approved institution of higher learning.
- The beneficiary is not eligible for other employee or military sponsored health insurance.
We recommend that you contact Member Services if you are considering enrolling your dependent in the TYA program to learn about premiums, the application process, and more.
For more information about dependent coverage, please call our Member Services team at 1-888-674-8734. If your dependent is ready to enroll in TRICARE Young Adult, please have them call 1-877-757-7087 and do not hit any prompts. They will reach one of our representatives to help them fill out the application over the phone.
Traveling Outside the US Family Health Plan Service Aread
US Family Health Plan members have urgent and emergent coverage across the country. When getting emergency or urgent care that is out of network, you may be asked to pay up front. In that case, you have one year to submit for reimbursement, minus your cost share.
If you are outside of the service area and require non-emergency care, one option you have is using the Point of Service (Out-of-Network) option. The Point of Service benefit allows you to receive some elective, non-emergency services from providers who are not in our network at an additional cost. Call Member Services for more details about how to use your Point of Service benefit.
Stay Up to Date with COVID-19 Vaccines and Boosters
COVID-19 is, unfortunately, still very present in our communities. To continue to protect yourself and your family, it’s important to stay up to date with the latest COVID-19 information and vaccine/booster guidance.
For the most current information visit the US Centers for Disease Control and Prevention website.
To find a vaccine location near you, visit your state’s COVID-19 website.
Special Hike Gives Memorial Day New Meaning for Martin’s Point Employees
On Memorial Day weekend, Martin’s Point employees Stacey Pardales and Kimberly MacDonald went for a hike. But this was no ordinary climb. In addition to the usual snacks, water, and raingear, each of their packs held a special stone honoring a fallen Maine hero, a young American who gave his life as a member of the US military.
Stacey and Kimberly were two of 48 hikers to join The Summit Project (TSP) for a three-day event that culminated in climbing The Owl, a rock-studded, 3,700-foot peak in Maine’s Baxter State Park. TSP—a nonprofit founded in 2001 as a living memorial—holds two major events a year to recognize the sacrifices made by Maine soldiers and their families.
Stacey and Kimberly have close connections with military families throughout the Northeast through their roles with the US Family Health Plan and were eager to participate. Read more (and view more pictures) about their special mountain trek and this unique way of honoring these and other Maine heroes and their families.
PLEASE COMPLETE OUR HEALTH EQUITY QUESTIONNAIRE
At Martin’s Point Health Care, we’re on a mission to deliver the care every person deserves. To help us do that, we want to find out more about you, your needs, and your communication preferences so we can better serve you.
We are asking our members to complete a brief questionnaire to collect race, ethnicity, and social information to help us better understand what unique needs they may have. Your information will be stored in your member profile and protected like all your other personal health information.
We would greatly appreciate it if you would take the time—just two minutes—to fill out this questionnaire. Your responses will help us deliver improved care to you and other health plan members.
