From playpen to prom From playpen to prom

~CHILDREN’S Health Information Inside~
Spring 2000
From playpen
to prom
* Keeping your child healthy *
Customer Service Numbers
Category
Little Rock
Toll-free
Number (501) Number
State/Public School Employees
378-2437 1-800-482-8416
e-mail: [email protected]
[email protected]
Medi-Pak (Medicare supplement)
378-3062 1-800-338-2312
Medicare (for beneficiaries only):
Part A (hospital benefits)
Part B (physician benefits)
378-2173 1-800-482-5525
378-2320 1-800-482-5525
UniqueCare, UniqueCare Blue,
Blue Select® (individual products) 378-2010 1-800-238-8379
Group Services
378-5579
1-800-421-1112
BlueCard®
378-2127 1-800-880-0918
Federal Employee Program (FEP)
378-2531 1-800-482-6655
Health Advantage
221-3733 1-800-843-1329
Medi-Pak HMO (Health Advantage) 954-5200 1-800-354-9904
USAble Administrators
378-3600 1-800-522-9878
Numbers to call for information about obtaining
coverage:
Category
Little Rock
Toll-free
Number (501) Number
Medi-Pak (Medicare supplement)
378-2937 1-800-392-2583
UniqueCare Blue, Blue Select®
(individual products)
378-2937 1-800-392-2583
Medi-Pak HMO (Health Advantage) 378-6987 1-800-588-5706
Regional Office locations:
Central
Northeast
Northwest
South Central
Southeast
Southwest
West Central
Little Rock
Jonesboro
Fayetteville
Hot Springs
Pine Bluff
Texarkana
Fort Smith
Customers who live in these regions may contact the
regional offices or call the appropriate toll-free telephone
number listed above.
is published four times a year by the
Arkansas Blue Cross and Blue Shield
Advertising and Communications
Division for the company’s members, health care professionals and
other persons interested in health
care and wellness. Opinions expressed herein do not necessarily reflect the views of Arkansas Blue Cross and Blue Shield or
any of its publics.
INSIDE
THIS ISSUE
~SPRING 2000~
3
Prenatal information ................................. 4-5
Special Delivery program ............................. 5
Immunize your child ..................................... 6
Signs of sinus & ear infections .................... 7
Measuring up, Sibling rivalry ....................... 8
Is your child getting enough sleep? ............. 9
Raising healthy kids ............................. 10-11
Help! My child has ADD! ............................ 12
Rules are good for children ....................... 13
Teen turmoil: Acne & Depression ............... 14
Talking to your teen ................................... 15
Focus on Children’s Health (ways to praise, the
general’s plan and word scramble contest winner) .... 16
Club Update, Ageless Heroes, Olympics .... 17
Leading the Way
(get to know some of Arkansas’ legislators) ....... 18-19
Who owns Arkansas Blue Cross? .......... 20-21
Survey results in a letter from the editor ... 21
Health Advantage news for members ......... 22
Blue & Your Community ............................. 23
Clearly Blue (a terminology guide) .................... 24
Vice President of Advertising and Communications
Patrick O’Sullivan
Editor
Kelly Whitehorn
Designer
Gio Bruno
Contributors
Mark Carter, Janice Drennan, Damona Fisher and Kathy Luzietti
4
Pregnant Women Guidelines*
1st Prenatal Visit
14-16 Weeks
24-28 Weeks
36 Weeks
1. Genetic and
obstetric history,
dietary intake,
tobacco/alcohol/
drug use, risk
factors for intrauterine growth
retardation and
low birthweight,
prior genital
herpetic lesions.
2. Fundal height and
fetal heart tones.
3. Urine culture.
4. Blood pressure.
5. Hemoglobin and
Hematocrit.
6. ABO/Rh typing.
7. Rh(D) and other
antibody screen.
8. Pap smear.
9. VDRL/RR.
10. Hepatitis B
surface antigen
(HBsAg).
11. Urinalysis for
glucose and
protein.
12. Gonorrhea
culture and
Chlamydial
testing.
13. Ultrasound
cephalometry.
14. HIV counseling
and testing.
Each Visit:
1. Fundal height and
fetal heart tones.
2. Blood pressure.
3. Urinalysis for
glucose and
protein.
Each Visit:
1. Fundal height and
fetal heart tones.
2. Blood pressure.
3. Urinalysis for
glucose and
protein.
Each Visit:
1. Fundal height and
fetal heart tones.
2. Blood pressure.
3. Urinalysis for
glucose and
protein.
(Clinical discretion
during 24 to 28
week period):
4. Maternal serum
alpha-fetoprotein
(MSAFP)(2).
5. 50g oral glucose
tolerance test.
(Clinical discretion
during 36-week
period):
4. Beta strep.
*NOTE:
These guidelines
represent minimum
levels of
recommended care.
Individual risk
factors may require
additional
screenings and
services.
Notice to all
mothers-to-be
I
mproving the health of mothers
and infants is a national challenge.
Talk to your physician today about
steps you can take toward ensuring a
healthy pregnancy. Adopted from
national guidelines, the services listed
here were reviewed by local physicians
prior to release. Health Advantage has
distributed this information to primary
care physicians and those physicians
specializing in obstetrics and gynecology (OB/GYN) within the Health
Advantage network. This information
is intended only as a guide. Individual
treatment is a coordinated effort
between you and your physician.
Planning to have a baby?
1. Take a vitamin pill that has a
folic acid in it every day. Folic
acid is a special vitamin that
can help prevent birth defects of
the brain and spine. Foods that
have folic acid include orange
juice, green vegetables, fortified
breakfast cereals and enriched
rice and whole wheat bread.
2. Have a medical checkup before
getting pregnant.
5
All about the
Special Delivery program
T
he Special Delivery program is a pregnancy program offered as an additional benefit to Arkansas Blue Cross and Blue Shield, Health Advantage and USAble Administrators members. It was created
with three strategies in mind to make sure our members have healthier pregnancies — education,
assessment and intervention.
The Special Delivery program seeks to assist the expectant mother and her physician in the
prevention of preterm births secondary to high-risk perinatal conditions. All program participants
receive educational materials and coupons by mail. Services not normally offered such as skilled
nursing assessments or nursing assistant care in the home for conditions including pregnancy-induced
hypertension, diabetes mellitus and preterm labor are covered through the Special Delivery program.
How the program works:
• Expectant mothers should enroll in the program by the 14th week of pregnancy.
• The expectant mother will complete a risk assessment brochure where she
answers a series of basic questions. The questions are designed to identify factors
that may put the mother and/or baby at risk.
• If risk exists, the expectant mother is followed throughout her pregnancy to
determine if home health care is appropriate.
If high risk exists, the mother and baby are monitored at regular intervals throughout the pregnancy to identify needs she might have (for example, home health), provide further education and to
encourage the mother-to-be to keep her appointments with her doctor.
If low risk exists, the patient will be rescreened at 24 to 28 weeks via telephone contact by the
Special Delivery nurse or by completing a risk assessment brochure that will be mailed to her and
returned to Medical Management.
If the Special Delivery program is a benefit of your health insurance and you would like more
information, please call toll-free 1-800-742-6457 or 501-954-5468.
~
Call toll-free
1-800-742-6457
or 501-954-5468.
Here are some helpful hints for having a healthy baby
3. Adopt a healthy lifestyle — eat
a balanced diet, get plenty of
exercise and reduce stress.
4. If you are not immune to
chicken pox and rubella, check
with your health care provider
about getting vaccinated before
you conceive.
5. Have medical problems like
diabetes, epilepsy and high
blood pressured treated.
6. Try to achieve your ideal
weight. If you are overweight
when you become pregnant,
you’re more likely to develop
high blood pressure and diabetes during pregnancy. If you’re
underweight, you’re more likely
to have a low-birthweight baby.
7. If you have had problem
pregnancies or birth defects in
your family, you should talk
about it with your health care
provider.
8. Avoid exposure to toxic substances and chemicals.
9. Don’t eat undercooked meat or
handle cat litter.
6
Be an overprotective parent — immunize
I f you have a newborn baby or are thinking
about starting a family, you have plenty to worry
about. One thing you shouldn’t worry about is whether
you should get your child immunized.
The American Academy of Pediatrics
recommends that parents protect their
children from serious childhood illnesses
through immunizations. Without
immunizations, your child is at
risk for illnesses such as measles,
whooping cough, hepatitis, polio
and much more.
Immunizations begin at birth, and children should
receive most of their immunizations during their first two
years of life.
Some immunizations are combined and protect
against numerous diseases. The current immunization
schedule is available from your pediatrician and was
featured in the Winter 1999 issue of Blue & You. Your
child needs the following immunizations to stay healthy:
• MMR vaccine to protect against measles, mumps
and rubella.
• Polio vaccine to protect against polio.
• DTaP or DTP vaccines to protect against diptheria,
tetanus and whooping cough.
• Hib vaccines to protect infants and children against
Haemophilus influenzae type B infection (this can
be a cause of meningitis or blood strain infections).
• HBV vaccine to protect against hepatitis B, which
causes liver disease.
• Varicella vaccine to protect against chicken pox.
Reactions to
immunizations may
occur, but they are
usually mild. Serious
reactions are very rare
but may occur. The
risks from these
potentially serious
diseases are greater
than the risk of a
serious reaction from
an immunization.
Immunizations are an important part of keeping your
child healthy. Immunize your child on time and keep
your child’s records up-to-date. Also, make sure your
child has regular checkups with his or her pediatrician or
health clinic.
Remember, the best way to make sure your child gets
the immunizations he or she needs is to check with your
child’s pediatrician or your local health clinic.
Information for this article was obtained from the
American Academy of Pediatrics.
Special thanks
A special thanks to Tony Johnson, M.D., and Charles Gist, M.D.,
for their time and commitment to this issue of Blue & You focusing
on their area of specialty — children. Dr. Johnson is a pediatrician
with the Arkansas Pediatric Clinic and Dr. Gist specializes in child,
adolescent and adult psychiatry with Psychiatric Associates of
Arkansas, PLLC. Both practice in Little Rock, Ark.
7
S O M ETI M ES
A SI N US I N FECTI ON
C AN MAS QU E R ADE AS A COLD
H ow can you tell if
your child has an acute
sinus infection rather than
a case of the common cold?
• Symptoms of a cold that linger more
than 10 days without any improvement.
• High fever.
• Large amount of yellow-green discharge
from the nose.
• Eye swelling and eye pain or headache.
• Coughing (worse at night).
• Bad breath.
If your child exhibits these symptoms,
chances are you’ve got an acute sinus infection on your hands.
Colds (viral upper respiratory infections)
can last a week to 10 days and include some
fever at the onset. But colds require no
specific treatment from a doctor. Nasal
discharge resulting from a cold will look clear
at first, turn yellow-green and then clear
again before disappearing. It’s important to
remember that antibiotics do not treat viral
infections.
Children get sinus infections for much the
same reason they get colds. The sinuses are
lined with the same layer of mucous-producing tissue found in the nose and upperrespiratory tract. When inflamed and swollen,
the sinus’ exit passages can’t drain properly
and bacteria creates an infection for which
antibiotic treatment is necessary.
Some children who have allergies and
thus swollen and inflamed upper respiratory
tracts are prone to sinus infections. Allergic
children with sinus infections should be
treated for the allergy as well as for the sinus
infection.
Information for this article was obtained from
“Ask Mom M.D.,” Dr. Karen Kaplan, Pediatrician
EAR I N FECTIO N
KNOW THE SIGNS
OR NOT?
E ar infections can be serious, especially
in children.
Acute ear infection, or infection of the
inner ear, can affect anyone but is
more common in children. It
results from bacterial or viral
infection of the fluid in the middle
ear, which causes production of
fluid or pus.
Chronic ear infection is the result of
prolonged or repeated acute ear infection and
can cause permanent damage to the ear.
Chronic infections may go unnoticed and
show less severe symptoms, leading to
delayed treatment.
Parents should always hold their babies in
a sitting position when feeding to help reduce
the risk of acute ear infection in infants.
Symptoms parents can look out for
include:
• Ear pain or discomfort
(severe earache, pressure in the ear).
• Pulling at the ear.
• Drainage from the ear.
• Hearing loss in the
affected ear.
• Fever.
• Chills.
• Irritability.
• Feeling of general illness.
• Nausea or vomiting.
• Diarrhea.
Ear drops, nasal sprays, nose drops, oral
decongestants, and sometimes oral antihistamines, can be used to help
promote drainage or
relieve pain.
But most importantly, if symptoms
persist, see your
doctor or health care
provider.
8
Measuring
up
I f your baby or child seems small for his or
her age, the best advice for you is — don’t panic.
Everyone is different, so what is normal for the child
next door may not be what is normal for your child.
The most
important thing to
watch for is a pattern
of steady growth and
development. Each
time you visit your
pediatrician’s office
for your baby or child’s checkup, the nurse will weigh
your child and take a height measurement. Those
measurements are usually graphed on a chart so the
pediatrician can watch your child’s growth.
Other factors to consider:
• Size at birth is a poor predictor of your child’s final
adult height or weight.
• Reaching developmental milestones (talking,
walking, fine motor skills, etc.) does not necessarily indicate greater intelligence.
What is normal for your child?
• Abnormalities in hearing or sight require early
corrective action, so be especially watchful of any
apparent problems.
Babies normally lose weight in the first few days
after birth. Breast-fed babies lose no more weight than
bottle-fed babies. Within the first few months after birth,
babies usually establish a growth rate that is consistent
for many years.
By the time your child is 2 or 3 years of age, he or
she should have established a consistent growth pattern
that is a fairly good indicator of final height.
The measurements that your pediatrician will be
taking — and
watching — for
a consistent
pattern are
weight, height,
head circumference and
developmental
milestones.
Sibling rivalry: A normal part of the sibling relationship
I t’s a scene that’s played out every day in homes
throughout the country. Your children are arguing
over which show to watch on television or maybe
arguing over whose turn it is to set the table.
If you have more than one child, you likely
recognize these scenarios immediately as something you
see in your own home — sibling rivalry.
No matter how much it seems to distract you and
take away from the harmony in your family, sibling
rivalry is a natural part of growing up. Sometimes the
arguments can work themselves out, but when they
seem out of hand, Mom or Dad
should step in and control the
situation.
Here are some tips for
handling sibling rivalry:
• When children are bickering,
pointedly praise the child who
is behaving more appropriately.
• Put a behavior plan into place,
with a written contract that
rewards certain behavior (for
example, give your brother a
sincere compliment each day).
• Many times, children are arguing for their parent’s
attention. Try to spend regular uninterrupted time
with each of your children.
• Parents should not quarrel or bicker with each other
in front of the children. Parents also should maintain
a calm demeanor with the kids.
• Family rules should be clearly explained and boundaries defined. The consequences of actions should be
appropriate. For example, if one child hits a sibling,
denial of a favorite treat or television program would
be appropriate.
• If your children cannot control their bickering,
separate them from each other for a period of time
Is your child getting
enough sleep?
W ith Mom and Dad both working and the kids
involved in numerous activities, today’s family is very
busy … and very tired. While adults can get by on eight
hours of sleep per night, children often need more
depending on their age, activity level and health status.
When school is out, kids are doing their homework,
going to soccer practice, taking piano lessons, working
on their school science project and much more. While
keeping your children involved in activities is an admirable goal, keep in mind that making sure your children
get enough sleep will help them in school and with their
extracurricular activities.
A 1999 survey commissioned by the National Sleep
Foundation found that a majority of kids say they are
sleepy during the day and 15 percent admit to falling
asleep in school. Teen-agers, more than any other age
group, are not getting enough sleep.
Researchers believe that access to the Internet,
television, academic pressures, social obligations and
after-school jobs all contribute to the sleep shortage
among children and teen-agers.
(separate parts of the house where they cannot see
or speak to each other).
• Don’t take sides in a sibling argument. Encourage
your children to work out their differences.
• Do not compare your children to each other, or to
their friends.
• Do not reward tattling. It will only encourage your
children to tell on each other and create more
friction between them.
And most of all, don’t give up. Time and persistence
will help you learn new ways of dealing with sibling
rivalry. Some bickering or disputes are entirely normal
and help the children to resolve conflict. In the long run,
you are teaching your children how to get along better,
and that will prepare them for important relationships
in the future.
9
Lack of sleep contributes to
problems comprehending and
retaining educational information during school hours. It also
contributes to behavioral
problems in children.
So how much sleep does
your child need? Here are a few
simple guidelines:
• Newborn babies — Anywhere
from 12 to 20 hours per day.
• Toddlers and preschoolers —Approximately 12 hours
per day and one afternoon nap.
• School-aged children (grades K-6) — Approximately
10 hours per day.
• Teen-agers — At least nine hours of sleep per day.
“Sleep hygiene” is another way to view sleep patterns for your children. Try to remember:
• Keep regular sleep patterns and wake-up times seven
days per week.
• Use the bedroom for sleeping only (keep computer,
television, etc., in a separate room).
• Teen-agers that have trouble sleeping may need to
get up, read a boring book until they feel sleepy, then
return to bed.
• Significant sleep problems can be a symptom of
clinical depression.
Remember that good sleep habits begin early —
between 2 and 4 months of age. Even at that young age,
babies are learning where to sleep, how to sleep and
when to sleep. By the time your
baby is 4 to 6 months of age,
he or she should be able to
sleep eight to 12 hours per
night. Establish a routine
that helps you — and
your baby — get a good
night’s sleep.
10
Raising
Healthy
Kids
Healthy Habits That Last a Lifetime
T
wo of the most important things that parents
can do for their children are making sure they get
proper nutrition and regular exercise. Teaching children
healthy habits early in life can help them develop
healthy attitudes and behaviors that can benefit them
throughout their lives. Unfortunately, in today’s world,
not only are getting proper nutrition and exercise
very important to children — they can also be very
challenging achievements for parents — at least without
appropriate planning.
Some Surprising Facts
Did you know that …
• Take-out foods make up 35 percent of the average
family’s meals.
• Three or more cans of soda are consumed daily by
two-thirds of teenage boys.
• Less than 35 percent of children participate in
physical education classes at school and the
majority do not get recess.
• By the time children reach ninth grade, 70 percent
of girls and 50 percent of boys do not take part in
any vigorous activity.
• Obesity in children has more than doubled since
the 1970s.
Nutrition
Good eating habits and table manners should begin
at a young age. By the time a child is eating in his high
chair, parents should establish regular meal
schedules and good table
manners. It is important
that children have their
meals at the same time and
avoid excessive snacking or
drinking juice, which interferes
with mealtime. Children also should
eat at the table — not in
front of the television or
anywhere else.
In today’s fast-paced
world, with families often going
in many different directions, we
often find ourselves grabbing
meals on the run. Most often,
microwave meals, snack foods and fast-food restaurants
win out over home-cooked meals. In fact, in the average
family, home-cooked meals are usually the exception
rather than the rule. So the best way to ensure that
your children get the nutrition they need is with
careful planning.
Some things you can do to help
your children be healthier eaters:
• Resist the tendency to let your kids “be in charge”
of what they eat.
• Become familiar with the Food Guide Pyramid for
Young Children and keep the shelves and refrigerator stocked with items from each food group.
• Spread out some of the recommended servings
from the Food Guide Pyramid so you can include
them, not only at mealtime, but in snacks as well.
• Pack healthy lunches for school.
• Offer a variety of foods and serve reasonable childsized portions that won’t overwhelm your child —
he or she might even go back for
seconds.
• Don’t make your kids “clean
their plate.” That’s asking them to
ignore their body’s own natural
signals that tell them when
they are full and might
possibly even lead to eating disorders.
• Limit the amount of beverages your child may
drink between meals. Beverages may spoil
their appetite for meals and snacks.
• Dessert should be just another part of a
healthful meal and not set up as a “reward.”
Got a picky eater in the family? What family
doesn’t? The first rule to remember when dealing
with a picky eater is — forget the hard sell! Try to
introduce new foods gradually by using a low-key
approach. Most children usually resist trying new
foods, but if given enough good-tasting variety to choose
from, almost all children will eventually give in. Let them
become familiar with the food by touching it, picking it
up and slowly tasting it. They may not try it until the
10th time it’s served, but the important thing is — they
will try it. If you’re concerned about your child not
eating enough, put at least one food on the table that
they like.
Overall, most children, if given an opportunity to
select from a variety of foods from all of the food groups,
will select sufficient amounts of nutrients, and eating
patterns will usually improve over time. If you’re seriously concerned about your child not getting the proper
nutrition, check with your pediatrician.
Exercise
Another important part of a child’s growth and
development is regular exercise. In recent years, studies
have shown that childhood obesity has increased at an
alarming rate. According to a recent survey, kids blame
homework
for their lack
of time for
physical
activity. But two
out of three
parents surveyed
say lack of interest
or competition from
television is the reason
their youngsters aren’t getting enough exercise.
Considering the decrease in physical activity in
schools in recent years and the fact that many children
choose television and video games as primary sources of
entertainment, it’s no wonder that there is a lack of
physical activity in our children’s lives. Once again,
involvement by adults or parents is critical if children are
11
to receive adequate exercise in their daily
routine.
Some things you can do to help
your children get more exercise:
• Limit your child’s time in front of the television or
computer.
• Encourage his or her participation in outdoor
sports — soccer, baseball, swimming, etc.
• Encourage fun
activities that
involve physical
movement such
as riding a bike,
jumping rope, a
game of chase,
playing hopscotch, etc.
• Ask older children to do chores that involve
physical activity, like walking the dog or helping
with yardwork.
• If your child’s school doesn’t have a recreation
program for children, encourage school officials to
add it to the curriculum.
• Volunteer your time at your child’s school to help
with recreational activities after school or on
weekends.
If you want your children to live a healthy lifestyle —
get involved in their lives and start the process now. It’s
up to you to teach them healthy habits and behaviors
that will benefit them the rest of their lives.
Resources for this article include: Stephen Tucker, M.D.,
Little Rock; International Life Sciences
Institute; NetBiochem: Nutrition;
and “Arkansas Times: 2000
How-to Guide.”
T
he bell rings. The children sit down in their
seats and the teacher gives instructions for the first
assignment of the school day. However, there is one
child who is looking out the window and thinking
about the airplane that just flew by, or wondering
what kind of bird she hears chirping. The teacher
notices and redirects that child to the assignment
at hand.
The child pays attention for a moment, but then her
pencil falls to the floor. She then is distracted by all the
different tennis shoes the other children are wearing and
begins thinking about when and where she might get her
next pair.
These are a few moments in the life of a child with
Attention Deficit Disorder (ADD) or Attention Deficit
Hyperactivity Disorder (ADHD). It is estimated that 3 to
10 percent of children have this disorder, which is
characterized by the inability to pay attention in class or
difficulty completing academic assignments.
• Often acts without thinking.
• Shifts excessively from one activity to another.
• Needs a lot of supervision.
• Speaks out of turn in class.
• Doesn’t wait for his or her turn in games or
group activities.
• Runs or climbs excessively.
• Can’t sit still.
• Excessive activity during sleep.
• Always on the go, acts as if “driven.”
• Experiences angry outbursts.
• May be a social loner.
• Blames others for problems.
• Fights with others quickly.
• Very sensitive to criticism.
ADD or ADHD symptoms are caused by a neurological dysfunction within the
brain. Studies have confirmed that there is a
My child
has ADD!
However, not every student who can’t sit still in
class or can’t complete an assignment has ADD or
ADHD. This is particularly true in the lower elementary
grades when children naturally have more energy and
have not reached a level of maturity to meet the
demands of the classroom.
If your child has had the symptoms of poor attention, concentration and/or poor impulse control for some
time, you should have your child examined by a physician. In addition to a physical exam, the physician may
have the parents and teachers complete questionnaires
about the child’s behavior.
A child with ADD or ADHD
may have some of the
following symptoms:
• Doesn’t seem to listen.
• Doesn’t complete
assignments.
• Easily distracted.
• Difficulty in concentrating or paying attention.
definite difference in
brain functioning between
those with ADD/ADHD and those without it. ADD or
ADHD may be acquired or inherited.
Treatment of ADD or ADHD includes medications
such as Ritalin®. Ritalin is used to improve the chemical
imbalance in the brain that is causing the symptoms. It
is considered a very effective and relatively safe form
of treatment.
When properly treated through medication and a
psychological treatment program under the direction of a
physician, children and adolescents with ADD or ADHD
can lead very normal and productive lives. In fact, many
traits in ADD or ADHD children lead them to very
successful adult lives. Children with ADD or ADHD
usually have average or above-average intelligence. They
are often creative and usually have a high energy level.
Remember that a loving, supportive and consistent
environment is essential for positive growth and development of children, especially those with ADD or ADHD.
Rules are good for
your children
What is your wish for your children?
Like most parents, you probably hope your
children grow up happy, healthy and well-adjusted
— all admirable (and achievable) aspirations, but
they may take a lot of dedication and work on your
part. Just remember that rules are tools … when
you are constructing a well-balanced child.
Children are not little adults. They do not have
the depth of experience, the knowledge or the
reasoning capacity to think as adults; therefore, it
is up to you to guide them, help them in decisionmaking, and most importantly, teach them the
difference between right and wrong.
As a parent, the best thing you can do to help
your children achieve those goals is to encourage
healthy habits, maintain rules and boundaries, and
be a role model for your children as to what is
appropriate and inappropriate behavior.
Tony Johnson, M.D., a pediatrician with the
Arkansas Pediatric Clinic in Little Rock, stresses that
parents should begin setting rules and limits when
their children are at a young age. Children also
should understand the disciplinary consequences
of their actions.
According to Dr. Johnson, setting formal bed
times, encouraging healthy eating habits and
establishing household rules is not only good for the
parents, it’s even better for the children. Dr. Johnson
maintains that consistent, effective parenting is
better for everyone in the long run.
“You have to maintain your role as a parent,”
said Dr. Johnson.
“It is important for the parents to be the parent
in the relationship with their children. In many
cases, with both parents working these days and
children busy with
extracurricular activities, sometimes it is
easier to let the
children stay up later
or ignore the household rules.
13
“Letting your
child establish unhealthy eating or
sleep habits or not
having established
rules or guidelines
may lead to an
unhealthy lifestyle or
inappropriate behavior later,” said Dr. Johnson.
“Children need rules,” said Charles Gist, M.D., a
psychiatrist with Psychiatric Associates of Arkansas,
PLLC, in Little Rock. “Think about those fourth-grade
boys on the playground. They may have 20 minutes for
recess, but they will spend 15 of those minutes making
up the rules for the game. It’s normal, and it is how they
understand the world.”
A common diagnosis today, and one that both
Dr. Johnson and Dr. Gist see among 7- to 13-year-olds,
is “episodic outburst disorder” or “intermittent explosive
disorder.” With this diagnosis, children under stressful
situations simply fall apart, throw tantrums or “just lose
it.” According to Dr. Gist, studies have been ineffective
and have not ruled conclusively the cause of this disorder, but theories include depression, manic-depressive
disorder or a chemical imbalance. Also, there is a possibility that the disorder could be the result of many years
of parents having failed to set limits. As a result,
children do not know how to react in stressful situations.
A 2-year-old has a tantrum because he or she hasn’t
learned appropriate behavior, but now physicians are
seeing this behavior with children who are much older.
Along with discipline and guidance, Dr. Johnson and
Dr. Gist agree that positive reinforcement goes a long
way in creating an emotionally healthy child.
“It’s self-fulfillment. If you expect joy
and success for your child, that is
what you will get. Parents should
exhibit a demeanor that concentrates on the positive and is
respectful to the child. Then, the
child will flourish,” said Dr. Gist.
14
Acne:
If your teen-ager has acne, he or she is not alone.
Close to 100 percent of young people between the ages of
12 and 17 have at least an occasional bout with acne.
Many teen-agers are able to manage their acne with
over-the-counter treatments; however, approximately 40
percent of teen-agers have acne severe enough for them
to seek treatment from a physician.
The two things that teen-agers should remember
about taking care of their skin are: 1) He or she should
wash his or her face twice a day with a mild cleanser
and 2) Keep their hands off of their faces as the hands
can spread bacteria, which may increase the acne.
So what causes acne? Acne is a disease of the
sebaceous glands. There are some basic factors that work
together to cause acne including hormones, the factor
that usually causes acne in teen-agers. Acne usually
begins when the body starts to produce hormones —
usually between 11 and 14 years of age.
There are many myths associated with acne and its
Good news,
it’s treatable
causes. Things that do not cause
acne are poor hygiene, food
(including pizza or chocolate)
and stress.
Besides physical symptoms, teen-agers usually
experience some psychosocial effects of acne. Recent
studies indicate that some teen-agers with acne experience social withdrawal, decreased self-esteem, reduced
self-confidence, poor body image, embarrassment,
depression, anger, preoccupation and frustration.
If your teen-ager has acne, don’t let it get him
or her down. If over-the-counter products have not
produced the desired results, contact your pediatrician or family physician. With all the outlets available
today for treating and preventing acne, teen-agers can
hopefully avoid the scars of acne — both physical
and emotional.
Information for this article was obtained from
the American Academy of Dermatology.
Troubled teens may be dealing with depression
Approximately 7 to 10 percent of children or adolescents will experience an episode of major depression
before the age of 15.
Recent studies show that
there is a significant
clinical occurrence of
depression among
adolescents.
Depression is not
everyday ups and downs.
It is when a “down” mood
lasts for weeks. The
condition may stem from a
biological illness, a chemical imbalance or certain
personality traits (low self-esteem,
extreme pessimism). There may be
a history of depression in the
family. Clinical depression is a
serious health problem that
affects the whole person. It can
change behavior, physical health
and appearance, academic
performance, social activity and the ability to handle
everyday decisions and pressures.
Signs include disruptive behavior, possible
academic difficulties, peer problems, irritability
and aggression or suicidal threats.
Approximately 3 to 5 percent of the teen
population experiences clinical depression each
year. With teen-agers, depression has been linked
to poor school performance, truancy, alcohol and
drug abuse, running away and feelings of worthlessness. Suicide is often linked to depression.
There is hope.
Depression is treatable.
Between 80 and 90 percent of
people with depression can be
helped. Symptoms may be
relieved with psychological
therapies, medications or a
combination. See your pediatrician or family physician if you
suspect your adolescent is
suffering from depression.
15
Take time for teen talk
The teen-ager behind the closed doors in his upstairs
bedroom used to be your clingy, cuddly toddler who
screamed when you left the room. Now it seems like he
wants to scream when you walk into the room.
The teen-age years can be difficult — for both the
teen and the parent. Despite their outward bravado, teenagers are unsure of who they are, what they want to be
or whether the choices they make are the best choices.
As a parent, what can you do to guide your teenager, yet give them room to help develop their own
decision-making skills?
1. Keep communications open. Try to listen
calmly even if you have a different opinion.
Develop a courteous, respectful tone. Avoid
making judgments. Keep the door open on
any subject. Many times, teens avoid
discussing things that make their parents
feel uncomfortable.
2. Encourage positive self-worth. Encourage (but don’t force) participation in
sports, music, art, dance or other hobbies
or interests.
3. Supervise and guide. Set limits on their freedom and
behavior. Teen-agers may want some “say” in the
decision-making, however, they do
not want parents to give up
authority or be wishy-washy.
Parents who appear confused
about discipline or who are
inconsistent may be perceived as weak.
4. Respect their need for independence. Parents can
accept and respect teen-agers as individuals without
always agreeing with their opinions and vice-versa.
5. Try not to overreact. Many parents brace themselves
for adolescence like they are preparing for battle. As
a result, they may be quick to overreact the first time
their teen-ager steps out of line. They punish severely, withdraw trust and lose confidence in their
teen-ager. Parents must prepare to let their children
make mistakes but step in when help is needed.
Being a parent is never easy. With each year comes a
different challenge. However, efforts to communicate and
understand your teen-ager will pay off in the long run.
And maybe you and your teen will look back at the teen
years as a positive experience in your relationship.
Communicating about substance
It is never too early to talk to your child about the
dangers of substance abuse. You are the parent, and it is
your responsibility to make sure your child understands
the dangerous consequences of substance abuse.
What can you do?
1. Talk with your child honestly and really listen when
your child is talking to you.
2. Help your child develop self-confidence. Praise his
or her successes.
3. Help your child develop strong values. Teach
your child how to make decisions based on right
and wrong.
4. Be a good example. If you smoke or drink excessively, your child is aware of your actions.
5. Help your child deal with peer pressure and acceptance. Discuss the importance of being an individual and the meaning of real friendships.
abuse — what all parents should know
6. Provide guidance and clear rules about not
using drugs.
7. Encourage healthy, creative activities.
8. Spend time with your child, sharing the good and
bad times.
9. Facilitate early intervention with the help of a
physician when your child is having problems in
school, dealing with learning disabilities, or
experiencing trauma, stress or depression.
Remember, prevention starts with you as the parent.
There are no guarantees that your
child will not choose to use drugs,
but you can influence their decision by setting a good example.
Information for this article
was obtained from the American
Academy of Pediatrics.
16
C H I L D R E N ’S
15 Ways
to Praise
Your Child
I f you want to tell your
child that he or she is doing a
good job but can’t quite think
of the right words, here are 15
ways to tell your child he or she is great!
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
You’re on the right track!
That’s a lot better!
I knew you could do it!
You’re getting better every day!
Terrific!
Fantastic!
Good thinking!
I’m very proud of you!
You’re learning very fast!
You’re very good at that!
Outstanding!
Wonderful!
You certainly did well today!
You are doing a good job!
You’re the best!
The general’s plan for
the future
T he surgeon general has unveiled a 10-year health
plan for the United States that focuses on getting our
nation’s children into better shape, helping people quit
smoking, eliminating drug abuse and encouraging teens
to either abstain from sex or use condoms.
Surgeon General David Satcher’s plan aims for 30
percent of Americans to exercise 30 minutes each day
and reduce by half the number of overweight or obese
children, which currently stands at about 11 percent of
our children.
To reach his goal, the surgeon general will begin
measuring 10 areas called the “leading health indicators”
which address a broad range of health and social concerns. Health goals include an increase in the number of
children getting vaccinated, encouraging people to
exercise more, combating depression, increasing access
to health insurance, and discouraging substance abuse.
The new program is the first to establish a set of
measurements. The surgeon general’s office will collect
data from state and local agencies and from federal
agencies that compile health statistics that track whether
Americans are annually reaching goals set by the program in the 10 areas.
The kid with the code
Corey Felts, 9, of Jonesboro, out-scrambled more than 530 other entrants from
throughout the state to win the Healthy Habits Word Scramble contest that appeared in
the Summer 1999 issue of Blue & You.
Kids of all ages decoded nine hidden health messages, and Corey’s correctly
completed entry was pulled from among them in a drawing for a $25 Wal-Mart gift
certificate and a fun assortment of Arkansas Blue Cross and Blue Shield novelty items
(many of which feature health-and-wellness ambassador BlueAnn Ewe).
Blue sheep could be parents’ best friend
Parents and teachers in Arkansas have tapped into a
new resource which is encouraging kids to eat their
veggies, brush their teeth, exercise and be safe ... and
have fun in the process.
Since September 1999, more than 5,000 elementary
school-aged children have joined the BlueAnn Health
Club or BlueAnn Class Club through their homes or
classrooms. The central figure of the clubs is BlueAnn
Ewe — Arkansas Blue Cross and Blue Shield’s ambassador of health and wellness — a blue sheep. The clubs
give parents and teachers a new set of fun tools to help
teach children about healthy habits and encourage
them to participate in positive behaviors that could last
a lifetime.
BlueAnn Club members receive packets of fun,
educational health information and activities in the mail.
Plus, they may have a chance to win some really cool
prizes when they practice doing healthy things.
So, if you need a little assistance motivating your
little ones to practice healthy habits, join lots of other
parents and teachers and let a big, blue sheep help out.
Sign up today! BlueAnn wants ewe!
Just call 1-800-515-BLUE, toll-free, and ask for the
BlueAnn Club.
The BlueAnn Health Club is recommended for
elementary school-aged children (5 to 10 years old). The
BlueAnn Class Club is recommended for kindergarten and
first-grade classrooms.
Ageless Heroes 2000
For the third year, Arkansas Blue Cross and Blue
Shield will be searching for seniors whose achievements
prove that the golden years can be a time of health,
vitality and accomplishments.
Ageless Heroes TM, a national and state awards
program, was created as a cornerstone of the Blue Cross
and Blue Shield Association’s commitment to healthy
aging and is designed to honor inspirational mature
individuals who set examples of how to live life fully,
with vigor and health.
The Ageless Heroes Awards Program encourages
people in communities throughout the state to nominate
senior heroes — colleagues, family, friends and
neighbors — who are age 65 and older and who continue
to achieve and inspire.
Nominations will be accepted beginning in May.
Watch for more information in the next issue of Blue &
You as well as your local newspapers.
Olympic village by the river side
To help bring the spirit of the Olympics to the
Natural State, Arkansas Blue Cross and Blue Shield is
bringing the “Caring for the Human Spirit” tour to
Arkansas during Riverfest 2000 May 27-28 in Little Rock.
The tour is part of the Blue Cross and Blue Shield
Association’s sponsorship of the United States Olympic
team in the 2000 Summer Games in Sydney, Australia,
and the 2002 Olympic Winter Games in Salt Lake City,
Utah. Arkansans will have an opportunity to visit a miniOlympic Village at our own River Market during the
weekend festival. There will be Olympic memorabilia
displays and three exhibits for visitors to enjoy, including
an Olympic mini-decathlon, health fair and nutrition
center. Visitors can get a body fat evaluation and blood
pressure, heart rate and vision screenings. Plus, sports
fans can shoot hoops, have the speed of their baseball
pitch checked by radar, shoot a fast and accurate hockey
puck, put on a bungee vest and sprint against resistance,
or ride a virtual cycle against a computer program and
clock. Look for the Olympic Village at the corner of
Markham and Rock Street, just north of the main library.
It’s fun. It’s free. And it’s only here this year!
18
Leading
T
his issue of Blue & You continues our mission to introduce our
state senators and representatives of the Arkansas General Assembly to
our customers.
Rep. Sarah Agee (R)
(Dist.9) Prairie Grove
City, County & Local Affairs;
Joint Performance Review;
Public Transportation
(O) 501-846-4606
(H) 501-846-4177
Rep. Jerry Allison (D)
(Dist. 86) Jonesboro
Vice-Chairman; Agriculture
& Economic Development;
Education; Joint Performance
Review
(0) 870-932-7765
(H) 870-932-7960
Rep. Denny Altes (R)
(Dist. 14) Fort Smith
Public Health, Welfare and
Labor; State Agencies &
Governmental Affairs
(O) 501-646-8922
(H) 501-484-5494
Rep. Russ Bennett (R)
(Dist. 22) Lewisville
Public Transportation; State
Agencies & Governmental
Affairs
O/H 870-921-4866
Rep. Bill Bevis (D)
(Dist. 70) Scott
Agriculture & Economic
Development; Energy; Public
Transportation
(O) 501-945-5630
(H) 501-676-5630
Rep. Pat Bond (D)
(Dist. 64) Jacksonville
Vice-Chairman, City, County &
Local Affairs; Education; Joint
Retirement & Social Security
(O) 501-982-1538
(H) 501-982-8872
Rep. Mike Hathorn (D)
(Dist. 24) Huntsville
Agriculture & Economic
Development; Judiciary; Rules
(O/H) 501-665-2448
Rep. Russ Hunt (R)
(Dist. 68) Searcy
City, County & Local Affairs;
Revenue & Taxation
(O) 501-268-3055
(H) 501-279-2928
Rep. Jimmy Jeffress (D)
(Dist. 83) Crossett
City, County & Local Affairs;
Education; Energy; Joint Budget
(H/O) 870-364-8291
Rep. Jim Milum (R)
(Dist. 29) Harrison
Agriculture & Economic
Development; Joint Retirement &
Social Security; Revenue &
Taxation
(O) 870-365-0042
(H) 870-741-7532
the Way
These elected officials spend numerous hours working on health care
issues that affect you. (Upcoming issues of Blue & You will feature
additional profiles of our legislators.)
Rep. Mark Smith (R)
(Dist. 49) El Dorado
City, County & Local Affairs;
Judiciary
(O) 870-862-7965
(H) 870-862-7929
Rep. Larry Teague (D)
(Dist. 19) Nashville
Vice-Chairman; Revenue &
Taxation; Insurance &
Commerce; Rules
(O) 870-845-5303
(H) 870-845-3708
Rep. Lindbergh Thomas (D)
(Dist. 74) Grady
Aging, Children & Youth;
Legislative & Military Affairs;
Judiciary
(H/O) 870-479-3969
Rep. Jim Wood (D)
(Dist. 80) Tupelo
Vice-Chairman, Public
Transportation; Agriculture &
Economic Development;
Rules
(O/H) 870-744-2266
Senator John Brown (R)
(Dist. 34) Siloam Springs
Children & Youth; Education;
Rules, Resolutions &
Memorials; State Agencies &
Governmental Affairs
(O) 501-549-3290
(H) 501-524-4667
19
Senator Bill Gwatney (D)
(Dist. 19) Jacksonville
Vice-Chairman, State Agencies &
Governmental Affairs; Children &
Youth; Joint Budget; Joint
Retirement & Social Security;
Revenue & Taxation; Rules,
Resolutions & Memorials
(O) 501-982- 2102
(H) 501-982-4817
Senator Jodie Mahony ( D)
(Dist. 2) El Dorado
Vice-Chairman, Education; City,
County & Local Affairs; Joint
Advanced Communications &
Information Technology; Joint
Retirement & Social Security;
Rules, Resolutions & Memorials
(O) 870-862-6464
(H) 870-862-5950
Senator Doyle Webb (R)
(Dist. 14) Benton
Children & Youth; City, County &
Local Affairs; Judiciary; Rules,
Resolutions & Memorials
(O) 501-315-9322
(H) 501- 315-4266
20
Guess who owns
Arkansas Blue Cross and
Blue Shield?
You do.
For more than 50 years, Arkansas Blue Cross and Blue Shield has been covering the lives of Arkansas residents,
growing and changing to meet your health care needs. Sometimes we are considered a big business or corporate entity in
our state, but Arkansas Blue Cross differs from commercial insurers in several ways.
Arkansas Blue Cross is a not-for-profit organization.
That means that nearly all the money collected as premium is paid out in benefits for customers — on the average
about 85 cents of every dollar. The remainder — about 15 cents of every dollar — is used for operating expenses and
reserve funds, which we are required by law to maintain. However, as a mutual not-for-profit company, Arkansas Blue
Cross does pay state premium taxes and federal corporate income taxes.
As a non-profit, mutual insurance company, Arkansas Blue Cross is owned by its policyholders, not by stockholders.
This means that premium dollars are used solely to pay claims and administrative costs, not to pay stock dividends.
Any excess funds are held in reserve for payment of future claims and expenses. Arkansas Blue Cross must maintain a
fiscal balance between premium income and benefits paid to ensure that we have the ability to continue to offer insurance products and to pay policyholder claims in the future.
Blue Cross and Blue Shield Association Affiliation
Arkansas Blue Cross is a member of the Blue Cross and Blue Shield Association. This means Arkansas Blue Cross
has licenses from the Blue Cross and Blue Shield Association to offer health insurance benefits and related services
under the Blue Cross and Blue Shield names and service marks in the state of Arkansas.
The Blue Cross and Blue Shield system is not a single company. Rather, it is a coordinated group of 49 individual and
autonomous Blue Cross and Blue Shield Association Plans located throughout the United States and Puerto Rico. Each
Plan is an independent corporation committed to providing affordable health care financing.
One of the unique aspects of the Blue Cross and Blue Shield Association is that each member Plan is managed and
controlled by its own community-based board of directors, which must contain a majority of “public members.” Public
members are people from the community who are not employed in the health care industry. As a result, the Blue Cross
and Blue Shield Plans have a strong commitment to their local communities and customers, which is not necessarily
shared by commercial insurance companies.
Neither the Blue Cross and Blue Shield Association nor the other member Plans of the Blue Cross and Blue Shield
Association act as guarantors of the financial obligations of Arkansas Blue Cross and Blue Shield. However, Arkansas
Blue Cross and Blue Shield and the other member Plans in the Blue Cross and Blue Shield Association are subject to
uniform financial standards established by the Blue Cross and Blue Shield Association which are intended to foster a
system in which each member Plan maintains adequate financial resources to meet its obligations to its customers.
National Institute for Health Care Management (NIHCM) Affiliation
In 1993, Arkansas Blue Cross joined with 11 of the nation’s leading health care companies to form the NIHCM. The
NIHCM is a non-profit organization based in Washington, D.C., that was established to: 1) sponsor high-quality, non-
partisan research of health care issues; 2) act as a clearinghouse for research on health care
management and state managed care data; and 3) promote innovation to continuously
improve the health care system.
21
Here to serve you
A staff of almost 2,000 Arkansas Blue Cross employees continues to meet the health insurance needs of you, our policyholder. Our employees are your neighbors, your family and
your friends.
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Kelly Whiteho
Editor
22
ge
Health Advanta
members —
take note!
MEMBER RIGHTS AND
RESPONSIBILITIES
A member should:
1. Become familiar with the
requirements and procedures of Health Advantage.
2. Present Member ID Card to
the health care provider
when seeking care.
3. Select a primary care
physician.
4. Maintain health levels by
living a healthy lifestyle.
5. Coordinate all health care
through the primary care
physician.
6. Provide information to
health care providers to
assist them in the care
needed to achieve health
outcomes.
7. Follow all instructions
given by health care
providers to achieve
maximum benefits of
the care.
8. Meet all co-payment and
co-insurance obligations
and any billed charges in
excess of allowable charges.
9. Notify Health Advantage of
any status change.
10. Obtain all care through
Plan providers.
11. Communicate any complaint or grievance immediately to Health Advantage.
12. Ensure all claims for
services provided by nonPlan providers are filed
within 60 days.
A member has a right to:
1. Information about Health
Advantage, its services and
2.
3.
4.
5.
6.
7.
8.
9.
10.
providers, and members
rights and responsibilities.
Access to a Plan physician.
An explanation of benefits.
Be treated with respect
with recognition of their
dignity and right to privacy.
Confidential treatment of
medical information.
Participate with practitioners in decision-making
regarding their health care.
A candid discussion of
appropriate or medically
necessary treatment options
for their conditions,
regardless of cost or benefit
coverage.
Change primary care
physicians.
Voice complaints or appeals
about Health Advantage or
the care provided.
Provide, to the extent
possible, information that
Health Advantage and its
practitioners and providers
need in order to care
for them.
CHANGE TO HEALTH ADVANTAGE
MEDICAL BENEFITS
Health Advantage has amended
the Evidence of Coverage and
Schedule of Benefits for all lines of
business. Coverage for the added
benefit was effective Feb. 1, 2000,
for all Health Advantage members.
The change shown in bold
print to the right will be added to
the Evidence of Coverage, Attachment B, Schedule of Benefits,
Section P. with the next revision. If
you have questions, please contact
your group marketing representative or Customer Service at 501-2213733 or toll-free 1-800-843-1329.
P. Dental Care Services
General dental services are not
covered under this evidence of
coverage; however, the following
services may be provided in an
inpatient or outpatient setting and
covered when authorized by the
primary care physician subject to
the co-insurance specified in
Attachment C, Benefit Summary.
1. Services for treatment and
X-rays necessary to correct
damage to non-diseased teeth
or surrounding tissue caused
by an accident occurring on or
after effective date of coverage
are covered subject to a
$2,000 maximum per member
per accident. Member must
seek treatment within 72
hours of injury for services to
be covered.
2. Treatment or correction of a
non-dental physiological
condition which has resulted in
severe functional impairment.
3. Treatment for tumors and
cysts requiring pathological
examination of the jaw, cheeks,
lips, tongue, roof and floor of
the mouth.
4. Pre-treatment dental services
in connection with the treatment of cancer of the head
or neck.
Injury to teeth while eating is not
considered an accidental injury.
23
rkansas Blue Cross and Blue Shield strives to be a
A
good corporate citizen. Our employees raise money and
spend many hours helping those causes near and dear to
the hearts of Arkansans.
Hansel and Gretel
More than 100 performances of the fairy tale classic
“Hansel and Gretel” have been scheduled for the Wildwood Park for the Performing Arts Spring Tour 2000,
sponsored by Arkansas Blue Cross and Blue Shield. This
is the fourth year Arkansas Blue Cross has teamed up
with Wildwood in an effort to entertain and teach
elementary schoolaged children through
a live theater experience. Through the
centuries, fairy tales
have taught children
and adults important
lessons in character,
conquering fears and
overcoming problems. BlueAnn Ewe and cast members of
the “Hansel and Gretel” production
Students today still
pose with young fans.
can learn these life
lessons as they experience this enchanting story, based
on the Grimm Brothers fairy tale, in a musical theater
setting — complete with a tasty gingerbread house and
the delightful tunes of composer Engelbert Humperdinck.
A question-and-answer session with the cast and students immediately following the performance focuses on
dealing with emotions and fears. The tour will continue
statewide through April.
High School Heroes
High School Heroes, a unique student-to-student
teaching program with a strong anti-smoking message
targeting fifth-graders, finished a successful year in 1999.
Developed by the American Lung Association and
sponsored statewide by Arkansas Blue Cross and Blue
Shield, more than 990
high school students
across the state were
trained by the ALA to
teach the program in
elementary and middle
schools. These specially trained high school students —
High School Heroes — presented a message on the
importance of never starting to smoke to 12,081 fifthgraders in Arkansas
BlueAnn Ewe and High School
last year. Using
Heroes teach fifth-graders about
brainstorming, rolethe dangers of smoking.
play, discussion and
question-and-answer
sessions, Heroes
teach and serve as
role models for the
kids. The goal is to
reach kids at an age
when peer pressure
and advertising
might entice them to
start smoking. The
message includes
information about
effects of smoking to
the body as well as
the deceptive
appeals of tobacco
advertising. High School Heroes now is active in 28
counties in Arkansas. With more than 3,000 youths
starting to smoke each day, it is more important than
ever to reach them early in an effort to avert this dangerous and damaging habit. If you are interested in bringing
the program to your school, please contact the American
Lung Association/Arkansas Chapter at 1-800-880-5864.
Healthy Me & Ewe
As part of St. Bernards Regional Medical Center’s
annual kindergarten education program in Jonesboro,
BlueAnn Ewe and Dwayne Pierce of the Arkansas Blue
Cross Northeast Regional Office brought “Wild and
Woolly Health Tips for Kids” to more than 800 students
in local schools. BlueAnn and Pierce presented a
20-minute wellness lesson to students, teaching them
about such things as healthy eating, exercise, bike safety,
good sleep and dental health. All students were presented with a coloring book and an opportunity to meet
BlueAnn following the program.
— a guide to health insurance terminology
I
f health care terminology (including abbreviations
and acronyms) leaves your head spinning … Arkansas
Blue Cross and Blue Shield would like to help you make
sense out of all the jargon. We want you to be an informed customer, so in each issue of Blue & You we will
explain the meaning behind those health insurance
words, acronyms and abbreviations that you may encounter when reading health care-related materials.
Case Management — A process where covered persons
with specific health care needs are identified. It typically
combines the care from all involved including the
physician, the hospital, the patient and the family — all
in an effort to find the most appropriate treatment for
that patient.
Disease Management — A coordinated system of
preventive, diagnostic and therapeutic measures for a
specific chronic illness or medical condition.
Exclusions — Specifically listed conditions or situations
which, under an insurance policy (or health insurance
contract), are not considered covered expenses. Common
exclusions include cosmetic surgery, custodial care,
services covered by Workers’ Compensation, treatment
which is experimental or investigational, etc.
Outpatient — A person who is receiving ambulatory care
at a hospital or other health care facility for diagnostic or
other treatment services without being admitted as an
inpatient.
Provider — Either an individual or an institution licensed by the state to provide health care services or
supplies to those in need of such, including but not
limited to a physician, osteopathic physician, dentist,
optometrist, podiatrist, psychologist or pharmacist, as
well as facilities such as a hospital, clinic, ambulatory
surgery center or skilled nursing facility.
Utilization — The use of health care services and
supplies. Usually measured in terms of average length of
stay, admissions and days of care per 100 or 1,000
population or enrollees of designated group. Utilization
rates are often compared by geographic location, peer
group, facility or by physician and are used in comprehensive health planning.
Wellness — A type of preventive medicine associated
with an individual’s lifestyle which, through a combination of exercise and diet, may have the effect of a reduction in health care utilization and costs.
Gatekeeper — A primary care physician (PCP) who
serves as the patient’s initial contact for medical care,
and who makes referrals to specialists.
Group Insurance — Any insurance policy or health
services contract by which groups of employees (and
often their dependents) are covered under a single policy
or contract issued to their employer or other group entity.
Inpatient — A patient who has been admitted, at least
overnight, to a hospital or other health facility and
occupies a hospital bed, crib or bassinet while under
observation, care and diagnosis.
Member — The individual actually eligible for health
care services due to employment or purchase of nongroup coverage. While the coverage also may pay benefits to a dependent, the dependent is not the member.
Arkansas Blue Cross and Blue Shield
P.O. Box 2181
Little Rock, AR 72203-2181
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