Issue 2

Issue 2 / 2011

a Full plate �

New Guidelines Favor Fruits, Veggies and Whole Grains

Super Summer mealS Try These Healthy Recipes PAGE 16

3 WayS To Help KidS STay in SHape PAGE 23

A magazine for CareFirst BlueCross BlueShield members

MEET THE WILLIAMS they’re wondering how heath care reform will impact their employees’ benefits

MEET THE

WILLIAMS � they’re wondering how health care reform will impact their kids’ coverage when they graduate college

All of these families share the same name, but their lives and their questions regarding health care reform are very different. That’s because health care reform affects everyone differently. Introducing AskBlue Health Care Reform. Your personal guide to understanding the basics of reform. To find answers to your health care reform questions, visit www.bcbs.com/askblue.

MEET THE WILLIAMS they’re wondering how health care reform will affect their new baby

Table of Contents

Member Update

Prevention & Screenings

4 C hangestothePreferred DrugList 5 DecisionsAboutMedical andMentalHealth 5 DoINeedaReferral? 5 FilinganAppealorGrievance 6 Don’tLeaveHomewithout YourCard 6 PreventiveGuidelinesOnline 7 CoverageInformation 7 MemberDiscountProgram OffersNewServices 8 MembersHaveExclusiveAccess toSecond Opinion 8 LanguageHelponCall 8 ProtectYourselffromFraud 8 ProgramsforMemberswith ChronicConditions 9 C ompareDoctorsandHospitals atwww.carefirst.com 9 D oYouHaveaQuality-of-Care Complaint? 10 H ealthBenefitsQ&A 10 R egisterforHealth News byEmail 10 CareFirstWantsYourInput 10 M edicalInformationon YouriPhone®

14 D idYouTakeYourBlood PressureMedicineToday? 15 H owtoCutYourCholesterol Food & Nutrition

16 SuperSummerMeals Living Well

18 HealthBytes:HotHealthTips 20 JugglingAct:BalancingHome LifeandWorkLife 21 HowtoPrepareforYour DoctorVisit On the Cover Your Family

22 R oleReversal:CaringforAging Parents 23 3HabitstoHelpKidsStayinShape Test Your Knowledge

24 H ealthQuiz:DoYouHave SunSense?

FullPlate: A NewGuidelinesFavor Fruits,Veggiesand WholeGrains earn how to eat better L and stay healthier by following the advice provided in this article.

Health Management

25 H owtoTreatanAsthma Attack 26 COPD:TakeaHandin YourHealth

Issue 2 / 2011 SENIOR VP OF MEDICAL AFFAIRS AND CHIEF MEDICAL OFFICER: Jon Shematek, M.D.

11

EDITOR: Joanne Drummond

For more health information, visit My Care First at www.mycarefirst.com. For help with mailing address issues, call Member Services at the telephone number on your health plan ID card.

Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date health information. But no publication can replace the advice of medical professionals, and readers are cautioned to seek such help. © 2011. (211)

MIS5052-9S (6/11)

CareFirst BlueCross BlueShield is an independent licensee of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc.

Vitality

Issue 2 / 2011 � 3

Member Update

Changes to the Preferred Drug List Thisinformationappliesonlytomembers whoseprescriptiondrugprogramisbased ontheCareFirstBlueCrossBlueShield (CareFirst)preferreddruglist(also calledaformulary).Thereare3types ofdrugprograms: ■ 2-tierprogram:generic,brand ■ 3-tierprogram:generic,preferred, nonpreferred ■ 4-tierprogram:generic,preferred, nonpreferred,self-administered injectables Brand Name

Generic Equivalent

Abstral®

NEW Generic

Accolate®

zafirlukast

Thepreferreddruglistincludesdrugs thatareselectedfortheireffectiveness andaffordability. Tier1:genericdrugs(lowestcost toyou) Tier2:preferredbrand-namedrugs (highercost) Tier3:nonpreferreddrugs(highest cost) Tier4:self-administeredinjectable drugs

Condition Treated

For More Information Forthemostcurrentpreferred druglist,requiredprocedures andprescriptiondrugupdates, visitwww.carefirst.com/rx.For aprintedcopyofthepreferred druglistandrequiredprocedures, pleasecall877‑800‑3086.If youhavequestionsaboutyour prescriptiondrugbenefits,call 800‑241‑3371.

Benefit Change: What This Means

cancer pain

Requires prior authorization. Your doctor must get prior approval from CareFirst for this drug to be covered.

asthma

New generic available. You will pay more for the brand-name drug (the tier 3 or nonpreferred benefit). To save money, ask for the generic version for the tier 1 or generic rate.

Allegra®, Allegra-D®

fexofenadine, fexofenadine D

allergies

Available over the counter. These drugs are no longer covered under the pharmacy program.

Ambien CR®

NEW Generic

insomnia


donepezil

Alzheimer’s, dementia


NEW Generic

infection


asthma

Added to the preferred drug list. You can get this drug for the preferred or tier 2 copayment.

high blood pressure


blood disorders


gastroesophageal reflux disease (GERD)


zolpidem NEW Generic

Aricept®

Doryx®

doxycyline

Dulera® Lotrel® 5/40 mg & 10/40 mg

NEW Generic

amlodipine/ benazepril

Pradaxa® Prevacid Solutab®

4

Vitality

NEW Generic

lansoprazole ODT

Issue 2 / 2011

Brand Name Quixin®

Rythmol SR®

Generic Equivalent NEW Generic

Xyzal

Benefit Change: What This Means

eye infections


irregular heart rhythm


opioid drug dependence


liraglutide

diabetes


NEW Generic

allergies


levofloxacin NEW Generic

propafenone

Suboxone® Victoza®

Condition Treated

levocetirizine

Decisions About Medical and Mental Health CareFirstwantstoensurethatits membersreceiveappropriatemedical andmentalhealthcareandservices. Ourprofessionalstaff,including doctorsandnurses,makescoverage decisions(utilizationmanagement) basedonmedicalinformation. Youshouldknowthat: ■ Theutilizationmanagementstaff makesdecisionsbasedonlyon theexistenceofcoverageand theappropriatenessofthecare andservice. ■ CareFirstandourbehavioralhealth vendorsdonotrewarddoctors, nursesorotherindividualsfor issuingdenialsofcoverageorservice. ■ CareFirstandourbehavioralhealth vendors’financialincentivesdonot encouragedecisionsthatresultin underuseofservices. ■ CareFirstandourbehavioralhealth vendorsmonitorforpossibleunderuseofservicesthroughouttheyear.

Do I Need a Referral? Doyouwonderwhetheryouneed areferral,orapprovalforservice beforeseeingaspecialist?Yourhealth planisanotahealthmaintenance organization(HMO),andgenerally, youdonotneedareferral. TheonlyexceptionistheMaryland PointofService(MPOS)plan.All MPOSmembersmustchoosea primarycarephysician(PCP),and theyneedareferralfromthePCP toreceivein-networkbenefits. MPOSmembersmayseespecialists withoutareferral,butwillpaymore out-of-pocket. Inaddition,yourdoctormust requestauthorizationforservices suchasnonemergencyhospitalization, outpatienthospitalservicesandhome healthcare.Ifyouhavequestions aboutthisprocess, pleasecontact MemberServices. Ifyouhave questionsabout howyourbenefit

planworks,pleaserefertothe materialsyoureceivedafteryou enrolledorcallMemberServices atthetelephonenumberonyour IDcard.

Filing an Appeal or Grievance Manymembershavearighttoan independentexternalreviewofany finalappealorgrievancedecision. Yourcontractstateswhetheryou areeligibletocontacttheinsurance regulatorydepartmentinyourarea tofileanexternalcomplaintoran appealregardingadenialorreduction ofbenefits. Ifyouwouldliketoreviewthe procedureforfilinganappealor findaddressesoftheregulatory departments,refertoyourmember handbook.Handbooksarealso onlineinthePlan Information sectionofwww.carefirst.com.For aprintedcopy,contactMember Servicesatthetelephonenumber onyourIDcard.

Vitality

Issue 2 / 2011

5

Member Update Don’t Leave Home without Your Card Alwaysremembertocarryyour currenthealthplanIDcard.You neverknowwhenyoumightneedit. Yourcardhasimportantinformation, includingthephonenumberfor MemberServices,yourmemberID numberandyourcopayment,ifyou haveone.Presentyourcardwhenever youreceivecare,sothattheprovider willbeabletobillproperly.Ifyouget newcards,besuretothrowtheold onesaway. WhenyouareoutsideofCareFirst’s servicearea,benefitsarestillavailable forhealthcareservices.Ifyouhavea PreferredProviderOrganization(PPO) orPreferredProviderNetwork(PPN) plan,in-networkbenefitsareavailable forcoveredservicesrenderedby providerswhoparticipateinthePPN planofanotherBlueCrossandBlue Shield(BCBS)plan.Nonemergency andurgenttreatmentcarebyproviders whoarenotinaBCBSPPNplanare eligibleforout-of-networkbenefits. Whenyouarriveatthedoctor’s officeorhospital,presentyourcurrent CareFirstIDcardwiththesuitcase logo.Afteryoureceivemedicalattention, yourproviderwillfiletheclaim.

CareFirstpaysall participatingand preferreddoctorsand hospitalsdirectly.You areresponsibleonly foranyout-of-pocket expenses(noncovered services,deductibles, copaymentsor coinsurance). Iftheproviderdoes notparticipatewith aBCBSplan,andyou mustpayatthetime ofservice,contactMemberServices orvisitthePlan Informationsection ofwww.carefirst.comtogetaclaim formforreimbursementofthecharges. NOTE: You are responsible for obtaining all necessary precertifications for out-ofarea services. Check your Evidence of Coverage for requirements specific to your health plan. To find a network provider, call BlueCard® Access at 800-810-Blue (2583). You can also search the BlueCard Provider Finder online at www.bcbs.com.

How to File a Claim When you see a provider who participates in our network, the office will submit claims for you. If you see a nonparticipating provider, you must submit the claim yourself. If you need claim forms, visit www.carefirst.com and click on Forms in the Plan Information section. You can also call Member Services at the telephone number on your ID card to request claim forms, if you do not have Internet access.

Preventive Guidelines Are Online Childrenaren’ttheonlyoneswho needcheckupsandshotstostay healthy.Didyouknowthatwomen shouldvisittheirdoctorforafinal checkupabout6to8weeksafter givingbirthtomakesuretheyhave properlyhealed? CareFirsthasalistoftheshots andpreventiveservicesthatmost adultsandchildrenneed,aswellas

6

Vitality

Issue 2 / 2011

guidelinesforahealthypregnancy. Tofindbothlistsonline,pleasevisit www.carefirst.com/prevention. Foraprintedcopy,pleasecallthe ClinicalInnovationsdepartment at800‑323‑4472. Tosavemoneyonhealthcare, yourchildcanhave2ormore shotsduringthesameoffice visit.

Yourdoctormayrecommenddifferent servicesifyouhavespecialneeds orriskfactors.Ifyouthinkyoumight beatriskforanycondition,tellyour doctor. Manyhealthplanscoverpreventive services.CallMemberServicesat thetelephonenumberonyourID cardorloginatwww.carefirst.com tocheckyourbenefits.

Information About Your Health Plan Benefits information Whenyoujoinedyourhealthplan, youreceivedenrollmentmaterials, includingamemberhandbookand abenefitsguide.Thesedocuments includecompleteinformationabout howandwheretogetprimary, specialtyandemergencyhealthcare andrelatedservices.Theyalsoinclude informationonpremiumchanges, policyrenewabilityandemployers’ responsibilitiesfordependentcoverage. Sometimes,changestoyourhealth planmayresultinnewinformation thatmaynotbereflectedinyour enrollmentmaterials.Foranswers toquestionsaboutyourmembership, callMemberServicesatthetelephone numberonyourIDcardorvisit My Account atwww.carefirst.com.

Continuation of coverage AsaCareFirstmember,youmayhave optionsforcontinuingyourhealth carecoverageifyouremployment statuschanges.Youroptionsmay includethefollowing: ■ ConsolidatedOmnibusBudget ReconciliationAct(COBRA): Forinformation,contactyour company’shealthbenefits administrator. ■ Groupconversionplan:Call MemberServicesatthetelephone numberonyourIDcard. ■ Statecontinuationplan:For information,contactyour company’shealthbenefits administrator. ■ Individualplan:Call 800-544-8703fordetails, includingbenefitsoptions.

Member Discount Program Offers New Services TheBlue365programtakesyouin ahealthydirectionbyopeningthe doortodiscountsonabroadrange ofalternativetherapiesandwellness services.CareFirstwelcomes3new companiestotheprogram.

H&r Block H&RBlock,oneoftheworld’slargest taxservicesproviders,offersmembers 25percentoffonlinefederaltax preparationthroughtheOctober extendedtaxseason.

experian Theleadingglobalinformation servicescompanyprovidesdataand toolstohelpclientschecktheircredit reportsandcreditscoresandprotects againstidentitytheft.WithExperian, memberswillreceive: ■ discountsofftheretailpriceof monitoringservices

dailymonitoringofconsumer creditreportsandalertsregarding keychangestoanycreditreport ■ toll-freeaccesstoExperian’sfraud resolutionrepresentativesand CustomerCareCenter ■ accesstocredit-relatedresources andarticles ■

dole Food Company, inc. Theworld’slargestproducerofhigh- qualityfreshfruitandvegetables givesmembersaccesstoawebsitethat featuresSuperKidsrecipes,gamesand comics,aswellasanewsletterthat featuresinformationfromthewebsite. Memberscanalsotakeadvantageof printablecouponsandotherin-store promotionsforpackagedgoods. Take advantage of these discounts and many others by visiting www.carefirst.com/options. Click on Blue365.

Vitality

Issue 2 / 2011 � 7

Member Update Members Have Exclusive Access to Second Opinion Membersnowhaveexclusiveaccess tonewandarchivedepisodesofthe award-winningAmericanPublic TelevisionhealthseriesSecond Opinion.Thegroundbreaking program,sponsoredbytheBlueCross andBlueShieldAssociation,shows viewersfirsthandhowdoctorswork throughtoughmedicaldecisions.The seriesaimstoimprovedoctor-patient communicationandempowerviewers totakechargeoftheirownhealthcare. To view past episodes, visit www.mycarefirst.com and click on PBS TV Health Topics in the CareFirst Programs and Events section of My Care First.

Language Help on Call Ifyouhavetroubleunderstanding English,pleasetelltherepresentative whenyoucallMemberServices.We willhaveaninterpreterwhospeaks yourlanguagejointhecall.

Protect Yourself from Insurance Fraud Insurancefraudincreasesthecost ofhealthcarecoverageforallof us.That’swhyit’simportantthat membersknowwhattolookforand whattodoiftheysuspectfraudhas beencommitted.Herearesometips toprotectyourself: ■ ReadyourExplanationofBenefits closelytomakesurethatthedate ofservice,theprovidernameand theservicerenderedarecorrect. ■ YouwillnotreceiveanExplanation ofBenefitsformedications,socheck My Accountatwww.carefirst.com tomakesurethatthedrugslisted aretheonesyoureceived.Makesure thepurchasedatesmatch,too.Also, verifythattheclaimisnotbilled asagenericdrugifyoureceiveda brand-namedrug.

Protectyourinsurancecardthe samewayyouprotectyourcredit cardtopreventmedicalidentity theft.Onlysharetheinformation withsomeonewhoneedstoknow. ■ Neverletanyoneborrowyour card,includingclosefriends andfamilymembers. ■ Neverrespondtoanemailor calleraskingyoutoverifyyour healthplanIDnumberorany otherpersonalinformation. ■ Bewareofproviderswhoaskfor yourinsuranceinformationwhen offeringfreeservices.Theyoften billfortheseservicesorsellyour informationtopeoplewhouseit tocommitfraud. ■

If you suspect fraud, please call us at 800-336-4522.

Programs for Members with Chronic Conditions Doyouhaveachronicillness, suchasdiabetes,asthmaor heartdisease?Youcanprevent ordelaycomplicationsbytaking anactiveroleinmanagingyour health.CareFirsthasthetools andresourcestoassistyou. CareFirstoffersfree,confidential programsformemberswithasthma, diabetes,COPD(chronicbronchitis/

8

Vitality

Issue 2 / 2011

emphysema),congestiveheartfailure andheartdisease.Uponenrollment intheprograms,membersreceive:

Ifyouwouldliketoenrollinthe program,pleasecall888‑264‑8648 tofindoutifyouareeligible.

■ accesstoatoll-freenumberto

NOTE: Members whose primary insurance is Medicare are not eligible for these programs and should contact Medicare at 800-MEDICARE or visit www.medicare.gov for a list of resources.

speakwitharegisterednurse ■ educationalmaterialswith

informationaboutyourcondition ■ remindersandtoolstohelp

youmanageyourcondition

Compare Doctors and Hospitals at www.carefirst.com CareFirstofferstoolstohelpyou findthebestcareatthemost reasonablecost. Visitwww.carefirst.com/doctor andclickonResearching a Doctor or HospitalintheQuick Linkssection forlinkstonationalmedicalsocieties, statemedicalboardsandindependent organizations.Thesegroupsprovide helpfultoolstohelpyoucompare thequalityofproviders.Resources include:

national Committee for Quality assurance TheRecognizedClinicianDirectory helpsyoufinddoctorswhomeet importantstandardsofcarein theareasofheartandstrokecare, diabetescare,backpainandpatientcenteredmedicalhome.

Quality check TheJointCommissionrateshealth careorganizationsthroughoutthe UnitedStatesonhowwelltheymeet theCommission’spatientsafetygoals andqualitystandards.

Be sure to search our online provider directory at www.carefirst.com/doctor to make sure the providers you choose are in your health plan’s network. For a printed copy of the information described, please call Member Services at the telephone number on your ID card.

Hospital comparison tool WebMDQualityServicesprovides thistool.Itletsyoucomparetreatment resultsfordiagnosesandprocedures atdifferenthospitals.

leapfrog TheLeapfrogGroupreportsinformationonhospitalqualityandpatient safetyefforts.Youcansearchfor hospitalinformationbyZIPcode, cityandstateandcomparetheresults fromthelatestLeapfrogHospital QualityandSafetySurvey.

Do You Have a Quality‑of‑Care Complaint? Wecareaboutthequalityofcareandservicesthatyou receive.Wewanttohearyourconcernsandcomplaints, sowecanresolvethem.Weinvestigateeachcomplaintand takeaction,whenappropriate,tocorrecttheproblem.We trackinformationfromcomplaintstoidentifyandaddress opportunitiesforimprovementwithinyourhealthplan andourprovidernetworks.Memberscannotbedisenrolled orotherwisepenalizedforfilingacomplaintoranappeal ofacomplaintdecision. Youmaycontactusifyouhaveaquality-of-careand servicecomplaintinvolvingmedicalissuesorservicegiven byadoctororproviderinournetwork,aswellasFirstHelp® HealthCareAdviceLine,HealthwaysorHealthFitnessstaff, mentalhealthspecialistsorDavisVisionproviders.You maysubmitacomplaintusinganyofthesemethods: ■ CallMemberServicesatthetelephonenumberonyour IDcard.IfyouhavetroubleunderstandingEnglish,

pleasetelltherepresentative,andwewillhavean interpreterwhospeaksyourlanguagejointhecall. ■ Sendanemailto[email protected]. ■ Faxawrittencomplaintto301-470-5866. ■ Mailawrittencomplaintto: CareFirstBlueCrossBlueShield QualityofCareDepartment CentralAppealsUnit,CT09-17 P.O.Box17636 Baltimore,MD21297 Pleaseincludeyourname,address,memberIDnumber, telephonenumberandasmuchdetailaspossibleaboutthe eventorincident,includingdate(s)ofservice.Werespond toallcomplaintsorlettersofconcernwithin60daysor sooner,dependingontheurgencyofthesituation. Vitality

Issue 2 / 2011 � 9

Member Update

Health Benefits Q&A Question: Mybenefitssummarysays experimental/investigational servicesarenotcovered. Whatareexperimental/ investigationalservices?

answer: Theterm“experimental/ investigational”describes servicesorsuppliesthatarein thedevelopmentalstageand areintheprocessofhuman oranimaltesting.Ifanyofthe statementsbelowarenottrue foraserviceorsupply,thenitis experimental/investigational:

1

Thetechnologymust havefinalapprovalfrom theappropriategovernment regulatorybodies.

2

Thescientificevidence mustpermitconclusions concerningtheeffectofthe technologyonhealthoutcomes.

3

Thetechnologymust improvethenethealth outcome.

4

Thetechnologymustbeas beneficialasanyestablished alternatives.

5

Theimprovementmust beattainableoutside theinvestigationalsetting. Technologyincludesdrugs, devices,processes,systems andtechniques.

Register for Health News by Email Betterhealthisjustaclickaway!If youenjoythehealthinformationyou findinVitality, signupforCareFirst’s e-newsletter.Eachmonth,we’llsendyou importanthealthinformationbyemail. Getthelatestinformationtohelp youandyourfamilymaintaina healthylifestyle.Learnhowto: ■ makehealthierchoices ■ managechronicconditions ■ addphysicalactivitytoyourday ■ makenutritiousanddelicious recipes ■ getthebesthealthcare CareFirst’s Health News offers all this and more. Register now at www.carefirst.com/healthnews. We do not share email addresses with other parties.

CareFirst Wants Your Input CareFirstinvitesmemberstoprovide feedbackthroughouradvisorygroup. ThegroupincludesCareFirststaff frommanyareasofthecompany. Wediscussqualityandservice activities,satisfactionsurveysand waystoimprovecareandserviceto ourmembers. Advisorygroupmembersparticipate inconferencecallsoremailsurveysat leasttwiceayear.Weaskthatadvisers participateforayear. CareFirstvaluesyourideasas wellasyourtimeandcommitment. Totakepartinthegrouporget moreinformation,pleasecall 800-323-4472.

Medical Information on Your iPhone® Feelingundertheweather,butdon’t knowwhetheryoushouldcallyour doctor?NowyoucanuseyouriPhone®, iPad®oriPod®Touchtocheckyour symptoms,thankstoCareFirst’s award-winningSymptomCheckerapp. Theapphelpsusersmakeappropriatedecisionsaboutthelevelofcare theyneed,fromtreatingsymptomsat hometoatriptotheemergencyroom. SymptomCheckerisbasedonstandards usedbyphysiciansandnursesand onnurseadvicelinesthroughoutthe UnitedStatesandCanada. Theappalsoallowsuserstocall911, healthcareprovidersandMember Services.Inaddition,userscan locatethenearestmedicalfacility andreviewchilddosagetablesfor over-the-countermedications.

To download the free app, visit www.carefirst.com/socialmedia. We hope to make the app available for other smartphones soon.

10 Vitality Issue 2 / 2011

On The Cover

A Full Plate New Guidelines Favor Fruits, Veggies and Whole Grains Long-awaitedU.S.dietaryguidelinesreleasedearlierthisyear, thefirstsince2005,focusongettingAmericanstocuttheir saltintake.

Vitality

Issue 2 / 2011 � 11

On The Cover

No more than

10%

of calories should come from saturated fat.

Specifically, the 7th edition of the U.S. Department of Agriculture’s Dietary Guidelines for Americans advises most people to limit their daily sodium intake to less than 2,300 milligrams (about a teaspoon) a day. It recommends less than 1,500 milligrams of sodium per day for: > adults ages 51 and older > African-Americans > people who have high blood pressure, diabetes or chronic kidney disease Given the current obesity epidemic and its related health problems, the 1,500-milligram limit applies to about half of the U.S. population, the guidelines state. “The focus is still on salt,” says Lona Sandon, M.Ed., R.D., an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas and a spokeswoman for the American Dietetic Association. “We know that most Americans are eating 2 times or more of what’s recommended. We still need to reduce our daily intake.”

U.S. HEALTH OFFICIALS AGREE “We know today the average American probably consumes 3,400 milligrams of sodium, so this is a fairly significant effort on our part, and it must be reflected in the decisions that food-processing companies, in particular, make over time so folks don’t necessarily reject out of hand these guidelines because the taste is so fundamentally different,” USDA Secretary Tom Vilsack said during a news conference announcing the new guidelines on January 31. The guide should help Americans as they look up the sodium content on the product labels of various foods, he added. FOCUS ON FATS The guidelines also put “more emphasis on getting people to choose healthier types of fats,” Ms. Sandon says. The new guidelines are “tools to give Americans better information about how to stay healthy, how to become healthier, how to make children

Key ReCommendAtionS The new Dietary Guidelines for Americans 2010 contains 23 key recommendations for the general public and 6 for certain populations, such as pregnant women and older adults.

Here are some of the main messages: �

1

Make half your plate fruits and vegetables and eat more whole grains to get more of needed nutrients.

2

Eat more lean meats and poultry, legumes, and nuts and seeds.

3

Use fat-free or low-fat (1 percent) milk.

12 Vitality Issue 2 / 2011

4

Stay away from added sugars, refined grains and solid fats, which tend to have many calories, but few essential nutrients.

5

Compare the amount of sodium in foods such as canned soup and frozen meals. Select those foods with the least salt.

6

Consume less than 300 milligrams per day of cholesterol.

7 8

Avoid trans fatty acids. Get nutrients primarily from nutritious food

instead of vitamins. �

9 10

Consume alcohol only in moderation, meaning 1 drink or less for women per day and 2 drinks for men. Drink water instead of sugary sodas or other

sweetened drinks.

Most people should limit their daily sodium intake to less than

2,300 mg a day.

better students and be prosperous in the future,” Kathleen Sebelius, secretary of the Department of Health and Human Services, said during the news conference. This time around, there are highly specific recommendations on fats: No more than 10 percent of calories should come from saturated fat. People should eat monounsaturated and polyunsaturated fatty acids instead. Americans are also urged to eat more seafood, particularly cold-water fish, which have healthier fats, such as omega-3. That was not specifically stated in past versions of the guidelines. EVIDENCE‑BASED TRUTHS In a way, the messages contained in this new document aren’t much different than what experts have been trying to promote for years. These include smaller portions, lower calorie intake and more physical activity.

The guidelines were published shortly after new federal guidelines for making school lunches healthier were released. Those proposals are similar, including adding more grains and vegetables into school meals and switching to low-fat or nonfat milk. “This is very much what many health professionals have been saying for years. There’s nothing particularly earth-shattering here,” Ms. Sandon says. “But these guidelines are based on science and what we know about healthy eating, weight loss and how nutrients promote our health, but tend to get lost among all the hype of fad diets. “If [only] we could make this the next fad diet,” she continues. “We need to get this to stand out in the public’s mind above all the hundreds of books that are making promises of quick fixes. This is as close as we can get to the truth about healthy eating.”

For more information

> The federal government provides the Dietary Guidelines for Americans 2010 at www.dietaryguidelines.gov.

> Our online Weight Management Center has

information on nutrition, physical activity and more at www.carefirst.com/weight. Vitality

Issue 2 / 2011 13

Interior Pages Prevention & Screenings

Did You Take Your Blood Pressure Medicine Today? When you miss a dose of your blood pressure medicine, you might not notice a difference. But your body does. Skipping your blood pressure medicine can make your blood pressure go up. This can cause damage to your heart and blood vessels. Takingyourmedicineatthesame timeeverydaywillhelpkeepyour bloodpressureattherightlevel andwillhelpyourheartandblood vesselsstayhealthy.Andknowing whenandhowtotakeyourmedicine willhelpensurethatit’sworkingthe wayitshouldbe. Herearesometipsfortakingyour bloodpressuremedicine: ■ Askyourdoctorwhattime ofdaytotakeyourmedicine andwhetheryoushouldtake itwithfood. ■ Keepyourmedicinewithsomethingyouuseeveryday—such asyourtoothbrush,coffeemug orcomputer—toremindyouto takeit. ■ Buyapillboxthathasacompartmentforeachday’spills. ■ Don’tforgetrefills.Everytime yourefillyourmedicine,makea noteonyourcalendartoremind youtopickupthenextrefill. ■ Askyourdoctorwhattodoifyou missadoseofyourmedicine. ■ Neverstoptakingyourmedicine withouttalkingwithyour doctorfirst.

14 Vitality Issue 2 / 2011 �

KNOW YOUr NUMberS Your doctor should take your blood pressure at every office visit. Keep a record, so you can track your health.

Blood preSSure leVel risk Category

Systolic (upper number)

diastolic (lower number)

Normal

Less than 120

Less than 80

Prehypertensive

120-139

80-89

High

140 or higher

90 or higher

These numbers are provided by the National Heart, Lung, and Blood Institute as a guide only. A single elevated blood pressure measurement does not always reflect a problem. Your doctor will want to see your blood pressure readings over several days or weeks before making a diagnosis.

How to Cut Your Cholesterol Butcanyoulowertherisk? “Ifyoumakeenoughlifestylechanges earlyenough,youcanreducetherisk forheartdiseasebyasmuchas80percent,”saysDavidL.Katz,M.D.,ofYale UniversitySchoolofMedicineinNew Haven,Conn.Hebasesthatestimateon thelong-runningFraminghamHeart Studyandresearchonothercultures wherealackofheartdiseasehasbeen linkedwithhealthierlifestyles.

High cholesterol levels

If you have high cholesterol, you’re at greater risk for heart disease.

About105millionU.S.adultshave cholesterollevelsabove200mg/dL, accordingtotheCentersforDisease ControlandPrevention.About42mil- lionhavelevelsof240mg/dL,whichis consideredhighrisk.Thesenumbers indicatethatashiftineverydayhealth habitsisinorder.Althoughyoucan’tdo muchaboutsuchriskfactorsasfamily history,ageorethnicity,thereareothers thatyoucancontrol. Startbygettingyourcholesterol checkedregularlyandtalkingwithyour doctorabouttheresults.Thentakea lookatyoureatinghabits,saysDr.Katz, coauthorofCut Your Cholesterol. Acholesterol-loweringeatingplan callsforfruits,vegetables,wholegrains, fish,skinlesspoultry,nonfatdairy, beans,seeds,nutsandhealthyvegetable oils,suchasoliveorcanola.Youshould limitsaturatedfat,transfatandsalt. Dr.Katzalsosuggeststhatyoucutback onsugarandrefinedflour,whichhave beenlinkedwithhightriglycerides (anotherdangerousfatinourblood). Eatingsensiblyshouldhelpyoukeep yourweightwithinahealthyrange (abodymassindexof18.5to25).

Ahealthyweightalsoreducesyour chancesofdevelopingmetabolic syndrome,aconditionassociated withhighcholesterol,highblood pressure,hightriglyceridesanda highriskfortype2diabetes.

What you can do Otherstepsyoucantaketolower yourcholesterollevelsinclude: ■ Getregularexercise.Regular physicalactivityiscriticalto improvingyourcholesterollevels andcuttingyourriskforheart disease.Exercisereducestotal cholesterol,LDL(bad)cholesterol andtriglycerides,anditincreases HDL(good)cholesterol. ■ Ifyoudrink,dosoinmoderation. Excessivealcoholuseincreases triglyceridelevels. ■ Reducestress.Itmayhelpkeep yourcholesterolincheck. ■ Ifyousmoke,quit.Smokingraises triglyceridelevelsandincreasesthe riskforheartdisease. ■ Ifyourdoctorprescribes medication,takeitasdirected.

CHoleSTerol: your Goal Total cholesterol

less than 200 mg/dL

LDL (bad) cholesterol

less than 100 mg/dL

HDL (good) cholesterol

Men: more than 40 mg/dL Women: more than 50 mg/dL

Triglycerides

less than 15 mg/dL

Vitality

Issue 2 / 2011 � 15

Food & Nutrition

Super Summer Meals

Turn off the stove. Put away the pots and pans. Forget about cooking. It’s time for the cool, easy foods of summer.


Whenthemercuryishigh, weallcravemealsthat arecoolandrefreshing, nutritionexpertssay. Weinstinctivelyturn tomealsthathaveahigh watercontenttoreplace thewaterweloseinthe warmweather. Soifyouwanttomake theseasonalswitch,where shouldyoubegin?Start withsoups.Buttermilk istheperfectbasefor whateveryouwanttoadd. Ithasonly2gramsoffat percup,comparedwith 5 gramsfor2percentmilk. Puréeyourfavoritefruit withbuttermilk,sprinkle withnutmegorcinnamon, andyou’redone.Orblend leftovervegetableswith buttermilkandgetcreative withseasonings. Cookingiscoolandeasy whenyouturnasaladinto anentrée.Thisdishgives youlotsoffreedomtomake itupasyougoalong. Don’tforgettothink “green.”Thedeeperthe greenofyoursaladfixings, themorenutrientsthey hold,expertssay.For instance,iceberglettuce isnotpackedwithvita- minsandminerals,but romaineandspinachare fullofthem. Toturnthatsaladinto amaindish,you’llneedto addprotein.Trycubesof reduced-fatcheese,tuna packedinwater,sliced

turkeyorchickenorlow- fatcottagecheese.Other proteinsourcesinclude nuts,seeds,chickpeasand kidneybeans. Addanotherdimension toyoursaladbyusingpasta orgrains.Startyoursalad withnoodles,rice,couscous orbulgurwheat,andbuild fromthere. Don’tspoilyoursalad bypouringonacreamy, high-fatdressing.Look forthemanyalternatives. Blendseasoningmixes intolow-fatyogurtinstead ofmayonnaise.Orlook forlow-fatornonfatsalad dressingsatthestore. Breadwilladdmore complexcarbohydratesto yourcoolandeasymeal. Choosewholewheatforits extrafiberandnutrients. Makearefreshingsummer dessertbypouringalittle orangejuiceorhoneyover yourfavoritefruits.Youcan alsopuréeraspberriesor strawberrieswithatouchof honeyorsugarasatopping. Forcompany,startwithan angelfoodcakeandtopwith puréedfruit.

Watch us make Roasted Beet Salad and other recipes at www.carefirst.com/recipes.

Roasted Beet Salad

Ingredients

Directions

Dressing* 1 shallot, peeled and minced 2 garlic cloves, peeled and minced 1/2 cup apple cider vinegar 1/2 cup olive oil 1/8 teaspoon salt 1/8 teaspoon black pepper

Dressing: In a small bowl, mix shallot, garlic, vinegar, olive oil, salt and pepper. Let dressing sit for flavors to combine, at least 2 hours. Salad: Arrange arugula on a large platter. Place nectarine and avocado wedges around the platter. Top with beets and feta cheese. Drizzle with 1/4 cup dressing.

Salad 1 bunch of baby arugula (or lettuce of your choice) 2 medium nectarines, sliced into wedges (skins on) 1/2 avocado, peeled and sliced thin 2 pounds beets, roasted, peeled and diced 2 ounces reduced-fat feta cheese, diced

*Note: This recipe only requires 1/4 cup dressing. Store remaining dressing, chilled, for up to 1 week. Makes 4 servings of salad and 1.5 cups dressing

Each serving contains (with 1 tablespoon dressing): 358 calories 10 grams fat | 399 milligrams sodium | 37 grams carbohydrates 13 grams fiber | 10 grams protein

Tuna Salad in the Round

Ingredients

Directions

1/2 cup roasted peppers (jar variety is fine, but not in oil) 6-ounce can white tuna packed in water, drained and flaked 1/2 cup chopped red onion 2 plum tomatoes, seeds removed, cut in strips 1/2 avocado, sliced 2 cups spring mix or shredded lettuce 1 cup cherry or grape tomatoes 1 carrot, peeled into strips

Place a mini-spring-form pan (without the bottom) or other ring mold on a serving plate. Line with the roasted peppers and spread the tuna over it. The next layer is the chopped onion, then the tomato strips. Press down lightly on each layer. Top with the avocado slices. Carefully remove the mold. Arrange spring mix or other shredded lettuce around the “cake” and decorate the plate with small tomatoes and carrot strips. Add garnishes, if desired.

Optional: small ripe olives, pepperoncini (Italian peppers) or artichoke hearts, for garnish

Makes 2 servings

Each serving contains: 255 calories | 10 grams fat | 258 milligrams sodium | 19 grams carbohydrates | 9 grams fiber | 24 grams protein 72 milligrams cholesterol Vitality

Issue 2 / 2011 � 17

Living Well

Health Bytes | HoT HEALTH TIPS WOrK OUT ON THe WATer Instead of getting in the water this summer, try getting on it. With a sailboat, canoe, kayak, windsurfing board or pair of water skis, you can explore a whole new world of activities. Once you’ve embraced proper training and safety, you’ll get a good, fun workout. Before you begin, consider these tips:

1

Take a class. Trialanderror isn’tthebestorsafestteacher. Tofindagoodschoolorinstructor, checklocalcollegesorlearning centersortheInternet.

2

Rent before you buy. Renting cutsyourinitialcostandlets youtestproductsandactivities, soyoucanmakethebestchoice whenyoubuy.

Halt That Hot Flash Hotflashesaffectmostmiddleagedwomenandareanatural partoflife.Onceyoufigureout whatcausesthem,youcantake stepstoavoidthem.Formany women,stress,alcohol,caffeine, dietpills,spicyorhotfood,hot tubs,saunas,hotshowers,hot beds,hotrooms,hotweatherand smokingaretheculprit. Evenifyoucan’tavoidhot flashes,youcansurvivethem. Herearesometips: ■ Takeacoolshowerbeforebed.


■ ■

■ ■ ■

■

Dressinlayers,soyoucanpeel themoffasyougetwarmer. Wearcotton,linenandrayon. Stayawayfromwool,synthetics andsilk. Avoidturtlenecks.Stickto open-neckshirts. Keepicewateronhand,so youcansiptocooldown. Whenpossible,turndown theheat.Inthesummer,turn ontheairconditionerorfan. Wearcottonpajamasornightgownandusecottonsheets.

3

Dress for safety. Apersonal flotationdeviceisessential fortheseactivities,although windsurfersmayopttowear awetsuitthataddsbuoyancy.

4

Get in shape. Lookfor exercisesthatstrengthen themusclesyou’lluseonthe water,suchassit-upsandback extensionsforpaddlingactivities.

5

Consider your location. Youdon’thavetoliveon thecoasttojoinin.Canoeists canpaddleinlandrivers,and boaterscanfloatacross inlandlakes.

OLder AdULTS: YOU CAN beAT THe HeAT You also may be at greater risk for heat‑related illnesses if you have a chronic health condition or take certain medications that interfere with your normal body response to heat. Some medications also restrict the body’s ability to perspire. You can enjoy a safe summer by taking a few precautions when it gets hot, says the National Institute on Aging. After age 65, your body can’t adjust to changes in air temper‑ ature, especially heat, as quickly as it did when you were younger. That puts you at risk for heat‑ related illnesses.

Unless you are on a water pill, and your doctor has told you to limit your fluids, you should drink plenty of cool liquids, such as water or fruit and vegetable juices. Don’t wait until you’re thirsty. Do not

drink alcohol because you’ll lose much of the fluid it offers. Here are some other ideas to beat the heat: ■ Take a cool shower, bath

or sponge bath. ■ Ask a friend or relative to drive

you to a cool place on very hot days if you don’t drive. ■ Dress for the weather. Natural

fabrics such as cotton feel cooler, as do light‑colored clothes. ■ Avoid exercising, walking

long distances or doing a lot of activities when it’s hot.

Make Your Cookout Sizzle Abarbecuegrillisasimplepleasure ofsummer.Becausebarbecuegrills areoperatedinacasual,relaxed atmosphere,theyareoftentakenfor granted.Andthatcanleadtoserious injury,evendeath.Herearesome tipstokeepyournextcookoutsafe andfun. Whenusingacharcoalgrill: ■ Charcoalproducescarbon monoxide,apoisonousgas. Therefore,neverusecharcoal indoors. ■ Neverplaceagrillindoorswith coalsyouhavejustburneduntil thecharcoaliscompletely snuffedout. ■ Neverusegasolinewhen startingacharcoalfire. Gasolinewillexplode.

Useonlyapprovedcharcoal lighterfluid. Whenusingagasgrill: ■ Checkforleakseverytimeyou disconnectorreconnectthe regulatortotheLPtank.Ifyou findaleak,immediatelyturn offthegasatthetankanddon’t attempttolightthegrilluntilthe leakisfixed. ■ Neveruseagrillindoors. Usethegrillatleast 10feetawayfrom anybuilding.Donot

■

■ ■

■

usethegrillinagarage,carport, porchorunderasurfacethatcan catchfire. Movegashosesasfarawayas possiblefromhotsurfacesand drippinghotgrease.Ifyoucan’t movethehoses,installaheat shieldtoprotectthem. Neverstartagasgrillwiththe coverclosed. Iftheburnerdoesn’tlight,turn offthegasandtryitagainin about5 minutes. Whennotinuse,turnoffthe LPtankvalve.

10feet

Yourgrillshouldbe awayfromanybuilding.

Vitality

Issue 2 / 2011 � 19

Living Well

Juggling Act: Balancing Home Life and Work Life thatit’snottheworstthingthatcould everhappen.Thenstartlookingfor creativewaystohandletheissue.Could acoworkercoverforyou?Couldyou postponethefamilyouting? Ifyou’restuckforsolutions,Dr.Smith recommendsbrainstorming:“Letallthe ideaspourout—thegood,thebadand thesilly.”Writeeverythingdown.Then, decidewhichideasaretrulyhelpful.

Juggling lessons Herearesomemoretipstoachieve balance: ■ Createboundaries.Forexample, setlimitsonwhenyou’llbe availablefornonemergency messagesandcalls. ■ Makealistofthemostimportant householdchores,andtakecareof For many of us, life seems to have 2 speeds: fast and faster. theessentialsfirst.Ifyou’repressed fortime,lettherestgo. Pressures at work compete with demands at home. Do you often ■ Askotherstosharetheload.If feel guilty at work because of home pressures and guilty at youfeeloverburdenedathome, home because of work pressures? A study by the Families and talkwithyourfamilyaboutways Work Institute found that more than half of American workers felt todistributethehouseholdchores morefairly. “overwhelmed” by their workload at some point. Even so, a third ■ Getafullnight’ssleep.Lackof of them had no plans to take any vacation days. sleepmakesithardertothink clearlyandmakegooddecisions. Italsoincreasestheriskforcar Nomatterhowenergeticyoumaybe, exerciseormissingsleep.Inthelongrun, accidents. stretchingyourselftothelimitevery thesesolutionswillonlymakeyoufeel ■ Maketimeforself-nurturing. dayputsyourhealthandhappinessat worse,whichcanaffectyourenergyand You’llbeabletodoabetterjob risk.Frequentstresstakesamentaland mentaloutlook.Instead,tryexercising, bothatworkandathomeifyou physicaltollonyourbody.Itmaymake meditatingorsimplybreathingdeeply takeafewminuteseverydayto youfeelirritated,worriedordepressed, forafewminutes. refreshyourself. andyoumayhavefrequentheadaches, Also,trytokeepapositiveoutlook, backachesoranupsetstomach. saysJonathanC.Smith,Ph.D.,a licensedclinicalpsychologistand De-stress for success stressexpert.Forexample,perhaps What’s Stressing you out? Too much stress can affect both Howcanyoufindabalance?Startby yourbossasksyoutoworklate your emotional and physical health. controllingwhatyoucan.Resisttheurge tonight,butyoualreadyhaveplans What causes your stress? Find out tocopewithstressbysmoking,drinking withyourfamily.Yourfirstreaction at www.carefirst.com/interactive and click on Risk Assessments. toomuch,eatingjunkfood,skipping maybenegative,butremindyourself 20 Vitality Issue 2 / 2011 �

How to Prepare for Your Doctor Visit

Whether buying a toothbrush or a new car, it’s become routine for shoppers to research before buying, so they know all the options and can get the best deal. Medical services should be tackled the same way any other purchase would be, consumer experts say. That begins with doing a little homework before going to see a doctor.

“Ordinarily,appointmentsarenot verylong,”saysArthurLevin, directorofthenonprofitCenter forMedicalConsumers.“Physicians talkalotanddon’talwayslisten. Youhavetoorganizeyourselfin awaythatmaximizesthechances thequestionsyouhavewillbeheard andanswered.” Writedownasmanydetailsas youcanaboutwhat’swrongwith you,suggestsDonPowell,Ph.D., presidentandchiefexecutiveofficer oftheAmericanInstitutefor PreventiveMedicine.Thentake thatsheetofpaperwithyoutothe appointment. “Whatthepatienttellsthedoctor is70percentresponsibleforacorrect diagnosis,”Dr.Powellsays. Youshouldalsonote: ■ anysymptomsyouhave ■ medicinesyouaretaking ■ relevantfamilyhistory ■ recentlifestylechanges ■ anyhealthconcernsyou’ve hadonyourmind

Ifyouhavesomeideaofwhyyou’re ill,youalsoshouldtrydoingsome research,usingtheInternetora medicalguidebook,explainsMr.Levin.

Keyquestionsinclude: Whyareyouprescribingthisdrug? ■ Aretherealternativestotakingthis medication? ■ Whatarethepossiblesideeffects? Jot down questions ■ Isthereagenericversionthatwill Beforeheadingouttothedoctor,though, dothesamejob? youshouldwritedownyourquestions aboutyourillnessorcondition. Andifyou’vebeenprescribeda “Patientswhowritedowntheir procedureortest,askwhetherthere questionsare90percent areanyrisksassociatedwith morelikelytogetthem it.Alsoaskaboutthechances Whatthe answered,”Dr.Powell thatthetestcouldproducea patienttells false-positiveresult,requiring says.“Youtendtoforget thedoctoris furthertestingandtreatment thingswhenyou’reinthe doctor’soffice,andthe whenyou’reactuallyhealthy. doctormayrushyou.” “Ifyouleaveandlater responsible rememberanimportant foracorrect Ask follow-up question,calltheoffice diagnosis. questions andtellthemyouforgot Ifyourdoctorprescribes animportantthingyou amedicine,besuretoaskfollow-up wanttoknow,”Mr.Levinadds. questions,Mr.Levinadvises. “Youdon’thavetoreschedulean “Physiciansoftenaren’tterribly appointmentjusttogetananswer.” inclinedtohaveafulldiscussionabout Somedoctorswillcallyouback thedrugtheyareprescribing,”hesays. orwillhaveanursecallyou.Other “Youneedtoprobe.” doctorswillsendemail. ■

70%

Vitality

Issue 2 / 2011 � 21

Your Family

Role Reversal: Caring for Aging Parents As more Americans live longer, millions of middle-aged adults find themselves caring for their aging parents. It’s not an easy task. “Caregivingcanbesooverwhelming, it’salmostimpossible,”saysDonna Cohen,Ph.D.,aprofessorinthe DepartmentofAgingandMental HealthattheUniversityofSouth FloridainTampa.“Butitcanbe doneifyoudevelopspecificskills.” Herearesometipstohelpyou providecaremoreeffectively.

Don’t parent your parents Asyourparentsbecomefrailor ill,don’tregardthemaschildren. Instead,thinkofcaregivingasa familybusinessandyourselfasan executivewithproblemstosolve. “Yourrolewillbetotakecontrol, butit’snotwiththesameauthority youusewithyourchildren,”says Dr.Cohen. Forexample:Yourmothercan’tsee wellanymorebutinsistsondriving. Insteadoftakingawayhercarkeys,say, “Mom,I’mworriedaboutyou.Aren’t youworriedaboutyourdriving?”

Kinds of care Thekindofcareyourparentsneed dependsontheirlevelofdependence. Discussthiswithyourparentsand theirhealthcareprovider:Cantheylive ontheirownwithsomeoutsidehelp? Shouldtheybeinanursingfacilityor inanassisted-livingarrangement? Avarietyofgovernmentprograms areavailableforolderadults.Youcan


findmoreinformationinyourlocal phonebookunderAging Services.

Don’t do it alone Thereisnosinglerightwayofcaring foragingparents.Thewrongway istodoitalone,Dr.Cohensays. Thedemandsofcaregivingcan becomesoimmensethattheycan affectyourhealth. “Halfofallcaregiversgetdepressed inthecourseofcaregiving,”she explains.“Depressiontakesatoll ontheirphysicalhealthandcan evenleadtoparentabuse.” Dr.Cohensuggestsseekinghelp andadvicefromprofessionalsand yoursiblings. ■ Workwithphysicianstounderstandyourparents’healthproblems andtheirtreatments. ■ Meetwithyoursiblingsover breakfast,notatnightwhen everyone’stired.

■

Consultafinancialplanneror attorneyregardingyourparents’ estate,livingwillsandother legalmatters.

Stay positive Caringforagingparentsinvolves therealitythattheirdeathsare approaching.However,youcan stillmaximizecomfortandimprove yourparents’qualityoflife. “Conveysupportandshowaffection bygivingyourmotherachenillethrow becauseshe’llenjoyitssoftnessand warmth,”Dr.Cohensays.“Evenholding someone’shandisapowerfulwaytoease painandloneliness. “Caringforyourparentsismore thanjustlovingthem,”shecontinues. “It’saseriesofdiscreetskillsthat involvelisteningtothem,making decisionsabouttheirneedsand takingaction.Andithasmutual benefits.”

3 Habits to Help Kids Stay in Shape

Researchsuggeststhatfamilybehaviors canhaveasignificantimpactonthe weightofpreschoolchildren. “Four-year-oldswhoregularlyate dinnerwiththefamily,gotenough sleepandwatchedlessthan2hoursof TVadaywere40percentlesslikelyto beobese,”saysthestudy’sleadauthor, SarahAnderson,anassistantprofessor ofepidemiologyintheCollegeof PublicHealthatOhioStateUniversity inColumbus. Thestudyincludedanational sampleof8,5504-year-oldchildren. Just14.5percentofthechildrenwere exposedtoall3ofthefollowing behaviorsonaregularbasis: eatingtheeveningmealasafamily 5ormorenightsaweek gettingmorethan10.5hoursof sleeppernight watchinglessthan2hoursofTV, videosorDVDsaday

1 2 3

Theresearchersfoundthatinchildren routinelyexposedtoall3ofthese behaviors,theobesityratewas

14.3 percent.Inchildrenwhoweren’t exposedtoanyofthesebehaviors,the obesityratewas24.5percent. Ms.Andersonexplainsthateach behaviorwaslinkedwitha17percent lowerriskforobesity. Thesefindingsheldtrueevenwhen theresearcherscontrolledthefactors thatmayaffectachild’sriskforobesity, includingobesityofthemother,race, gender,socioeconomicstatusandliving inasingle-parenthousehold. Ms.Andersonpointsoutthatthis studycouldonlyfindanassociation betweenthesebehaviorsandachild’s riskforobesity.Thestudywasnot designedtoassesscauseandeffect. “Wedon’tknowifit’stheroutines, orifit’stheparentingassociated withtheseroutinesorsomethingelse correlatedwiththeseroutines,butwe doknowtheseroutinesareassociated withalowerincidenceofobesity,”says Ms.Anderson. “Thesearerelativelysimplethings youcandoinyourhomethatchange thehealthenvironmentofyourchild,”

saysJenniferHelmcamp,M.D.,a pediatriciananddirectoroftheJump Start!PediatricWeightManagement ClinicinRoundRock,Texas.“Not onlywillithelpyourchildwith obesityrisk,butplentyofotherstudies haveshownthatitwillalsohelpwith behaviorandcognitivedevelopment.” Ifitseemsimpossibletoadopt allofthesebehaviors,Ms.Anderson saysthatanyhabitalonecanhave aneffect. AndDr.Helmcampfurthernotes thatifyoucan’tfollowthetime constraintsexactly,it’sOKtoveeroff slightly.Forexample,ifit’stoughto eatdinnertogether5timesaweek, shootforatleast3 nightsaweek.She alsorecommendsremovingTVsfrom children’sbedrooms.Thiscanhelpwith limitingscreentimeandwithgetting enoughsleep. Help your Child manage Weight For more tips to prevent or manage childhood obesity, visit our online Weight Management Center at www.carefirst.com/weight.

Vitality

Issue 2 / 2011 � 23

TesIn t te Yoru iorrKPnaogw esledge

Health Quiz | Do You Have Sun Sense? Hot weather, clear skies and extra leisure time in the summer mean that many people spend hours in the sun. Sun exposure can raise the risk for skin cancer if you don’t take steps to protect yourself. Find out how much you know about sun safety by taking this quiz. Test Your Knowledge: 1.Duringwhichhoursofthedayare youmostatriskfromthesun’srays? A.10a.m.to4p.m. B.8a.m.to1p.m. C.7a.m.tonoon D.noneoftheabove 2.Whichtypeofultravioletraysdoes thesunemit? A.UVA B.UVB C.UVC D.UVA,UVBandUVC 3.Whatisthebestwaytoprotect yourselffromthesun’srays? A.Avoidthesunduringpeakhours. B.Wearprotectiveclothingand ahat. C.Wearwraparoundsunglasses. D.WearsunscreenwithanSPF ofatleast15. E.Alloftheabove 4.ExcessiveexposuretoUVrayshas whatdetrimentaleffectonhealth? A.Itbooststheriskforskincancer. B.Itbooststheriskforlipcancer. C.Itbooststheriskforcataracts. D.Alloftheabove 24 Vitality Issue 2 / 2011 �

5.WhatistheUVIndex? A.aratingsystemforsunscreens B.aforecastofUVradiationtied tothelocalweatherforecast C.aratingsystemforprotective clothing D.noneoftheabove 6.Whichcommonmedicationscan makeyoumoresensitivetothesun? A.ibuprofen B.doxycycline C.sulfadrugs D.alloftheabove 7. Howdosunscreenswork? A.Theyabsorbthesun’srays. B.Theyreflectthesun’srays. C.Theyscatterthesun’srays. D.Alloftheabove

8.Whichoftheseclothingchoices offersthebestprotectionand comfortfromUVrays? A.jeansandaT-shirt B.shortsandatanktop C.longpantsoftightlywoven fabricandaloose-fitting, long-sleevedshirt 9. Ifyouworkoutdoorsorspendalot oftimeinthesun,whichtypeof hatoffersthebestprotectionfrom UVrays? A.strawhat B.baseballcap C.canvashatwithabrimallthe wayaround D.bikehelmet (Answers can be found on back page.)

Health Management

How to Treat an Asthma Attack � Asthma is a serious and often life-threatening condition.

ASTHMA reSOUrCeS ■ For help in managing

Peoplewithasthmacanhaveanattack iftheyarearoundcertainthingscalled triggers.Commontriggersinclude dust,animaldander,pollenand mold.Triggersarenotthesamefor allpeoplewithasthma,sowhiledust orpollenmightcauseapersontohave anasthmaattack,moldmightnot. Whenanasthmaattackbegins, theairwaysandthemusclesaround themtighten.Thenabuildupof mucuscausescongestioninthe lungs,makingithardtobreathe.

your asthma, visit our online Asthma Center at www.carefirst.com/asthma. You will find educational articles, videos and inter‑ active calculators and quizzes, as well as an asthma action plan form that you and your doctor can complete. ■ Our Asthma Management

Program offers eligible members access to nurses, who will work with you and your doctor to support your treatment plan, set goals and track your progress. You will also receive a new member kit and educational materials to help you manage your condition. To find out if you are eligible, call 888-264-8648. Members whose primary insurance is Medicare are not eligible for this program and should call the American Lung Association at 800-LUNGUSA or visit its website at www.lungusa.org.

Warning signs Themostimportantfactorin controllingasthmaisspottingthe earlywarningsignsofanattack, accordingtotheAmericanAcademy ofAllergy,Asthma&Immunology. Thesignsaren’tthesameforeveryone. Warningsignsmayinclude: ■ adropinpeak-flowmeterreading ■ afrequentcough,especiallyatnight ■ difficultorfastbreathing ■ chesttightnessordiscomfort ■ itchy,wateryorglassyeyes ■ sneezing ■ stuffyorrunnynose ■ headache ■ fever ■ restlessness ■ darkcirclesundertheeyes

How to respond Someonewhoishavinganasthma attackoftenhasthesesymptoms: ■ shortnessofbreathandwheezing ■ coughorraspybreathing ■ agitatedmovement ■ bluelipsorfingertips ■ appearingtouseneckandfacial musclestobreathe

Ifsomeonehasthesesigns,followthis 3-stepplan: Havethepersonsitupright.Be calmandreassuring;asthma worsenswithpanic. Givetheperson2puffsofan albuterolinhaler(therescue inhaler).Usetheperson’sown inhaler,ifpossible.Inhaler medicationisbestgiventhrough aspacer,ifavailable.Theperson shouldtake1puffatatime,then take4breathsfromthespacer aftereachpuff. Wait5minutes.Iftheperson showslittleornoimprovement, orhasbluelipsorfingertips,call 911immediately.Keeptheperson calmuntilhelparrives.

1 2

3

Knowwhichthingscauseyour asthmaattacksandstayaway fromthem. ■ Visityourdoctorevery6months. ■ Workwithyourdoctortocomplete awrittenasthmaactionplan. ■

Keep it controlled Thebestwaytopreventasthmaattacks istokeepasthmacontrolled. ■ Takeasthmamedicationexactly asprescribed.

Vitality

Issue 2 / 2011 25

Health Management

COPD: Take a Hand in Your Health � What to ask Everyperson’sneedforinformation isdifferent.Yourconcernsmightvary fromvisittovisit.Torememberwhat youwanttoaskyourprovider,write downyourquestionsinadvanceand takenotesontheanswers.Youmight wanttobringalongafamilymember orfriendwhocanhelpyouremember alltheinformationyoureceive.Atape recorderisanotheroption,butalways askforpermissionbeforetaping. Herearesomeexamplesofcommon questionstoask. Yoursymptoms HowcanImanagemysymptoms? ■ WhatshouldIdoifmysymptoms getworse? ■ WhenshouldIcallyouroffice,and whatnumbershouldIuse? ■ WhenshouldIcall911orgotothe emergencyroom? ■

Yourtreatment ■ Whataretheexpectedbenefits,and howlongwillittaketonoticethem? ■ Whatsideeffectsmightdevelop, andwhatshouldIdoiftheyoccur? ■ WhenandhowshouldIusepursedlipbreathing? ■ DoIneedtousesupplemental oxygen?Ifso,whenandatwhat flowrate?

When it comes to managing COPD (chronic obstructive pulmonary disease), your provider works hard to develop a treatment plan that will help control your symptoms. Your input on this plan can make it easier to care for your health. That is why it is important to talk with your provider when you have questions about your symptoms, treatment, medications, exercise or eating habits. By preparing questions ahead of time, you can get the most out of every office visit. 26 Vitality Issue 2 / 2011

Yourmedicine HowmuchmedicineshouldItake, andwhen? ■ WhatshouldIdoifIskipadose byaccident? ■ Arethereanyover-the-counter drugsorherbalsupplementsI shouldnottake? ■ HowlongwillIneedtocontinue takingmedicine? ■

COPd reSOUrCeS ■ For help in managing your COPD, visit our online COPD Center at www.carefirst.com/copd. You will find educational articles, videos and inter‑ active calculators and quizzes. ■ Our COPD Management

Yourlifestyle ■ HowwillCOPDaffectmyhome andwork? ■ HowcanIquitsmoking? ■ DoIneedtoloseorgainweight? ■ ShouldIchangewhatIeat? ■ Arethereanyvitaminsor supplementsIshouldtake? ■ DoIneedtobecomemoreactive? ■ Whatkindofphysicalactivityis mostappropriateforme? ■ HowcanIpacemyselftomakethe bestuseofmyenergy? ■ HowcanIgetabetternight’ssleep?

Why speaking up works Studieshaveshownthatpatientswho haveagoodrelationshipwiththeir providertendtoseebetterresultsand aremoresatisfiedwiththecarethey receive.Also,youknowmoreabout yourownmedicalhistorythananyone else.Youandyourprovidercanuse thisinformationtomaketheright treatmentchoicesforyou. Byspeakingup,youcanhelp preventproblems,suchasallergic

reactionsordruginteractions.At times,youmightfeeluncomfortable discussingpersonalmatterswithyour provider.Donotletthisstopyou. Keepinmindthatyourprovider istheretohelp,nottojudge.Your providerhasalreadyheardthesame thingorsomethinglikeitfromother patientsbefore. Onceyougetstarted,youwill thinkofyourownquestions.With theanswers,youwillknowmore abouthowtomanageyoursymptoms, preventcomplicationsandimprove yourqualityoflife.

Program offers eligible members access to nurses, who will work with you and your doctor to support your treatment plan, set goals and track your progress. You will also receive a new member kit with tips to help you manage your condition. To find out if you are eligible, call 888-264-8648. Members whose primary insurance is Medicare are not eligible for this program and should call the American Lung Association at 800-LUNGUSA or visit its website at www.lungusa.org.

HOW WeLL Are YOUr LUNGS WOrKING? Your doctor will use a device called a spirometer to test your lung function. A spirometry test is simple and painless. The spirometer can: ■ determine how well the lungs receive, hold and use air ■ monitor a lung disease ■ monitor the effectiveness of treatment ■ determine the severity of a lung disease ■ determine whether the lung disease is decreasing or disrupting airflow

Vitality

Issue 2 / 2011 27

PRSRT STD � U.S. Postage � PAID � Permit #462

Maple Grove, MN �

My Account on My Time

IND 6203MA

Health Quiz Answers | Do YoU HAVE SUN SENSE? � (See quiz on page 24.)

CareFirst is making it more convenient for you to manage your health plan. Log in to My Account at www.carefirst.com to find personalized information about your health plan: • �covered members • �claims history • �out-of-pocket expenses you’ve paid You can also: • �request an ID card • �supply other insurance information if you or any dependents are covered by another plan • �check prices for your drugs and find out if generic versions are available

1.A.However,youshouldprotect yourskinwheneveryouareoutin thesun,nomatterwhattimeofday, timeofyearortypeofweather.

whenoutdoors:from1(lowrisk)to 11andhigher(extremerisk).You canusuallyfindtheUVIndexon yourlocalnewspaper’sweatherpage.

2.D.UVAandUVBraysareabsorbed bytheskinandcancausedamage. UVCisverydangeroustotheskin, buttheseraysareabsorbedbythe ozonelayer.

6.D.Medicationsandotherproducts canmakeyoumoresensitivetothe sun.Thebestprotectionistoavoid sunexposure,buthealthexperts stillrecommendusingsunscreen andprotectiveclothingifyouhave togooutside.

3.E.Whenpossible,avoidoutdoor activitiesduringthemiddleoftheday, whenthesun’sraysaremostintense. Ifyoumustbeoutdoors,thenwear protectiveclothing,awide-brimmed hatandwraparoundsunglassesthat block100percentofUVAandUVB rays.Wearsunscreenandlipscreen ratedwithatleastSPF15. 4.D.ExposuretoUVrayscanlead toskincancer.UVradiationalsohas beentiedtolipcancer,cataractsand othereyeconditions.UVradiation alsocanleadtoprematureaging oftheskinandabnormalchanges inskintexture. 5.B.TheUVIndexgivesaforecast oftheexpectedriskforexposureto UVraysandrecommendswhich degreeofcautionyoushouldtake

7.D.ThehighertheSPFnumber, thegreatertheprotection.Even withasunscreen,youshouldstill limitthetimeyouspendinthe sun,wearingprotectiveclothing, wraparoundsunglassesanda broad-brimmedhat. 8.C.Tobeprotective,clothing mustcoverasmuchofyourskin aspossible.Dark-coloredclothing appearstooffermoreprotection thanlight-coloredclothing. 9.C.Thistypeofhatprovidesshade foryourface,earsandbackofyour neck.Astrawhatmayhaveholes thatletthesunlightthrough.Aball capdoesn’tcoveryourearsorthe backofyourneck.

Find more quizzes at www.carefirst.com/interactive.

Notice of Nondiscrimination and Availability of Language Assistance Services CareFirst BlueCross BlueShield, CareFirst BlueChoice, Inc. and all of their corporate affiliates (CareFirst) comply with applicable federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. CareFirst does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. CareFirst:  Provides free aid and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information in other formats (large print, audio, accessible electronic formats, other formats)  Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages If you need these services, please call 855-258-6518. If you believe CareFirst has failed to provide these services, or discriminated in another way, on the basis of race, color, national origin, age, disability or sex, you can file a grievance with our CareFirst Civil Rights Coordinator. Civil Rights Coordinator, Corporate Office of Civil Rights Telephone Number

410-528-7820

Mailing Address

P.O. Box 8894 Baltimore, Maryland 21224

Fax Number

410-505-2011

Email Address

[email protected]

You can file a grievance by mail, fax or email. If you need help filing a grievance, our CareFirst Civil Rights Coordinator is 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, SW Room 509F, HHH Building Washington, D.C. 20201 800-368-1019, 800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc., First Care, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc.

Foreign Language Assistance Attention (English): This notice contains information about your insurance coverage. It may contain key dates and you may need to take action by certain deadlines. You have the right to get this information and assistance in your language at no cost. Members should call the phone number on the back of their member identification card. All others may call 855-258-6518 and wait through the dialogue until prompted to push 0. When an agent answers, state the language you need and you will be connected to an interpreter.

አማርኛ (Amharic) ማሳሰቢያ፦ ይህ ማስታወቂያ ስለ መድን ሽፋንዎ መረጃ ይዟል። ከተወሰኑ ቀነ-ገደቦች በፊት ሊፈጽሟቸው የሚገቡ ነገሮች ሊኖሩ ስለሚችሉ እነዚህን ወሳኝ ቀናት ሊይዝ ይችላል። ይኽን መረጃ የማግኘት እና ያለምንም ክፍያ በቋንቋዎ እገዛ የማግኘት መብት አለዎት። አባል ከሆኑ ከመታወቂያ ካርድዎ በስተጀርባ ላይ ወደተጠቀሰው የስልክ ቁጥር መደወል ይችላሉ። አባል ካልሆኑ ደግሞ ወደ ስልክ ቁጥር 855-258-6518 ደውለው 0ን እንዲጫኑ እስኪነገርዎ ድረስ ንግግሩን መጠበቅ አለብዎ። አንድ ወኪል መልስ ሲሰጥዎ፣ የሚፈልጉትን ቋንቋ ያሳውቁ፣ ከዚያም ከተርጓሚ ጋር ይገናኛሉ። Èdè Yorùbá (Yoruba) Ìtẹ́tíléko: Àkíyèsí yìí ní ìwífún nípa iṣẹ́ adójútòfò rẹ. Ó le ní àwọn déètì pàtó o sì le ní láti gbé ìgbésẹ̀ ní àwọn ọjọ́ gbèdéke kan. O ni ẹ̀tọ́ láti gba ìwífún yìí àti ìrànlọ́wọ́ ní èdè rẹ lọ́fẹ̀ẹ́. Àwọn ọmọ-ẹgbẹ́ gbọ́dọ̀ pe nọ́mbà fóònù tó wà lẹ́yìn káàdì ìdánimọ̀ wọn. Àwọn míràn le pe 855-258-6518 kí o sì dúró nípasẹ̀ ìjíròrò títí a ó fi sọ fún ọ láti tẹ 0. Nígbàtí aṣojú kan bá dáhùn, sọ èdè tí o fẹ́ a ó sì so ọ́ pọ̀ mọ́ ògbufọ̀ kan. Tiếng Việt (Vietnamese) Chú ý: Thông báo này chứa thông tin về phạm vi bảo hiểm của quý vị. Thông báo có thể chứa những ngày quan trọng và quý vị cần hành động trước một số thời hạn nhất định. Quý vị có quyền nhận được thông tin này và hỗ trợ bằng ngôn ngữ của quý vị hoàn toàn miễn phí. Các thành viên nên gọi số điện thoại ở mặt sau của thẻ nhận dạng. Tất cả những người khác có thể gọi số 855-258-6518 và chờ hết cuộc đối thoại cho đến khi được nhắc nhấn phím 0. Khi một tổng đài viên trả lời, hãy nêu rõ ngôn ngữ quý vị cần và quý vị sẽ được kết nối với một thông dịch viên. Tagalog (Tagalog) Atensyon: Ang abisong ito ay naglalaman ng impormasyon tungkol sa nasasaklawan ng iyong insurance. Maaari itong maglaman ng mga pinakamahalagang petsa at maaaring kailangan mong gumawa ng aksyon ayon sa ilang deadline. May karapatan ka na makuha ang impormasyong ito at tulong sa iyong sariling wika nang walang gastos. Dapat tawagan ng mga Miyembro ang numero ng telepono na nasa likuran ng kanilang identification card. Ang lahat ng iba ay maaaring tumawag sa 855-258-6518 at maghintay hanggang sa dulo ng diyalogo hanggang sa diktahan na pindutin ang 0. Kapag sumagot ang ahente, sabihin ang wika na kailangan mo at ikokonekta ka sa isang interpreter. Español (Spanish) Atención: Este aviso contiene información sobre su cobertura de seguro. Es posible que incluya fechas clave y que usted tenga que realizar alguna acción antes de ciertas fechas límite. Usted tiene derecho a obtener esta información y asistencia en su idioma sin ningún costo. Los asegurados deben llamar al número de teléfono que se encuentra al reverso de su tarjeta de identificación. Todos los demás pueden llamar al 855-258-6518 y esperar la grabación hasta que se les indique que deben presionar 0. Cuando un agente de seguros responda, indique el idioma que necesita y se le comunicará con un intérprete. Русский (Russian) Внимание! Настоящее уведомление содержит информацию о вашем страховом обеспечении. В нем могут указываться важные даты, и от вас может потребоваться выполнить некоторые действия до определенного срока. Вы имеете право бесплатно получить настоящие сведения и сопутствующую помощь на удобном вам языке. Участникам следует обращаться по номеру телефона, указанному на тыльной стороне идентификационной карты. Все прочие абоненты могут звонить по номеру 855-258-6518 и ожидать, пока в голосовом меню не будет предложено нажать цифру «0». При ответе агента укажите желаемый язык общения, и вас свяжут с переводчиком. CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc., First Care, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc.

हिन्दी (Hindi) ध्यान दें : इस सच ू ना में आपकी बीमा कवरे ज के बारे में जानकारी दी गई िै । िो सकता िै कक इसमें मख् ु य ततथियों का उल्लेख िो और आपके ललए ककसी तनयत समय-सीमा के भीतर काम करना ज़रूरी िो। आपको यि जानकारी और संबथं ित सिायता अपनी भाषा में तनिःशल् ु क पाने का अथिकार िै । सदस्यों को अपने पिचान पत्र के पीछे हदए गए फोन नंबर पर कॉल करना चाहिए। अन्य सभी लोग 855-258-6518 पर कॉल कर सकते िैं और जब तक 0 दबाने के ललए न किा जाए, तब तक संवाद की प्रतीक्षा करें । जब कोई एजेंट उत्तर दे तो उसे अपनी भाषा बताएँ और आपको व्याख्याकार से कनेक्ट कर हदया जाएगा।

Ɓǎsɔ́ ɔ̀-wùɖù (Bassa) Tò Ɖùǔ Cáo! Bɔ̃̌ nìà kɛ ɓá nyɔ ɓě ké m̀ gbo kpá ɓó nì fù à-fṹá-tìǐn nyɛɛ jè dyí. Bɔ̃̌ nìà kɛ

ɓéɖé wé jɛ́ ɛ́ ɓě ɓɛ́ m̀ ké ɖɛ wa mɔ́ m̀ ké nyuɛɛ nyu hwɛ̀ ɓɛ́ wé ɓěa ké zi. Ɔ mɔ̀ nì kpé ɓɛ́ m̀ ké bɔ̃̌ nìà kɛ kè gbokpá-kpá m̀ mɔ́ ɛɛ dyé ɖé nì ɓíɖí-wùɖù mú ɓɛ́ m̀ ké se wíɖí ɖò pɛ́ ɛ̀. Kpooɔ̀ nyɔ ɓě mɛ ɖá fṹùn-nɔ̀ ɓà nìà ɖé waà I.D. káàɔ̀ ɖeín nyɛ. Nyɔ tɔ̀ ɔ̀ séín mɛ ɖá nɔ̀ ɓà nìà kɛ: 855-258-6518, ké m̀ mɛ fò tee ɓɛ́ wa kéɛ m̀ gbo cɛ ɓɛ́ m̀ ké nɔ̀ ɓà mɔ̀ à 0 kɛɛ dyi pàɖàìn hwɛ̀ . Ɔ jǔ ké nyɔ ɖò dyi m̀ gɔ̃̌ jǔǐn, po wuɖu m̀ mɔ́ poɛ dyiɛ, ké nyɔ ɖò mu ɓó nììn ɓɛ́ ɔ ké nì wuɖuɔ̀ mú zà.

বাাংলা (Bengali) লক্ষ্য করুন: এই ননাটিশে আপনার ববমা কভাশরজ সম্পশকে তথ্য রশেশে। এর মশযয গুরুত্বপূর্ে তাবরখ থ্াকশত পাশর এবাং বনবদে ষ্ট তাবরশখর মশযয আপনাশক পদশক্ষ্প বনশত হশত পাশর। ববনা খরশে বনশজর ভাষাে এই তথ্য পাওোর এবাং সহােতা পাওোর অবযকার আপনার আশে। সদসযশদরশক তাশদর পবরেেপশের বপেশন থ্াকা নম্বশর কল করশত হশব। অশনযরা 855-258-6518 নম্বশর কল কশর 0 টিপশত না বলা পর্েন্ত অশপক্ষ্া করশত পাশরন। র্খন নকাশনা এশজন্ট উত্তর নদশবন তখন আপনার বনশজর ভাষার নাম বলুন এবাং আপনাশক নদাভাষীর সশে সাংর্ুক্ত করা হশব। ‫یہ نوٹس آپ کے انشورینس کوریج سے متعلق معلومات پر مشتمل ہے۔ اس میں کلیدی تاریخیں ہو سکتی ہیں اور ممکن‬: ‫) توجہ‬Urdu( ‫اردو‬ ‫ہے کہ آپ کو مخصوص آخری تاریخوں تک کارروائی کرنے کی ضرورت پڑے۔ آپ کے پاس یہ معلومات حاصل کرنے اور بغیر خرچہ‬ ‫کیے اپنی زبان میں مدد حاصل کرنے کا حق ہے۔ ممبران کو اپنے شناختی کارڈ کی پشت پر موجود فون نمبر پر کال کرنی چاہیے۔ سبھی دیگر‬ ‫ دبانے کو کہے جانے تک انتظار کریں۔ ایجنٹ کے جواب دینے پر اپنی مطلوبہ زبان‬0 ‫پر کال کر سکتے ہیں اور‬855-258-6518 ‫لوگ‬ ‫بتائیں اور مترجم سے مربوط ہو جائیں گے۔‬ ‫ ممکن است حاوی تاریخ های مھمی باشد و الزم است تا تاریخ‬.‫ این اعالمیه حاوی اطالعاتی درباره پوشش بیمه شما است‬:‫) توجه‬Farsi( ‫فارسی‬ .‫ شما از این حق برخوردار هستید تا این اطالعات و راهنمایی را به صورت رایگان به زبان خودتان دریافت کنید‬.‫مقرر شده خاصی اقدام کنید‬ ‫ سایر افراد می توانند با شماره‬.‫اعضا باید با شماره درج شده در پشت کارت شناساییشان تماس بگیرند‬ ‫ زبان‬،‫ بعد از پاسخگویی توسط یکی از اپراتورها‬.‫ را فشار دهند‬0 ‫تماس بگیرند و منتظر بمانند تا از آنھا خواسته شود عدد‬855-258-6518 .‫مورد نیاز را تنظیم کنید تا به مترجم مربوطه وصل شوید‬ ‫ وقد تحتاج إلى اتخاذ‬،‫ وقد یحتوي على تواریخ مھمة‬،‫یحتوي هذا اإلخطار على معلومات بشأن تغطیتك التأمینیة‬: ‫( تنبیه‬Arabic) ‫اللغة العربیة‬ ‫ینبغي على األعضاء االتصال‬. ‫یحق لك الحصول على هذه المساعدة والمعلومات بلغتك بدون تحمل أي تكلفة‬. ‫إجراءات بحلول مواعید نھائیة محددة‬ ‫یمكن لآلخرین االتصال على الرقم‬. ‫على رقم الھاتف المذكور في ظھر بطاقة تعریف الھویة الخاصة بھم‬ ‫ اذكر اللغة التي تحتاج إلى التواصل بھا‬،‫ عند إجابة أحد الوكالء‬0. ‫ واالنتظار خالل المحادثة حتى یطلب منھم الضغط على رقم‬855-258-6518 .‫وسیتم توصیلك بأحد المترجمین الفوریین‬

中文繁体 (Traditional Chinese) 注意：本聲明包含關於您的保險給付相關資訊。本聲明可能包含重要日期及您在特定期限之前需要採取的行動。您有權利免費獲得這份資訊，以及透過您的母語提供的協助服務。會員請撥打印在身分識別卡背面的電話號碼。其他所有人士可撥打電話 855-258-6518，並等候直到對話提示按下按鍵 0。當接線生回答時，請說出您需要使用的語言，這樣您就能與口譯人員連線。 CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc., First Care, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc.

Igbo (Igbo) Nrụbama: Ọkwa a nwere ozi gbasara mkpuchi nchekwa onwe gị. Ọ nwere ike ịnwe ụbọchị ndị dị mkpa, ị nwere ike ịme ihe tupu ụfọdụ ụbọchị njedebe. Ị nwere ikike ịnweta ozi na enyemaka a n’asụsụ gị na akwụghị ụgwọ ọ bụla. Ndị otu kwesịrị ịkpọ akara ekwentị dị n’azụ nke kaadị njirimara ha. Ndị ọzọ niile nwere ike ịkpọ 855-258-6518 wee chere ụbụbọ ahụ ruo mgbe amanyere ịpị 0. Mgbe onye nnọchite anya zara, kwuo asụsụ ị chọrọ, a ga-ejikọ gị na onye ọkọwa okwu. Deutsch (German) Achtung: Diese Mitteilung enthält Informationen über Ihren Versicherungsschutz. Sie kann wichtige Termine beinhalten, und Sie müssen gegebenenfalls innerhalb bestimmter Fristen reagieren. Sie haben das Recht, diese Informationen und weitere Unterstützung kostenlos in Ihrer Sprache zu erhalten. Als Mitglied verwenden Sie bitte die auf der Rückseite Ihrer Karte angegebene Telefonnummer. Alle anderen Personen rufen bitte die Nummer 855-258-6518 an und warten auf die Aufforderung, die Taste 0 zu drücken. Geben Sie dem Mitarbeiter die gewünschte Sprache an, damit er Sie mit einem Dolmetscher verbinden kann. Français (French) Attention: cet avis contient des informations sur votre couverture d'assurance. Des dates importantes peuvent y figurer et il se peut que vous deviez entreprendre des démarches avant certaines échéances. Vous avez le droit d'obtenir gratuitement ces informations et de l'aide dans votre langue. Les membres doivent appeler le numéro de téléphone figurant à l'arrière de leur carte d'identification. Tous les autres peuvent appeler le 855-258-6518 et, après avoir écouté le message, appuyer sur le 0 lorsqu'ils seront invités à le faire. Lorsqu'un(e) employé(e) répondra, indiquez la langue que vous souhaitez et vous serez mis(e) en relation avec un interprète.

한국어(Korean) 주의: 이 통지서에는 보험 커버리지에 대한 정보가 포함되어 있습니다. 주요 날짜 및 조치를 취해야 하는 특정 기한이 포함될 수 있습니다. 귀하에게는 사용 언어로 해당 정보와 지원을 받을 권리가 있습니다. 회원이신 경우 ID 카드의 뒷면에 있는 전화번호로 연락해 주십시오. 회원이 아니신 경우 855-258-6518 번으로 전화하여 0을 누르라는 메시지가 들릴 때까지 기다리십시오. 연결된 상담원에게 필요한 언어를 말씀하시면 통역 서비스에 연결해 드립니다.

CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc., First Care, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc.