GET CARE , STAY WELLCommunity HealthChoices...Brush your teeth at least 2 times a day and floss every day. Regular brushing and flossing help keep bacteria away, which helps keep your

A newsletter for Participants of Keystone First Community HealthChoices

STAY WELLGET CARE,

Vol. 2, Issue 2, Summer 2020

Your opinion counts! .................................................................................2

Resources for care and support workers ...........................................2

We need your help! ....................................................................................3

High blood pressure: Are you at risk? ..................................................4

More ways we can help you ....................................................................6

Your voice counts .......................................................................................7

Formulary .....................................................................................................7

Have a healthy mouth for life .................................................................8

Important numbers ...................................................................................9

Each year, Participants are randomly chosen to fill out a survey that tells us how satisfied you are with your care. Go to page 2 to learn more.

Keystone First Community HealthChoices2

Your opinion counts!

Each year, Keystone First Community HealthChoices (CHC) Participants are randomly chosen to fill out a survey that tells us how satisfied you are with your care. If you receive a survey, please fill it out and return it right away. Your opinion counts!

Resources for care and support workers

Are you a Participant self-directing your own long-term home care? Visit http://www.publicpartnerships.com/programs/pennsylvania/PADPWOLTL/index.html to see what supports may be available to you.

If you do not have access to the internet, you can also call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976). Participant Services is available 24 hours a day, 7 days a week.

http://www.publicpartnerships.com/programs/pennsylvania/PADPWOLTL/index.html

http://www.publicpartnerships.com/programs/pennsylvania/PADPWOLTL/index.html

Participant Services: 1-855-332-0729 (TTY 1-855-235-4976) 3

We need your help!

Participants can help Keystone First CHC uncover provider fraud, waste, and abuse. You should keep track of the following things: • Who provided your health care. • What services you received during the

visit and any additional tests or visits the doctor ordered.

• When you got a health care service. • Where the service took place.

Call Keystone First CHC if you think the provider may have billed incorrectly or offered a service you didn’t think you needed. Please remember, do not: • Give your ID card or numbers to anyone

other than your doctor, clinic, hospital, or other health care provider.

• Ask your doctor or any other health care provider for medical services or supplies that you don’t need.

• Sign your name to a blank form. • Share your medical records with anyone

other than your doctor, clinic, hospital, or other health care professional.

Keystone First CHC has a team that works hard to identify and prevent fraud, waste, and abuse. But we still need all Participants to report possible fraud, waste, and abuse. Please call the Fraud Hotline at 1-866-833-9718 (TTY 711). You can remain anonymous at all times.


High blood pressure: Are you at risk?

What is blood pressure?Blood pressure is the pressure that moving blood puts on your artery walls (the tubes that carry blood through your body). High blood pressure, also called hypertension, is when the pressure is higher than normal.

There are 3 main factors that can raise your risk of high blood pressure.

1. Health conditions. Some health conditions, such as diabetes, can increase your risk for high blood pressure. Talk with your doctor about steps you can take to best manage all of your health conditions and help keep your heart healthy.

(continued on page 5)


High blood pressure: Are you at risk? (continued from page 4)

2. Lifestyle and behavior choices. The choices you make every day may impact your heart health and may increase your chance of having high blood pressure. Here are some lifestyle choices that can impact your risk of high blood pressure.

– Diet. An unhealthy diet that is too high in sodium (salt) can increase your risk of high blood pressure. Try to avoid sodium in your diet.

– Physical activity. Regular physical activity helps keep your heart strong and healthy and can help you keep a healthy weight. These 2 things may help lower your blood pressure.

– Weight. Being overweight or having obesity can impact your heart health and increase your risk for high blood pressure. Talk with your doctor about a healthy weight level for you and the things you can do to help stay healthy.

– Alcohol use. Drinking too much alcohol can cause your blood pressure to increase. Limit the amount of alcohol you consume.

– Tobacco use. Tobacco use can also increase your risk for high blood pressure and impact the health of your heart. Don’t smoke. And if you smoke, now is the time to quit. Go to page 8 for more information on how we can help you quit.

3. Genetics, family history, and other factors. Your risk for high blood pressure may increase if members of your family also had high blood pressure. Here are some other characteristics that may increase your risk:

– Age: Your risk for high blood pressure increases as you get older.

– Sex: Women and men share about the same risk for high blood pressure.

– Race or ethnicity: African Americans/Blacks have a higher risk for high blood pressure compared to Whites, Hispanics, Asians, Pacific Islanders, American Indians, or Alaska Natives.

Some factors, like your genetics and family history, can’t be controlled. Some factors, like your lifestyle choices, can be controlled. It’s important to talk with your doctor about your risk factors and the best ways you can help lower your risk.

Have questions or need more information?Talk with your doctor if you have questions about your health. Need help finding a doctor or making an appointment? Call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976).

Source: https://www.cdc.gov/bloodpressure/risk_factors.htm

https://www.cdc.gov/bloodpressure/risk_factors.htm


More ways we can help you

Keystone First CHC wants to help you get the care you need. We are here to help you.

For all Participants: Care ManagementOur Care Management team works with you to coordinate the care you need to help you live the healthiest life possible. • We can help you get the care you need

by talking with your doctor, helping with transportation, and giving you resources, like information on housing and food assistance.

• We can help you learn more about your health and support you with setting goals, creating a care plan, and helping you as you make decisions about your care.

• We have special disease management programs to help you. You do not need a referral from your doctor to be a part of any of these programs. If you have one of the health care conditions listed here, you can become a part of one of our special programs.

– Asthma. – Chronic obstructive pulmonary disease (COPD).

– Diabetes. – Heart disease. – Hemophilia. – HIV/AIDS. – Sickle cell anemia.

Call 1-855-349-6280 (TTY 711) to learn more about Care Management and what it means to be in the program.

For Participants with long-term services and supports (LTSS): Person-Centered Planning Team

Participants who have LTSS will have a Person-Centered Planning Team and a Service Coordinator.

What is a Person-Centered Planning Team?The Person-Centered Planning Team focuses on you and what your life can be. Your team is led by you. Your Service Coordinator is there to help you.

The goal of having a team is to have open communication. Important information is shared with you and with those who support you, with your consent.

What is the role of your Service Coordinator?Your Service Coordinator will meet with you in person. It’s important to meet with your Service Coordinator as a new Keystone First CHC Participant. Your Service Coordinator will:• Go over and document your health care

needs and goals.• Coordinate your care with other health

and service providers, like Personal Assistance agencies and your primary care practitioner (PCP).



More ways we can help you (continued from page 6)

• Schedule your team meetings.• Help you develop your Person-Centered

Service Plan.• Update your plan as needed.• Guide you and your team through the

CHC program.

Remember, you are the most important person on your team. It will be important for you to share your needs and concerns with your team. This will help keep you as independent as possible.

Have questions? We are here to help. We want to help you get the care and services you need. Just call our Personal Care Connection Team at 1-855-349-6280 (TTY 711).

Your voice counts

Keystone First CHC has a Participant Advisory Committee (PAC) that comes together throughout the year to talk about issues that matter to you. Helping you understand your benefits and services is important to us.

If you would like to know more about the PAC, including how to become a member, please call 1-484-496-7623. Space is limited.

You can also find more information at www.keystonefirstchc.com > Community.

Formulary

A drug formulary is a list of covered medicines. Some medicines are covered as a part of the Pennsylvania Statewide preferred drug list. Some medicines are covered under the Keystone First CHC Supplemental Formulary. For the most up-to-date formulary listings, visit www.keystonefirstchc.com. You can also call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976). If you have Medicare, please refer to your Medicare Part D plan for your formulary medicines.


Have a healthy mouth for life

Oral health is the health of your mouth, teeth, and gums. Some oral health problems become more common with age. But without the right care, these problems can happen earlier in life, too.

No matter what your age, there are ways to keep your mouth healthy.

1. Brush your teeth at least 2 times a day and floss every day. Regular brushing and flossing help keep bacteria away, which helps keep your teeth and gums strong and healthy. Talk with your dentist about how often you should brush and floss.

Having trouble remembering to brush and floss? Try setting an alarm or keeping your toothbrush and floss in plain sight to help you remember.

2. Use a mouthwash and toothpaste that have fluoride. Fluoride helps to:

– Prevent gum disease. – Reduce sensitivity. – Protect teeth from decay.

3. Keep your mouth moist. Saliva helps protect your mouth from gum disease and tooth decay. Drink plenty of water and use sugar-free mints, gum, or lozenges to increase your saliva.

4. If you smoke, now is the time to quit. Smoking can make your mouth dry and cause other oral health problems. Here’s how we can help you quit:

– As a Keystone First CHC Participant, you are eligible for counseling sessions to help you quit. Call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976) for more information. You may be eligible for medicines that can help you quit. Talk with your doctor about what medicine is best for you.

– Call the PA Free Quitline, 1-800-QUIT NOW (1-800-784-8669) or go to http://pa.quitlogix.org.


http://pa.quitlogix.org


Have a healthy mouth for life (continued from page 8)

5. Eat healthy. Choosing the right food can help keep your teeth healthy.

– Try to eat: Fresh fruits. Vegetables. Lean protein like chicken, beans,

and fish. – Try not to eat:

Sticky foods like caramels, raisins, and gummy bears.

Lollipops and other hard candies. Desserts like cookies, cakes, and

brownies. Sugar. This includes brown sugar,

honey, and even molasses.

6. Visit your dentist. You should have a dental checkup 2 times a year. Regular checkups will help spot small problems before they become big ones.

If you have questions about your teeth, talk with your dentist. To find a dentist, visit www.keystonefirstchc.com and click Find a Provider or call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976).

Important numbers

Participant Services: 1-855-332-0729

Participant Services TTY: 1-855-235-4976

Nurse Call Line: 1-855-332-0117 (TTY 711)

Care Management and Personal Care Connection Team: 1-855-349-6280 (TTY 711)

Bright Start® (pregnancy): 1-800-521-6867 (TTY 711)

Pennsylvania Tobacco Cessation Information: 1-800-QUIT-NOW (1-800-784-8669)

Fraud Hotline: 1-866-833-9718 (TTY 711)

Medical Assistance Transportation Program (MATP): Call your county number for more information. You can find a list of phone numbers for your county on our website at www.keystonefirstchc.com > Participants > Important numbers. MATP phone numbers may change. Visit http://matp.pa.gov for the most up-to-date phone numbers.

Behavioral health treatment contact numbers: Call your county number for more information. You can find a list of phone numbers for your county on our website at www.keystonefirstchc.com > Participants > Important numbers.

http://www.amerihealthcaritaschc.com

http://keystonefirstchc.com/participants/eng/getting-care/phone-numbers.aspx




Nondiscrimination Notice

Keystone First Community HealthChoices complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, creed, religious affiliation, ancestry, sex gender, gender identity or expression, or sexual orientation.

Keystone First Community HealthChoices does not exclude people or treat them differently because of race, color, national origin, age, disability, creed, religious affiliation, ancestry, sex gender, gender identity or expression, or sexual orientation.

Keystone First Community HealthChoices provides free aids and services to people with disabilities to communicate effectively with us, such as:

• Qualified sign language interpreters • Written information in other formats (large print, audio, accessible electronic formats, other formats)

Keystone First Community HealthChoices provides free language services to people whose primary language is not English, such as:

• Qualified interpreters • Information written in other languages

If you need these services, contact Keystone First Community HealthChoices at 1-855-332-0729 (TTY 1-855-235-4976).

If you believe that Keystone First Community HealthChoices has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, creed, religious affiliation, ancestry, sex gender, gender identity or expression, or sexual orientation, you can file a complaint with:

Keystone First Community HealthChoices, Participant Complaints Department, Attention: Participant Advocate, 200 Stevens Drive Philadelphia, PA 19113-1570 Phone: 1-855-332-0729, TTY 1-855-235-4976, Fax: 215-937-5367, or Email: [email protected]

The Bureau of Equal Opportunity, Room 223, Health and Welfare Building, P.O. Box 2675, Harrisburg, PA 17105-2675, Phone: (717) 787-1127, TTY/PA Relay 711, Fax: (717) 772-4366, or Email: [email protected]

You can file a complaint in person or by mail, fax, or email. If you need help filing a complaint, Keystone First Community HealthChoices and the Bureau of Equal Opportunity are available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services, 200 Independence Avenue S.W., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 800-537-7697 (TDD).

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.































200 Stevens DrivePhiladelphia, PA 19113-1570

www.keystonefirstchc.com

CHCKF_20868937 2020-2

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GET CARE , STAY WELLCommunity HealthChoices...Brush your teeth at least 2 times a day and floss every day. Regular brushing and flossing help keep bacteria away, which helps keep your