US Family Health Plan eNews | ISSUE 4 | 2024

Avoid Higher Costs by Using Your Online Member Portal

Always check the status of your Specialty Care Referrals before seeking specialty care.

Did you know that all future referral notifications will be posted in the US Family Health Plan Online Member Portal? As a valued plan member, we want to help you avoid higher costs by regularly checking your referral status before seeking specialty care. If you receive specialty care without an approved referral, you will be subject to the TRICARE Point of Service option (POS) cost share, which may result in significantly higher costs.

Checking your referral status is easy: Log in to the Online Member Portal here. If you need help or have any questions about your referral status, our Member Services team is here to help. You can reach them at 1-800-574-8494. Taking a moment to verify your referral status can save you time and money.

If you haven’t already, register for access to the US Family Health Plan Member Portal.

NOTE ABOUT USING THE POINT OF SERVICE (POS) OPTION:

You may choose to receive care without a referral under the Point-of-Service (POS) option at a much higher cost share. The POS option allows you the flexibility to choose to see a TRICARE^®-authorized provider without an approved referral. While this option can give you greater freedom, you should be sure you understand what your out-of-pocket costs will be before seeking care without a referral.

Flu Shots: It’s Not Too Late

Flu season began in early fall and goes to the end of spring, peaking from December through February. If you haven’t already gotten a flu shot (influenza vaccine), now’s the time.

Flu shots are recommended annually because immunity to the previous year’s vaccine fades over time, and the newest vaccine is made to cover the most common strains that researchers expect to see during the current season.

In addition to getting vaccinated, protect yourself by covering sneezes and coughs, washing hands frequently and thoroughly, avoiding sick people, and disinfecting surfaces.

Getting a flu shot is an easy way to protect yourself, your family, and your community from the flu. Act now! 

For more information, visit MartinsPoint.org/Flu or please visit the Centers for Disease Control Prevent Seasonal Flu webpage.

Think You Have Bronchitis? You Might Not Need an Antibiotic.

Also known as a chest cold, acute bronchitis occurs when the airways of the lungs swell and produce mucus, triggering coughing. Acute bronchitis is usually caused by a virus and can’t be cured with antibiotics. Symptoms can last for up to three weeks.

When to See Your Provider

The Centers for Disease Control recommends seeing your provider if you have or experience:

• An elevated temperature
• A cough with bloody mucus
• Shortness of breath
• Symptoms that last more than 3 weeks
• Repeated episodes of bronchitis

This list is not all-inclusive. Please see your doctor if your symptoms are severe or concerning. Also, keep in mind that taking unwarranted antibiotics can cause harm, ranging from a minor rash to serious conditions, such as antibiotic-resistant infections and an abdominal infection called C. diff that causes diarrhea and colon damage as a result of the loss of beneficial flora bacteria in the colon.

Tips to Help You Feel Better

• Get plenty of rest.
• Drink plenty of fluids.
• Use a humidifier or cool mist vaporizer.
• Use saline spray for a stuffy nose.
• Breathe in steam from a shower or hot bowl of water.
• Suck on lozenges (not recommended for children under age 4).
• Take honey (not recommended for children under age 1).
• Ask your pharmacist to recommend over-the-counter cough/cold medications.

Thank you for considering this information before you request or take antibiotics that are not likely to help you get better.

Diabetes and Depression

Diabetes is a chronic condition characterized by high blood sugars. Unmanaged, it can lead to multiple health complications. Diabetes has also been linked to mental health and depression. Staying informed about diabetes management and following your treatment plan will help you maintain control and optimal health.

Whether you are newly diagnosed or have had diabetes for several years, knowledge is key to managing self-care. Regular communication with your health care providers and your supportive network, and keeping essential tips in mind, are important parts of controlling diabetes.

Diabetes and Mental Health

A diagnosis of type 1 or 2 diabetes often brings a considerable lifestyle change.

Diet is one significant change. Usually, your provider will tell you to stop eating certain foods and to avoid sugar and alcohol. You will also need to track your blood glucose and insulin levels. Interrupting old habits can cause emotional reactions and stress.

Symptoms of Depression

• Sad feelings
• Feeling empty
• Changes in your eating habits, like binging or eating less
• Insomnia (learn more)
• Feeling lethargic
• Sleeping too much
• Difficulty with decision-making
• Trouble concentrating
• Despair
• Irritability
• Anxiety (learn more)
• Feeling overly guilty
• Aches and pains
• Digestive issues
• Thoughts of suicide or death

Diabetes Distress

This condition causes hopeless feelings of despair. You might feel that your efforts to manage diabetes are not working. Often, people feel like diabetes is controlling them, not the other way around. This can cause you to revert to unhealthy habits.

Tips for Managing Diabetes

• Monitor blood sugar regularly. Understanding your blood sugar is crucial. Knowing your blood sugar levels helps you make informed decisions about diet, activity, and medication.
• Take medications consistently. Keep a schedule of when to take medication for the best sugar control. Notify your provider about any concerns of side effects.
• Join a diabetes support group. Knowing others share the same challenges can help.
• Balance meals. Incorporate foods from all food groups and focus on lower carbohydrates.
• Stay active. Establish a consistent exercise routine, like walking, swimming, or cycling. A good goal is to aim for 150 minutes of exercise per week.
• Schedule regular health maintenance appointments. Talk to your provider about your feelings regarding diabetes and ask for a referral to a mental health care specialist if needed.

For further information and support, call the Martin’s Point Care Management line at 877-659-2403.

Heart Failure Care Management at Martin’s Point

What is Heart Failure?

Heart failure is a condition in which muscle in the heart wall slowly weakens and enlarges, preventing the heart from pumping enough blood. The heart keeps working, but the body’s needs for blood and oxygen aren’t being met.

Common Symptoms Include:

• Shortness of breath
• Fatigue
• Coughing or wheezing, especially during exercise
• Swelling in feet and legs
• Weight gain from fluid buildup

Martin’s Point Can Help

Many members have experienced improvements in their health and well-being with the help of Martin’s Point care management programs. Our care managers provide a coordinated approach that includes education, self-management skills, and support. They strive to provide information and resources to help you manage and maintain your health at home and avoid unnecessary hospitalization.

You might also hear from a Martin’s Point care manager soon. In the meantime, to learn more, call 877-659-2403 or visit MartinsPoint.org/HeartHealth.

Have Diabetes? Take Care of Your Kidneys.

Chronic kidney disease is common in people with diabetes. Kidney disease can develop slowly and without many symptoms, so many people don’t know they have problems until they are advanced.

According to the Centers for Disease Control (CDC), approximately one in three adults with diabetes and one in five adults with high blood pressure have chronic kidney disease. Kidney disease is more likely for people with diabetes because higher amounts of blood sugar can cause damage to the tiny filters in your kidneys. If your blood sugar levels are out of control, kidney damage and disease can develop much faster.

Why You Should Get Your Kidneys Checked

Getting your kidneys checked annually is an important strategy for catching kidney disease early, when it’s easier to treat. Your provider can monitor your kidney health with yearly blood work and a urine test.

To Learn More, Please Visit:

• The Martin’s Point Health Care webpage, MartinsPoint.org/Diabetes, for more self-care tips and care management support, available through your Martin’s Point US Family Health Plan.
• What is diabetes? | CDC

Low Back Pain: Don’t Rush to Imaging

Did you know four out of five people will experience lower back pain in their lifetime? It’s one of the most common reasons for a physician visit.

Most people recover from low back pain within several weeks, whether they have imaging or not. We recommend delaying imaging for six weeks to give your body a chance to recover.

Rushing to get an X-ray, MRI, or CT scan is proven unnecessary. It does not increase recovery time, though it does increase medical costs. Despite this, when X-rays are readily accessible, some providers automatically send patients for X-ray.

Low Back Pain Healthwise, the Martin’s Point Health and Wellness platform, has education, information, and tools to help you make informed decisions about care, as well as to help you prevent and manage back pain.

Why Wait?

Imaging is expensive and it can expose you to unnecessary radiation. Imaging can also identify abnormalities that may have been present all along and are not the cause of your pain, resulting in unnecessary surgery. People who undergo surgery put themselves at risk of complications like infections and can have similar outcomes compared to those who took conservative measures.

Examples of Conservative Treatment or Nonprescriptive Therapy for Low Back Pain:

• Heat or ice packs
• Exercise like walking and gentle stretching
• Medications
• Acupuncture
• Physical therapy
• Transcutaneous electrical nerve stimulation (TENS)

When to Consider Imaging Sooner

In some situations, it might be appropriate to have imaging done sooner than six weeks. Symptoms that could influence your health care provider to order imaging sooner include:

• Unexplained weight loss
• Fever over 102°F
• Loss of bowel or bladder control
• Loss of feeling or strength in your legs
• Problems with reflexes
• A history of cancer

If you experience low back pain, speak to your health care provider about treatment, and understand why your provider might not suggest or recommend imaging.

Health and Wellness Resources Are a Click Away

• Respiratory Health and Wellness — Protect the health of your airways and lungs and breathe easier.
• Pediatric Health and Wellness — Support for you and your child’s health at every stage.
• Diabetes Wellness Guide — Learn to optimize health and wellness while living with diabetes.
• Women’s Health and Wellness – Learn about preventative screenings and women’s health conditions.

Increasing Our Community Impact for the Better

Martin’s Point strives to strengthen our communities and support organizations that make a difference. Learn more about our work and our amazing community partners in our 2023 Community Impact.

Suicide Prevention/Mental Health Crises: Here to Help

Our online Health and Wellness pages help you learn about important health topics and take steps to protect your and your family’s health:

• Supporting Mental Health – Find resources designed to support your and your family’s mental health at every stage of life – from childhood through adulthood.

If you or someone you know talks about suicide, self-harm, a mental health crisis, substance use crisis, or any kind of emotional distress, get help right away.