For members of BMC HealthNet Plan Commonwealth Care – What It Means for You Y ou may have heard about a new health program created by the state called Commonwealth Care. BMC HealthNet Plan, along with other managed care organizations in Massachusetts, will be offering Commonwealth Care insurance. What does this mean for you? Your MassHealth coverage is not affected. As long as you are eligible for MassHealth, your BMC HealthNet Plan coverage will continue. That will not change. In the future, if your income changes, it’s possible that you could qualify for Commonwealth Care. What is Commonwealth Care? Commonwealth Care is a new insurance program for Massachusetts residents who don’t qualify for MassHealth and who don’t have health insurance through their employer. Massachusetts residents must meet certain income guidelines in order to be eligible for Commonwealth Care coverage. The Plan expects to begin enrolling Commonwealth Care members on October 1, 2006. If you have questions about Commonwealth Care, please call the Member Services Call Center at 1-888-566-0010 or our marketing line at 1-800-792-4355. September 2006 How to Have a Healthy Pregnancy T he key to a healthy pregnancy starts with seeing your doctor. The earlier in your pregnancy you see your doctor, the quicker he or she can get you on the right track to staying healthy right through the delivery. If you think you might be pregnant, take a home pregnancy test which you can buy at any drug store. You’ll only pay a $1 copay if your doctor gives you a prescription for the test kit. And if you’re under age 19, there is no copayment. If the test says you’re pregnant, call your doctor right away to make an appointment. Let us know Don’t forget to tell us if you’re pregnant too! We need to know, so we can send you a packet of useful information, including a pregnancy calendar. You can call the Member Services Call Center at 1-888-566-0010. You can also go to our Web site (www.bmchp.org) and in the member health information section, you can submit a form online letting us know about your pregnancy. A representative from our Health Services department will contact you by phone to help with your care. During your pregnancy In the early part of your pregnancy, your doctor will talk to you about the importance of eating right and getting rest. He or she will also prescribe vitamins to make sure you’re getting the right nutrients. If you smoke, your doctor will talk to you about the importance of quitting and the effects that smoking can continued on page 2 How to Have a Healthy Pregnancy continued from page 1 Your Frequently Asked Questions What should I do if I receive a bill? As a member of BMC HealthNet Plan, you should not get billed for your medical services that are covered by the Plan. Providers are not supposed to bill patients who receive MassHealth benefits. But sometimes mistakes happen. If you ever get a bill for covered services, mail the bill to us and we’ll take care of Send the bill to: getting it paid. BMC HealthNet Plan Attn: Member Services Call Center Two Copley Place Suite 600 Boston MA 02116 You can also call the Member Services Call Center at 1-888-566-0010 for help. To make sure you don’t get bills in the future, make sure you show your BMC HealthNet Plan and MassHealth ID cards every time you go to the doctor. That way the provider will know that you’re covered by the Plan. How do I get a list of providers? When you joined the Plan, you received a Provider Directory listing providers in your area. Recently, the Plan updated the Provider Directory. To request a copy, call the Member Services Call Center at 1-888-566-0010. Check Out Our Audio Health Library Even when you’re not sick, you may want to learn more about a disease or condition. BMC HealthNet Plan’s Audio Health Library contains prerecorded messages on many health topics. Like the Nurse Advice Line, the 2 Audio Health Library is available 24 hours a day, 7 days a week. You can reach the Audio Health Library at the same toll-free number you dial for the Nurse Advice Line: 1-800-973-6273. Listen for the Audio Health Library menu option and then select the health topic you want. For a complete listing of Audio Health Library topics, go to BMC HealthNet Plan’s Web site (www.bmchp.org). have on your unborn baby. BMC HealthNet Plan has just added a new benefit to help you quit smoking. See the article entitled We Can Help You Stop Smoking to learn about this great benefit. After the baby arrives Once you’ve delivered your baby, it’s important to follow up with the doctor. Just as your baby needs to see the pediatrician, you need to see your doctor about four to six weeks after the delivery. Your doctor will make sure you’re recovering well from the delivery. He or she can also talk to you about how you’re doing at home. Having a baby can add stress to your life. Your doctor can help make sure you’re able to cope with your new responsibilities… and help you. Want more information about having a healthy pregnancy? Go to the member page at www.bmchp.org Here are just a few of the hundreds of health topics to choose from: •Arthritis •Epilepsy •Stroke •Crying baby •Rashes •Colon cancer •Chest pain •Many, many more… CALL 1-800-973-6273 Domestic Violence: What You Can Do A We Can Help You Stop Smoking S moking is bad for your health and it causes more than 400,000 deaths each year in the United States. It also leads to other health problems like heart disease, cancer and lung problems. Smoking also harms others. More than 50,000 people die each year from second-hand smoke. Second-hand smoke is the smoke you inhale from someone else’s cigarette. Young children are also more likely to smoke if a parent smokes. New benefit to help you quit On July 1, 2006, BMC HealthNet Plan added a new benefit to help members quit smoking. The Plan now covers oneon-one and group counseling to give you the support you need. You are also eligible for medications to help you quit, including nicotine replacement therapy. To find out more about your benefit and how we can help you to stop smoking, call the Member Services Call Center at 1-888-566-0010. Members Tell Us What They Think of the Plan Earlier this year, BMC HealthNet Plan asked a leading market research group to conduct a survey of our members. We wanted to find out what our members thought about the Plan and the services they receive. The company, Market Measurement, conducted a random telephone survey to ask members a variety of questions about the Plan. They found that, overall, members are happy with us. In fact, 79% of members surveyed reported that they are “Very Satisfied” with us. 17% reported being “Somewhat Satisfied.” Only 4% said they are either “Slightly Satisfied” or “Not At All Satisfied.” Members listed “Coverage/ Benefits” and “Ease of Use” as the most popular features of the Plan. In addition, members said that they liked getting free kids’ car seats and free kids’ bicycle helmets. There were also some areas where members told us we could improve. Coverage for certain health issues was mentioned, including improved dental coverage. Since the survey was completed, MassHealth has added new dental benefits for members. See the article on the back cover entitled New Benefits to learn about this benefit. If you ever have questions or concerns about the Plan and your coverage, please let us know. nyone can be the victim of domestic violence. Abuse happens to people of every age, race, culture, religion, gender and sexual orientation. Domestic violence is not just physical abuse. Abuse also can be emotional, financial or sexual. Here are just some of the warning signs of an abusive relationship: • A batterer or abusive person may make it difficult for you to leave the house to spend time with family or friends. • He or she may constantly criticize you and put you down. • The abuser may make you believe the abuse is your fault. If any of these sound familiar, you may be in an abusive relationship. You are not to blame. No one has the right to hurt you – ever. Remember: domestic violence is also a crime. So there are laws to protect you and also your children if they are being abused. If you are in immediate danger, CALL 911 right away to get out of that situation. If you or someone you know is not in immediate danger, but is still in an abusive situation and need help, call the Domestic Violence SafeLink at 1-877-785-2020. They can help you by offering resources, support, safe shelter, counseling and understanding. You can also find more information on domestic violence at www.janedoe.org. 3 NONPROFIT ORG. U.S. POSTAGE PAID BOSTON, MA PERMIT NO. 56027 Two Copley Place Suite 600 Boston, MA 02116 New Benefits; Dental, Vision, Smoking Cessation and more How to Have a Healthy Pregnancy page 1 We Can Help You Stop Smoking page 3 Boston Area Main Office: Two Copley Place Suite 600 Boston, MA 02116 Western Massachusetts Regional Office: 354 Birnie Avenue, 3rd Floor Springfield, MA 01107 Southeastern Massachusetts Regional Office: Bourne Counting House One Merrill's Wharf New Bedford, MA 02740 Berkshire Regional Office: 163 South Street Pittsfield, MA 01201 www.bmchp.org New benefits covered directly by BMC HealthNet Plan •Chiropractic Services – up to 20 visits/treatments for members of all ages •Wigs – must be medically necessary and prescribed by a physician •Acute hospital inpatient administratively necessary days •Tobacco cessation – individual and group counseling as well as pharmacotherapy treatment •24-hour post-medical detoxification substance abuse treatment services •Non-emergency transportation (out-of-state location) – arranged by the Plan for services located outside a 50-mile radius of the Massachusetts border New benefits covered directly by MassHealth •Dental services (non- emergency) – preventive and basic services for children and adults •Eye glasses and contact lenses – prior authorization required If you have any questions or need more information about these new benefits, please call us. ARE YOU MOVING? Make sure you let us know. That way you’ll be sure to get this newsletter and other important information. Call the Member Services Call Center at 1-888-566-0010. Este boletín de noticias esta disponible en español. Si usted quisiera una copia de la traduccion en español, llame el Centro de Llamada de Servicio de Miembros al 1-888-566-0012. 09/06 96.6M As of July 1, 2006, BMC HealthNet Plan and MassHealth began offering members several new benefits. You should have received a letter from BMC HealthNet Plan that included details on these new benefits. Here is a brief overview: