port final ing

DECEMBER 2011
B ENESTAR
EDUCATION AND ENTERTAINMENT FOR YOUR HEALTH...
Merry Christmas and happy new year!
Asthma
is a chronic condition that affects the
respiratory tract. There is no cure for asthma but it
can be controlled. People with asthma can enjoy a full
and active life.
Asthma can develop at any age, episodes or attacks
can occur at any time and can last minutes, hours or
days. People with asthma have increased sensitivity or
allergies to certain substances.
The most common symptoms of an
asthma attack are:
• cough
• chest tightness
• wheezing (whistle when
breathing)
• shortness of breath
Beat
asthma
You may reduce asthma attacks by avoiding those factors
that can trigger it, such as mold and mildew, animal
dander, dust mites, and air pollution, including
cigarette smoke.
Most important is to identify those factors that will cause
your attacks; to take your medications as prescribed and
regularly visit your doctor. If you meet all the recommendations,
you can keep your condition under control.
MP-PRD-PUB-170-110911-E
Review: Myths and Facts
about Influenza
I
nfluenza, also known as the flu, is easily transmitted from person to person,
primarily through the air when an infected individual coughs or sneezes without
taking proper precautions, or through contact with contaminated objects and
surfaces *. According to the Centers for Disease Control and Prevention (CDC)
people with chronic conditions like diabetes, asthma, heart disease and kidney
disease should be vaccinated every year. Some of the most common myths about
the flu are:
Myth: "Influenza isn’t a serious disease."
Fact: Influenza is a serious disease which can have significant complications, including
pneumonia, ear infections, sinus infections and dehydration. Some of the most
common symptoms are fever, headache, muscle aches, chills, dry cough and runny
nose, among others.
Myth: "Influenza vaccine may make me sick."
Fact: Flu vaccine cannot transmit the flu to you; most people feel slight pain or
redness at the site of application of the vaccine, which disappears in a day or two.
Serious complications from the vaccine are very rare.
To find out where you can
get the vaccine, ask your
primary physician today.
Prevention is the key, we
want you to be healthy.
Get vaccinated!
*Reference: Vacuna y seguridad(2011) Centro para el Control y Prevención de Enfermedades. Retrieved on 10/07/2011 from
http://espanol.cdc.gov/img/cdc/CDC_Speedbump/cdc_speedbump2.html?http://espanol.pandemicflu.gov/pandemicflu/enes/24/_www_flu_gov
Haciendo
Contacto
This is a medical helpline specialized on health
situations. Healthcare professionals will provide
recommendations to help you determine if your
condition requires emergency services, urgent
attention or if it can be treated in any other way.
Remember: whenever you have a health situation,
call Haciendo Contacto so they may help you to
receive the medical services you need. The line is
available 24 hours a day, seven days a week.
Telephone numbers are:
1-866-677-7779 (MMM)
1-866-516-7704 (PMC)
1-866-690-7771 TTY (both plans)
Are you a Platino member?
Remember to recertify!
If you have Medicare Parts A and B, and you are also a beneficiary of Medicaid
(the government’s health insurance: Mi Salud), you are eligible for a Platino
coverage under a Medicare Advantage Plan. In order to keep your Platino
coverage, every year you are required to recertify your Medicaid eligibility, as
per your due date as a beneficiary. Visit your nearest Medicaid office.
Recertifying yourself does not affect your current plan.
For further information, contact the Medicaid program at 787-641-4224
(Metro Area) or at 1-855-400-4224 (toll-free), Monday through Friday, from
8:00 a.m. to 6:00 p.m.
If you are not eligible for Medicaid (Mi Salud) any longer, and need assistance,
contact our Member Services Department, Monday through Sunday, from
8:00 a.m. to 8:00 p.m.: 787-522-5634 (Metro Area), 1-877-522-8613 (toll
free), 1-866-333-5469 TTY MMM (hearing impaired), 1-866-516-7701 TTY
PMC (hearing impaired)
MMM Healthcare, Inc. (HMO) and PMC Medicare Choice (HMO) are
coordinated care plans with a Medicare Advantage contract and a contract
with the Puerto Rico Medicaid program.
H4004 – PMC Medicare Choice, Inc. H4003 – MMM Healthcare, Inc.
Y0049_2012 1009 0059 1 File & Use 11152011
2
You are in a
comprehensive
plan!
R
Members Club
Cuidándote
Mucho Más
Haciendo
Contacto
CAMPs
keep
increasing:
emember that we offer the Primary Medicine
Support Centers (CAMP, for its acronym in Spanish) in
case you urgently need medical care, and your life is not at
risk. These centers offer you easy-access options when
your physician’s office may not be available to provide
services. For more information about a CAMP near you,
call us at our Member Services phone numbers (see back
cover).
2012
without
referrals!
Nos mueve tu salud.
Because we want you to enjoy your life and
projects, we have developed Innovative Programs
that complement the benefits of our health plans.
For example, we have Members Club, with
facilities in Carolina, Bayamón, Manatí, Mayagüez
and Ponce, featuring a safe environment where you
may enjoy good times to share with others, have
fun and learn.
Experience the advantages of physical activity with
Patitas Calientes, and renew your body as
well as your emotional being! The services
provided by Cuidándote Mucho Más, for
members with chronic conditions, give access to a
team of professionals who carefully monitor your
health status. And since prevention is essential, you
got the Preventour mobile unit, where health
screening tests are performed.
These programs, together with other plan’s
initiatives, help you maintain a good quality of life.
Take advantage of them!
I
n order to facilitate continuous access to treatments
for you, we have designed coverage options that will
allow you to visit your specialist physicians, without
having to get a referral from your primary care physician.
This way, the process is faster for you.
This benefit will be offered by most of our plans starting
January 2012; for example: Único in MMM and PMC
Max in PMC. Our specialist network includes
cardiologists, pulmonologists, podiatrists, nephrologists,
neurologists, ophthalmologists, and more.
You must know that the Health Insurance
Administration (ASES, by its acronym in Spanish) has
stated that Platino coverage options do require referral.
Ask one of our Representatives if your current plan will
have the no-referral benefit, and find out what other
advantages you may get from our plans. Call the phone
numbers shown on the back cover.
3
Go somewhere else?
Ángel Santos,
56 years old,
PMC member
But our
Advantage Plans
are dedicated only
to us!
“To know that we’re valued, that they offer us programs that no one
else has and that our health is well cared for, gives us confidence and
security.They watch over the quality of service, with a vast provider
network and coverage options for every need”.
“Other companies can come and
offer villas and castles, but no one
can move us from our health plan!”
Call
MONDAY THROUGH SUNDAY 8:00 A.M. TO 8:00 P.M.
787-522-5670 1-877-522-1644
(Metro Area)
(toll free)
1-877-522-0655
1-877-522-0656
TTY MMM (hearing impaired) TTY PMC (hearing impaired)
PMC Medicare Choice, Inc. (HMO) and MMM Healthcare, Inc. (HMO) are health plans
with a Medicare contract. Paid Advertisement.
H4004 – PMC Medicare Choice, Inc. H4003 – MMM Healthcare, Inc. Y0049_2012 4002 0028 1 File & Use 11022011
Do you
know…
Julio González, 67 years old,
MMM member
MP-PRD-PRI-159-102811-E
An important decision in order to stay healthy is to actively participate in the care of your own
condition. To meet special health needs, such as chronic diseases, it is important to visit your primary
care physician (PCP) regularly. It is recommended that you perform these visits at least 4 times a year
even if you're not sick.
During the visit to your PCP, it is important to ask all the necessary questions related to your health
conditions and talk to your doctor about your treatment plan.
Here are a few tips to make the most of your visit to your PCP:
•Do not hide any discomfort you feel
• Bring all the latest laboratory results
• Bring all the medicines you use, or a list of them, including those you take without a prescription.
• Write down questions you have before your visit
• Ask for written instructions or educational material that can help you better understand your
treatment
By actively participating in decisions that have to do with your care, you can collaborate to maintain
yourself in good condition. Be part of your health care... take action!
Reference: Chequeo médico (2011). Biblioteca Nacional de Medicina de Estados Unidos. Retrieved on
10/06/2011 from: www.nlm.nih.gov/medlineplus/spanish/healthcheckup.html
Enrolling is as easy as picking up the phone.
In one call we offer personal, fast and secure service. And all from the comfort of your home!
If you know someone that wants to enjoy the benefits of your plan, tell them to call us at
787-522-5633 1-877-522-8612 1-877-522-0656 TTY
1-877-522-0655 TTY
Metro Area
Toll Free
MMM hearing impaired
PMC hearing impaired
H4004 – PMC Medicare Choice, Inc. H4003 – MMM Healthcare, Inc. Y0049_2012 4005 0029 2 File & Use 11072011
After a fracture, what
to do if you have
Osteoporosis
As senior age approaches, our body evidences a series of changes; for
example the decrease in the minerals of the bone, which wears out
the bones and makes them thin and fragile.This condition is known as
Osteoporosis. As we age, and if Osteoporosis has been diagnosed, a
fall or fracture may be the beginning of more serious problems.
If you suffer from Osteoporosis, below you’ll find important
recommendations to help prevent complications as a result of a
fracture, or to help heal faster if you had a fracture:
1. Talk to your doctor and ask for an evaluation through a bone
density exam.This test measures the mineral density of the bones and
may indicate how strong they are.
2. Consult your doctor about the medication you may take to help
fortify your bones and prevent fractures, especially after you’ve had a
fracture or fall.
3.Talk to your doctor about the secondary effects of the medications
you take on a daily basis; some may affect your coordination and
equilibrium and may cause a fall.
4. Talk to your doctor about an adequate exercise plan for you.
Exercise helps in making your bones stronger and maintaining
flexibility of the joints. For example: walking.
5. Comply with other follow -up exams, like the eye exam. This
may help prevent falls or accidents.
6. If necessary, make use of any equipment
of assistance to walk, like a cane or a
walker, these will help you in being more
stable.
7. Follow an adequate calcium intake
(1,200 mg a day) and Vitamin D (500
mg a day) and refrain if possible from
taking any medications which may
help increase the tendency to
develop Osteoporosis (for example:
Cortisone and an excess of the
thyroid hormone).
Remember, you have the control of your health care. Talk to your
doctor if you have any questions about the adequate management of
Osteoporosis and how to effectively recover after a fall.
References:
Instituto Nacional sobre el envejecimiento,
Instituto Nacional de artritis y enfermedades músculoesqueletales
Choose
to be
happy!
Happy Holidays! Christmas is near and it is time for joy
and parties! Some people, however, are surrounded by a
feeling of sadness that makes them wish this season may end
soon. What’s the reason for this? Some of them evoke the
memories of loved ones who have passed away or are
located in distant places. Others focus on retrospection; there
are those who simply think about the goals they have not
been able to reach, or are still unfulfilled. Sadness itself is bad;
moreover you should be alert to depression! Depression is
an illness with defined symptoms. But the good news is that
there is a way to get out of it! Reach out for people with
whom you may share nice moments. Even if you live alone,
get together with your neighbors; of course you got the
option to visit your nearest Members Club.
Think about pleasant aspects of life. Do not focus on
negative things! Value the fact that you are still alive and are
able to think, read, feel…
What about helping others? You will see that there is always
someone who is in deeper need, and having the chance to
give them support and a helping hand will lead you to renew
your perspective of life!
Turn the lights on! Don’t lock yourself at home; depression
gets stronger in the dark. Open the windows, go out for a
walk. Reach out for light.
Seek help from the experts. In the same way you visit your
doctor for your physical conditions, there are professionals
who will help you to manage depression symptoms.
If something is funny, just laugh! Don’t be afraid to smile
again. Remember that life brings challenges to face; but also
nice surprises. Even if you have no control over circumstances,
you do may decide over the way you will react to them. So
start today and choose to be happy, in Christmas and always.
If you need help to manage your feelings, call CompCare de
Puerto Rico and get mental health care. Toll free:
1-877-721-7222.
9
Help your medications get along
As part of your health care, maybe you are taking more than one
medication at a time. Read the information below to learn about
the importance of having an adequate control in the use of your
medications. An important aspect of this control is medication
reconciliation.
What is medication reconciliation?
Medication reconciliation is a revision your primary physician
makes of all the medications you are taking. After this revision the
doctor determines which medications you’ll keep on using and
which will be discarded. This process usually happens when a
change in your health requires a new medication.
By whom is the medication reconciliation process
completed?
The reconciliation should be completed between you (or your
• Helps to avoid the inadequate administration of medications (a medication
caregiver) and your physician.
is not administered as prescribed).
•
It helps you to better know the medications you are taking, what are you
When should the reconciliation take place?
taking
it for and which is the importance of the treatment.
In case of any event that forces a change in your health treatment.
For example, when you are discharged from the hospital and the
attending physician had recommended a new medication. It is References:
important that you bring your hospital discharge summary or ASHP– American Society of Heath – System Pharmacists - Bona E. Benjamin, BS
consultation answers to your primary care physician, in order for Pharm. ASHP, Cynthia L. LaCivita, Doctor en Farmacia, Diario de Medicina y
Hospital de la Comisión Mixta Journalon Calidad y Seguridad del Paciente them to update the treatment you must follow.
Reconciliación centrada en el paciente hospitalizado, clínicamente relevante y
aplicable.ASHP.
Which are the benefits of medication reconciliation?
ASHP– American Society of Heath – System Pharmacists - Jane H. Barnsteiner,
• It helps prevent the intake of duplicate medications.
• Prevents medication interaction (when mixing certain medications Ph.D.,R.N.,F.A.A.N.,Patient Safety and Quality:An Evidence-Based Handbook for Nurses.
Chapter 38 – Medication Reconciliation, University of Pennsylvania Hospital NCQA,
these may change the action of others).
HEDIS 2011 Technical Specifications, Medication Management – Medication
• Prevents medication overdose (the danger of taking more dose
Reconciliation post discharge.Volume 2
than what is adequate).
Up-to-the-minute technology for you!
We are pleased to announce that we have launched the new member’s portal
known as HOT (Health on Touch). This site allows performing tasks that
previously you were able to complete only by phone or by visiting the provider.
Now you can complete them from your computer in the comfort of your home
or from your cell phone, 24 hours a day, 7 days a week. The portal will allow you
• Eligibility
to access:
• Provider Directory
• Clinical profile
• News
• Medication information
• Event information
• Direct communication with
• Educational facts on critical conditions
our Call Center
Follow these instructions to register at the Member’s Portal:
If you belong to MMM,
If you belong to PMC,
enter www.mmm-pr.com
enter www.pmcpr.org
and choose
and choose
I am part of the healthy people of MMM.
Information in English for Members
For both brands, the user shall click the Subscribe now! Option
This is just the beginning. We will include new applications each quarter. Share this information with your loved
ones and friends who are part of MMM and PMC
10
Come and participate in educational talks
MANAGING DEPRESSION
DURING THE HOLIDAYS
Activities will begin at 8:00 AM. We will have snacks.The following are dates and
locations:
Location
Date
December 12
Aguadilla: Cielo Mar Hotel, Montemar Ave. #84
December 13
Gurabo: El Josco Activity Center, PR 189 km 5.3
December 14
Canóvanas: Salón Coquimar 65 de Infantería PR #3
December 15
Ponce: El Señorial Conventions Center, E. Ruberté Ave.
December 16
Arecibo: Arecibo Country Club, Club Rotario Ave.
We’ll expect your visit!
Confirm your attendance in order to receive educational material. Call us at:
787-522-5634 1-877-522-8613
(Metro Area)
(Toll free)
1-866-333-5469
1-866-516-7701
TTY MMM (hearing impaired
) TTY PMC (hearing impaired
)
Monday to Sunday, from 8:00 a.m. to 8:00 p.m.
Member:
Please help us to prevent,
detect and investigate and
report any activity related
with fraud, waste or abuse.
If you notice any situation
that may arise suspicion or
allegation of fraud, waste or
abuse, please contact us.
www.aveta.ethicspoint.com
1-877-307-1211