Blue & You - Autumn 2016
Arkansas Blue Cross and Blue Shield sponsors games, supports communities p10-13 Medicare plans p4 Medical screenings p14 Opioid dangers p16
Arkansas Blue Cross and Blue Shield sponsors games, supports communities p10-13
Medicare plans p4
Medical screenings p14
Opioid dangers p16
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@<br />
<strong>Autumn</strong><br />
<strong>2016</strong><br />
A publication for the policyholders of the Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield family of companies<br />
presented by hootens.com<br />
pages<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield 10 -13<br />
sponsors games, supports communities<br />
Medicare<br />
plans<br />
page<br />
4<br />
Medical<br />
screenings<br />
page<br />
14<br />
Opioid<br />
dangers<br />
page<br />
16
3<br />
4<br />
6<br />
7<br />
8<br />
9<br />
10<br />
12<br />
14<br />
16<br />
18<br />
19<br />
20<br />
- Out of the <strong>Blue</strong><br />
- Make Medicare work for you<br />
- Introducing payment kiosks<br />
- Important information for members<br />
with individual or family policies<br />
- #TGFI - Thank Goodness For Insurance<br />
- Get information through the Wire<br />
- An Arkansas classic gets a new partner<br />
- Arkansas <strong>Blue</strong> Cross brings Pep Rallies<br />
with a Purpose to communities<br />
- Screenings vs. diagnostic medical tests<br />
- The dangers of opioid medications<br />
- Two UAMS students planning rural<br />
medical practices receive scholarships<br />
from Arkansas <strong>Blue</strong> Cross<br />
- Arkansas <strong>Blue</strong> Cross once again named<br />
one of the best places to work in Arkansas<br />
- Arkansas <strong>Blue</strong> Cross invests in<br />
new medical technology through<br />
HubX-LifeSciences<br />
- Introducing <strong>Blue</strong>Listens<br />
- Nursing scholarships awarded<br />
<strong>Autumn</strong><br />
<strong>2016</strong><br />
Rylee Jackson of<br />
Caddo Valley punts<br />
a football during<br />
the Fourth and<br />
Fearless “Skills and<br />
Drills Challenge”<br />
halftime contest at<br />
the Arkansas <strong>Blue</strong><br />
Cross Kickoff Classic,<br />
presented by Hootens.<br />
21<br />
22<br />
23<br />
24<br />
25<br />
26<br />
27<br />
28<br />
See more about<br />
the game and the<br />
preceding hometown<br />
Pep Rallies with a<br />
Purpose on<br />
pages 10-13.<br />
- <strong>Blue</strong> summer fun<br />
- Go! Fit! Win! The <strong>2016</strong> <strong>Blue</strong> & <strong>You</strong><br />
Fitness Challenge wraps up!<br />
- Reminder: Changes to cervical<br />
cancer screening medical policy<br />
take effect in 2017<br />
- More coverage changes for breast pumps<br />
- Annual Summary of Benefits notice<br />
- Need affordable vision coverage?<br />
See us first!<br />
- URAC health plan reaccreditation<br />
awarded<br />
- New and upcoming generics<br />
- Pharmacy article<br />
- Privacy practices notice availability<br />
- Customer service numbers<br />
- Have a <strong>Blue</strong> holiday weekend with us!<br />
EDITOR: Jennifer Gordon – bnyou-ed@arkbluecross.com • DESIGNER: Ryan Kravitz • PHOTOGRAPHER: Chip Bayer<br />
CONTRIBUTORS: Chip Bayer, Katie Eisenhower, Ben McVay and Alex Roberts<br />
VICE PRESIDENT of CORPORATE MARKETING: Eric Paczewitz • DIRECTOR of CORPORATE MARKETING: Kelly Whitehorn<br />
BLUE & YOU <strong>Autumn</strong> <strong>2016</strong><br />
on the<br />
cover<br />
An Arkansas <strong>Blue</strong> Cross Kickoff Classic trophy sits<br />
on the sidelines, waiting to be given to one of four<br />
winning teams. See page 10 to find out the winners.
Looking to the future of healthcare<br />
while remembering the past<br />
When Arkansas’ legislature originally voted to<br />
expand Medicaid through the private option in<br />
2013, Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield stepped<br />
up in a very uncertain environment and worked<br />
to assist those charged with implementing the<br />
program. We initially served as the only insurance<br />
company providing private option health plans in<br />
the underserved southern half of Arkansas.<br />
This year, the Medicaid expansion was revised<br />
by the state legislature and given a new name –<br />
Arkansas Works. This means a change beginning<br />
January 1, 2017, for Arkansans receiving healthcare<br />
coverage through the Medicaid expansion, but the<br />
fact remains that more than 275,000 Arkansans<br />
have received healthcare coverage through private<br />
insurers under the Medicaid expansion, reducing<br />
the uninsured rate by almost 50 percent.<br />
Today, Arkansas <strong>Blue</strong> Cross insures about one<br />
in three Arkansans, including more than 150,000<br />
through the Medicaid expansion. We will continue<br />
to work with state government, doctors and<br />
hospitals to find innovative ways to improve the<br />
cost and quality of healthcare. We recognize that<br />
by improving the health of individual Arkansans –<br />
whether they are students, part of the workforce,<br />
seniors or people on disability – we are improving<br />
the health of our society. We have served Arkansans<br />
for almost 70 years, and we look forward to serving<br />
the thousands of Arkansans who will have coverage<br />
through Arkansas Works.<br />
As I look at our company’s commitment to the<br />
future health of Arkansans, I can’t help but reflect<br />
on the past. When I first came to Arkansas <strong>Blue</strong><br />
Cross in 1970, people used gasoline that contained<br />
lead, smoked cigarettes at their desks and thought<br />
suntans were the sign of a “healthy glow.” Certainly,<br />
much has changed over the years, and as I prepare<br />
I think the company<br />
is well positioned to<br />
continue on the path of<br />
leading positive change<br />
in the healthcare system<br />
... and I am proud to<br />
have been a partner<br />
on this journey.<br />
to retire at the end of this year, I can say I<br />
am happy to have been associated with a company<br />
that has continually focused on the health and<br />
welfare of its members and employees. This has<br />
been proven by many surveys conducted over the<br />
years and by Arkansas <strong>Blue</strong> Cross being recognized<br />
by Arkansas Business as a great place to work for<br />
the past four years.<br />
A personal goal of mine was to guide the<br />
company through the implementation of the<br />
Affordable Care Act, which we knew would be<br />
extremely challenging. We are near the end of<br />
those first three years, and given we have been<br />
developing future leaders for an even longer<br />
period, I think the company is well positioned to<br />
continue on the path of leading positive change in<br />
the healthcare system. The dedicated employees<br />
at Arkansas <strong>Blue</strong> Cross are making lasting<br />
contributions toward the goal of improving the<br />
health of all Arkansans and I am proud to have<br />
been a partner on this journey.<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU
MAKE<br />
Medicare<br />
WORK FOR YOU<br />
<strong>You</strong>’ve paid less than a buck for McDonald’s coffee<br />
for a decade now (senior coffee starts at age 55!)<br />
— one of the many benefits of having a few years<br />
under your belt. But have you been making the<br />
most of your Medicare?<br />
Medicare’s Annual Election Period starts on<br />
October 15 and ends December 7 for people<br />
65 and older. During this time, you can purchase<br />
a Medicare Advantage, Medicare Supplement or<br />
prescription drug plan.<br />
4 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong><br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield offers Medicare<br />
products that feature convenient access to the<br />
healthcare services you need and low monthly<br />
premiums. Find the healthcare coverage — whether<br />
its parts A, B, C or D or a supplemental plan — that’s<br />
best for you. We’ll help you understand what you’re<br />
getting with each.<br />
Protect yourself with Medicare that works for you.<br />
THE FOUR BASIC PARTS OF MEDICARE<br />
Part A:<br />
HOSPITAL<br />
INSURANCE<br />
• Hospital care<br />
• Skilled nursing facility care<br />
• Hospice<br />
• Home healthcare<br />
: ADVANTAGE<br />
Part C MEDICARE<br />
• Everything in parts A and B<br />
• Prescription drugs (depending on plan)<br />
• Fitness program membership<br />
(depending on plan)<br />
PartB MEDICAL<br />
INSURANCE<br />
• Doctor visits<br />
• Mental healthcare<br />
• Outpatient surgery<br />
• Lab tests<br />
• Durable medical equipment<br />
:<br />
Part D:<br />
DRUG PRESCRIPTION<br />
PLAN<br />
• Helps pay for<br />
prescription medications
Coverage that works for you<br />
Parts A and B are called “original Medicare”<br />
and consist of the most basic Medicare coverage<br />
available. They help pay for many expenses —<br />
but there are gaps, because parts A and B were<br />
never designed to cover all of your medical costs.<br />
We can help you fill the gaps.<br />
MEDICARE’S ANNUAL<br />
ELECTION PERIOD STARTS<br />
ON OCTOBER 15 AND<br />
ENDS DECEMBER 7.<br />
Many people supplement original Medicare with<br />
secondary (supplemental) policies from Arkansas<br />
<strong>Blue</strong> Cross. These will help protect you against<br />
uncovered, unexpected expenses.<br />
The whole package<br />
Why Choose Medicare Advantage (Part C)?<br />
A Medicare Advantage plan is a worry-free<br />
approach that combines your Medicare coverage<br />
into a single, complete package with extra benefits.<br />
<strong>You</strong> get everything in parts A and B, plus additional<br />
benefits all rolled into one premium payment. Plus,<br />
you can choose a plan that includes prescription<br />
drug coverage.<br />
Build your own<br />
Why Choose Medicare Supplement?<br />
Medicare supplement plans help pay for some<br />
of the out-of-pocket costs you have with original<br />
Medicare, like deductibles, premiums and<br />
copayments. Build your own Medicare package,<br />
starting with original Medicare Part A and Part B.<br />
Then fill any gaps with a supplement plan that<br />
takes care of certain healthcare costs that aren’t<br />
covered by original Medicare. Then add Part D<br />
standalone drug coverage.<br />
Why Choose a Prescription Drug (Part D) Plan? Part<br />
D is insurance that helps you pay for prescription<br />
medications. People with supplemental plans add<br />
Part D to cover the costs of their medications. If you<br />
have a Medicare Advantage (Part C) plan, check<br />
to make sure you don’t have prescription drug<br />
coverage already included in that plan.<br />
Every Part D standalone drug plan has a drug<br />
list. Check to see if the drugs you take are<br />
covered by the plan. If they are, you might pay<br />
less with a Part D plan.<br />
Enroll your way<br />
Remember, Medicare’s Annual Election Period<br />
begins October 15 and runs through December 7.<br />
We want you to pick the plan that’s best for you —<br />
and we’re ready to help!<br />
• Call us toll free at 1-844-298-2444<br />
(8 a.m. – 8 p.m., CST, Monday – Friday)<br />
• Contact your local agent<br />
• Enroll online at arkbluecross.com/medicare<br />
FIND YOUR MEDICARE PLAN, today!<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
5
Introducing...<br />
payment kiosks<br />
Paying your bill is easier<br />
than ever with our new<br />
convenient payment kiosks.<br />
Similar to an ATM machine,<br />
our kiosks have touch<br />
screens that take eligible<br />
members step-by-step<br />
through an easy process to<br />
pay your bill with a check,<br />
credit or debit card*. Our<br />
Shackleford Crossings<br />
Arkansas<strong>Blue</strong> store in Little<br />
Rock is the first location to<br />
offer this new service.<br />
Other Arkansas<strong>Blue</strong> stores<br />
will get their kiosks in 2017.<br />
There is no additional fee<br />
or charge to use this method<br />
of payment and the kiosk<br />
can provide a printed<br />
receipt, or you can choose<br />
to have one sent via email.<br />
Our friendly staff is nearby<br />
if you need assistance.<br />
Payment kiosks – another<br />
way Arkansas <strong>Blue</strong> Cross<br />
is making healthcare<br />
coverage easier.<br />
* Medicare Advantage and Prescription Drug plan product members<br />
can mail their monthly payment or set up an automatic monthly<br />
bank draft. The kiosk is not set up to take their payments. If you<br />
have questions, please call customer service. Health Advantage<br />
conversion plans are not eligible for online, mobile, or pay-byphone<br />
payment options.<br />
all the convenient<br />
ONLINE OR MOBILE<br />
When you receive your bill, you<br />
can make a secure payment with<br />
a check, credit or debit card.*<br />
No transaction fee applies.<br />
PHONE<br />
Payments can be made using<br />
a check, credit or debit card<br />
when you call 1-800-354-9904.*<br />
No transaction fee applies.<br />
**MoneyGram is an independent company that provides health<br />
insurance payment services for Arkansas <strong>Blue</strong> Cross and<br />
<strong>Blue</strong> Shield customers.<br />
6 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong><br />
For more information,
I M P O R T A N T I N F O R M A T I O N<br />
For members with individual<br />
or family policies<br />
†<br />
For policies purchased before April 1, 2010,<br />
OEP is October 1 through December 15.<br />
We know selecting a<br />
health insurance plan is<br />
one of the most important<br />
decisions you can make<br />
to protect you and your<br />
family, so we want you to<br />
know we are here to help.<br />
If you need an individual<br />
or family health plan, your<br />
open enrollment period<br />
(OEP) begins November<br />
1 and ends January 31 † .<br />
During OEP you will<br />
be able to review your<br />
information and decide if<br />
you want to keep the plan<br />
you have, make changes<br />
to your current plan or<br />
change health plans.<br />
Watch your mail for a<br />
letter from Arkansas <strong>Blue</strong><br />
Cross that explains your<br />
options in more detail.<br />
If you need to choose<br />
a new health plan<br />
because you either<br />
didn’t have coverage<br />
before or are leaving a<br />
group health plan<br />
provided by your<br />
employer, call us, or<br />
if you have an agent,<br />
call your agent. We<br />
can help you determine<br />
your options. Call<br />
1-800-238-8379 after<br />
November 1 for<br />
more information.<br />
ways to pay:<br />
BANK DRAFT<br />
When you sign up<br />
for our free monthly<br />
bank draft program,<br />
you don’t have to<br />
write checks, keep MAIL<br />
bills or <strong>You</strong> buy can stamps. send a check or money order through<br />
Bills are the paid U.S. even Postal Service. Remember to include<br />
when you’re your away, member ID or account number.<br />
and there is never<br />
a risk of For a lapse members with metallic medical plans<br />
in coverage. (Gold, Silver, Bronze, Catastrophic):<br />
Enterprise Exchange Services<br />
P.O. Box 790308 • St. Louis, MO 63179-0308<br />
For all other members (including dental<br />
and non-metallic medical plans):<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />
P.O. Box 3590 • Little Rock, AR 72203-3590<br />
go to arkbluecross.com/paybill<br />
We want your health insurance coverage to be easy, right down to the way you pay for it.<br />
If you have an individual or family health plan, we have several convenient ways for you<br />
to pay your premium. It’s as easy as a click, call, visit or AutoPay away!<br />
IN PERSON<br />
Visit any MoneyGram**<br />
location, or Arkansas<br />
<strong>Blue</strong> Cross location.<br />
AND NOW...<br />
KIOSK! *<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
7
A way to share<br />
As a company, we are forever grateful for the opportunity to support, guide<br />
and safeguard you to better health and security.<br />
Sometimes our impact is small, like helping you get a wellness checkup. Other<br />
times it’s bigger, like a nurse explaining a new diabetes diagnosis. Every moment<br />
we’re able to help is one we cherish, so we’d love to hear about them!<br />
#TGFI, or thank goodness for insurance, is a new hashtag we’re inviting you to<br />
use online to tell us about a time health insurance made a difference in your life.<br />
<strong>You</strong>r choice in us means everything, and we’re proud to serve you. If we have ever<br />
helped you live fearlessly, overcome a challenge, or simply made life easier, please<br />
tell us by using our hashtag and tagging us on Facebook, Twitter or Instagram!<br />
When my wife was diagnosed with breast cancer, my first thoughts were<br />
if she was going to live. My second was how was I going to afford this.<br />
It was all a whirlwind, but she is now a breast cancer survivor. #TGFI<br />
– Clay, 53<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield member<br />
Our son has Type 1 Diabetes, which means that he needs insulin<br />
and diabetic supplies to LIVE. Thankfully, we have been provided<br />
an insulin pump, a continuous glucose monitor, and the needed<br />
day-to-day supplies that we need to keep him healthy!<br />
– Bradley, 37<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield member<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield @Ark<strong>Blue</strong>Cross Arkansas<strong>Blue</strong>Cross<br />
Visit arkbluecross.com/tgfi for more #TGFI stories from real people<br />
8 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong>
Carrier<br />
6:25 PM<br />
Ark<strong>Blue</strong> Wire<br />
Get information<br />
through the Wire<br />
Our exclusive, members-only mobile service,<br />
the Wire, can help you stay organized.<br />
Virtually a one-stop-shop in your pocket,<br />
you can use it on your smartphone to:<br />
• Learn cost-saving methods for quality care<br />
• Receive health benefit reminders<br />
• Access your personalized member account,<br />
My <strong>Blue</strong>print<br />
• Find care and member discounts<br />
Welcome to your private connection with<br />
Arkansas <strong>Blue</strong> Cross designed to help you<br />
manage your account, and stay on top of<br />
important information. Tap the button below<br />
to learn how to get the most out of your<br />
health plan!<br />
Get started!<br />
Arkansas <strong>Blue</strong> Cross<br />
2/12/16 at 6:25 pm<br />
No download is required and the service is free.<br />
Standard message and data rates may apply<br />
depending on your mobile carrier.<br />
Sign up today<br />
It’s an easy-to-use, free resource that you can trust to help you<br />
at every stage of your healthcare journey.<br />
Online<br />
Sign in to My <strong>Blue</strong>print to update the<br />
notification preferences within Settings.<br />
Carrier<br />
6:25 PM<br />
By Phone<br />
Call the customer service number for your<br />
plan. Numbers are listed on page 27.<br />
Arkansas <strong>Blue</strong> Cross<br />
2/12/16 at 6:25 pm Carrier 6:25 PM<br />
Welcome to your private connection with<br />
Arkansas <strong>Blue</strong> Cross designed to help you<br />
manage your account, and stay on top of<br />
important information. Tap the button below<br />
to learn how to get the most out of your<br />
health plan!<br />
Get started!<br />
Mobile messaging is not available<br />
at this time for: Medi-Pak Advantage<br />
and Medi-Pak Prescription Drug<br />
Plan members, Health Advantage<br />
conversion plans, Federal<br />
Employee Program, Arkansas<br />
State Employees/Public School<br />
Employees, and Short-Term<br />
<strong>Blue</strong> members.<br />
View Message Feed<br />
QUICK LINKS<br />
Member Sign-In<br />
Arkansas <strong>Blue</strong> Cross<br />
2/12/16 at 6:25 pm<br />
Using <strong>You</strong>r Policy<br />
Welcome to your private connection with<br />
Arkansas <strong>Blue</strong> Cross designed to help you<br />
manage your Find account, a Doctor and stay on top of<br />
important information. Tap the button below<br />
to learn how to get the most out of your<br />
health plan! Member Discounts<br />
Get started!<br />
Contact Us<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
9
presented by hootens.com<br />
An Arkansas Classic<br />
gets a new partner<br />
McClellan<br />
Dallas Parish Episcopal<br />
McCrory<br />
Mount Ida<br />
10 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong>
The late summer sun may have been beating down on the field and pushing the temperature<br />
into the 90s when the first high school football game of the season kicked off in Arkansas, but<br />
the boys of autumn left no doubt in the minds of everyone who attended the <strong>2016</strong> Arkansas<br />
<strong>Blue</strong> Cross and <strong>Blue</strong> Shield Kickoff Classic presented by Hootens.com — football is back.<br />
Arkansas <strong>Blue</strong> Cross joined Hootens.com for the first time this year to present the annual<br />
event. Eight teams (who combined for 81 wins last season) clashed in four games over two<br />
nights to officially begin the high school football season in the Natural State.<br />
Hamburg<br />
England<br />
Centerpoint<br />
Sheridan<br />
McClellan - 76<br />
Dallas Parish<br />
Episcopal - 50<br />
Mount Ida - 22<br />
Centerpoint - 19<br />
England - 42<br />
Hamburg - 28<br />
Sheridan - 35<br />
McCrory - 0<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
11
Pep Rallies with a Purpose brings 79,960 meals<br />
to Arkansas communities<br />
P<br />
ep Rallies with a Purpose – held in each<br />
of the seven Arkansas communities with<br />
a football team in the Arkansas <strong>Blue</strong><br />
Cross and <strong>Blue</strong> Shield Kickoff Classic<br />
– brought together football players,<br />
cheer squads and band members to do<br />
something more than pump themselves<br />
up for the games; they filled the food<br />
pantries in their hometowns while<br />
working together as a team.<br />
Each school packed more than 10,000<br />
meals through the Pack Shack, a<br />
northwest Arkansas nonprofit organization<br />
dedicated in bringing people together to<br />
fight hunger. After packing the meals, real<br />
pep rallies were held and Arkansas <strong>Blue</strong><br />
Cross gave each of the schools a check<br />
for $1,500. No matter the outcome of the<br />
football games, every school was a winner<br />
during the Pep Rallies with a Purpose.<br />
Chad Hooten, (right) co-owner, Hooten’s<br />
Arkansas Football pitches in at the<br />
McCrory pep rally with head coach of the<br />
McCrory Jaguars, Chris Kennon.<br />
Hamburg 8.8.16 England 8.9.16<br />
12
Centerpoint 8.18.16 McClellan 8.22 .16<br />
Sheridan 8.23.16<br />
Mount Ida 8.24.16 McCrory 8.25.16<br />
13
If you’ve ever had an annual physical,<br />
you know you may get a number of “routine” medical<br />
tests. Some of those tests are preventive screenings<br />
and some may be diagnostic medical tests. Do you<br />
know the difference? Not knowing the difference can<br />
cost you money, and possibly your health.<br />
Diagnostic tests are done when you and your<br />
doctor know you have a health problem and you<br />
need to know the cause. For instance, if you have<br />
chest pain, your doctor may order a number of<br />
tests to find out why.<br />
Preventive screenings look for diseases or<br />
conditions that have no evidence of symptoms<br />
or signs. These usually are done at certain ages.<br />
The idea is that if you catch and treat a disease<br />
early it will be easier to manage or eliminate.<br />
Because preventive screenings are so important<br />
in protecting your health, many of them are<br />
covered at no cost to you under your medical plan.<br />
True screening stories<br />
These true stories show the value of getting<br />
preventive screenings, along with some things<br />
to watch for during those appointments.<br />
When Richard went to his doctor for<br />
a routine/preventive colonoscopy and<br />
esophagogastroduodenoscopy (EGD), his blood work<br />
showed he was a little anemic. His doctor referred<br />
him to a gastroenterologist, who found a growth in<br />
his esophagus. A biopsy showed that the growth<br />
was cancerous, and it was surgically removed<br />
just a few weeks later followed by six months of<br />
weekly chemotherapy. Richard was able to return<br />
to work after surgery and work during his chemo<br />
treatments. He is now cancer free.<br />
14 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong><br />
SCREENINGS vs<br />
Very different, but<br />
Preventive healthcare is similar to car maintenance;<br />
when you get regular oil changes, check your tire<br />
pressure, change filters and have diagnostic tests, your<br />
car is less likely to break down on the side of the road.<br />
An annual physical is considered preventive<br />
healthcare, and may be covered at 100 percent<br />
under your health plan. Call the customer service<br />
number on your member ID card to find out.<br />
Also, did you know if you schedule a physical and<br />
then bring up a health issue, you might get charged<br />
for a regular office visit? That’s one reason it is<br />
important to know the difference.<br />
All preventive lab tests are considered “screenings,”<br />
but did you know not all screenings are preventive?<br />
“It saved my life,” Richard said. “If my cancer<br />
was caught at a later stage, the outcome would<br />
have been worse. There is no reason not to do<br />
screenings. It is good practice to take care of<br />
you and your family.”<br />
Bert was feeling pretty good at his annual<br />
checkup, but as part of the screening, his doctor<br />
recommended that he have an electrocardiogram<br />
on his heart. Much to his surprise, Bert found<br />
his heart was in atrial fibrillation (irregular<br />
heartbeat) even though he had no symptoms.<br />
He was treated for this and is now on medication<br />
to prevent any complications.
.<br />
DIAGNOSTIC medical<br />
tests:<br />
both can save your life!<br />
If your doctor orders a “screening,” it may not be<br />
covered as a preventive test under your health plan.<br />
The key to preventive screenings is that they are used<br />
to find illnesses in their early stages so you can get<br />
treatment that can save your life. If a test is diagnostic,<br />
you still will receive medical coverage for it, but it will<br />
not be at 100 percent. How will you know? Call us!<br />
Getting the most out of your<br />
preventive healthcare benefits<br />
There are steps you can take to get the most<br />
out of your benefits:<br />
1. To find out what screenings are covered under your<br />
health plan, call the customer service number on<br />
your member ID card before you go to the doctor.<br />
2. When you go for your wellness checkup,<br />
talk to your family doctor first about what<br />
screenings you are eligible to receive.<br />
If he or she suggests a test not on your<br />
preventive care benefits list, ask if there<br />
is a reason for the test to be done.<br />
3. Make sure you visit doctors who are in<br />
your network to get free or low-cost<br />
preventive healthcare. If your preventive<br />
screenings turn up a health issue and<br />
you need to see a specialist, make sure<br />
your doctor recommends a specialist<br />
who is also in your network. <strong>You</strong> can find<br />
out if a doctor is in network by going to<br />
our websites or calling customer service.<br />
“Because I have a good relationship with my<br />
doctor, we are able to work together to ensure<br />
I get the proper screenings. A regular primary<br />
care doctor knows your history, spends time with<br />
you, and meets with you when you are feeling<br />
well and not only when you’re in distress.”<br />
A friend urged Alex to get a mole on her leg<br />
checked. Although it had always been dark<br />
and irregular, she made an appointment for a<br />
screening. Her dermatologist removed the mole<br />
and one other for testing. Alex didn’t realize<br />
that by removing the moles, the scope of the<br />
visit changed from a preventive screening to<br />
a diagnostic visit, which meant she had to pay<br />
for a portion of the final bill. On a brighter side,<br />
the results showed no abnormalities.<br />
“The tests established a baseline so my doctor<br />
can compare all future cell samples,” Alex said.<br />
She added that she now gets checked once a<br />
year for changes.<br />
These stories are based on benefits specific to<br />
the health plans of these members. To find out<br />
what your health plan covers, call the customer<br />
service number for your health plan (page 27).<br />
We’re here to help!<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
15
the dangers of<br />
OPIOID<br />
medications<br />
n o one likes pain. It interferes with our focus<br />
and concentration, affecting everyday tasks.<br />
It keeps us from resting and sleeping well, which,<br />
after a long day of fighting pain, makes us even<br />
more tired and cranky. Side effects from pain<br />
medications cause more problems, for which<br />
we may take other medications.<br />
Opioids such as hydrocodone (Vicodin),<br />
oxycodone (OxyContin), morphine or codeine<br />
are often prescribed for moderate to severe pain<br />
associated with surgery or traumatic injury.<br />
Used properly, these medications are effective in<br />
treating pain. Used improperly, these drugs can<br />
have some of the same risks as heroin.<br />
Most people can take opioids for the time originally<br />
prescribed, but some people become dependent<br />
on these medications. Prolonged use can lead to<br />
tolerance, meaning people need to take more and<br />
more of the drug to achieve the same effects. The<br />
brain can become damaged by overuse and can<br />
stop the body from producing endorphins, which<br />
help to ease pain naturally.<br />
Opioids are among the most abused drugs because<br />
they are easy to obtain, readily prescribed and very<br />
addictive. The number of opioid prescriptions has<br />
nearly doubled since the late 1990s and now exceeds<br />
200 million. In parallel, there’s been a dramatic<br />
increase in prescription drug overdoses, with more<br />
than 47,000 drug overdose deaths in 2014 alone.<br />
Concerns about growth in opioid misuse, addiction<br />
and overdoses have led many health plans to take a<br />
leadership role in combating this public health crisis.<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield has established<br />
a special group, the Substance Abuse Program<br />
Team, that is focused on issues of opioid addiction<br />
and abuse of other controlled substances. We are<br />
carefully monitoring the new regulations being<br />
passed by Congress and the new prescribing<br />
guidelines from the Centers for Disease Control.<br />
We also promote member safety by managing<br />
the quantities and dosages allowed through the<br />
member’s pharmacy benefit. We stay current on<br />
best practices, and many of our health plans have<br />
support for behavioral health programs that address<br />
addictions and promote healing and recovery.<br />
Opioid dependence and withdrawal require medical<br />
professionals to safely detox. If you or someone you<br />
know is struggling with an addiction to prescription<br />
painkillers or heroin, we encourage you to seek help.<br />
<strong>You</strong> have reason to be hopeful; treatment can be<br />
highly successful and you and your loved ones can<br />
get back to life and health.<br />
16 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong>
THE EFFECTS OF OPIOIDS<br />
ON YOUR BODY<br />
BLOOD<br />
Heroin or<br />
crushed pill<br />
injections can<br />
cause veins<br />
to collapse.<br />
BRAIN<br />
Heavy<br />
opiate use<br />
can cause<br />
sedation.<br />
HEART<br />
Heart lining<br />
can become<br />
infected due to<br />
contamination<br />
from heroin or<br />
crushed pills.<br />
LUNGS<br />
Ensuing<br />
respiratory<br />
depression<br />
can lead<br />
to slowed<br />
breathing<br />
which is<br />
potentially<br />
fatal.<br />
clean out<br />
that<br />
CABINET!<br />
Check your medicine cabinets for<br />
unused opiate prescriptions. <strong>You</strong><br />
may be tempted to keep them for<br />
later use, but we encourage you to<br />
find a way to dispose of them safely.<br />
They are a hazard to anyone who<br />
may find them, including children<br />
and teens. Many municipal police<br />
departments and Rotary Clubs<br />
have prescription drug take-back<br />
programs for unused prescriptions.<br />
examples<br />
of<br />
OPIOID CONTAINING<br />
medicines<br />
GENERIC<br />
BRAND NAME<br />
morphine<br />
MSIR, Roxanol<br />
DIGESTIVE<br />
SYSTEM<br />
Slowing of<br />
the digestive<br />
system can<br />
result in<br />
constipation.<br />
NERVOUS<br />
SYSTEM<br />
Chronic opiate<br />
abuse can<br />
create a greater<br />
sensitivity to pain.<br />
LIVER<br />
Shared<br />
infected<br />
needles<br />
can cause<br />
hepatitis.<br />
IMMUNE<br />
SYSTEM<br />
Vulnerability and<br />
infection can occur<br />
due to reduced<br />
immune response.<br />
SOURCE: Drugabuse.com<br />
DrugAbuse.com<br />
LONG-ACTING SHORT-ACTING<br />
oxycodone<br />
oxycodone<br />
(with<br />
acetaminophen)<br />
hydrocodone<br />
(with<br />
acetaminophen)<br />
hydromorphone<br />
morphine<br />
oxycodone<br />
fentanyl<br />
OxylR, Oxyfast,<br />
Endocodone<br />
Roxilox, Roxicet,<br />
Percocet, Tylox,<br />
Endocet<br />
Vicodin, Lorcet,<br />
Lortab, Zydone,<br />
Hydrocet, Norco<br />
Dilaudid,<br />
Hydrostat<br />
MSContin,<br />
Oramorph SR,<br />
Kadian, Avinza<br />
Oxycontin<br />
Duragesic patch<br />
SOURCE: National Safety Council<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU 17
Two UAMS students planning rural<br />
medical practices receive scholarships<br />
from Arkansas <strong>Blue</strong> Cross<br />
Two medical students at the<br />
University of Arkansas for Medical<br />
Sciences (UAMS) have received<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />
Shield Primary Care Scholarships,<br />
which encourage aspiring<br />
physicians to pursue primary care<br />
practices in rural Arkansas.<br />
Evan Branscum, a senior who grew<br />
up in Marshall, and Julie Sherrill,<br />
a junior from Dumas, are this year’s<br />
recipients. The $20,000 scholarships<br />
have been presented to two UAMS<br />
College of Medicine juniors or<br />
seniors annually since 2012.<br />
Arkansas <strong>Blue</strong> Cross established<br />
the endowed scholarship in 2010<br />
with a $1 million gift to the UAMS<br />
Foundation Fund. The scholarship is<br />
a part of a broad effort to produce<br />
more family medicine, general<br />
internal medicine and general<br />
pediatric doctors for Arkansas,<br />
especially in rural areas where<br />
access to primary care is limited.<br />
More than two-thirds of Arkansas’<br />
75 counties include federally<br />
designated primary care health<br />
professional shortage areas.<br />
Primary care physician shortages are<br />
expected to increase substantially as<br />
the state’s population continues to<br />
age and require more medical<br />
care, and as more Arkansans,<br />
now insured as a result of<br />
health insurance expansion,<br />
seek primary care services.<br />
“All Arkansans deserve access to<br />
high-quality primary care, and we<br />
encourage our students to consider<br />
practicing in smaller communities,”<br />
said UAMS Executive Vice Chancellor<br />
and College of Medicine Dean Pope<br />
L. Moseley, M.D. “Scholarships such<br />
as this are crucial because they help<br />
us attract talented students while<br />
reducing the burden of debt on our<br />
future rural practitioners. We are<br />
grateful for Arkansas <strong>Blue</strong> Cross<br />
and <strong>Blue</strong> Shield’s commitment to<br />
improving access to primary care<br />
through this scholarship.”<br />
“We at Arkansas <strong>Blue</strong> Cross are<br />
committed to improving access to<br />
quality healthcare across the state,<br />
and this scholarship addresses a<br />
small part of that need,” said Mark<br />
White, president and chief executive<br />
officer. “More Arkansans than ever<br />
are receiving necessary care, and<br />
with the approval of Arkansas Works,<br />
ensuring access to primary care<br />
for people across Arkansas is of<br />
paramount importance.”<br />
“Evan and Julie represent the<br />
spirit and commitment we want<br />
to see from our medical students<br />
to help those most in need across<br />
Arkansas, and we congratulate<br />
them as the recipients of this<br />
year’s award,” Mark said.<br />
Evan graduated from Marshall<br />
High School and received<br />
his undergraduate degree at the<br />
University of Arkansas, Fayetteville.<br />
He plans to practice in north central<br />
Arkansas in or near Searcy County,<br />
where his family has lived for more<br />
than four generations.<br />
“One of the most important things<br />
urban areas have that rural areas<br />
lack is access to healthcare,” Evan<br />
said. “Marshall only had two<br />
physicians for the majority of my<br />
childhood. That was two physicians<br />
not only in Marshall, but also the<br />
only two in the whole county of<br />
8,000 people.”<br />
Julie graduated from Dumas<br />
High School and received her<br />
undergraduate degree from the<br />
University of Arkansas, Fayetteville.<br />
She plans to pursue a career in family<br />
medicine upon graduating from<br />
UAMS in 2018. Primarily, her interests<br />
are in southeast Arkansas, including<br />
both Desha and Arkansas counties.<br />
“I have personally witnessed the<br />
degree to which communities in<br />
rural Arkansas suffer due to the<br />
lack of medical care,” Julie said. “In<br />
Dumas, we have two primary care<br />
physicians serving a large rural<br />
territory. Our hospital does its best<br />
to bring in additional help, but it<br />
struggles to keep the emergency<br />
room covered.”<br />
18 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong>
Arkansas <strong>Blue</strong> Cross<br />
ONCE AGAIN NAMED ONE OF THE<br />
Best Places to Work<br />
IN ARKANSAS<br />
The employees at Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />
Shield have spoken and the company is celebrating<br />
four consecutive years on the list of Best Places to<br />
Work in Arkansas, sponsored by Arkansas Business<br />
and Best Companies Group.<br />
The annual survey and awards program is designed<br />
to identify, recognize and honor the best employers<br />
in Arkansas, benefiting the state’s economy,<br />
workforce and businesses. Arkansas <strong>Blue</strong> Cross is<br />
one of 29 companies in this year’s Best Places to<br />
Work in Arkansas.<br />
“Our employees go above and beyond for our<br />
members, and we are proud to provide them a<br />
fun, positive work environment,” said Mark White,<br />
president and chief executive officer for Arkansas <strong>Blue</strong><br />
Cross. “Being ranked so high in the Best Places to<br />
Work survey for a fourth time tells us our employees<br />
appreciate the programs and benefits we offer.”<br />
Arkansas <strong>Blue</strong> Cross offers employees tuition<br />
reimbursement, free onsite gyms, a cafeteria focused<br />
on healthy foods and an employee health clinic. The<br />
average tenure at Arkansas <strong>Blue</strong> Cross is 10 years,<br />
and hundreds of employees have been with the<br />
company 15 years or more.<br />
If you’d like to know more about career<br />
opportunities at Arkansas <strong>Blue</strong> Cross, visit our<br />
website, arkbluecross.com or like our Facebook<br />
page. Come join the <strong>Blue</strong> Team!<br />
Arkansas <strong>Blue</strong> Cross<br />
invests in new medical<br />
technology through<br />
Hub X -LifeSciences<br />
The HubX-LifeSciences<br />
healthcare business<br />
accelerator program<br />
brought seven<br />
companies to Little<br />
Rock over the summer to receive help<br />
in bringing their cutting-edge medical<br />
technology to market. Arkansas <strong>Blue</strong> Cross<br />
and <strong>Blue</strong> Shield and Baptist Health joined<br />
the Innovation Hub in North Little Rock to<br />
sponsor the program with the idea that at<br />
least one up-and-coming medical device<br />
would be worthy of further investment. By<br />
the end of the inaugural session, however,<br />
three projects stood out as potential<br />
investment opportunities:<br />
• Technology to help high-risk patients and<br />
seniors take their prescriptions correctly<br />
• Non-invasive heart monitoring for<br />
patients at home<br />
• Precise, automated glucose monitoring<br />
for hospital patients<br />
According to Steve Abell, vice president of<br />
Strategic Services for Arkansas <strong>Blue</strong> Cross,<br />
these new companies will complete pilots<br />
(in central Arkansas) and launch patented<br />
solutions in 2017. The new technology will<br />
likely be shared first with The Partnership<br />
for a Healthy Arkansas, LLC, the shared<br />
services organization that includes Arkansas<br />
<strong>Blue</strong> Cross, Baptist Health, the University<br />
of Arkansas for Medical Sciences (UAMS),<br />
Washington Regional Medical System and<br />
St. Bernards Medical Center in Jonesboro.<br />
Other local investors have also become<br />
involved, including a new group of<br />
physicians who – after working with the top<br />
HubX teams – also want to invest in them.<br />
“Encouraging and developing other local<br />
investors in the healthcare technology<br />
sector was a stretch goal and it is becoming<br />
a reality,” Steve said.<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
19
NEWS<br />
Introducing <strong>Blue</strong>Listens:<br />
<strong>You</strong> share. <strong>Blue</strong>Listens.<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />
wants your honest-to-goodness opinion.<br />
As a consumer, you know better than<br />
anyone if our products and services are<br />
meeting your needs and expectations. We’ve created<br />
an online community where you can share your<br />
experiences and help us create a better <strong>Blue</strong>.<br />
By joining the <strong>Blue</strong>Listens community,<br />
you have the opportunity to:<br />
• Be heard through surveys, forums and conversations<br />
• Influence future Arkansas<br />
<strong>Blue</strong> Cross decisions with<br />
your insight and feedback<br />
To become a <strong>Blue</strong>Listens contributor:<br />
GO TO:<br />
arkbluecross.com/membercommunity<br />
YOU’LL NEED:<br />
<strong>You</strong>r member ID number and an email address<br />
We want to focus on real opinions, not just<br />
statistics, so the size of the community is limited<br />
to 1,000 contributors. If you don’t get immediate<br />
access, don’t worry. Membership is updated as<br />
spots become available.<br />
We’ll need your help through the <strong>Blue</strong>Listens<br />
community to make real improvements that<br />
benefit all of our members – so please, join today.<br />
Nursing scholarships awarded<br />
Lauren, of Little Rock,<br />
would like to become a<br />
flight nurse in the U.S.<br />
Air Force after graduation.<br />
Brittani, of Cabot, plans<br />
to work at Arkansas<br />
Children’s Hospital.<br />
20 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong><br />
18<br />
Baptist Health’s School of<br />
Nursing freshman students<br />
Lauren Kerr and Brittani<br />
Detar are the recipients of<br />
the fall semester Arkansas<br />
<strong>Blue</strong> Cross and <strong>Blue</strong><br />
Shield Endowed Nursing<br />
Scholarships.<br />
The scholarships are a<br />
result of a 2015 grant of<br />
$250,000 to the Baptist<br />
Health Foundation. Interest<br />
generated from the grant<br />
is used to fund four<br />
scholarships a year;<br />
two for the fall semester,<br />
and two for the spring<br />
semester.<br />
Lauren Kerr (left) and Brittani Detar
<strong>Blue</strong><br />
Fun summer safety was the theme in June as Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield<br />
invited members and guests to a free <strong>Blue</strong> Summer event at the Museum of Discovery.<br />
<strong>Blue</strong>Ann Ewe, Arkansas <strong>Blue</strong> Cross’ health ambassador, visited with kids and everyone<br />
received giveaways, like sunblock, bug repellent, beach balls and sunglasses.<br />
Go! Fit! Win!<br />
The <strong>2016</strong> <strong>Blue</strong> & <strong>You</strong> Fitness<br />
Challenge wraps up!<br />
Representatives from Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />
Shield, the Arkansas Department of Human Services<br />
and the Arkansas Department of Health gathered<br />
on June 21 at the Statehouse Convention Center<br />
to announce the winners of the <strong>2016</strong> <strong>Blue</strong> & <strong>You</strong><br />
Fitness Challenge.<br />
The Challenge, which began 13 years ago in<br />
Arkansas, has spread throughout the nation with<br />
the goal to promote wellness in the community and<br />
at the worksite. This year, the contest consisted of<br />
117 groups with 5,707 participants from 33 states!<br />
Groups ranged in size from two to 928 participants<br />
and were divided into 11 size categories.<br />
To see the winners from the <strong>2016</strong> Fitness Challenge,<br />
go to blueandyoufitnesschallenge-ark.com<br />
and select the Leaderboard tab.<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU 21
REMINDER:<br />
Changes to cervical cancer screening<br />
medical policy take effect in 2017<br />
22 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong><br />
18<br />
Beginning January 1, 2017, preventive screenings for cervical cancer<br />
(known commonly as Pap tests) will be covered at 100 percent every<br />
three years by Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield and our family of<br />
companies. This is a change from covering the test annually, and it is a<br />
way for us to better protect our members.<br />
What is a cervical cancer screening?<br />
Pap tests detect abnormal cells in a woman’s cervix before they become<br />
cancerous. Part of the test may include a human papillomavirus (HPV)<br />
DNA test to identify high-risk forms of HPV that can cause cervical<br />
cancer. Women vaccinated for HPV still need cervical cancer screenings<br />
because the vaccines do not protect against all cervical cancers.<br />
Why the change?<br />
Cervical cancer takes 10 to 12 years to develop, and in more than 90<br />
percent of women with HPV, the infection clears up on its own in<br />
eight to 24 months. In examining the data regarding cervical cancer<br />
screenings, the U.S. Preventive Service Task Force (USPSTF) determined<br />
that screening women too young, too frequently or beyond a certain<br />
age does not improve the prevention of cervical cancer. In fact, the<br />
USPSTF concluded that annual testing exposes women with an<br />
average risk, who are without symptoms, to potential harm, including:<br />
• False positives, which can lead to additional, more invasive testing<br />
• Pain and bleeding from cervical biopsies and excisional treatments<br />
• Unnecessary worry and appointments<br />
• Potential problems with child bearing due to unnecessary biopsies<br />
This change is supported by a broad coalition of medical specialty<br />
societies, including the American Cancer Society, the American College<br />
of Physicians and the American Congress of Obstetrics and Gynecology.<br />
Changes to cervical cancer screening policy<br />
AGE<br />
RECOMMENDATION / BENEFIT<br />
Under 21<br />
No screening<br />
21 - 65 Pap test every three years<br />
30 - 65 Pap test every three years<br />
OR<br />
Pap test and co-testing for HPV every five years<br />
65 and older No screening<br />
If you have had a hysterectomy with removal of cervix for a benign<br />
(noncancerous) disease, a Pap test is not necessary.<br />
EXCEPTIONS<br />
These recommendations do not apply to women who:<br />
• Are at high risk for cervical cancer because they:<br />
– Have had in-utero exposure to diethylstilbestrol (DES)<br />
– Are immunocompromised (such as those who are HIV positive)<br />
• Are being followed for an abnormality on a Pap test<br />
In these situations the test would be considered diagnostic and would<br />
not be covered under preventive services.<br />
Women’s Health<br />
AND<br />
Cancer Rights Act<br />
The Women’s Health and<br />
Cancer Rights Act of 1998<br />
introduced changes in<br />
insurance coverage<br />
for mastectomy.<br />
In accordance with the law,<br />
all group and individual<br />
health plans that provide<br />
medical and surgical<br />
benefits for mastectomy will<br />
cover reconstructive<br />
breast surgery, including:<br />
• Reconstructive surgery<br />
on the breast on which<br />
the mastectomy was<br />
performed.<br />
• Reconstructive surgery<br />
on the unaffected breast<br />
needed to “produce a<br />
symmetrical appearance.”<br />
• Prostheses and treatment<br />
of complications<br />
of any stage of a<br />
mastectomy, including<br />
lymphedema (postsurgical<br />
fluid buildup).<br />
These provisions apply to all<br />
policies issued by Arkansas <strong>Blue</strong><br />
Cross and <strong>Blue</strong> Shield, Health<br />
Advantage and <strong>Blue</strong>Advantage<br />
Administrators of Arkansas and<br />
are subject to the applicable<br />
copayments, coinsurance,<br />
benefit limitations, exclusions<br />
and benefit maximums.<br />
If you have questions about<br />
your insurance coverage,<br />
contact your group benefits<br />
administrator or a customer<br />
service representative.
More coverage changes for breast pumps<br />
New moms have enough going on<br />
without trying to figure out their<br />
insurance coverage. We know it<br />
is important for you to breastfeed<br />
your baby; that’s why we’ve made it<br />
one of our top priorities to keep you<br />
informed of any changes to your<br />
benefits regarding breast pumps.<br />
Most fully insured Arkansas <strong>Blue</strong><br />
Cross and <strong>Blue</strong> Shield and Health<br />
Advantage members may request<br />
coverage of an individual electric<br />
breast pump, up to $160, with no<br />
cost sharing and no prescription.<br />
This benefit renews with each<br />
pregnancy. Because the providers<br />
of breast pumps bill differently,<br />
some may bill us directly and<br />
others may need you to pay for it<br />
and then be reimbursed.<br />
Renting a hospital-grade electric<br />
breast pump due to medical<br />
complications also is covered.<br />
This benefit requires a prescription<br />
from your doctor. Rental of a<br />
hospital-grade electric breast pump<br />
is covered for six months and is<br />
available after each pregnancy<br />
depending on need.<br />
Because your benefit package may<br />
differ, please contact the Customer<br />
Service number listed on the back<br />
of your member ID card or the<br />
number associated with your health<br />
plan on page 23 for more details.<br />
Disclaimer: Federal Employee Program<br />
members must order their electric breast<br />
pump through CVS Caremark. Baptist<br />
Health and Arkansas State Employee/Public<br />
School Employee members should contact<br />
the customer service number on their<br />
member ID card for specific information<br />
about their policy. Self-insured groups that<br />
choose to cover electric breast pumps may<br />
have additional out-of-pocket costs.<br />
ANNUAL NOTICE<br />
2017 Summary of Benefits and Coverage –<br />
available November 15 for individual/family policyholders<br />
As required by the Patient<br />
Protection and Affordable Care<br />
Act (PPACA), the Summary of<br />
Benefits and Coverage (SBC)<br />
(OMB Control Numbers 1545-<br />
2229, 1210-0147 and 0938-1146)<br />
provides information regarding<br />
coverage specifications and<br />
limitations that apply to the health<br />
insurance plan you have selected.<br />
Before the end of each year,<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong><br />
Shield provides members that<br />
have individual/family health<br />
insurance policies* but do not have<br />
Medicare policies with an SBC.<br />
This official communication<br />
includes information about<br />
the coverage provided by<br />
your health insurance plan<br />
in a summary format for the<br />
upcoming year. Beginning<br />
November 15, <strong>2016</strong>, you may<br />
access this information:<br />
• Online in the “Benefits”<br />
section of the Arkansas <strong>Blue</strong><br />
Cross secure member selfservice<br />
center, My <strong>Blue</strong>print,<br />
at arkbluecross.com<br />
• By calling Arkansas <strong>Blue</strong><br />
Cross customer service at<br />
1-800-800-4298 to receive<br />
a printed version<br />
After that date, you also may go<br />
to arkbluecross.com/sbc and<br />
enter your member number<br />
(found on your member ID card)<br />
into the SBC locator tool to<br />
review the document online<br />
and print it.<br />
If you make changes to your<br />
Arkansas <strong>Blue</strong> Cross health plan<br />
benefits that differ from your<br />
current coverage, a new SBC<br />
will be created for you within<br />
seven work days of our receipt<br />
of your change request. It will<br />
be available to you in the same<br />
manner described above.<br />
* These are members who do not have<br />
health insurance through an employer,<br />
a Medicare health plan, or short-term,<br />
limited-duration <strong>Blue</strong> policies, to<br />
include Essential <strong>Blue</strong> Freedom.<br />
Arkansas <strong>Blue</strong> Cross, Health<br />
Advantage and <strong>Blue</strong>Advantage<br />
Administrators of Arkansas<br />
members who receive health<br />
coverage through an employer<br />
group will get their SBC from their<br />
employer group plan administrator<br />
at the appropriate time.<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
23
Need affordable vision coverage? See us first!<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield has teamed up with VSP to offer<br />
two vision plans to care for your vision and save you money. Our plans will:<br />
• Save you money on eye care<br />
• Help cover your glasses or contact lenses<br />
• Ensure you receive regular eye exams<br />
• Provide access to an exclusive network<br />
of eye doctors and eye care centers,<br />
including large retail locations<br />
Extra Savings<br />
Our exclusive offers to members can help you find savings everywhere!<br />
• Get an extra $20 to spend on featured frame brands like Anne Klein,<br />
bebe, Calvin Klein, Flexon, Lacoste, Nike, Nine West and more.<br />
• Get 20 percent off unlimited additional pairs of glasses.<br />
• Save an average of 15-20 percent when you have LASIK.<br />
• Get mail-in rebate savings on Bausch & Lomb brand contact<br />
lenses (at participating providers).<br />
How Our Vision<br />
Coverage Works<br />
• Find an in-network eye doctor at arkbluecross.com/findcare.<br />
• Make an appointment for an exam.<br />
• Tell your provider you have an Arkansas <strong>Blue</strong> Cross<br />
vision plan through VSP. <strong>You</strong> don’t need an ID card.<br />
• Shop the extensive selection of frames, and take<br />
advantage of exclusive member-only rebates. Find<br />
rebates at vsp.com/optical-discounts.<br />
Questions?<br />
Call 1-800-877-7195, Monday through Friday, 7 a.m. to 10 p.m., Saturday<br />
from 9 a.m. to 10 p.m., and Sunday from 9 a.m. to 9 p.m., CST. There’s also<br />
a 24/7 automated system to help you find a doctor or check your eligibility.<br />
18 24 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong>
URAC<br />
health plan<br />
reaccreditation<br />
awarded<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield received full<br />
accreditation in support of the Health Insurance<br />
Marketplace (HIM) and the Federal Employee Program<br />
(FEP) from URAC, a Washington, DC-based healthcare<br />
accrediting organization that establishes quality standards<br />
for the healthcare industry. Arkansas <strong>Blue</strong> Cross received<br />
initial Health Plan Accreditation from URAC in 2013.<br />
Reaccreditation runs through 2019.<br />
URAC’s Health Plan accreditation standards require a<br />
comprehensive review of an organization’s operations,<br />
specifically related to: network management; quality<br />
improvement; credentialing; member protection and<br />
utilization management. Companies must pass reviews<br />
of all of these sections to receive accreditation.<br />
NEW and UPCOMING GENERICS<br />
The following medications may be available soon (or now!) in generic form. Ask your pharmacist<br />
if there is a generic available for your prescription. Generic medications are the same as their<br />
brand-name counterparts in dosage form, safety, strength, route of administration, quality,<br />
performance characteristics and intended use. And, they cost less! <strong>You</strong> can learn more about<br />
generics on the U.S. Food and Drug Administration’s website, fda.gov.<br />
BRAND NAME<br />
GENERIC<br />
USE<br />
Released in <strong>2016</strong><br />
Glyset miglitol Type 2 diabetes<br />
Nuvigil armodafinil sleep disorders<br />
TIKOSYN dofetilide irregular heartbeat<br />
Dapsone Tablets diaminodiphenyl sulfone antibiotic<br />
Mirapex ER pramipexole dihydrochloride Parkinson’s disease<br />
Zegerid OS omeprazole-sodium bicarbonate acid reflux<br />
ASACOL HD (800 mg) mesalamine ulcerative colitis<br />
Upcoming in <strong>2016</strong><br />
Epzicom abacavir sulfate-lamivudine antiretroviral<br />
Azor amlodipine-olmesartan high blood pressure<br />
Benicar, Benicar HCT olmesartan high blood pressure<br />
Tribenzor<br />
amlodipine-olmesartan-hydrochlorothiazide high blood pressure<br />
Seroquel XR quetiapine mood disorders<br />
Zetia azetimibe cholesterol<br />
Upcoming in 2017<br />
Azilect rasagiline Parkinson’s disease<br />
Minastrin 24 fe norethindrone-ethinyl estradiol contraceptive<br />
Vytorin ezetimibe-simvastatin cholesterol<br />
Strattera atomoxetine attention deficit<br />
Relpax eletriptan migraine<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
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GET IMMUNIZED AT YOUR PHARMACY:<br />
Fast, convenient and free to you<br />
Did you know that as our member * you<br />
can get many important immunizations<br />
at your local pharmacy for no cost? This<br />
is a benefit of your pharmacy coverage,<br />
not your medical coverage, so it is<br />
important to understand the difference.<br />
How it works<br />
1. Check out the list of vaccines available<br />
2. Go to your local pharmacy<br />
3. Tell the pharmacist what<br />
immunization you need<br />
4. Wait while they process the claim<br />
through their system<br />
5. Get immunized!<br />
Be sure you are not asked to pay for<br />
the immunization yourself and ask for<br />
reimbursement from us. Not only would<br />
that be inconvenient, it won’t be covered!<br />
Just ask your pharmacist to run the<br />
claim before you get your immunization.<br />
Vaccines **<br />
Haemophilus Influenzae Type b (Hib)<br />
Hepatitis A<br />
Hepatitis B<br />
Herpes Zoster / Shingles<br />
Human Papillomavirus (HPV)<br />
Inactivated Poliovirus (Polio)<br />
Influenza (Flu)<br />
Measles, mumps, rubella (MMR)<br />
Meningococcal<br />
Pneumococcal<br />
Rotavirus<br />
Tetanus<br />
Tetanus, Diphtheria and Pertussis (TDaP)<br />
Varicella (chickenpox)<br />
Children<br />
Adults<br />
*<br />
This benefit does not include our members with Medicare health plans.<br />
**<br />
Pharmacists in Arkansas can vaccinate children age seven and older. Those between the ages of 7<br />
and 18 require a prescription from a physician for all immunizations except for the seasonal flu shot.<br />
18 26 BLUE & YOU <strong>Autumn</strong> <strong>2016</strong>
Notice of Privacy<br />
Practices Availability<br />
ARKANSAS BLUE CROSS<br />
AND BLUE SHIELD<br />
and<br />
HEALTH ADVANTAGE<br />
Arkansas <strong>Blue</strong> Cross and <strong>Blue</strong> Shield and its affiliated<br />
company, HMO Partners, Inc., d/b/a Health Advantage,<br />
are required by law to protect your protected health<br />
information (PHI), and to explain how we may use and<br />
release (disclose) your PHI. Our Notice of Privacy Practices<br />
is posted on our websites and includes:<br />
How we may use your PHI<br />
Circumstances when your PHI may<br />
be released to other entities<br />
<strong>You</strong>r rights regarding your PHI<br />
How to exercise your rights<br />
How to file a complaint<br />
To view the Notice of Privacy Practices, please go to<br />
arkbluecross.com or healthadvantage-hmo.com.<br />
<strong>You</strong> can obtain a paper copy of the Notice by contacting<br />
the customer service number on your member ID card<br />
(see below for a complete list of customer service numbers).<br />
CUSTOMER SERVICE NUMBERS<br />
May we help?<br />
For customer service, please call:<br />
TOLL FREE Number<br />
Medi-Pak ® members 1-800-338-2312<br />
Medi-Pak ® Advantage members 1-877-233-7022<br />
Medi-Pak ® Rx members 1-866-390-3369<br />
Arkansas <strong>Blue</strong> Cross members 1-800-238-8379<br />
• Pharmacy questions 1-800-863-5561<br />
• Specialty Rx pharmacy questions 1-866-295-2779<br />
Arkansas <strong>Blue</strong> Cross Metallic members<br />
(Gold, Silver, Bronze, Catastrophic) 1-800-800-4298<br />
• Pharmacy questions 1-800-969-3983<br />
Health Advantage members 1-800-843-1329<br />
• Pharmacy questions 1-800-863-5567<br />
<strong>Blue</strong>Advantage members 1-888-872-2531<br />
• Pharmacy questions 1-888-293-3748<br />
Federal Employee members 1-800-482-6655<br />
Looking for health or dental insurance? We can help!<br />
For individuals, families 1-800-392-2583<br />
For employer groups* 1-800-421-1112<br />
*Arkansas <strong>Blue</strong> Cross, Health Advantage and <strong>Blue</strong>Advantage Administrators of Arkansas<br />
PAY YOUR *<br />
B I L L<br />
To pay by phone*, please call 1-800-354-9904<br />
Medicare Advantage and Prescription Drug plan product<br />
members must call Customer Service to discuss available<br />
payment options. Health Advantage conversion plans are not<br />
eligible for online, mobile or pay-by-phone payment options.<br />
Prefer to speak with someone close to home?<br />
Call or visit one of our offices near you:<br />
• Arkansas State Employees /<br />
Public School Employees 1-800-482-8416<br />
• Arkansas<strong>Blue</strong> — Little Rock<br />
2612 S. Shackleford Rd., Suite J 1-501-378-2222<br />
• Arkansas<strong>Blue</strong> — Fayetteville<br />
516 East Millsap Rd., Suite 103 1-800-817-7726<br />
• Fort Smith<br />
3501 Old Greenwood Rd., Suite 5 1-866-254-9117<br />
• Arkansas<strong>Blue</strong> — Hot Springs<br />
1635 Higdon Ferry Rd. – Suite J 1-800-588-5733<br />
• Arkansas<strong>Blue</strong> — Jonesboro<br />
2110 Fair Park Boulevard – Suite I 1-800-299-4124<br />
• Little Rock<br />
601 S. Gaines Street 1-800-421-1112<br />
• Arkansas<strong>Blue</strong> — Lowell<br />
507 W. Monroe Ave. – Suite B 1-888-872-2539<br />
• Arkansas<strong>Blue</strong> — Pine Bluff<br />
509 Mallard Loop Drive 1-800-236-0369<br />
• Texarkana<br />
1710 Arkansas Boulevard 1-800-470-9621<br />
Visit our websites for more information:<br />
arkbluecross.com<br />
healthadvantage-hmo.com<br />
blueadvantagearkansas.com<br />
blueandyoufoundationarkansas.org<br />
<strong>Autumn</strong> <strong>2016</strong> BLUE & YOU<br />
27
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Have a<br />
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3<br />
<strong>Blue</strong> Christmas at the<br />
Museum of Discovery<br />
6 to 9 p.m.<br />
Friday, December 2<br />
Get in FREE with a member ID card or<br />
pick up free tickets (while supplies last)<br />
at any Arkansas<strong>Blue</strong> location.<br />
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with us!<br />
*<br />
X<br />
FREE tickets (while supplies last)<br />
at all Arkansas<strong>Blue</strong> locations<br />
beginning November 1.<br />
Visit arkbluecross.com for more details<br />
on both events. Find Arkansas<strong>Blue</strong><br />
locations on page 27 or go to our website.<br />
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The Elves and<br />
X<br />
the Shoemaker"<br />
*<br />
3<br />
at the<br />
Arkansas Arts Center’s Children Theater<br />
4 p.m.<br />
Sunday, December 4<br />
FREE tickets (while supplies last)<br />
at all Arkansas<strong>Blue</strong> locations.<br />
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blue<br />
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MPI 5566 9/16