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CARE Management Care You Can Count On Pearson Benefits FOR TODAY AND TOMORROW FOR YOUR BENEFIT. GET CONNECTED. BE INFORMED.

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Page 1: BE INFORMED. Pearson Benefits GET …pearsonbenefitsus.com/wp-content/uploads/Anthem_CM_En.pdf · FOR TODAY AND TOMORROW FOR YOUR BENEFIT. GET CONNECTED. BE INFORMED. Live your

CareManagementCare You Can Count On

Pearson BenefitsFOR TODAY AND TOMORROW

FOR YOUR BENEFIT.GET CONNECTED.

BE INFORMED.

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Live your healthiest life by taking advantage of the care management programs offered by Pearson in partnership with Anthem BCBS.

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1

REGISTER for Online ToolsGo to www.anthem.com to register today and get free, immediate access to wellness information, tools and resources. You can:

�� Complete a MyHealth Assessment. Identify your potential health risks and learn how to make improvements in order to maintain a healthy lifestyle.

�� Calculate your Health Footprint. Use this online tool to see how your healthy choices influence those around you.

�� Train with Bob Harper from “The Biggest Loser”. Watch interactive videos, take the 10-Day Boost challenge or browse through his 18 health tips and live Twitter stream.

�� Find a provider. Search for doctors and health care facilities by name or location. You can narrow your search by provider type, specialty, gender or languages spoken.

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2

CALL for SupportGet one-on-one health and wellness support through the 360° Health programs, including:

NurseLine: 1-800-700-9184

�� Talk to a nurse 24/7, 365 days a year.

�� Describe your symptoms and receive guidance on what to do.

�� Learn how to make more informed decisions about choosing the most appropriate and cost-effective care.

�� Get health education and/or prevention information.

For all other services listed here, call 1-877-898-0747

BlueCare Consultant:

�� Manage your health, from coaching on weight loss to education about the side effects of chemotherapy.

�� Learn how to set and achieve healthy lifestyle goals with a personalized health plan.

�� Discuss your doctor’s recommendations and your treatment options.

�� Talk about how your health plan works so you can get the most out of it.

�� Get help coordinating your health care benefits before, during and after a hospital stay.

�� Find the right Anthem health coaching program for your situation.

Family members covered by your health plan can talk to the same BlueCare Consultant.

You May Receive A CallIf your claims data indicates you could benefit from the anthem health management resources described in this brochure, a BlueCare Consultant (BCC) will reach out to you. Your participation is completely voluntary and confidential. Pearson is committed to protecting your privacy. Pearson will have no knowledge of who is contacted, and your individual information will not be shared with Pearson.

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3

ComplexCare:

�� Get help if you or your family members have multiple health issues or a condition that requires frequent or high levels of medical care.

�� Team up with a nurse and other clinicians to help you achieve tailored health goals.

�� Receive individualized education as well as preventive care and self-management tips to help you and/or your family members make more informed decisions about health care options.

ConditionCare:

�� Obtain personalized, one-on-one support and guidance to help you manage asthma, diabetes, chronic obstructive pulmonary disease (COPD), heart failure and/or coronary artery disease (CAD).

�� Find information and tools that can help you avoid unnecessary doctor’s visits, hospitalizations and time away from work.

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4

Future Moms:

�� Get tips to help you take care of your baby before you deliver, whether it’s your first child or your fifth.

�� Register to receive educational materials to help you handle unexpected events, a questionnaire to evaluate your risk for preterm delivery, and tools to track your pregnancy and spot possible risks.

Behavioral Health Resource Program:

�� Get individualized assistance beyond what the Employee Assistance Program (EAP) can provide. Anthem’s Behavioral Health Resource Program offers personalized support to help you deal with combined mental and physical health conditions. It can also help if you are affected by depression, anxiety, drug or alcohol dependency, eating disorders and other issues impacting your day-to-day quality of life.

MHN Ref #: 00123456-01Group #: GRX 123678

MHN Ref #: 00123456-01Group #: GRX 123678

Report for: Jane W. Public

Your recent medical and pharmacy claims as of

Your Medical and Pharmacy Claims

March 23, 2010

Date Service / Prescription Qty Days Doctor/Prescriber(†)

† Doctor/Prescriber listed may be another name from that medical office/practice.

Visits03/12/10 Office Visit -- -- Wilson, Michelle L. 03/02/10 Office Visit -- -- Lynn, Samuel F. 02/25/10 Office Visit -- -- Lynn, Samuel F. 02/05/10 Office Visit -- -- Jones, Terry M. 12/02/09 Office Visit -- -- Wilson, Michelle L.

Prescriptions03/12/10 Nexium - 20 mg 30 30 Lynn, Samuel F. 03/01/10 Coumadin - 5 mg 30 30 Jones, Terry M. 02/10/10 Proair - 8.5 gms 30 30 Lynn, Samuel F. 02/10/10 Nexium - 20 mg 30 30 Lynn, Samuel F. 02/10/10 Zomig - 2.5 mg 09 30 Lynn, Samuel F. 01/23/10 Coumadin - 5 mg 30 30 Wilson, Michelle L. 02/13/10 Accupril - 20 mg 60 30 Lynn, Samuel F. 01/18/10 Zomig - 2.5 mg 09 30 Lynn, Samuel F. 12/18/09 Proair - 8.5 gms 30 30 Lynn, Samuel F. 12/12/09 Accupril - 20 mg 60 30 Lynn, Samuel F. 10/13/09 Accupril - 20 mg 60 30 Lynn, Samuel F.

Other Medical Services03/02/10 Cholesterol Panel -- -- LabCorp Laboratories 02/15/10 Ambulatory ER Visit -- -- St. Lucy’s Hospital ER 02/06/10 Medical Equipment -- -- Lynnwood Medical Mart 02/05/10 Metabolic Panel -- -- LabCorp Laboratories 11/04/09 Head CT Scan -- -- Radiology Assoc. - SFSL 11/15/09 Sinus XRay -- -- Mercy Hospital - Rad

FOR PRESENTATION PURPOSES ONLY FOR PRESENTATION PURPOSES ONLY

Based on your available claims as of

Suggestions for You

More Information For You From Harvard Medical SchoolVisit http://www.anthem.com/myhealthnote and enter the number shownin [ ] to get information on your conditions, treatments and medications.

Si necesita ayuda en español para entender este documento, puede solicitarla sin costo adicional, llamando al número de servicio al cliente que aparece al dorso de su tarjeta de identificación o en el folleto de inscripción.

March 23, 2010

Ask your doctor about medication to prevent migraines. [285]*Your medical and prescription claims suggest you frequently take medication to treat migraine headaches after they occur. They also suggest you are not taking a medication to prevent migraines before they start. There are medications that may stop migraines before they happen. Call your doctor soon to ask if you should take a medication to prevent migraines.

Ask your doctor about a mammogram. [2130]*Your medical claims suggest you have not had a mammogram in the past year. Women in your age group (40-70) should have a mammogram every year to look for abnormal breast tissue that may be cancerous. Finding breast cancer early helps make it easier to treat and cure. Call your doctor soon to ask if you should have a mammogram.

*

Learn more about these suggestions from Harvard Medical School*

Please list any medications you take that are not shown on the other side.

Other Medications You Are Taking

Bring this list to each doctor visit.

Drug Name Dose How Often You Take Your Reasons for Taking

Prescriptions

Over-the-Counter Drugs

Vitamins and Supplements

Your Medication History (other side) and information you add here will help your doctors.

ANTMHNMGSS_2_071210

Save money by switching from Coumadin. [3564] *Asking for the generic form of a drug is a good way to pay less for prescriptions. Recently, you filled a prescription for Coumadin. Warfarin is the generic form of Coumadin, and it is as safe and effective as Coumadin. If you switch to warfarin, you may save money. Call your doctor or pharmacist to ask if you can make this switch.

Exercise regularly to stay healthy. [1004] *Exercise is an important part of staying healthy. If you don’t exercise, start slowly, working your way up to more intense exercise. Walk regularly, working up to a half hour a few times a week. Start making the walk harder or longer. And have fun! Join clubs, dance, swim, ride a bike, or find something else you enjoy. Check with your doctor before starting or changing your exercise program.

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5

LOOK for MyHealth Notes at HomeAnthem may send personalized alerts, called MyHealth Notes, to your home. MyHealth Notes:

�� Let you know about resources and treatment options based on your health status.

�� Inform you of any possible missed opportunities in your medical care.

�� Provide updates on your medication.

�� Share ways to save money.

This information will also be provided to your doctor.

Finding potential health problems early can lead to a better outcome. Plus, being healthier may reduce the number of visits to the doctor or hospital.

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Ask your doctor about a mammogram

MyHealth NoteA confidential health care summary for

Jane W. PublicMay 2010

Share this report with your doctors

Ask your doctor about medication to prevent migraines

Suggestions for You (details inside)

FOR PRESENTATION PURPOSES ONLY

Report for: Jane W. Public

Based on pharmacy claims as of

MHN Ref #: 00123456-01

March 23, 2010

Medications You Take RegularlyMore on

other side

Prescription filled Drug lasts until Were you taking? Prescription filled, days supply unknown

X

How To Read “Medications You Take Regularly” Jan Feb Mar Apr May Jun JulDrug Type

Your Drug - Dose

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Accupril - 20 mg

Anticoagulants

Coumadin - 5 mgBronchodilators

Proair - 8.5 gms

Ulcer Drugs

Nexium - 20 mg

Sep Oct Nov Dec Jan Feb Mar

XX

Save money by switching from Coumadin

Exercise regularly to stay healthy

MHN Ref #: 00123456-01Group #: GRX 123678

MHN Ref #: 00123456-01Group #: GRX 123678

Report for: Jane W. Public

Your recent medical and pharmacy claims as of

Your Medical and Pharmacy Claims

March 23, 2010

Date Service / Prescription Qty Days Doctor/Prescriber(†)

† Doctor/Prescriber listed may be another name from that medical office/practice.

Visits03/12/10 Office Visit -- -- Wilson, Michelle L. 03/02/10 Office Visit -- -- Lynn, Samuel F. 02/25/10 Office Visit -- -- Lynn, Samuel F. 02/05/10 Office Visit -- -- Jones, Terry M. 12/02/09 Office Visit -- -- Wilson, Michelle L.

Prescriptions03/12/10 Nexium - 20 mg 30 30 Lynn, Samuel F. 03/01/10 Coumadin - 5 mg 30 30 Jones, Terry M. 02/10/10 Proair - 8.5 gms 30 30 Lynn, Samuel F. 02/10/10 Nexium - 20 mg 30 30 Lynn, Samuel F. 02/10/10 Zomig - 2.5 mg 09 30 Lynn, Samuel F. 01/23/10 Coumadin - 5 mg 30 30 Wilson, Michelle L. 02/13/10 Accupril - 20 mg 60 30 Lynn, Samuel F. 01/18/10 Zomig - 2.5 mg 09 30 Lynn, Samuel F. 12/18/09 Proair - 8.5 gms 30 30 Lynn, Samuel F. 12/12/09 Accupril - 20 mg 60 30 Lynn, Samuel F. 10/13/09 Accupril - 20 mg 60 30 Lynn, Samuel F.

Other Medical Services03/02/10 Cholesterol Panel -- -- LabCorp Laboratories 02/15/10 Ambulatory ER Visit -- -- St. Lucy’s Hospital ER 02/06/10 Medical Equipment -- -- Lynnwood Medical Mart 02/05/10 Metabolic Panel -- -- LabCorp Laboratories 11/04/09 Head CT Scan -- -- Radiology Assoc. - SFSL 11/15/09 Sinus XRay -- -- Mercy Hospital - Rad

FOR PRESENTATION PURPOSES ONLY FOR PRESENTATION PURPOSES ONLY

Based on your available claims as of

Suggestions for You

More Information For You From Harvard Medical SchoolVisit http://www.anthem.com/myhealthnote and enter the number shownin [ ] to get information on your conditions, treatments and medications.

Si necesita ayuda en español para entender este documento, puede solicitarla sin costo adicional, llamando al número de servicio al cliente que aparece al dorso de su tarjeta de identificación o en el folleto de inscripción.

March 23, 2010

Ask your doctor about medication to prevent migraines. [285]*Your medical and prescription claims suggest you frequently take medication to treat migraine headaches after they occur. They also suggest you are not taking a medication to prevent migraines before they start. There are medications that may stop migraines before they happen. Call your doctor soon to ask if you should take a medication to prevent migraines.

Ask your doctor about a mammogram. [2130]*Your medical claims suggest you have not had a mammogram in the past year. Women in your age group (40-70) should have a mammogram every year to look for abnormal breast tissue that may be cancerous. Finding breast cancer early helps make it easier to treat and cure. Call your doctor soon to ask if you should have a mammogram.

*

Learn more about these suggestions from Harvard Medical School*

Please list any medications you take that are not shown on the other side.

Other Medications You Are Taking

Bring this list to each doctor visit.

Drug Name Dose How Often You Take Your Reasons for Taking

Prescriptions

Over-the-Counter Drugs

Vitamins and Supplements

Your Medication History (other side) and information you add here will help your doctors.

ANTMHNMGSS_2_071210

Save money by switching from Coumadin. [3564] *Asking for the generic form of a drug is a good way to pay less for prescriptions. Recently, you filled a prescription for Coumadin. Warfarin is the generic form of Coumadin, and it is as safe and effective as Coumadin. If you switch to warfarin, you may save money. Call your doctor or pharmacist to ask if you can make this switch.

Exercise regularly to stay healthy. [1004] *Exercise is an important part of staying healthy. If you don’t exercise, start slowly, working your way up to more intense exercise. Walk regularly, working up to a half hour a few times a week. Start making the walk harder or longer. And have fun! Join clubs, dance, swim, ride a bike, or find something else you enjoy. Check with your doctor before starting or changing your exercise program.

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6

“I’ve gained 30 pounds over the past few years. What can I do?”

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7

�� Take the MyHealth Assessment to learn about your health risks. Your health profile results may prompt a BlueCare Consultant (BCC) to call and offer guidance on how to make healthy changes.

�� Work with your doctor and personal BCC to come up with a plan for changing your lifestyle.

�� Stay in touch with your health coach regularly to discuss your progress.

�� Connect with a counselor through the Behavioral Health Resource Program to work through any anxiety about making lifestyle changes.

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8

“I was just diagnosed with Type 2 diabetes and need help dealing with my condition.”

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9

�� Call the 24/7 NurseLine and get answers to general health questions related to your condition and receive tips for dealing with Type 2 diabetes, such as eating well, exercising and maintaining a healthy weight.

�� At the recommendation of the NurseLine, connect with a ConditionCare nurse for weight loss coaching and help setting healthy lifestyle goals.

�� Based on your needs, you may be assigned a coach who will provide one-on-one support to help you manage your diabetes.

�� Work with your doctor and ConditionCare to develop a diabetes treatment plan that keeps meals, exercise and insulin in balance.

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The examples in this brochure were created to demonstrate the anthem programs. They do not represent any specific Pearson employee, nor are they based on actual claims data.

anthem 492.018