Member Newsletter


2011 Idaho Edition

Quick links:
Changing Kids’ Lives with YEAH!
Take Advantage of Your Preventive Care Benefits
Four Plan Perks You Might Not Know About
Make the Most of Your Doctor Visits


Changing Kids’ Lives with YEAH!

The YEAH Program (Youth Education on Athletics and Health) is a program that we’re proud to support in Boise, Idaho. This program gives children (ages 6-14), who are diagnosed by a pediatrician as “at a significant health risk,” the education and resources needed to make healthy lifestyle changes. Not only does YEAH help kids lose weight, but it also works to improve their self-esteem and emotional well-being, as well as promote the long-term benefits of healthy eating and active living.

Exercise is more fun when you have a buddy! Kids exercise weekly with a trainer. YEAH staff members also work with the entire family to institute healthy changes in the household.Perhaps the most important aspect of YEAH is that it works with the entire family to institute these changes in the household. Families visit grocery stores with a dietician who advises them on finding and cooking healthy foods. A social worker provides counseling to the families on the reasons why children may overeat. And the kids exercise weekly with a trainer. In nearly every household that has taken part, the parents and siblings of these children have also shown significant health improvements.

“When kids can see and feel themselves becoming healthier, it’s incredibly uplifting for all of us,” said Sue Peterson, RN, YEAH Program Coordinator. “The turning point for one child was when he could wear jeans without elastic. It might seem small, but seeing that change really changed his life. At his 12-month evaluation, his BMI is still dropping, and his entire family has lost weight and kept it off.”

The YEAH Program is one of many made possible through funding from PacificSource’s Community Health Excellence Program in collaboration with our community partners. We would like to thank St. Luke’s and Treasure Valley Pediatrics for their work and dedication in bringing this important program to Boise families.

See for yourself what kids think about YEAH through our YouTube videos. Visit youtube.com/pacificsource and select a “YEAH” video.

Apples are a healthy snack.Take Advantage of Your Preventive Care Benefits

Seeing your doctor on a regular basis and receiving the screenings recommended for your gender and age group are important parts of staying healthy. However, it’s also important to understand which services are considered preventive care, and what your coverage limitations are. This way you don’t end up with unexpected out-of-pocket costs.

Preventive care is focused on screening for illnesses at regular intervals, even though you have no symptoms. Preventive care is important because many health issues can be better treated if detected early.

Examples of preventive care:

  • Well baby exams
  • Routine physicals
  • Colorectal cancer screening
  • Prostate cancer screening
  • Immunizations
  • Mammograms

Your PacificSource plan covers certain preventive services at 100 percent.* This means you’ll have no copay, coinsurance, or deductibles applied to preventive care services when:

  • You see an in-network provider,
  • You meet the age, gender, and frequency recommendations for the preventive service, and
  • Your provider bills your claim as a preventive service.

Preventive Care: Understanding Your BenefitsPlease note, however, that we are required by law to process your claim according to the medical codes your provider billed. We understand that it can be confusing if you made an appointment to have a preventive service, but then find your claim was not processed as preventive care.

To learn more about how we cover preventive care services, and download our new flier, please visit PacificSource.com/healthcare-reform/preventive-care.

*May not apply to large group employers whose health plan is “grandfathered” under federal healthcare reform. Please check your plan’s specific benefits.

Four Plan Perks You Might Not Know About

Weight Watchers 

Weight Watchers® is now a permanent part of our wellness program. A program reimbursement is available to all PacificSource members with medical coverage. You may choose either the in-person or online Weight Watchers programs. To learn more about this program, visit PacificSource.com/WeightManagement.

Prenatal vitamins 

Prenatal Vitamins are available to expectant mothers who have a PacificSource pharmacy benefit. Mothers-to-be can receive up to nine months of physician-prescribed prenatal vitamin supplements at no cost! The program was recently expanded from six months. For program details, please visit PacificSource.com/PrenatalProgram.

Get a flu shot! 

Get a flu shot! The seasonal flu vaccine is a great way to help you stay healthy this flu season. Check your plan’s specific benefits, but the flu shot and mist are covered by most plans at little or no cost to you. To learn more about this benefit, visit PacificSource.com/flu.

Save money on prescription drugs! 

Save Money on Prescription Drugs! Show your PacificSource ID card each time you purchase prescriptions at a CVS Caremark® participating retail pharmacy to ensure you’re receiving the best benefit. Ask your local pharmacy if they participate with CVS Caremark, or find participating pharmacies on the CVS Caremark website: Caremark.com/wps/portal.

Make the Most of Your Doctor Visits

With a little preparation, you can make the most of your doctor visits. We’ve created a guide to help you before, during, and after your appointment so that you can be an informed, confident healthcare consumer, ready to take charge of your care.

Getting Ready for Your Appointment

  • Make a list of your questions and concerns, all medications and supplements you take, and any allergies you have.
  • Think about asking someone to go with you.
  • Check your insurance benefits.

During Your Appointment

  • Explain why you’re there.
  • Answer your doctor’s questions clearly and completely.
  • Listen to your provider’s diagnosis and recommendations.
  • Ask questions about any medications, tests, or procedures your doctor recommends.
  • Ask any remaining questions from your list.
  • Know what happens next—make sure you’re clear about the next steps

After Your Appointment

  • Make the Most of Your Doctor VisitsDo your part. Follow directions and schedule appointments.
  • Watch for possible problems or new symptoms.
  • Call back with new questions or concerns if you need to.

Our full “Make the Most of Your Doctor Visits” guide also includes tips for how to ask questions and a helpful Doctor Office Visit Worksheet.

Download the guide. Or contact our Customer Service Department and we’ll be happy to send a printed copy to you.


This Member Newsletter is provided for general information only, and is not to be used to determine benefits. Your benefits are determined only by your policy. Please refer to your plan materials or our Customer Service Department for specific benefit information.

 

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Need help?

We are always happy to assist you if you have any questions about your benefits. Feel free to email cs@pacificsource.com.

¿Necesita ayuda? Siempre estamos dispuestos a ayudarle si tiene alguna pregunta acerca de sus beneficios. Llámenos sin cargo al (800) 624-6052 ext. 1009 o envíe un correo electrónico a cs@pacificsource.com.

 

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Last updated 11/14/2013