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Diabetes – Take Charge!
IN THIS ISSUE:Is It a Cold or the Flu? | pg. 2Asthma in the Winter | pg. 4Recipe Contest Winner | pg. 5Things to Remember | pg. 7
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Controlling your diabetes can help prevent many long term problems. Diabetes is a major cause of heart disease, stroke, high blood pressure and other illnesses. You can take charge of your diabetes, and these 6 steps can help:
Know your blood sugar levels. Talk to your doctor about what your numbers should be throughout the day. Test your blood at home with a glucometer.
Know your Hemoglobin A1c. This is a blood test that looks at blood sugar levels over the past two to three months. Ask your doctor how often you need to have this test.
Eat the right foods in the right amounts. Balanced meals have some starches (carbohydrates), proteins, and fats. Try to eat these in each meal every day, along with lots of fresh vegetables.
Make exercise a part of each day. Moving your body lowers your blood sugar levels and keeps your heart strong.
Take your medications. Follow your doctor’s advice on taking pills or insulin.
Get the right tests. You need to have your eyes, feet, and teeth checked regularly. Ask your doctor how often to have these check-ups.
Learn all you can about diabetes. L.A. Care offers group diabetes appointments. You can also talk to a health educator at 1-888-839-9909, or take a community class at one of L.A. Care’s Family Resource Centers, 1-877-287-6290.
Need a Ride to Visit Your Doctor?
L.A. Care now works with LogistiCare to help those with a medical need* get to and from the doctor’s office.
Medi-Cal, Healthy Families or Healthy Kids enrollees have no limit on rides. Medicare enrollees have 32 one-way trips.
To plan a ride, call at least 48 hours before your office visit. The ride is free but is not for emergencies. You can call at any time (24/7):
English 1-866-529-2141 Spanish 1-866-529-2142
When you call, have your health ID card, your doctor’s name, phone and street address.
* Medi-Cal enrollees must have a medical necessity form from your doctor on file with LogistiCare that tells why you need a ride to the doctor.
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Q: What is pharyngitis? A: Put simply, pharyngitis is a sore throat. Usually this is a sign of another illness, such as a cold or the flu. In most cases, you do not need antibiotics to treat pharyngitis.
Q: Sometimes I have green mucus. Do I need an antibiotic?
A: Mucus can become thick and yellow or green when we get sick. This does not mean you need an antibiotic. It just means your body is fighting an illness.
Q: When should I see the doctor?A: You can treat most illnesses at home for the first few days. See your doctor if your fever does not go away after a few days, or if cold symptoms last longer than two weeks or do not get better.
Q: What can I do to stay healthy?A: Get a flu shot each year. This is the best way to avoid the flu. Wash your hands during the day and do not touch your eyes, nose or mouth.
Ask the Doc: Is It a Cold or the Flu?
L.A. Care welcomes all new members. We want to help you get what you need. For members who are seniors or people with disabilities, we can help you:
Find a doctor’s office nearby.
Find a doctor’s office that has parking close to the doors, ramps, elevators, and exam tables and scales that are easy to use.
Find a doctor who speaks your language.
You can call us any time at 1-888-839-9909 (TTY/TDD 1-866-522-2731). You can also find this information at www.lacare.org in the “I Am a Member” section.
Q: How do I know if I have a cold or the flu?A: Cold symptoms include a cough, scratchy or sore throat, and a runny or stuffy nose. Flu symptoms come on quickly and can be much worse. Flu also brings body aches, fever, and fatigue.
Help for Seniors & People with Disabilities
2 | MEMBER NEWS FALL 2012
ATTENTION: Measles on the Rise
Measles is on the rise in the U.S. This is because fewer parents are getting their children immunized. The disease spreads very easily and quickly. The best way to stay safe is to get your immunizations (shots).
Kids need measles and many other shots before starting school. Talk to your doctor about which shots your family needs and when to get them.
FALL 2012 MEMBER NEWS | 3
Pregnant or a New Mom?Get free messages and tips on your cell phone to help you through your pregnancy and your baby’s first year. To sign up, text the word BABY to 511411. Enter your baby’s due date or birthday and your zip code. You may opt out at any time by texting STOP to 511411. Learn more at www.text4baby.org.
Stop Breast Cancer Early! All women are at risk for breast cancer. You are more likely to get breast cancer if you:• Are over the age of 50• Have a family member who has had cancer• Got your first period before age 12 or stopped having periods (menopause)
after age 55• Have never had kids or had kids after age 30• Drink more than 1-2 glasses of alcohol a day• Are obese• Have been taking hormone replacement therapy with estrogen for a while
Cancer is easier to treat when found early. The best way to find breast cancer is to have an X-ray called a mammogram. You stand in front of an X-ray machine. One at a time your breasts are put between two plates. Two pictures of each breast are taken, one from the side and one from above. This takes about 15 minutes.
All women over 50 years old need to get a mammogram. You do not need a doctor’s referral. Talk to your doctor about when and how often you should get yours.
Using the Nurse Advice LineYour health plan’s free nurse advice line may save you a trip to the emergency room in the middle of the night. Three out of four callers to L.A. Care’s Nurse Advice Line avoid a trip to the ER and are able to care for an illness at home!
What happens when you call? Calls are answered immediately by a live person 24 hours per day, 7 days a week. You answer yes or no questions about you or your child’s illness. A licensed nurse works with you to decide the best course of treatment.
Choosing to call the Nurse Advice Line provides immediate help and often prevents you from having to wait in long lines at urgent care or ER. You can always choose to seek emergency care even if you call the nurse advice line first, but calling first only takes a few minutes and is a smart way to save time and get the care you need.
You can find the Nurse Advice Line phone number on the back of your health plan ID card, or use these:
Anthem Blue Cross 1-800-224-0336Care1st Health Plan 1-800-605-2556 Kaiser Permanente 1-888-576-6225L.A. Care Health Plan 1-800-249-3619
Active Steps to Better Health
L.A. Care’s Community Outreach & Education group has a new nutrition and exercise program called “Active Steps.” This program can help you set health goals and work toward reaching them. There are 14 classes being held in all 11 of L.A. Care’s Regional Community Advisory Council regions all over L.A. County. Blood pressure, weight, height, waist size and BMI are taken at the start and end of the classes. You learn how cooking and eating healthier, smaller portions, and moving more daily can help your health.
L.A. Care’s Health Promoters are also helping those in Active Steps learn more about health care reform. They have been trained to talk to groups about what health care reform means to them.
For more news about Active Steps and the health care reform talks, call 1-888-522-2732.
FALL 2012 MEMBER NEWS | 3
4 | MEMBER NEWS FALL 2012
Do you have questions about your health plan or your benefits? Call your health plan directly or call L.A. Care Health Plan.
Important Phone Numbers
Medi-Cal MembersAnthem Blue Cross1-888-285-7801
Care1st Health Plan 1-800-605-2556
Kaiser Permanente 1-800-464-4000
L.A. Care Health Plan 1-888-839-9909
L.A. Care Health Plan Medicare Advantage (HMO SNP)1-888-522-1298
L.A. Care Healthy Families Program and Healthy Kids1-888-839-9909
L.A. Care Compliance Helpline1-800-400-4889
L.A. Care Family Resource CentersInglewood or Lynwood1-877-287-6290
Visit us online• Find a doctor, hospital or pharmacy
• Find out about your benefits
• Learn about health topics
• Register for L.A. Care events
• Find a class
These are just some of the things you can find on our website. Take a minute to visit www.lacare.org today!
Asthma in the WinterWinter can be a hard time of the year for people with asthma. Getting sick or simply breathing in cold, dry winter air can cause asthma symptoms. Here are some ways to keep asthma away this winter:
•Wash your hands •Cover your cough •Get a flu and a pneumonia shot •Wear a scarf over your nose and face when outdoors •Take your asthma medicines
L.A. Care’s free asthma program, L.A. Care’s About Asthma®, won a national award from the U.S. Environmental Protection Agency for 2012.
This program helps members with asthma learn more about asthma. They can talk to a nurse about ways to get the best asthma care and know what to do if their asthma flares up.
If you want to know more about the program, call the asthma line at: 1-888-200-3094 or TTY/TDD at 1-888-448-6894 to speak with a nurse.
When Your Child Has ADHDAttention Deficit Hyperactivity Disorder (ADHD) is when a child has trouble paying attention or sitting still.
Medicine may be a part of your child’s treatment plan to help with ADHD symptoms. There is a right dose for your child. The doctor may have to make dose changes or try different medicines.
How you can help:•Make sure your child takes medicine as ordered
•Don’t run out of medicine
•Keep track of how your child feels with new medicine; see the doctor if you have any questions
•When your child starts a new ADHD medicine, make sure your child sees the doctor within the first month
•Your child should see the doctor at least 2 more times within the next 9 months to make sure the medicine is working
FALL 2012 MEMBER NEWS | 5
FRCs Announce Healthy Recipe Contest Winner!
We are pleased to announce that Vicky Mehany has won L.A. Care’s Healthy Recipe Contest! Vicky has been visiting the Inglewood Family Resource Center (FRC) since March. Her winning recipe is low
calorie and low fat. Contest judge and Kitchen Diva Veronica Mayes-Jackson teaches cooking classes at the Inglewood FRC, 1-877-287-6290. She likes the fact that the recipe uses fresh foods which are high in vitamins and minerals. Congratulations, Vicky!
Stuffed Grape LeavesPrep: 30 minutes, cook 30-45 minutes, serves 4
1 pound ground beef or ground chicken1/2 cup of brown rice1 cup chopped cilantro 1 cup chopped fresh dill 1 cup chopped parsley 1 cup chopped green onions 2 fresh whole tomatoes, chopped4 cloves fresh garlic (more or less to your taste)1 green chili, finely chopped1 teaspoon cumin10-15 large grape leaves8-ounce can of tomatoes sauce (not paste)½ can of chicken broth
Mix the first 10 ingredients in a bowl. Unfold and rinse grape leaves with water. Place grape leaves with the rough side up, one at a time, on a large flat plate. Place a teaspoon of the mixture on the bottom of each leaf near the stem. Arrange it lengthwise with your fingers.
Roll the flat edges near the stem upward and tuck them slightly under the filling. Then tuck one side of the leaf at a time with leaf pointing outward to create a packet. Apply pressure to keep the leaves rolled tightly.
Stand the stuffed leaves around the bottom of a large stock pot. Add more layers until the pot is full. Pour the tomato sauce and chicken broth over the leaves. Cover pot and cook on low for 40-45 minutes. Check one leaf to see if rice has cooked fully. If not, continue to cook. Serve warm.
Note: if you don’t care for grape leaves, try bell peppers cut in half.
Things to Know About Health Care ReformThe nation’s health care reform law, called the Affordable Care Act, is very important for all of us. The law has many features that will help more people get health care. It is a first step in truly changing our health care system.
Most of the major changes will start on Jan. 1, 2014. California started planning and using the law early to help people sooner. After the entire law is in use, about 92% of Californians will have health insurance and a way to get health care.
You may have questions about how the law applies to you or about sections that are unclear. Here are some answers that may help.
Q. Will I have to buy health insurance?A. As a member of L.A. Care you already have health insurance. As long as you qualify to be an L.A. Care member you are okay. Starting in 2014, most people will have to have some form of health insurance or pay a tax.
Q. How is Medi-Cal going to change?A. Medi-Cal will raise the top limit on the most money you can earn and still qualify for the program. This will allow about 800,000 more people in L.A. County under age 65 to be in Medi-Cal and get health coverage. Many of them will be adults without children. Undocumented immigrants will still not be eligible.
Q. What is the Health Exchange?A special state-run group is being set up to offer health insurance at a discount starting in 2014. This is called the California Health Benefit Exchange. Some low-income people may get help to pay for their insurance when they buy through the exchange. Some people with higher earnings may get tax credits for buying through the exchange.
Q. What else does health care reform do to help people?A. The law says that children can stay on their parent’s health insurance until age 26. Also, for the first time women will get preventive care services like mammograms at no extra cost. There may also be more money to pay more doctors to treat Medi-Cal patients. This will make getting health care easier. L.A. Care will keep helping L.A. County’s safety net clinics to provide services to those who still need health coverage.
For more about the health care reform law, go to
www.healthcare.gov or call the L.A. Care Member
Services Department at 1-888-839-9909.
FALL 2012 MEMBER NEWS | 5
6 | MEMBER NEWS FALL 20126 | MEMBER NEWS FALL 2012
Know Your Rights and Responsibilities
As a member of L.A. Care, you have the responsibility to…
Act courteously and respectfully. You are responsible for treating your doctor and all providers and staff with courtesy and respect. You are responsible for being on time for your visits or calling your doctor’s office at least 24 hours before the visit to cancel or reschedule.
Give up-to-date, accurate and complete information. You are responsible for giving correct information and as much information as you can to all of your providers and L.A. Care. You are responsible for getting regular check-ups and telling your doctor about health problems before they become serious.
Follow your doctor’s advice and take part in your care. You are responsible for talking over your health care needs with your doctor, developing and agreeing on goals, doing your best to understand your health problems, and following the treatment plans and instructions you both agree on.
Use the Emergency Room only in an emergency. You are responsible for using the emergency room in cases of an emergency or as directed by your doctor.
Report wrongdoing. You are responsible for reporting health care fraud or wrongdoing to L.A. Care. You can do this without giving your name by calling the L.A. Care Compliance Helpline toll-free at 1-800-400-4889.
Respectful and courteous treatment. You have the right to be treated with respect, dignity and courtesy from your health plan’s providers and staff. You have the right to be free from retaliation or force of any kind when making decisions about your care.
Privacy and confidentiality. You have the right to have a private relationship with your provider and to have your medical record kept confidential. You also have the right to receive a copy of, amend, and request corrections to your medical record. If you are a minor, you have the right to certain services that do not need your parent’s okay.
Choice and involvement in your care. You have the right to receive information about your health plan, its services, its doctors and other providers. You have the right to choose your Primary Care Physician (doctor) from the doctors and clinics listed in your health plan’s provider directory. You also have the right to get appointments within a reasonable amount of time. You have the right to talk with your doctor about any care your doctor provides or recommends, discuss all treatment options, and participate in making decisions about your care. You have the right to a second opinion. You have the right to talk candidly to your doctor about appropriate or medically necessary treatment options for your condition, regardless of the cost or what your benefits are. You have a right to information about treatment regardless of the cost or what your benefits are. You have the right to say “no” to treatment. You have the right
to decide in advance how you want to be cared for in case you have a life-threatening illness or injury.
Receive timely customer service. You have the right to wait no more than 10 minutes to speak to a customer service representative during L.A. Care’s normal business hours.
Voice your concerns. You have the right to complain about L.A. Care, the health plans and providers we work with, or the care you get without fear of losing your benefits. L.A. Care will help you with the process. If you don’t agree with a decision, you have the right to appeal, which is to ask for a review of the decision. You have the right to disenroll from your health plan whenever you want. As a Medi-Cal member, you have the right to request a State Fair Hearing.
Service outside of your health plan’s provider network. You have the right to receive emergency or urgent services as well as family planning and sexually transmitted disease services outside of your health plan’s network. You have the right to receive emergency treatment whenever and wherever you need it.
Service and information in your language. You have the right to request an interpreter at no charge and not use a family member or a friend to interpret for you. You have the right to get the Member Handbook and other informa-tion in another language or format.
Know your rights. You have the right to receive information about your rights and responsibilities. You have the right to make recommendations about these rights and responsibilities.
As a member of L.A. Care, you have the right to…
FALL 2012 MEMBER NEWS | 7 FALL 2012 MEMBER NEWS | 7
1. Always keep your ID card with you. Show your ID card when you:
•Go to a doctor’s office•Go to the hospital•Need emergency services•Pick up a prescription
Don’t give your ID card to anyone else to use. If you lose or damage your ID card, call L.A. Care at 1-888-839-9909.
2. You have the right to receive service and information in a language or format you understand. If you need a FREE interpreter for a doctor’s visit, or member information in another language or format (like Braille, large print, or audio), call 1-888-839-9909 (TTY/TDD 1-866-522-2731).
3. You can talk to a nurse for free, any time day or night, 7 days a week. Check your I.D. card for the phone number. Nurse advice lines also provide pre-recorded information on many health topics. There is a list of these topics at the end of the Member Handbook we mailed to you.
4. Visit our website at www.lacare.org. You can:•Find a doctor
•Learn about your benefits
•Look into our health education services and Family Resource Center classes
•Find out about your rights and responsibilities
•File a complaint, called a “grievance”
5. Do you have questions? L.A. Care is here to help you get the care and service you need. Call our Member Services department at 1-888-839-9909 (TTY/TDD 1-866-522-2731) 24 hours a day, 7 days a week (open holidays).
Things to Remember
A Heart-to-Heart on Heart DiseaseCardiovascular disease or heart disease affects the heart and/or blood vessels that go to and from the heart. It is the biggest cause of death around the world.
While it mostly affects older adults, it can begin early in life. That is why you should make sure to take steps early on to prevent it.
Know your ABCS:A Aspirin (ask your doctor if aspirin is right for you)B Blood pressure controlC Cholesterol controlS Stop smoking (or don’t start)
It also helps to eat healthy foods, such as fresh fruits and vegetables, and to be active.
What is Urgent Care?Urgent Care gives medical care at night and on weekends without an appointment. Call your health plan’s member services ahead of time to find the urgent care center closest to you. That way you know where to go when you need it. This can be helpful if your child plays sports and gets hurt.
If you are not sure if you need Urgent Care, call your doctor or your plan’s nurse advice line. The numbers are located on the back of your insurance card. Your doctor or the nurse advice line can give you help on where to go and what to do if you or your child has an earache, sore throat, cough, cold or flu.
Help Stop Fraud & AbuseEach year the Medi-Cal program loses millions of dollars to fraud and abuse. That’s money that can help kids, families and seniors who need health care. People who misuse the Medi-Cal system can be fined, lose their coverage, or go to jail.
You can help stop fraud and abuse:
•Never let a friend or family member use your I.D. card to go to a doctor, drug store, hospital or to get other health care.
•Never give your I.D. card or number to any person, even if they offer you money.
Report what you think may be fraud or abuse by calling the L.A. Care Compliance Helpline at 1-800-400-4889, or the Medi-Cal Fraud Hotline at 1-800-822-6222. You do not have to give your name.
FALL 2012
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Health or wellness or prevention information
IN THIS ISSUE:Is It a Cold or the Flu? | pg. 2Asthma in the Winter | pg. 4Recipe Contest Winner | pg. 5Things to Remember | pg. 7
©2012 L.A. Care Health Plan. All rights reserved.
www.lacare.org
Member News is a publication for members of L.A. Care Health Plan. Published two times a year by L.A. Care, Member News goes to members in Medi-Cal, L.A. Care Health Plan Medicare Advantage (HMO SNP), Healthy Kids and Healthy Families Programs.
If you want the information contained in this newsletter in another language or in large print, Braille, or audio (cassette or CD) call L.A. Care at 1-888-839-9909 or TTY 1-866-LA-CARE1 (1-866-522-2731).
Անվճար թարգմանչական ծառայություններ խնդրելու կամ այլ լեզվով, խոշոր գրվածքով, ձայնագրությամբ կամ Բրայլի տպագրով տեղեկություն ստանալու համար, զանգահարեք L.A. Care ՝1-888-839-9909 կամ TTY 1-866-522-2731հեռախոսահամարներով:
如果您需要免費口譯服務，或需要其他語言版本、大型字體、音訊或盲文版本的資訊 請致電 L.A. Care的電話1-888-839-9909或 TTY 專用電話1-866-522-2731。
To request free interpreting services or for information in another language, large print, audio or Braille, call L.A. Care at 1-888-839-9909 or TTY 1-866-522-2731.
edImºIes~IsuMesvabkE¨bPasaeday²tKit«fÂ É sMrab’BtámanCaPasamYyep§geTot Gk§reVHBumõx~atFM sMeLg É Gk§rsMrab’mnus§xÃak’ sUmTUrs&Bæmk L.A Care elx 1-888-839-9909 É TTY 1-866-522-2731 .
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Чтобы запросить о предоставлении бесплатных услуг переводчика или о получении информации на другом языке, напечатанной крупным шрифтом, записанной в аудио формате или шрифтом Брайля, звоните в L.A. Care по телефону 1-888-839-9909 или по телетайпу TTY 1-866-522-2731.
Para solicitar servicios de interpretación o pedir información en otro idioma,letra grande, audio o Braille, llame a L.A. Care al 1-888-839-9909 o TTY 1-866-522-2731.
Upang humiling ng libreng serbisyo ng pagsasalin o para sa impormasyon sa ibang wika, malalaking titik, audio o Braille, tumawag sa L.A. Care sa 1-888-839-9909 o TTY 1-866-522-2731.
Để yêu cầu dịch vụ thông dịch hoặc nhận tin tức bằng ngôn ngữ khác, bản in khổ lớn, băng âm thanh hoặc chữ nổi Braille, xin gọi L.A. Care tại số 1-888-839-9909 hoặc TTY 1-866-522-2731.
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