US Family Health Plan eNews Issue 3 2019

 

Be Aware of Preteen Immunizations

National Immunization Awareness Month

Did you know that the Centers for Disease Control and Prevention (CDC) recommend several vaccinations for preteens? Below is an overview of their adolescent vaccination recommendations.

All 11- or 12-year-olds should receive the following:

• One (1) dose of Tdap vaccine that protects against tetanus, diphtheria, and pertussis (whooping cough)
• One (1) dose of meningococcal vaccine that protects against meningococcal meningitis. This is a rare, but serious, bacterial infection.
• Three (3) doses of HPV vaccine that protects your child from human papillomavirus. Some types of this virus can lead to cancer.

If your child is 11 or 12 (or about to turn 11), talk to their doctor about these important vaccines.

Important Facts for You to Know!

What is colon cancer?

Colorectal cancer (sometimes called colon cancer) occurs in the colon or rectum. The colon is the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus.

Why are colorectal cancer screenings important?

• Colorectal cancer is the second-leading cause of cancer death in the United States.
• Colorectal cancer usually starts from a precancerous polyp in your colon or rectum. A polyp is a growth that should not be there.
• Over time, some polyps can turn into cancer.
• Screening tests can find precancerous polyps, so they can be removed before they turn into cancer.
• Screening tests can also find colorectal cancer early, when treatment will work best.

Who should be screened for colorectal cancer?

Adults aged 50-75 should be screened for colorectal cancer. Over the age of 75, the screening decision should be made with your doctor on an individual basis.

What are your choices for screening?

There are several types of colorectal cancer screenings:

 

If you are between the ages of 50 and 75 and are due for a colorectal cancer screening, feel free to call Member Services to request a FIT kit. There’s no cost to you. We will be happy to mail one to you right away. Take this opportunity for a quick test that could save your life!

If you are 76 years old or older, the decision to screen for colorectal cancer should be made after a discussion with your primary care provider. Your doctor should take into account your prior screening history and overall health. If you have questions about screening, please talk with your primary care provider.

Source: https://www.cdc.gov/cancer/colorectal/pdf/basic_fs_eng_color.pdf
HEDIS 2019, Volume 2 Technical Specifications

Don’t be scammed! Help us prevent fraud, waste, and abuse!

Unfortunately, not everyone is as honest as we would like them to be, and costly instances of health care fraud, waste, and abuse occur frequently. We recommend that our members be especially alert to protect themselves from identity theft. Many legitimate businesses engage in telemarketing, but criminals can also use live or recorded calls to try to steal your private information.

To protect yourself:

• Never give your personal information to someone you don’t know.
• Write down suspicious numbers and report them!

Martin’s Point Health Care and the Social Security Administration will not call to ask for your bank account or Social Security numbers.

If you have concerns about a situation that you think may involve fraud, waste, and abuse, you may call our Martin’s Point Compliance Hotline at 1-800-297-8616. To report telemarketing scams to the Federal Trade Commission (FTC), call 1-888-382-1222.

Cervical Cancer Screening— Important Facts for You to Know!

Did you know that, over the last 50 years, there has been a 70% decrease in deaths from cervical cancer in the US?

This is largely due to prevention and early discovery and treatment made possible by regular cervical cancer screenings.

What is cervical cancer screening?

There are two kinds of cervical cancer screenings:

• A Pap test finds abnormal cell changes on the cervix before they have a chance to turn into cancer.
• A human papillomavirus (HPV) test detects “high-risk” kinds of HPV which can lead to cervical cancer. 

Why are cervical cancer screenings important?

Most women diagnosed with cervical cancer either have never had a Pap test or did not have one in the last five years. Cervical cancer is completely preventable if precancerous cell changes are found and treated early, before cervical cancer develops. Cervical cancer usually takes years to progress. Regular screening with Pap tests, along with HPV testing, will find almost all precancerous changes and cervical changes before they progress.

Who should have the screening?

Cervical cancer screening (a Pap smear and/or human papillomavirus (HPV) test) is recommended for women:

• ages 21–30 should have a Pap smear every 3 years
• ages 30–64 should have a Pap smear every 3 years OR a Pap smear and HPV co-testing every 5 years

Who does not need the screening?

If you have had any of the following in your medical history, please inform your provider of your history, including the month and year they occurred:

• a complete, total, or radical abdominal or vaginal hysterectomy with no remaining cervix
• cervical agenesis
• acquired absence of cervix

Source: http://www.nccc-online.org/images/pdfs/HPV_fact_sheet_2015.pdf
HEDIS 2019, Volume 2 Technical Specifications

Expecting? Our Maternity Support Program is Here for You!

Members can connect with a nurse case manager to receive personal support during pregnancy and after delivery. It’s our goal for our pregnant members to have healthy pregnancies and deliver healthy babies. The Maternity Support Program is available to pregnant members and to new mothers up to 6 to 8 weeks after delivery.

Participation is free. Please call us at 1-877-659-2403 to ask about a free incentive and to answer a few questions so we can get to know you.

Send Martin’s Point US Family Health Plan to College with Your Child

Is your student hitting the books at college this fall? For many eligible dependents, their US Family Health Plan coverage can follow them to college.

Normally, children are eligible for TRICARE benefits under the sponsor’s eligibility until age 21.  But coverage can extend up to age 23 if all the following are met:

• The child is unmarried
• The child is a college student enrolled in a full-time course of study at an approved institution of higher learning
• The Defense Enrolment Eligibility Reporting System (DEERS) is updated to reflect the student status.

What you’ll need to do to extend benefits past your student’s 21st birthday:

• You’ll need to get a letter from the school registrar’s office stating that your child is enrolled full time in an accredited college in pursuit of an associate degree or higher. Bring the letter to an ID card-issuing facility.
• To avoid automatic disenrollment when your child turns 21, you should update DEERS information before their 21st birthday.
• Be sure to call Martin’s Point 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.

Is your child between the ages of 21-26 and not a full-time student?

They may be eligible for TRICARE Young Adult.

The TRICARE Young Adult (TYA) program is a premium-based health care plan available for purchase by qualified dependents. TRICARE Young Adult Prime coverage is available for purchase from Martin’s Point through the US Family Health Plan. TYA includes medical and pharmacy benefits but excludes dental coverage.

Your adult-aged dependent may purchase TYA coverage based on the eligibility established by their uniformed service sponsor and where they live.

Note: Special eligibility conditions may exist.

They may purchase TYA coverage if ALL of the following apply to them:

• A dependent of an eligible uniformed service sponsor
• Unmarried
• At least age 21 (or age 23 if enrolled in a full-time course of study at an approved institution of higher learning and if the sponsor provides at least 50 percent of the financial support), but have not yet reached age 26
• Not eligible to enroll in an employer-sponsored health plan as defined in TYA regulations
• Not otherwise eligible for TRICARE program coverage

Remember, when your child travels outside the US Family Health Plan service area to attend college, only qualified emergency and urgent care are covered. An exception would be care received using the Point of Service (Out-Of-Network) option. The Point of Service benefit allows you to receive non-emergency services from providers who are not in our network at an additional cost–call Member Services for details.  Examples of care that will not be covered by the US Family Heath Plan while they are out of the area include:

• Routine office visits and lab work
• Routine treatment for a chronic condition
• Equipment or supplies necessary to treat a chronic condition

Routine care (i.e. physicals, routine lab work) should always be scheduled with your child’s in-network primary care provider (PCP) or specialist when they are home for school breaks.

For more information about dependent coverage, please call our Member Services team at 1-888-674-8734. If your child is ready to enroll in TRICARE Young Adult, please have them call 1-888-241-4556 and do not hit any prompts. They will reach one of our representatives to help them fill out the application over the phone.