2009 - Autumn

A publication for the policyholders of the Arkansas

Blue Cross and Blue Shield family of companies

Autumn 09

• Read our CEO’s editorial about health care reform, Page 3

• Enroll now in one of our Medicare plans, Page 5

• Dr. David offers healthy eating tips, Page 16

Dan Peterson of Little Rock, Ark., is a survivor of pancreatic cancer. See his story on Page 6.

5 Medicare enrollment information

12 SilverSneakers adds to active lifestyle

19 Yarnell’s & Arkansas Blue Cross

Out of the Blue

Great options for members 65 and over

Beating the odds: Dan Peterson’s journey

with pancreatic cancer

Can Zicam damage your sense of smell?

Caffeine may reduce Alzheimer’s memory loss

Beware: Tanning beds cause cancer

Prepare for two flus this fall

SilverSneakers adds to active lifestyle

Prediabetes? Take the warning seriously!

Lose weight The Healthy Weigh!

Taking calcium supplements for weight loss?

What not to feed Junior

Senior Moments with Dr. David

Where does your health-care dollar go?

A sweet relationship:

Yarnell’s and Arkansas Blue Cross

From the Pharmacist —

Are you an unintentional drug dealer?

Curves offers discount to members

What is a formulary?

The Doctor’s Corner

Three benefits added to group DentalBlue plans

Mental Health Parity: What it means for you

Women’s Health and Cancer Rights Act

Blue & You Fitness Challengers win with

better health

Customer Service telephone numbers

Good for you

Vice President, Communications and Product Development: Karen RaleyEditor: Kelly Whitehorn — [email protected]: Gio Bruno Photographer: Chip BayerContributors: Chip Bayer, Matthew Creasman, Damona Fisher, Kristy Fleming, Jennifer Gordon, Trey Hankins, Heather Iacobacci-Miller, Ryan Kravitz, Kathy Luzietti and Mark Morehead

356

10

111214

15

161819

20

21222324

2526

2728

Autumn 09

is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health-care professionals and other persons interested in health care and wellness.

on Page 12

INSIDE

A special thank you to Stacy Harter, a University of Arkansas at Little Rock graduate student, who contributed the article on chiropractic medicine in the Summer 09 edition of Blue & You.

3

Blue & You Autumn 2009

Our stance on health care reformIn the ever-changing environment around health care

reform, there are a few constants. At Arkansas Blue

Cross and Blue Shield, our position on health care re-

form has not changed.

• We support health care reform. We believe chang-

ing our current system is important to Americans

individually and collectively. The rate of growth in

health-care costs today is not sustainable for the

long term. The impact of these costs on our na-

tion’s ability to compete in a global economy and

on hard-working Americans will be unbearable. We

believe so strongly in the need for change that we

will support responsible changes even if they require

that we as a health insurance company significantly

change the way we do business.

• We believe that every American should have ac-

cess to high-quality, affordable health care, and

that any reform enacted should address the problem

of the uninsured by providing financial assistance to

those who cannot afford coverage on their own.

• We believe that the most significant issue we

face in health care today is cost. To be success-

ful, any reform enacted must address cost as the

primary issue. It is cost that has created a situation

in which many Americans lack health coverage. It is

the cost of health care that makes our current sys-

tem unsustainable. We must first address the cost in

order to reform health care without bankrupting the

country in the process.

As an industry, we must be — and are — prepared to

make radical changes in the way we do business. One

much-maligned insurance company practice is denying

coverage or payment for those with pre-existing medi-

cal conditions. Early in the health-care discussions, our

industry pledged to support guaranteeing coverage for

everyone despite any pre-existing health condition

they might have. But to make this proposal affordable,

we must have laws that require everyone who can

afford it to purchase insurance and stiff penalties for

those who fail to do so. Without these laws, people

would not buy insurance until they got sick. And we all

know you don’t wait until after you’ve burned dinner to

turn off the oven.

But other changes are needed to make health care

Out of the

BlueA message from our CEO and President, Mark White

4


available and affordable for all Americans. Remember

that the problem is the cost of health-care services,

which directly impacts your health insurance costs.

Health-care costs drive health insurance costs — not

the other way around. There are a number of reform ini-

tiatives that hold promise for addressing our cost prob-

lem. The most important has not been part of the public

debate. Payment reform is an important first step if we

are serious about controlling the cost of health care.

We must change how we pay health-care providers,

not necessarily how much we pay them. Today, doc-

tors, hospitals and other health-service

providers are paid for each service

they provide, even if that service isn’t

helpful or already has been done. This

method of payment is called “fee-for-

service.” In this environment, patients

often see specialists and undergo

many tests and procedures with no

one coordinating the care they receive

from one doctor to the next. We need

a system in which doctors and hospi-

tals are paid to treat a patient’s “medi-

cal episode” rather than each medical

service provided. An episode might be a hysterectomy

or a heart attack or any other condition for which a

patient might seek medical care. When we pay doctors

and hospitals to treat a patient’s medical episode, they

are incented to coordinate the care the patient receives,

avoid duplicate and unnecessary testing and provide

care that has been proven effective and necessary.

Another important initiative that will contribute to a

more efficient system is the expansion of health infor-

mation technology (IT) in the health-care delivery sys-

tem. This initiative already is included in many reform

proposals and is part of the American Recovery and

Reinvestment Act (ARRA) of 2009. We need a system

that links the health plan, the doctor, the hospital and

the patient together so that everyone has access to the

information they need to best treat each patient and get

their claims paid. This means when you see your doctor

or visit the emergency room, the physician or nurse

should be able to enter your name and other identifi-

able information in a computer and review your medical

records. This will help avoid delays in care and unneces-

sary tests, as well as give the health-care providers a

clear understanding of your medical history.

Let me give an example: your 80-year-old mother

goes to the emergency room and the doctor doesn’t

have any experience treating her. He

has no access to her medical records.

He may have to order more tests, pre-

scribe more medicines and take more

time trying to diagnosis the problem.

Some of these procedures are prob-

ably not necessary and may actually be

harmful. The doctor won’t know if the

same tests or procedures were con-

ducted just a few months before. He

could save time and money if he had

access to her medical history, and he

would be more effective in treating her

with the appropriate information at his fingertips. That is

the promise of improved health IT.

As you listen to all the discussion surrounding the

current health-care debate, I encourage you to keep

one question in mind. How will this particular proposal

or plan help control cost? Responsible health care

reform will build on our current employer-based system

in ways that make it more affordable. Will huge, new

government bureaucracies control costs? How about in-

creasing taxes or placing new demands on employers?

I hope that each of you will take the time to consider all

the proposals out there and make an educated decision

about what is best for you and those you love. That’s

the American way.

We need a system in which doctors and hospitals are

paid to treat a patient’s

“medical episode”

rather than each medical service

provided.

5


GREAT OPTIONSfor members 65 and over

If you are eligible for Medicare, November 15 is an

important date to remember. From November 15 until

December 31, you can purchase a Part D prescription

drug plan or Medicare Advantage plan. You also can

change the plan you have. The federal government’s

Centers for Medicare and Medicaid Services (CMS)

calls this time period the Annual Election Period (AEP).

If you join a plan during the AEP, or make changes to

an existing plan, your new benefits will be effective

Jan. 1, 2010.

Medi-Pak Choice plans offer peace of mind

Arkansas Blue Cross and Blue Shield’s Medi-Pak

Choice plans provide the same affordability, conve-

nience and peace of mind you’ve come to expect

from us.

For 2010, Arkansas Blue Cross will offer:

• ThreeMedi-Pak Rx Prescription Drug Plans (PDP)

with competitively priced monthly premiums – Basic

at $25.90, Classic at $57.20 and Premier at $86.50.

Our Medi-Pak Rx (PDP) plans cover all Medicare-

approved generic drugs plus an extensive list of

brand-name prescription drugs. In addition, more

than 95 percent of the pharmacies in Arkansas are in

our network.

• $0premiumsforMedi-Pak Advantage MA-PD

Private Fee-for-Service (PFFS) plans (includes drug

coverage) in 27 counties and affordable premiums

in all Arkansas counties. Medi-Pak Advantage MA-

PD (PFFS) plans are Medicare PFFS plans, which

combine all the benefits of original Medicare (Part A

hospital and Part B medical) with valuable extras.

Beginning Jan. 1, 2010, our Medi-Pak Advan-

tage (PFFS) customers have a great new benefit!

Arkansas Blue Cross has contracted with more than

6,000 doctors and hospitals all over the state that

have agreed to accept our Medi-Pak Advantage

members as valued patients. No more searching for

a doctor who will accept your health plan. You will

know in advance the doctors and hospitals that will

accept your plan. And when you use these doctors

and hospitals, you’ll have lower out-of-pocket costs.

Plus, our Medi-Pak Advantage members will contin-

ue to receive a membership in the SilverSneakers®

Fitness Program at no additional cost.

• $0premiumsforMedi-Pak Advantage MA (PFFS)

(does not include drug coverage) in 52 counties. These

plans offer all the health benefits of our Medi-Pak

Advantage MA-PD plans, but do not include drug cov-

erage. Members have access to a network of 6,000

doctors and hospitals that have agreed to accept their

plan and receive a SilverSneakers membership.

Great options, continued on Page 18

6


Miracles can happen. Dan

Peterson is living proof.

In late 2002, Dan began having

severe pain in his upper abdomen.

After a few days with no relief, he

and his wife, Donna, went to the

emergency room at a local hospital.

Dan endured several tests, includ-

ing a CAT scan, and was diagnosed

with pancreatitis — inflammation of

the pancreas. One of the medical

professionals noted that there was

“something” on the CAT scan re-

sults but did not suggest any follow

up, and Dan was sent home.

Two days later Dan returned

to the hospital, still in pain, and

was admitted. After a few more

tests, Dan’s doctor walked into

the room and told his family he had

bad news.

“It was like the air was sucked

out of the room,” Donna said, still

fighting back tears from that pain-

ful memory. “He said that Dan had

stage-four pancreatic cancer and he

needed to go home and settle his

affairs because he only had a few

months to live.”

Dan’s pancreas had an adeno-

carcinoma, a cancer originating in

glandular tissue, and it had spread

to two locations in his liver. There

was no talk of oncologists, surgery

or other treatments. The doctor sug-

gested that Dan and his family start

saying goodbye.

Donna said that the only thing

keeping her together at that point

was that she had to be strong for

their five children. “I couldn’t eat;

I couldn’t take a deep breath; I

couldn’t imagine life without him.”

Dan went back to his job as a

human resources director for the

Central Arkansas Veterans Health-

care System and contacted his

friend, Nick Lang, M.D., a surgical

oncologist who was chief of staff for

the Department of Veteran’s Affairs

Beating the odds:

Dan and Donna Peterson enjoy the view from their front porch.

7


(DVA) hospital at the time and who

now is chief medical officer for the

University of Arkansas for Medical

Sciences (UAMS). Lang contacted

Laura Hutchins, M.D., director of

the UAMS division of Hematology/

Oncology and director of clinical

research for the UAMS Winthrop P.

Rockefeller Cancer Institute.

The Cancer Institute has a tight-

knit group of physicians and re-

searchers who focus on specific

types of cancer, one of the reasons

it’s been named a Blue Distinc-

tion Center of Excellence for Rare

Cancers by the Blue Cross and Blue

Shield Association. Dr. Hutchins

quickly paired Dan up with Issam

Makhoul, M.D., associate professor

of medicine in the division of Hema-

tology/Oncology.

The first person to talk with Dan

and Donna at Dr. Makhoul’s office

was Michelle Welch, R.N., Dr. Mak-

houl’s nurse. Donna remembers her

shock when Michelle said, “It’s not

over — we have lots of things we’re

going to throw at you.” Michelle

confirmed that it is true that the

prognosis for pancreatic cancer

is not good for anyone, but given

Dan’s relatively young age of 57, and

his excellent health otherwise (at

the time he also was a warrant offi-

cer in the Arkansas National Guard),

she felt he had a better chance than

many people.

“I will always be grateful to her

for that,” Donna said. “She gave me

my world back.”

That glimmer of hope shone

even brighter as they visited with

Dr. Makhoul himself. His warm

demeanor and positive attitude

allowed them to think toward the

future for the first time in weeks.

He told Dan that he believed he had

at least a year to live, if not longer,

and that his team would try several

of the latest therapies to shrink

the tumor and look into ongoing

research to see if new treatments

were available.

“We had considered going out of

state for Dan’s treatment,” Donna

said, “but after that first visit we

realized how blessed we were to

live in Little Rock, so close to such a

renowned medical center.” She said

she and Dan visited with people

from throughout the country in the

waiting rooms of the Cancer Insti-

tute who had come for the excel-

lent, state-of-the-art treatment.

Part of the reason UAMS is rec-

ognized nationally for its treatment

of rare cancers is that its missions

of teaching, healing, searching and

serving are interwoven into the

daily activities of its employees. Dr.

Makhoul said he originally planned

to only stay a short time at UAMS,

but found he enjoyed the balance

of treating patients, heading the

fellowship program, interacting with

the residents and working on his

own research.

As a Blue Distinction Center of

Excellence for Rare Cancers, the

Cancer Institute must meet high

quality standards established by an

expert panel of physicians, surgeons

and other health-care professionals.

When a hospital has been desig-

nated a Blue Distinction Center, you

know they have expertise in that

specialty, that they focus on quality,

and that they have a history of pa-

tients with

positive

outcomes.

Hospitals

provide

care differ-

ently, and

the Blue

Cross and

Dan Peterson’s journey with pancreatic cancer

Dan and Donna before he was diagnosed with cancer.

Issam Makhoul, M.D.

8


Blue Shield Association has created

a process where hospitals can dem-

onstrate their expertise.

If you are looking for a hospital

with a Blue Distinction designation,

go to our Web sites and visit our

“Members” section. We do the work

for you, so you can be assured you

are receiving the best care possible.

The Petersons also were grateful

to have Arkansas Blue Cross and

Blue Shield as their health insur-

ance provider. “Arkansas Blue Cross

has just been fantastic,” Dan said,

remembering the ease of getting

his expensive treatments covered.

When Dan retired from the National

Guard he qualified for Tricare, a

program for retired military mem-

bers. Still, he insisted on keeping

Arkansas Blue Cross as his second-

ary insurance because he knew the

importance of having good health-

care coverage.

A few days after Dan’s diagnosis,

Donna listened to a voicemail from

Brenda Strange, R.N., C.C.M., case

management coordinator for Arkan-

sas Blue Cross. Donna dismissed

the first call, but Brenda was insis-

tent and, through one of the visiting

nurses, got Donna to call her back.

Brenda explained that case manag-

ers don’t direct member’s care, as

some often think. “As a case man-

ager, I help coordinate the plan of

care already in place, work with the

member and health-care

team to maximize the

benefits available and help

them return to self-manag-

ing their care.”

“I had no idea in the be-

ginning that there would

be that kind of help, but

any time I had a question I

knew I could call Brenda,”

Donna said. Part of Dan’s

treatment still includes a

nightly infusion of IV flu-

ids, and the port must be

changed weekly. For sev-

eral months, nurses came

out to change the port, but then the

Petersons received a notice that the

number of visits was running out.

Donna immediately called Brenda

for help.

“We were able to offer an alterna-

tive benefit plan that would allow for

an extension of Dan’s skilled nursing

visits to support Donna,” Brenda

remembered. “This allowed Dan to

receive some of his treatments at

home, which would have otherwise

caused him to return to the hospital

during acute episodes of his ill-

ness.” For more about case manag-

ers at Arkansas Blue Cross, visit

our Web site at arkansasbluecross.

com and select “Case Management

Services” under the “Members”

section.

Dan’s treatment included visits

to the Central Arkansas Radiation

Therapy Institute (CARTI) along with

If you are looking for

a hospital with a Blue

Distinction designation, go

to our Web sites and visit

our “Members” section.

We do the work for you, so

you can be assured you are

receiving the best

care possible.

9


powerful doses of chemotherapy

that thinned his hair but not his spir-

it. At one point Dan asked Brenda,

“Why do you think I’m still here?”

and her answer was, “Because you

make everyone better.”

By September 2003, Dan’s tumor

had shrunk enough that the doc-

tors decided to try to remove it.

With the waiting room packed with

family members, Ralph Broadwater,

M.D., chief of Surgical Oncology for

UAMS, started the operation, only

to stop three hours later in frustra-

tion. The tumor was too close to a

main artery. He was, however, able

to remove one of the tumors on

the liver; the other had disappeared

from the treatments.

While the operation wasn’t suc-

cessful, Dan continued to keep a

positive outlook and to “live in the

moment.” During a long wait to

see Dr. Makhoul, Dan and Donna

decided to have some fun. Using a

marker,

they

drew a

face on

Dan’s

belly,

using the scar from the operation as

a frown. They tried to keep straight

faces as Dr. Makhoul lifted Dan’s

shirt, but it was no use and they

burst out laughing. As time went

by Dr. Makhoul and his staff found

quirky notes on the door of the ex-

amination room, silver nail polish on

Dan’s toes when they became dis-

colored from the medication — any-

thing to make light of the situation.

“We relied a lot on humor and just

staying in the moment,” Dan said.

By 2005, the chemotherapy had

taken a toll on Dan’s bone marrow.

Dr. Makhoul found information

regarding a medication not yet ap-

proved for pancreatic cancer, but

one that sounded promising. Arkan-

Peterson, continued on Page 21

sas Blue Cross approved the “de-

signer” drug for Dan, which is now

an accepted medication for certain

types of pancreatic cancer.

One of the misunderstandings

people have about cancer is that

they consider it all to be the same

thing. Dr. Makhoul said he often

hears people ask, “Why can’t you

cure cancer?” but in reality there

are many subsets of cancers, some

much more easily treatable than

others.

Research began about 25 years

ago into the link between genetics

and certain forms of cancer. “We

now are harvesting the fruits of this

work,” Dr. Makhoul said, through

medications focused on specific hu-

man genes that may contribute to a

person’s predisposition for a type of

cancer. In Dan’s case, even though

pancreatic cancer in general is dif-

ficult to treat, his specific cancer

responded extremely well to the

medications, and his excellent over-

all physical health allowed him to

endure treatments that many other

patients couldn’t have tolerated.

“There is no question in my mind

that he is cured at this point,” Dr.

Makhoul said of Dan.

Almost seven years after his jour-

Go to Blue & You Online on our Arkansas Blue Cross and Health Advantage Web sites

for more on Dan’s journey.

http://www.arkansasbluecross.com/about/byonline.aspx

10


In a recent study pub-

lished in the Journal of

Alzheimer’s Disease, re-

searchers found that caf-

feine may reverse memory

loss associated with the illness.

The study was conducted using mice bred to develop

symptoms of Alzheimer’s disease. They were given 500

milligrams of caffeine in their water daily upon develop-

ing memory problems. Mice that drank the caffeinated

water performed better on memory tests and thinking

skills over the mice given plain water. They also expe-

rienced a nearly 50 percent reduction in the level of

beta-amyloid — a protein found in the brains of people

with Alzheimer’s disease.

Human studies are planned based on these positive

findings.

Source: WebMD

The U.S. Food and Drug Administration (FDA) has re-

ceived more than 130 reports of loss of sense of smell

associated with the following Zicam® products:

1. Zicam Cold Remedy Nasal Gel

2. Zicam Cold Remedy Nasal Swabs

3. Zicam Cold Remedy Swabs, Kid’s Size (a discontin-

ued product)

The FDA advises consumers to stop using these

over-the-counter cold remedy products due to the risk

of loss of sense of smell, which may be long lasting or

permanent. If you have used any of these products and

experienced a loss of sense of smell, you are encour-

aged to contact your health-care professional.

Source: FDA

Beware:

Caffeine may reduce Alzheimer’s memory lossCan Zicam

damage your sense of smell?

Tanning beds and other sources of ultraviolet radia-

tion are in the top cancer risk category — as deadly as

arsenic and mustard gas — according to a study from

the International Agency for Research on Cancer.

The research showed that skin cancer risk increases

by 75 percent when tanning beds are used before the

age of 30.

Researchers also found evidence that UV-emitting

tanning devices are associated with ocular melanoma.

Ocular melanoma is a cancer of the eye that can be

lethal, especially if it spreads to the liver, a common

complication.

Tanning bedscause cancer

11


Every flu season has the potential to cause a lot

of illness, doctor’s visits, hospitalizations and deaths,

but this year the Centers for Disease Control and

Prevention (CDC) is concerned that the novel H1N1

(swine) influenza virus could result in a particularly

severe flu season.

Vaccines are the best tool we have to prevent the

flu, so this year, plan to vaccinate twice — once for the

seasonal flu and once for the H1N1 flu. Vaccinations

for the seasonal flu already may be available in some

areas, and the H1N1 vaccine is expected to be ready

sometime this fall. The H1N1 vaccine is not intended to

replace the seasonal flu vaccine — it is intended to be

used alongside the seasonal flu vaccine.

The CDC’s Advisory Committee on Immunization

Practices recommends that the following groups re-

ceive the novel H1N1 (swine) influenza vaccine when it

becomes available:

• Pregnantwomen*

• Peoplewholivewithorcareforchildrenyounger

than 6 months of age

• Health-careandemergencyservicespersonnel

• Personsbetweentheagesof6monthsthrough24

years of age

• Peoplefromages25through64yearswhoareat

higher risk for novel H1N1 because of chronic health

disorders or compromised immune

systems.

Once the demand for vaccine for the

prioritized groups has been met at the

Go to Blue & You Online on our Arkansas Blue Cross and Health Advantage Web sites

for more on the H1N1 flu.

Prepare for

two flus this fall

local level, vaccinations will be available for everyone

fromtheagesof25through64years.Currentstudies

indicate that the risk for infection among persons age

65 or older is less than the risk for younger age groups.

However, once vaccine demand among high-risk groups

has been met, vaccinations will be offered to people

65 or older. People 65 and older should continue to get

the seasonal flu shot as soon as it becomes available in

their area.

My Blueprint, our self-service online member portal,

can help you access information on your health-care cov-

erage24/7,whichcouldbehelpfulduringafluoutbreak.

* Pregnant women are more at risk from

swine flu

Pregnant women may be at higher risk for severe

complications from the H1N1 swine flu virus. Therefore,

the CDC recommends that pregnant women should re-

ceive the same treatment and prevention regimens as

recommended for seasonal flu — oseltamivir (Tamiflu®)

and zanamivir (Relenza®) or a vaccine when available.

If you are pregnant and suspect you may have been

exposed to the H1N1 virus, or are experiencing flu-like

symptoms, contact your physician right away.

Source: CDC


12


SilverSneakers adds to active lifestyle


12

Pat Hagemeier of Russellville, Ark., and her husband, Dean, make exercise a part of their life together.

13


Center, adding that the SilverSneak-

ers classes are so popular, “there’s

alwaysaroomfull”of40ormore

people. And the classes aren’t easy,

even for a seasoned exerciser like

Pat. “They push you a bit and chal-

lenge you to increase your endur-

ance. You leave feeling really good.”

Pat and Dean have made the

fitness center a part of their daily

routine, even though they often

don’t go at the same times. Pat said

she likes to go early in the day for

the classes, while Dean often goes

later in the day to use the whirlpool

and other facilities. She said the

fitness center has brought them

even closer together, because they

both see their friends and can share

the latest news when they get back

together for meals.

Dean, 76, is an avid bicycle rider

who has participated three times in

the Des Moines Register’s Annual

Great Bicycle Ride Across Iowa, a

seven-day bicycle ride. According to

the Des Moines Register, the ride

is the

longest,

largest

and

oldest

touring

bicycle ride in the world.

Walking is a big part of Pat’s exer-

cise regime, and for several years,

she and two of her friends have

been virtually walking across the

United States. They each put in one Hagemeier, continued on Page 27

Pat Hagemeier of Russellville

started life as a self-proclaimed

klutz, but her love of exercise has

helped her overcome numerous

obstacles.

When her children were small,

she enrolled in an exercise class

at the YWCA and was immediately

hooked. “I bought a Good House-

keeping 78 rpm exercise record to

use when I couldn’t find a class to

take and faithfully worked out to

it.Ialsogota45rpmrecordcalled

“Chicken Fat,” and my children

would join me in marching, doing

jumping jacks and touching toes

during cooped-up winter days.”

Later, as a school counselor, she

and other teachers would exercise

to a video in the library at the end of

the day and then walk the track. She

said her children would often join

her on the walk to share their day.

“It was a wonderful time to talk and

to transition.”

About 17 years ago, St. Mary’s

Wellness Fitness Center opened in

Russellville, and Pat and her hus-

band, Dean, began taking advantage

of all the classes and facilities. “I

did weight lifting, cardio and stretch

classes and loved the way I felt.”

Two years ago, the center added

the SilverSneakers® Program, and

Pat said that with those added

classes she is at the facility four or

five times a week.

“They’re fantastic,” Pat said of the

staff at St. Mary’s Wellness Fitness

dollar per mile as a travel kitty for a

mutual trip when they finished. “It

took us varying amounts of time to

complete the goal because life has

a way of constantly interfering with

plans, but eventually we all reached

the goal and we’re off to Greece

this fall!”

Part of life’s “interference” for Pat

included two surgeries for cancer.

“The day my staples came out I

asked the doctor if I could begin

walking again, and she said to just

not overdo it. I decided that I would

try to walk around our block that day

and then double the distance each

day. It was no time before I was

back up to four to six miles a day,

and I felt great.” Recovery after the

second surgery was a bit slower,

Pat said, but she still credits her

quick recovery with the fact that she

was in excellent physical shape.

This year, at age 71, Pat reached

another fitness goal. She partici-

pated in walking the half marathon

at the Little Rock Marathon in early

March. “It was a great experience!

Training for it with my dedicated

walking buddies, seeing the mass

of racers committed to a single goal,

hearing words of encouragement

Go to Blue & You Online on our Arkansas Blue

Cross and Health Advantage Web sites for more on

SilverSneakers and upcoming speaker events.


14


is getting your blood sugar levels

back to a normal range. You can

do this by making some lifestyle

changes.

• Make healthy food choices.

Limit how much fat you eat and

try to eat foods high in fiber. Try

to eat about the same amount

of carbohydrates at each meal.

This helps keep your blood

sugar steady.

• Watch your weight. If you are

overweight, losing just a small

amount of weight may help.

• Be active. Exercise at least

30 minutes each day. You may

want to swim, bike or walk.

Remember, staying at a healthy

weight, eating healthy foods, and

getting regular exercise can help

prevent prediabetes.

Prediabetes is a warning signal

that you are at risk for diabetes —

your blood sugar is higher than it

should be. Most people who get

type 2 diabetes have prediabetes

first, but the good news is that

lifestyle changes may help you get

your blood sugar back to normal

and avoid or delay diabetes.

Often, prediabetes has no signs

or symptoms. But it’s important to

watch for the classic red flags of

type 2 diabetes, including:

• Increasedthirst

• Frequenturination

• Extremehunger

• Unexplainedweightloss

• Fatigue

• Blurredvision

How is it treated?

The key to treating prediabetes

and preventing type 2 diabetes

The Healthy Weigh! Education

Program is free for members of Ar-

kansas Blue Cross and Blue Shield,

Health Advantage, Blue Cross and

Blue Shield Service Benefit Plan

(Federal Employee Program), and

eligible members of BlueAdvantage

Administrators of Arkansas.

To enroll, complete the attached

enrollment form and return it in the

self-addressed, postage-paid enve-

lope included in this magazine. The

program starts when you enroll.

After enrollment, you will begin

to receive information through the

mail, which you can read in the

privacy of your own home and at

your own pace. The program is

completely voluntary, and you may

leave the program at any time. If

you have further questions about

the program, call the Health Educa-

tion Program’s toll-free number at

1-800-686-2609.

Simply complete, sign and return the attached enrollment form in the self-addressed, postage-paid envelope.

Lose weight

The Healthy Weigh!

Prediabetes?

Take the warning seriously!

15

Blue & You Autumn 2009Blue & You Autumn 2009

According to a new study published in the

Annals of Internal Medicine, taking calcium

supplements may not prevent weight gain. The

two-year study was meant to test claims that

taking calcium supplements might prevent

weight gain in overweight or obese individuals.

Thestudyincluded340overweightand

obese individuals in their mid-30s. Participants

were either given 1500 mg per day of calcium

carbonate or a placebo to take with meals. Re-

searchers found that there were no statistically

or clinically significant differences in change

in body weight or body fat mass between the

two groups.

While researchers conclude that taking cal-

cium supplements is not beneficial for weight-

loss purposes, the researchers do note that

taking them may help prevent fractures.

Source: Annals of Internal Medicine

Taking calcium supplements for weight loss?

Baby’s first year is full of new discoveries, including new

foods. Several food items, however, should be left off the

menu until a later time.

According to the American Academy of Pediatrics, babies

are fine with breast milk or formula for their first four months,

and then a bit of cereal can be added to the diet. Around six

months, vegetable baby food can be introduced

slowly, giving each new experience a few days

to watch for allergic reactions.

Within a few months of starting solid foods,

your baby’s daily diet should include a variety of

foods each day that may include the following:

• Breastmilkand/orformula

• Meats

• Cereal

• Vegetables

• Fruits

• Fish

There are some foods your baby should not

eat within the first year. The following foods are

considered no-nos by pediatricians:

Grapes – while these seem like a perfect size for babies, they

can be a choking hazard. Also avoid apple chunks or any hard

vegetables like carrots.

Honey – this natural sweetener can contain botulism spores,

which doesn’t pose a threat to adults but can poison babies.

Nuts and peanut butter – these can cause allergic reactions

and the nuts can cause babies to choke.

Hot dogs and sausages – these are high in salt and fat and

can be a choking hazard.

Food and drinks with artificial sweeteners

Teas and coffees

Food with added spices, seasoning and salt

Shellfish – could cause allergic reactions.

Potato or corn chips – these are very salty and can be a

choking hazard.

What not to feed

Junior

15

16


Don’t diet; eat healthy!Your choices can lead to a longer and better life

There’s no denying it. The statistics prove it. With

each passing decade, Americans are gaining more and

more weight. We define being overweight or obese by

the body mass index (BMI) — calculated by your weight

over your height squared. You can find your own BMI

by visiting the National Heart Lung and Blood Institute

at nhlbisupport.com/bmi and entering your height and

weight, or you can calculate it yourself (see calculation

formula at the far lower right).

A BMI above 30 is considered obese, between 25

and 30 is defined as overweight and less than 18.5 is

considered too thin. Studies show that those who are

overweight, but not obese, live the longest. However,

they don’t live the healthiest with advancing age, and

they are far more prone to cancer, diabetes, hyperten-

sion, heart disease and osteoarthritis.

Remember, what we eat determines how long we

live and the diseases we may endure late in life. Even

at the ideal weight or below, you might have dietary

habits that predispose you to hypertension, heart dis-

ease, cancer or even Alzheimer’s disease. No matter

what you weigh, you must develop a healthy relation-

ship with food. Start with these basic steps:

1. Change how you eat

Recognize your motives for eating. Are you even

hungry? How do you hope to feel after your meal? De-

veloping a healthy relationship with food often means

changing lifelong habits. Second, slow down. A key

element of developing a healthy relationship with food

is actually noticing that you eat! Stop rushing through

meals. Stop eating “on the run.” Enjoy every bite of

food that passes your lips. Pay attention to it! Chew

slowly, and notice how it tastes and feels.

Regulate portion size. In the past 20 years, portion

sizes for the average American meal have grown expo-

nentially. Clearly, portion size is important. It’s not about

depriving yourself of food; it is about giving your body

the amount of food it needs to feel satisfied.

2. Educate yourself about food

After you change how you eat, you can begin the

process of changing what you eat. Remember — diets

Senior Momentswith Dr. David

David A. Lipschitz, M.D., Ph.D.

17


fail and the best diet by far is the “don’t diet, diet.” This

is easy to follow:

• Eat the right fats. A fat-free diet is unhealthy

and may promote weight gain. The right fats

are monounsaturated olive or canola oils and

omega-3 fatty acids obtained in fatty fish, a

handful of nuts or avocados. In moderation,

these foods are good for you.

• Eat the right protein. The right proteins are

lean meat, fatty fish and legumes.

• Eat as many fruits and vegetables as you

want. Whole fruits are better than juices, and

eat sugar-rich fruits (oranges, grapes) in mod-

eration. Eat as much healthy salad or as many

vegetables (for example: broccoli, zucchini or

squash) as you want.

• Watch the carbohydrates. Too much sugar and

starch leads to weight gain, diabetes and other

illnesses. Avoid empty calories such as sodas

or candy. With each meal, eat no more than two

servings of starch (bread, pasta, beans, rice or

potatoes). Portion sizes should be no more than

two thirds the size of your fist.

• Don’t overuse supplements. The best way to

get nutrients is from what you eat. Too much

vitamins C, D and E, for example, can cause

more harm than good. You can get adequate

calcium and vitamin D either from dairy prod-

ucts or from a supplement. Those above age 70

should take a multivitamin without iron and a

1000 microgram B12 tablet.

3. Maintain the same weight.

It is better to be overweight (pleasantly plump) than

lose weight on a diet and gain it back with a vengeance.

Find your stable weight and stick with it. Learn to be

happy with what you weigh and the way you look. In

the long term, this will improve self-esteem, confidence

and promote health.

4. Exercise.

Find something you enjoying doing (walking, running,

aerobics, swimming) to keep you feeling younger and

healthier.

Calculate Your Own BMI

1. Convert your height into inches. (For

example,ifyouwere5feet,4inches

tallyourheightwouldbe64inches.

2. Squareyourheight(64X64)

3. Divide your weight by the squared

height(forexample,140dividedby

4096=.0342)

4. Multiplyby703(703x.0342)

5. BMI=24inthisexample.

… or go to nhlbisupport.com/bmi

and enter your height and weight.

Editor’s Note: David A. Lipschitz, M.D, Ph.D., is na-

tionally recognized as a leader in the field of geriatrics.

Arkansas Blue Cross and Blue Shield is honored to have

him as a contributor to Blue & You magazine.

18


Take a look. Nearly 75 percent of the private insurance health-care dollar nationwide goes toward hospitals, phy-

sicianservicesandprescriptiondrugs.Whileabout14percentgoestoadministrativecostsnationally,thosecosts

at Arkansas Blue Cross and Blue Shield are slightly below the national average.

Where does your health-care dollar go?

Attention Medi-Pak Advantage and Medi-Pak Rx plan members

If you have a Medicare Advantage or Medicare Part D

plan, during October, you will receive an Annual Notice

of Change (ANOC), which will

explain any changes to your

current plan that will become

effective in January. If you are

satisfied with your current

plan, you are not required

to change anything. Every

year, the Centers for Medicare

and Medicaid Services (CMS)

requires companies to inform

members of these changes prior

to AEP, so that those who would

like to shop their coverage have

the opportunity to do so. The Annual Notice of Change

includes a dedicated toll-free telephone number to call

on or after November 15 to learn about plan options.

If you are interested in learning more about Medicare plans

Call your local Medi-Pak

Choice certified agent or 1-800-

392-2583 to learn more, or visit

our Web site, arkansasbluecross.

com. We love to hear from you!

Also, if you have a friend or fam-

ily member who doesn’t have

our Part D prescription drug plan,

we hope you’ll recommend that

they enroll in Medi-Pak Rx (PDP)

during the AEP.

Great options, continued from Page 5

19


The taste of cold Yarnell’s ice cream

on a hot summer’s day is an Arkansas

family tradition that dates back to 1932,

and for 26 of those years, Arkansas Blue

Cross and Blue Shield has been a part of

keeping that tradition healthy.

The Searcy-based ice cream company’s

240employeeskeepthemid-Southsup-

plied with dairy-based treats and work

hand-in-hand with other manufacturers

across the nation. The factory has been

modernized throughout the years to facili-

tate production of premium ice creams,

sherbets, frozen yogurts, low-fat and

low-sugar treats as well as a variety of ice

cream sandwiches, ice cream bars and

other novelty items.

“We compete in the marketplace with

national brands,” said Floyd Washburn,

vice president of Human Resources and

Quality Assurance for Yarnell’s Ice Cream

Co. Likewise, Yarnell’s maintains high

standards when it comes to the health of

its employees.

Washburn said Yarnell’s was one of the first compa-

nies in the state to hold a company-wide health fair for

its employees, and offer incentives to those who at-

tend. Additional incentives are given to employees who

don’t smoke.

After reviewing different health insurance companies,

Washburn said Arkansas Blue Cross consistently has

risen to the top like cream. “The service level is excep-

tional,” he said, adding that the human resources staff

A sweet relationship:Yarnell’s Ice Cream Co. and

Arkansas Blue Cross

knows they can rely on the Arkansas Blue Cross Central

Regional Office to handle any issues that may come up.

“Yarnell’s and Arkansas Blue Cross have a true part-

nership,” Washburn said. So, whether your passion is

Homemade Vanilla or Woo Pig Chewy, the next time

you dip into a creamy scoop of Yarnell’s, you’ll know

that the ice cream company you love trusts the health

insurance company that is good for you!

Albert Yarnell, chairman emeritus of Yarnell’s,

and his granddaughter, Christina, chief operat-

ing officer of the family business, taste the various

brands of ice cream as a final check to ensure the quality of their product.

20


Are you an unintentional drug dealer?

by Brandon Griffin, Pharm D.,Arkansas Blue Cross and Blue Shield

From the Pharmacist

You wouldn’t knowingly give your

teenagers alcohol, cigarettes or

illegal drugs, but if you are keeping

prescription medications in easy

reach, you may be contributing to

a problem that is reaching alarm-

ing proportions across the United

States.

During the past decade, there

has been an increase in prescrip-

tion drug misuse by adolescents.

The “Monitoring the Future Survey,”

an annual survey of about 50,000

high school students assessing their

beliefs and extent of drug misuse,

has reported trends on substance

misuse since 1975. The most recent

survey reports that:

• Roughly14percentofeighth

graders, 27 percent of 10th grad-

ers, and 37 percent of 12th grad-

ers reported illicit drug misuse

within the previous year.

• Roughly 3 percent, 7 percent,

and 10 percent of eighth, 10th,

and 12th graders, respectively,

reported using Vicodin (an opioid

combination of hydrocodone and

acetaminophen) for a non-medi-

cal use within the previous year.

• Roughly 15 percent of 12th grad-

ers reported using a prescription

drug (including amphetamines,

sedatives/barbiturates, tranquil-

izers, and opiates) for a non-med-

ical use within the previous year.

Let me interpret that last bullet.

For every 20 friends your 12th grader

has, three of those friends (or pos-

sibly your child) may have misused

a prescription drug within the last

year. That is a sobering statistic.

So, how difficult is it for those

three friends to find their next sup-

ply of prescription drugs? A recent

article published in the August edi-

tion of the Journal of the American

Academy of Child and Adolescent

Psychiatry revealed that the most

common source of free misused

prescription drugs is friends and

family. The second most common

source of prescription drugs, ex-

cept painkillers, involved purchasing

the prescription medications from

friends and family.

Adolescents know where to look

for your medications, and with a lit-

tle online research, they might even

know which of your medications

would give them the best high.

Here are a few tips to make your

medications more secure:

1. Know your medications. Are

you taking any high-risk medica-

tions such as painkillers, anti-anx-

iety pills, sleeping pills, attention-

deficit pills, weight-loss pills or

steroids? If so, be careful where

you leave them.

2. Know where your medications

are. Are your medications in a

medicine cabinet, on a bathroom

counter, in a bedside drawer, in

a purse, in the refrigerator, in a

kitchen cabinet or on a kitchen

counter? Are your high-risk medi-

cations locked up?

3. Know how much medication

you have. Are you running out of

pills? Are you getting early refills?

Have you lost a bottle of pills? Is

this a recurring event? Recurrent

events could signal a problem.

21


21

4. Make sure that any family

member or friend your adoles-

cent sees on a regular basis

knows this information. Let

them know that you will be keep-

ing a close eye on your house-

hold medications and that you

would appreciate it if they would

do the same.

5. Monitor your adolescent’s

Internet use. There are many

Web sites that provide informa-

tion on what drugs to misuse,

how to misuse them and how to

find a source for them.

6. Visit the Web site: theantidrug.

com. This excellent Web site

for parents and other family

members has numerous articles

concerning misuse from psycho-

logical, medical and prevention

perspectives. It also has testi-

monials from parents and family

members, along with information

regarding adolescent perspec-

tives on drug misuse.

While these steps may not pre-

vent every case from happening,

by adhering to them and educating

yourself, the likelihood that your

adolescent will grow up drug free

will increase. We do our best to

protect our infants and toddlers

from the chemicals under our sinks,

so let’s do our best to protect our

adolescents from prescription

drug misuse.

Peterson, continued from Page 9

ney with pancreatic cancer began, Dan’s pancre-

as shows no signs of cancer, but his body has

suffered. Due to toxins building up in his body,

Dan went into a coma for a week before doctors

were able to devise a way to flush his system effectively. Today he still

suffers from some equilibrium problems and can get a bit fuzzyheaded if

his toxins get too high, but he is able to live a relatively normal life.

The Petersons say they don’t know if it was Dr. Makhoul’s innovative

approach to medicine, the excellent care from a Blue Distinction Center

of Excellence, Dan’s positive attitude or divine intervention that helped

him through one of the most aggressive cancers known, but they cherish

each moment together and hope their story will inspire others to never

give up and keep searching for treatments — even if it is the smallest of

glimmers, there is still hope.

For more information about pancreatic cancer and the latest research

and treatments, the Petersons recommend the Pancreatic Cancer Action

Network, pancan.org.

Thereare14CurveslocationsinArkansasofferingdiscountstoour

members — just by showing your insurance ID card.

Participating Curves are: Benton, Bryant, Conway, Fayetteville, Jackson-

ville, Little Rock (four locations — Capitol Avenue, Shackleford, Kavanaugh

and Chenonceau Boulevard), Maumelle, Morrilton, North Little Rock,

Sherwood and Springdale.

The discount is a $59 service fee (regularly $199) when purchasing a

12-month membership with a bank draft.

The Curves program is dedicated to women’s fitness and allows partici-

pants to get an aerobic and strength training workout in just 30 minutes.

Curves also offers a weight management program.

Curves offers discounts to members

Go to Blue & You Online on our Arkansas Blue Cross and Health Advantage Web sites for more on Curves and wellness discounts.


22


You may have heard someone from your health plan

refer to a “formulary.” It sounds more complicated than

it really is ... a formulary is simply insurance jargon for

“prescription drug list.”

A prescription drug list is the list of drugs covered by

your health plan. It usually includes both generic and

brand-name prescription drugs.

A generic drug is a drug that has been approved by

the U.S. Food and Drug Administration (FDA) and is

equal to its brand-name counterpart. For FDA approval,

the generic drug must contain the same amounts of

the same active ingredients as the brand-name drug.

It usually is less expensive and is sold under a generic

name for that drug (usually its chemical name).

There are generic versions of many brand-name

drugs that can save you money. (For example, the anti-

depressant Zoloft has a generic sold under the name

sertraline, and the cholesterol-lowering drug Zocor

has a generic called simvastatin.) Choosing lower-cost

generic drugs is like using store-brand products at your

grocery store — you can get the same product at a low-

er price. In some cases, the generic version is made by

the same company that makes the brand-name version.

The generic version just comes in a different bottle.

What is the difference in cost between a generic and

a brand-name? Using the previous examples, you can

see the cost comparison in the chart below.

Usually, there are several prescription drug list co-

payment options (we call these options “Tiers” in the

health insurance world). First Tier drugs have the low-

est copayments and Third Tier drugs have the highest

copayment.

• Lowest copayment/First Tier — The majority of

the prescription drugs on the first level are the less

expensive generic drugs.

• Mid-range copayment/Second Tier — This is your

mid-range copayment choice and includes covered

brand-name drugs that have been selected because

of their overall value. Consider this copayment op-

tion if you and your doctor decide that no First Tier

medication is right for you.

• Highest copayment/Third Tier — Usually the most

expensive prescription drugs and the highest copay-

ment. It includes many brand-name medications.

Be sure to ask your doctor and/or pharmacist for

generic prescription drugs. It will save you out-of-pocket

expenses immediately and could keep your health plan

costs down in the long run.

What is a formulary?

Brand name Cost per pill Generic Cost per pill Cost difference

Zoloft $3.43 sertraline $0.92 $2.51 per pill

Zocor $4.98 simvastatin $0.86 $4.12 per pill

23


by Ray Bredfeldt, M.D.,Regional Medical DirectorNorthwest Region, Fayetteville

TheDoctor’s Corner

Want to lose weight? Count calories!

Here’s the bottom line — the way

you lose weight is to burn more

calories than you consume. This is

what determines weight loss, not the

amount of carbs or fat in your diet.

So, eat healthy foods and exercise.

Although there are a million books

out there advocating one diet ap-

proach or another, the New England

Journal of Medicine recently pub-

lished research that shows that for

weight loss, the type of diet doesn’t

really matter. People lost similar

amounts of weight if they consumed

similar amounts of calories regard-

less of the percentages of protein, fat

and carbohydrates in their diet. Now,

that doesn’t mean eat 1,500 calories

worth of Twinkies each day and you’ll

be healthy — it means eat a balanced

diet, watch your calories and exercise

regularly.

Sleep is good for you

Mom always told us that we

should get plenty of rest to keep

from getting sick. Turns out she was

right. Researchers recently have

discovered that people who get less

than seven hours of sleep each night

are more likely to develop a cold

after exposure to a cold virus when

compared to people who get more

than seven hours of sleep. Addition-

ally, research found that less than

seven hours of sleep is associated

with heart disease, obesity and pre-

mature death. These studies show

that seven to eight hours of sleep per

night is ideal for adults.

Second-hand smoke: risky for seniors

Older non-smokers exposed to

tobacco smoke in the home are as

muchas44percentmorelikelyto

suffer from dementia (a decline in

memory, reasoning and thinking),

according to a recent study. It’s long

been known that people who smoke

are at an increased risk for dementia.

With cancer — it matters what we eat

Research clearly shows a link

between obesity and an increased

risk for developing cancer. Now, a

new study suggests that what we

eat may determine how fast a cancer

spreads to other parts of the body.

The study found that a diet high in fat

might cause cancer cells to spread

faster throughout the body than a

diet low in fat.

Stomach drug may interfere with heart drug

Plavix, a prescription medication

frequently prescribed for patients

with heart disease or for prevention

of stroke, may be less beneficial if

a patient also is taking a medication

for stomach ailments. The type of

drug that may interfere with heart

medication is called a proton pump

inhibitor (PPI). Common PPIs are

Achipex, Nexium, Prilosec, Protonix

and Omeprazole. If you take one of

these drugs plus Plavix, contact your

doctor to see if there is an alternative

medication you can take.

24


New standard dental benefits will be added to group

DentalBlue dental insurance plans for new and renew-

ing small and large groups effective Oct. 1, 2009.

Members with group dental plans through Arkansas

Blue Cross and Blue Shield should have received a let-

ter and Benefit Certificate in September with complete

details about the changes, but the following is a general

overview of the new benefits:

Maximum rollover benefit – allows members to roll

over a portion of their unused maximum to the next

calendar year. A member is eligible for the rollover

benefit if:

• They have at least one paid dental claim in the cur-

rent calendar year.

• A member’s total paid claims for the year did not

exceed the threshold amount.

• The member is enrolled in the group dental plan on

the last day of the calendar year.

• The member has not reached the accumulated

rollover maximum.

Implants – Implants will be a major benefit in all group

dental insurance plans. A dental implant is an artificial

tooth root that a dentist places into the jaw to hold a re-

placement tooth or bridge. Dental implants are an ideal

option for people in good general oral health who have

lost a tooth, or teeth, due to periodontal disease, an

injury or some other reason. Implants will be covered at

50 percent, up to the maximum benefit.

Family deductible (three times the individual de-

ductible) – if a member has family coverage, once three

family members have met the deductible, no further de-

ductible will be required for the balance of the calendar

year, regardless of whom in the family incurs a claim.

The new Mental Health Parity Act, which takes effect

later this year, requires that mental health benefits be

equal to physical health benefits.

Members under some employer group health plans

with Arkansas Blue Cross and Blue Shield and Health

Advantage, and a number of plans administered by

BlueAdvantage Administrators of Arkansas will see

changes to their benefits upon the renewal of their em-

ployer’s group health plan as a result of the act. If you

receive a new ID card with a mental health assistance

telephone number, your plan will include changes under

Mental Health Parity.

Members with individual health plans for those under

age 65 and those over age 65 will not see changes to

their existing plans. However, beginning October 15,

Comprehensive Blue PPO (an individual plan for those

under 65) will offer a mental health rider for an addition-

al fee to new policies only. This rider must go through

underwriting to be approved.

The act:

• Removeslimitsonthenumberofdaysforinpatient

Three benefits added to group DentalBlue plans



25


The Women’s Health and Cancer Rights Act of

1998 introduced changes in insurance coverage for

mastectomy.

In accordance with the law, all group and individual

health plans that provide medical and surgical benefits

for mastectomy will cover reconstructive breast sur-

gery, including:

• Reconstructive surgery on the breast on which the

mastectomy was performed.

• Reconstructive surgery on the unaffected breast

needed to “produce a symmetrical appearance.”

• Prostheses and treatment of complications of any

stage of a mastectomy, including lymphedema (post-

surgical fluid buildup).

The provisions of the Women’s Health and Cancer

Rights Act of 1998 apply to all group health insurance

coverage effective on the first day of the plan year

(which in most cases is the anniversary date of the

group contract) after Oct. 21, 1998. The law went into

effect on all individual insurance policies issued, re-

newed or in effect on or after Oct. 21, 1998.

These provisions apply to all policies issued by Arkan-

sas Blue Cross and Blue Shield, Health Advantage and

BlueAdvantage Administrators of Arkansas and are sub-

ject to the applicable copayments, coinsurance, benefit

limitations, exclusions and benefit maximums.

If you have questions about your insurance coverage,

contact your group benefits administrator or a customer

service representative at your local Arkansas Blue

Cross office.


Women’s Health and Cancer Rights Act

hospital stays and outpatient visits per calendar year.

• Requiresthatcopayments,coinsurancemustbe

the same as for physical health benefits, and out-of-

network mental health benefits must be provided if

provided for physical health.

The following benefits will be required for members

whose health plans were revised in response to the act:

Inpatient:

• Priorauthorizationofinpatientadmissionsformental

health and substance abuse. Please call the tele-

phone number for mental health services on your

ID card.

• Concurrentstayreviewanddischargeplanning.


Outpatient:

• Priorauthorizationofoutpatientcounselingservices.

Please call the telephone number for mental health

services on your ID card.

• 24/7accesstomentalhealthprofessionalswhowill

assist in locating and referring you to professional

resources.

To find out if your health plan includes modifications

for the Mental Health Parity Act, you can contact your

human resources administrator, check our Web sites

and review your benefits information on My Blueprint,

or call the customer service number on your health plan

ID card. We love to hear from you!

26


Groupsfrom41states,includingalmost12,000par-

ticipants, scored better health through the 2009 Blue &

You Fitness Challenge.

For six years, the Blue & You Fitness Challenge

(formerly the Arkansas Fitness Challenge) has helped

participants improve their

fitness levels. The annual

exercise contest, held March

1 through May 31, encourages

individuals toward the public

health recommendation of 30

minutes of physical activity

each day, most days of the week. The contest promotes

wellness in the community and at the worksite by orga-

nizing groups that compete against like-size groups.

Arkansas Blue Cross and Blue Shield, the Arkansas

Department of Health (ADH) and the Arkansas Depart-

ment of Human Services (DHS) serve as Challenge

hosts each year. This year, representatives from other

companies, organizations and state agencies statewide

— and outside of Arkansas — joined in the competi-

tion and were recognized at the awards ceremonies (a

complete list of participants can be found at arkansas-

bluecross.com) to “Invest in Fitness.”

“Exercise requires only a small investment of time

and movement, and promises a great rate of return

on your health,” said Richard Cooper, vice president of

Human Resources for Arkansas Blue Cross and team

champion for the Challenge. “A

total of 167 groups represent-

ing large and small companies,

banks, schools and universities,

physician offices, churches, hos-

pitals and state agencies made a

commitment to spend some time exercising and reap

the rewards of better fitness.

“The 11,791 participants logged 262,681.5 hours of

exerciseduringtheChallenge,upfrom221,465.5hours

of exercise in 2008,” Cooper said.

“The Challenge continues

to yield great results,” said

John Selig, director of DHS.

“Our online survey was com-

pleted by 2,628 contest par-

ticipants.Almost84percent

of respondents said they

reached their personal goals through the Challenge.”

Respondents also indicated they had lowered their

bloodpressure(73respondents),cholesterollevels(41

respondents), weight (327 respondents), and blood

sugar (26 respondents). Ninety-six percent said they

would participate in future programs like the Blue & You

Fitness Challenge.

Charles McGrew, ADH deputy director and chief op-

erating officer, said, “The costs in treating diseases that

result from preventable diseases is skyrocketing. And

yet, 30 minutes of moderate-intensity exercise five or

more days a week can reduce so many of these risks.

Programs like the Blue & You Fitness Challenge make

positive steps toward turning the trend.”

Now is the time to start planning for the 2010

Challenge.

Blue & You Fitness Challengers win with better health

Go to Blue & You Online on our Arkansas Blue Cross and Health Advantage Web sites for a list of the 2009 Blue & You Fitness Challenge winners.


27


We love to hear from you!May we help? For customer service, please call:

Little Rock Toll-free Number (501) Number

Medi-Pak members 378-3062 1-800-338-2312

Medi-Pak Advantage or Medi-Pak Rx 1-866-390-3369

Arkansas Blue Cross members 378-2010 1-800-238-8379

Pharmacy questions 1-800-863-5561

Specialty Rx Pharmacy questions 1-866-295-2779

HealthAdvantagemembers 378-2363 1-800-843-1329

Pharmacy questions 1-800-863-5567

BlueAdvantage members 378-3600 1-888-872-2531

Pharmacyquestions 1-888-293-3748

StateandPublicSchoolmembers 378-2364 1-800-482-8416

FederalEmployeemembers 378-2531 1-800-482-6655

Looking for health or dental insurance? We can help!

For individuals, families and those age 65 or older 378-2937 1-800-392-2583

Foremployergroups 378-3070 1-800-421-1112 (Arkansas Blue Cross Group Services, which includes Health Advantage and BlueAdvantage Administrators of Arkansas)

Prefer to speak with someone close to home? Regional Office telephone numbers:

Pine Bluff/Southeast Region 1-800-236-0369 1800 West 73rd St.Jonesboro/NortheastRegion 1-800-299-4124 707 East Matthews Ave.Hot Springs/South Central Region 1-800-588-5733 100 Greenwood Ave., Suite CTexarkana/SouthwestRegion 1-800-470-9621 1710 Arkansas BoulevardFayetteville/Northwest Region 1-800-817-7726 516 East Milsap Rd., Suite 103FortSmith/WestCentralRegion 1-866-254-9117 3501 Old Greenwood Rd., Suite 5LittleRock/CentralRegion 1-800-421-1112 320 West Capitol Ave., Suite 900

Web sites: arkansasbluecross.comhealthadvantage-hmo.com

blueadvantagearkansas.com blueandyoufoundationarkansas.org

blueannewe-ark.com

Hagemeier, continued from Page 13

shouted from the sidelines,

crossing the finish line and

having my 10-year-old grand-

daughter run up to me and say,

‘You did it, Grammy!’ made

race day one to be remembered.”

To enroll in SilverSneakers, Medi-Pak and Medi-Pak

Advantage members can go to a participating fitness

center near them and show their ID card. Fitness cen-

ter staff will assist with enrollment and provide tours

of the locations.

Because new fitness centers are being added to

the program regularly, members can go online to

silversneakers.com to find all participating locations in

Arkansas.

Experts on aging are coming to a SilverSneakers

location near you in October for fun talks on a variety

of topics.

Topics for the speaker events include: Nutrition for a

Healthy Heart, What is Normal Aging and Breast Can-

cer Education and Awareness.

Date CityOctober 1 Jacksonville October 6 ArkadelphiaOctober 8 Little RockOctober 9 Little RockOctober 13 RogersOctober14 BellaVista,RussellvilleOctober 15 El Dorado, Fayetteville, MorriltonOctober 19 NashvilleOctober 21 ClarksvilleOctober 22 Conway, SearcyOctober 23 LonokeOctober 30 Cabot, Magnolia

SilverSneakers Speaker Events

Go to Blue & You Online on our Arkansas

Blue Cross and Health Advantage Web sites

for more on SilverSneakers speaker events.


28


At Arkansas Blue Cross and Blue Shield, we are always looking for new ways to be "Good for You." Here are some of our latest accomplishments.

We have so much information that is good for you that

we have to share some of it online! Blue & You Online

contains longer versions of our featured stories, links

for more information on hot topics, and fun photos

we couldn’t squeeze into our print version. Go to our

Arkansas Blue Cross and Health Advantage Web sites

(arkansasbluecross.com and healthadvantage-hmo.

com) to find the Blue & You Online link and enjoy even

more information!

Easy online access to informationOn the home page of any of our Web sites (see com-

plete list on Page 27), you can register for an online

account that allows you to order an ID card, check the

status of a claim for you or your dependent, find out

more information about your coverage and your ben-

efits, manage your Personal Health Record, access

health information and much more. It’s an easy way to

get your personalized information. Go online and regis-

ter today for My Blueprint!

Is your child in college out of state?Well, we’re going to give you one less thing to worry

about — your college student’s health-care benefits

travel with him or her. With BlueCard®, he or she

doesn’t have to worry about filing complicated claims

forms or dealing with billing hassles. He or she simply

needs to present their Arkansas Blue Cross and Blue

Shield ID card before receiving care from a participat-

ing provider. He or she can call 1-800-810-BLUE (2583)

or visit arkansasbluecross.com (under

“Need a Provider?” select the “Blue-

Card® Doctor and Hospital Finder”)

to find a participating provider.

In an emergency situation, he

or she can go to the near-

est hospital’s emergency

room. He or she can use any

BlueCard provider in the state

where they are living just as

they would if they were home

with you.

http://www.healthadvantage-hmo.com

http://www.healthadvantage-hmo.com

Documents

2009 - Autumn