US Family Health Plan eNews 2022: Issue 4
Posted 10/20/22
For more of eNews Member Newsletter
IN THIS EDITION:
US Family Health Plan Earns 5 Stars for Patient Experience
We’re proud to announce that the Martin’s Point US Family Health Plan remains among the most highly rated health insurance plans in the nation, offering excellent health coverage to close to 50,000 active-duty and retired military family members throughout the Northeast.
The National Committee on Quality Assurance (NCQA)* has awarded the Martin’s Point US Family Health Plan a 4.5-out-of-5-star overall rating for quality performance in Maine and a 4-out-of-5-star overall rating for quality performance in New Hampshire, New York, Pennsylvania, and Vermont as part of its Private Health Insurance Plan Ratings for 2022. This includes earning a rating of 5-out-of 5 stars for Patient Experience measures in all states. The overall rating is the weighted average of a plan’s HEDIS® and CAHPS® measure ratings, plus bonus points for plans with a current Accreditation status as of June 30, 2022.
Click here to learn more!
NCQA uses measures of clinical quality (HEDIS®) and patient experience (CAHPS®) and standards from the NCQA Accreditation process to annually rate over 1,000 health plans (over 90%) across the country.
Measures include:
- Management of chronic disease
- Prevention and wellness efforts, including recommended screenings and immunizations
- Access to quality primary and specialty care
- Quality of member experience
“Our continued high ratings from NCQA highlight our commitment to providing the highest-quality care for our US Family Health Plan members,” said Dr. Paul Kasuba, Martin’s Point Health Care President and CEO. “Our 5-out-of-5-star rating for the “Patient Experience” measure is particularly important to us, as it reflects the commitment of our service team, together with our network providers and hospitals, to deliver an excellent health care experience for our military families.”
*National Committee for Quality Assurance (NCQA) is a private, nonprofit organization that accredits and certifies a wide range of health care organizations. NCQA's HEDIS® is the most widely used performance measurement tool in health care.
It’s Time for Your Flu Shot
If you haven’t gotten your flu shot (influenza vaccine) yet, it’s not too late!
Flu season begins in early fall and goes to the end of spring, peaking from December to February.
Flu shots are a yearly vaccine for two reasons:
- The immunity you gained from the previous year’s vaccine fades over time
- The newest year’s vaccine is designed to cover the most common influenza strains researchers expect to see that flu season.
Flu shots help reduce your risk of illness, hospitalizations, and death associated with flu. Flu can weaken your immune system causing you to develop other infections like pneumonia. Being sick with flu may allow a chronic condition like diabetes, heart disease, or lung disease to flare up. Although some people may still get the flu when they’ve been vaccinated, their symptoms tend to be much less severe.
The Centers for Disease Control and Prevention (CDC) recommend flu shots for the following groups:
- All healthy adults, especially those 65 years of age or older
- All children, six months of age and older
- Pregnant women
- Healthcare workers
- People with chronic conditions like asthma, heart disease, diabetes, or weakened immune systems
- Caregivers of children under five years of age
Groups that should not get a flu shot are:
- Children under six months of age
- Anyone with an egg allergy should speak with their health care provider before receiving a flu shot
- Anyone who had a severe reaction to a flu shot in the past
- Anyone who currently has a moderate or severe illness or fever
In addition to getting vaccinated, make sure to cover your sneezes and coughs, wash your hands often, avoid sick people, and disinfect surfaces.
If you would like further information, please go to the CDC website: https://www.cdc.gov/flu/prevent/flushot.htm
Finding Strength to Keep Going: Overcoming Suicidal Thoughts
If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away.
Call the Suicide and Crisis Lifeline at 988. Call 1-800-273-TALK (1-800-273-8255) or text HOME to 741741 to access the Crisis Text Line. Consider saving these numbers in your phone.
For more information, visit our Suicide Prevention Resources page. Additional mental health resources can be found on our Mental Health page.
Planning Ahead: What You Must Know about Long-Term-Care Coverage
Medical advances and healthier lifestyles are leading to longer lives. With aging, many of us may find the need for assisted living, memory care facilities, or nursing homes, also referred to as “Long-Term Care.” These services are expensive, and planning for them is important.
You should know that long-term-care expenses are generally not covered by any health insurance plans. This is true for traditional Medicare as well as TRICARE® plans, including both the US Family Health Plan and TRICARE for Life.
There are many companies that offer long-term-care insurance options, including the Federal Long-Term Care Insurance Program—available to eligible federal and US Postal Service employees and annuitants, active and retired uniformed service members, and certain qualified relatives. They can be reached at 1-800-LTC-FEDS (1-800-582-3337) or on their website, ltcfeds.com. Additional financial assistance for that coverage may also be available through your state’s income-based Medicaid program. Contact your local Medicaid office for information.
You may need to change your insurance plan: If you are a member of the US Family Health Plan at the time you enter a long-term-care facility, you may need to change your insurance plan to better suit your needs. To remain eligible for the US Family Health Plan, members must be able to meet all three of these managed-care criteria:
- Able to get to and continue to use an in-network primary care provider
- Able to get to and use in-network specialists
- Able to use the Martin’s Point Mail-Order Pharmacy for all maintenance medications (or one of our retail Martin’s Point Pharmacies in Portland, Maine or Portsmouth, New Hampshire)
What to do if you enter a long-term-care facility:
- Contact your Martin’s Point US Family Health Plan Member Services team as soon as you know you will need to enter a long-term-care facility. We can help you determine if you need to make an insurance change, and what your next steps will be. If you are unable to meet the requirements to remain enrolled in the US Family Health Plan, we will help you transition out of the Plan to another TRICARE plan.
- If you are eligible for Medicare, you may want to switch to TRICARE for Life (TFL) as your military coverage. TFL acts as your Medicare wraparound if you need to disenroll from the US Family Health Plan. To be eligible for TRICARE for Life, you must already be enrolled in Medicare Parts A & B.
We hope this information helps you plan for your future. If you have any questions at any time, please reach out to us by contacting Member Services at 1-888-674-8734
Bronchitis: Antibiotics Aren’t Always the Right Treatment
Are you coughing and have soreness in your chest or feel tired? You could have a chest cold—also known as acute bronchitis.
Did you know?
- Antibiotics will not help you get better if you have acute bronchitis. This will usually get better on its own.
- Taking antibiotics when they aren’t needed can cause harmful side effects—mild or severe reactions, including allergic reactions.
- Acute bronchitis is caused by a virus that makes your airways (bronchi) in your lungs swell and makes your lungs produce mucus. Bronchitis can last up to three weeks.
Symptoms of acute bronchitis that last under three weeks:
- Coughing with or without mucus
- Sore chest/throat
- Feeling tired
- Mild headache/body aches
Seek medical care if you have:
- Temperature 100.4 F or higher
- Cough with bloody mucus
- Shortness of breath or trouble breathing
- Symptoms that last more than 3 weeks
- Repeated episodes of bronchitis
Ways to help you feel better:d
- Get plenty of rest and drink lots of fluids.
- Breathe in steam from a clean humidifier, hot shower/bowl of water.
- Use saline spray to relieve nasal discomfort.
- Lozenges. Do not give to children under 4 years old.
- Honey to relieve cough. Do not give to children under 1 year old.
- Ask your provider/pharmacist about appropriate over-the-counter medications.
For more information, please visit the CDC website about bronchitis: https://www.cdc.gov/antibiotic-use/bronchitis.html
Managing Diabetes
Diabetes is a chronic disease but, by following the treatment plan and lifestyle changes recommended by your health care provider, it is manageable. Check out our Diabetes web page.
