Be Healthy Event - Virginia Premier

Be Healthy Event


Welcome to the Virginia Premier “Be Healthy” digital event.

We are highlighting the 24/7 Nurse Advice Line and the importance of bladder health.

In this presentation we want to help you understand what the 24/7 Nurse Advice Line is.

You can call the Nurse Advice Line 24 hours a day 7 days at week at 1-800-256-1982 (TTY:711).

The 24/7 Nurse Advice Line puts you in contact with an experienced, professional registered nurse 24 hours a day, 7 days a week.
The nurse can assess your signs and symptoms and make recommendations when you have medical related questions.

The RN can advise you where to seek care, and if possible, suggest self-care options until you can see your physician. The 24/7 Nurse Advice Line is part of your Medicare benefits and there are no copays or fees for using the service.

Please note, the 24/7 Nurse Advice Line cannot provide medical diagnoses or treatment, general health plan customer service,
member benefit information, transportation arrangements, or recommend a provider for you.

For questions about your plan or benefits, please contact Member Services. They will be able to answer your questions.

To use the 24/7 Nurse Advice Line, call the number listed on your member ID card. Within 30 seconds, you will be connected to a live RN. The RN will verify who you are. He or she will then talk to you about the medical symptoms you are experiencing.

The nurse will then make a recommendation for your next steps of care based on your medical signs and symptoms that could include:

  • Self-care at home
  • Seeing a primary care provider in the next few days
  • Going to an Urgent Care Facility
  • Going to the Emergency room
  • Or calling 9-1-1

Please take note that RNs do not make medical diagnoses or provide medical treatment.

The 24/7 Nurse Advice Line has benefits. The 24/7 Nurse Advice Line can help you:

  • Get care advice you can do at home
  • Prevent an unnecessary trip to the urgent care or emergency room
  • And can give you peace of mind about the health problem you are experiencing

Meet Bob, age 67, who has recently been feeling run down and now has a sore throat. Bob started feeling some body aches and chills, so he checked his temperature with his thermometer at home. Bob’s temperature was 101-degrees. Unsure of whether he should go to the hospital to be checked out, Bob called the 24/7 Nurse Advice Line.

The RN verified Bob’s information and talked to him about what he was feeling. Based on the nurse advice line’s established protocols, the RN advised Bob to rest, drink lots of fluids, and try to lower his temperature at home by taking over the counter fever reducing medication, wearing lightweight clothing, and placing cool, damp washcloths to his head and neck.

Bob was instructed by the RN to monitor his temperature and if it reached higher than 104 degrees to call the 24/7 Nurse Advice Line again for further instructions. Bob was also advised to call his primary care provider if his fever lasted more than three days.

Please note that recommendations from the 24/7 Nurse Advice Line are highly individualized based on the caller’s medical history and current symptoms and situation. This is just an example of what you might encounter when using the 24/7 Nurse Advice Line.

Sam is 48. She was seen in the Emergency Room for vomiting and diarrhea caused by a GI bug and given medication and IV fluids and then sent home.

After being home from the emergency room for a few hours, in the middle of the night, Sam began feeling sick again. She called the 24/7 Nurse Advice Line to ask if she should return to the emergency room. The RN verified her information and then assessed her symptoms.

Based on the information provided by Sam, the RN advised her to treat her symptoms at home and to follow up with her primary care provider in the morning.

The RN told Sam to call back if she developed abdominal or back pain, decreased urine output, a fever, loose stools, or if she is unable to keep small amounts of fluid down. The next day, Sam began slowly feeling better and by that evening was no longer feeling ill.

Please note that recommendations from the 24/7 Nurse Advice Line are highly individualized based on the caller’s medical history and current symptoms and situation. This is just an example of what you might encounter when using the Nurse Advice Line.

When and Where to go to seek care.

Call your primary care provider for health issues such as routine wellness, renewing prescriptions, management of chronic conditions, vaccines, long term digestive and urinary concerns, flu, sore throat or fever questions.

This is just a small list of the conditions your primary care provider can help with. If you are unsure who your primary care provider is, please contact member services.

Many conditions can be managed by your primary care provider, but there could be a wait to get an appointment.

In these cases, urgent care may be a better option. Consider urgent care for minor injuries, cuts or burns, throat pain, ear pain, urinary pain, nausea and vomiting, diarrhea, rashes, back pain and headaches.

Urgent Care centers are typically open after-hours, weekends, and holidays, unlike a doctor’s office, and usually have shorter wait times and a lower cost than the emergency room.

The ER is where you go for serious or life-threatening conditions that require treatment right away. The ER usually has high costs and can have long wait times. You would want to go to the Emergency room if you are experiencing any of the following: chest pain, head trauma, trouble breathing, broken bones, poisoning, seizures, severe bleeding, loss of vision, stroke symptoms, or if you are feeling you might harm yourself.

A viewer note. These lists are intended as general information and are not inclusive lists of medical problems that can be treated. During a medical emergency, go to the nearest hospital or call 911.

Some Emergency Room visits are preventable with other care options.

According to the Agency for Healthcare Research and Quality, 27 percent of Emergency Room visits in the United States could be taken care of in a doctor office, clinic, or urgent care center. Which could save over four billion dollars annually.

Now that you have viewed our presentation, you might still have some questions.
call member services at 1-877-739-1370 (TTY: 711) The hours of operation are on your screen. Thank you for choosing Virginia Premier!

In this presentation we will give you information about bladder health and urinary tract infections, or UTIs.

Why is taking care of your bladder health important? Bladder health is often a concern, but it is rarely talked about, even with your doctor.

People are often embarrassed to discuss what is going on with their bodies, especially bladder problems. It’s important to talk about as you age, because your bladder changes and you may experience new problems.

As you age, it’s not uncommon to encounter a urinary or bladder problem. Some of the most common issues in older adults are bladder and urinary tract infections caused by bacteria that enters the bladder through the urethra. These infections can spread to the kidneys.

Urinary incontinence, or the inability to hold your urine, is another common problem many older adults experience.

As you age, your bladder becomes stiffer and cannot hold as much urine. The bladder muscles can also weaken. Urinary retention happens when you can’t completely empty your bladder.

Urinary retention can be caused by blockages developed due to pelvic prolapses in women and enlarged prostates in men.

There are a number of factors that can affect your bladder health. Constipation prevents the bladder from expanding properly.
Individuals with diabetes may experience nerve damage around the bladder that makes it difficult to control urine.

Being overweight can affect the ability to control urine and leakage. Some medications, like those for anxiety or sleep, can make it difficult to feel the urge to go to the bathroom.

Many controllable lifestyle habits, such as smoking, alcohol and caffeine intake, and inactivity can affect your bladder health.
Finally, your diet can impact bladder health. For instance, soda, artificial sweeteners, and spicy, foods can make your bladder problems worse.

So, what can you do to improve or maintain your bladder health? First, always talk to your provider if you are experiencing a urinary problem, whether it’s a new or existing concern. It can be difficult to talk about bladder health, but your doctor can’t help you if you don’t share the problems you are experiencing.

Second, empty your bladder every three to four hours this keeps your bladder muscles from getting weak. Holding urine in the bladder for too long can lead to infections and leakage. Third, cotton underwear and loose-fitting clothing help prevent trapped moisture and bacteria growth. And fourth, by exercising your pelvic floor daily, you can strengthen your bladder muscles.

Women are more likely to get UTIs than men because their urethras are shorter. Your UTI risk increases with age. According to PubMed Central, more than one-third of all infections in nursing homes residents are UTIs.

More than 10 percent of women over age 65 report having a UTI within the past year. That number increases to almost 30 percent in women over 85. Men also tend to experience more UTIs as they age. The classic symptoms of a urinary tract infection are burning pain, and frequent urination.

Older adults may also experience behavioral symptoms such as confusion. You may also notice that your urine is a dark yellow with a strong smell.

If you suspect that you have a urinary tract infection, go to the doctor. They may order a urine sample to test for a UTI.
If you are unable to see or speak to your doctor, you can call our 24/7 Nurse Advise Line at 1-800-256-1982 (TTY: 711).

That number is also listed on the back of your member ID card. Or you can go to an Urgent Care center. You may be prescribed an antibiotic. If so, always take the medication according to the directions. Drink lots of water to help flush the bacteria from your body. You might also find a heating pad helpful.

Here are some tips to help prevent getting a UTI. Empty your bladder often and as soon as you feel the need to go. Don’t wait until you feel rushed. Women are encouraged to wipe from front to back after going to the bathroom. Drink lots of water. Choose showers over baths. Stay away from feminine hygiene sprays and scented bath products. They’ll only increase irritation.

Both men and women can benefit from Kegel exercises. Find the pelvic floor muscles by stopping the flow of urine.
You should only do this to learn how to engage the muscles because frequent starting and stopping of the flow of urine can lead to infections. You should feel the muscles tighten more in the back of the pelvic area versus the front. Don’t tighten the abdominal, leg, or buttock muscles. Always speak to your doctor before starting an exercise program.

Here are some instructions on how to do a Kegel exercise:

  • Contract the pelvic floor muscles for 3-5 seconds
  • Relax for 3-5 seconds
  • Repeat the contract/relax cycle 10 times
  • Gradually increase the length of time for contractions and relaxation until you reach 10 seconds
  • Try to do 3-4 rounds of Kegel exercises throughout the day.

The diagram on your screen shows examples of ways you can perform the Kegel exercise.

Now that you have viewed our presentation, you might still have some questions.

Call member services today at 1-877-739-1370 (TTY: 711) The hours of operation are on your screen. Thank you for choosing Virginia Premier!

Summer is in full swing! It’s time to get out of the house and into the sunshine.  No matter what you’re doing –relaxing at the pool or just hanging in the backyard – it’s important to protect your skin from the sun’s ultraviolet rays. While UVB rays are the main cause of sunburns, overexposure to UVA rays may cause skin cancer.

Continue reading about Fun in the Sun

Where should you go for the care you need? Different health problems require different levels of care. If you or someone you know feels sick, it is important you know where to go for appropriate care. The severity of your condition, wait times, and costs are all factors to consider. With Virginia Premier you have control. Get to know which health option is best for you at the appropriate time.

Continue reading about Where to Go To Seek Care

Your oral health is just as important as your physical and mental health.

According to the Mayo Clinic, just like other areas of the body, your mouth builds up bacteria. Your mouth is the entry point to your digestive and respiratory tracts and some of these bacteria can cause disease. That is why proper oral hygiene is important.

Continue reading about Dental Health

All you need for your dental care is available in your Over-the-Counter Benefit Catalog – toothpaste, various types of toothbrushes, dental floss, and oral mouth rinse to name only a few selections.

Continue reading about Using Your OTC Benefit

Start making the most of your health plan by registering to use the Member Portal.

Virginia Premier gives you an easy way to organize and access your health insurance information and healthcare. Visit virginiapremier.com/member-portal/ and select from the options on the web page to access your secure member account.

Continue reading about your Digital Resources

Digital Resources

Each member has access to a personalized, secure account. Once you register for an account, you can:

  • Take a Health Risk Assessment
  • Communicate with a Health Educator
  • Search health topics
  • Use the Health Tracker tools
  • Reference a health library

Using Your Virginia Premier OTC Benefit

Over-the-Counter (OTC) Benefit

Your Virginia Premier plan can help keep more money in your pocket when you take advantage of your OTC quarterly allowance.

Order from a wide selection of non-prescription medications and vitamins, first aid supplies, personal care products, incontinence supplies, and so much more through the plan’s catalog of items. You must spend your allowance each quarter. Leftover funds cannot be carried over to the next quarter.

How to Use Your OTC Benefit

Online

How to place an order through the website:

  1. Visit cvs.com/otchs/virginiapremier
  2. Create an account
    • If it is your first time placing an order online, you will need to create an account by choosing the “Create Account” button and following the instructions.
    • You will need your member ID, date of birth, ZIP code and current email address.
    • You will be prompted to create a password.
  1. Place an order
    • Once you sign in, your benefit amount and balance will be displayed at the top of the page.
    • Browse through the available products and add to your basket. Your order total will automatically deduct from your balance at the top of the page.
    • Once you are ready to place your order, choose “Checkout.”
    • On the Checkout page, confirm your shipping address, review your order, and place your order. It will arrive within 14 days.
    • You’ll receive an email with tracking information once your order has shipped and another email once your order is delivered.

By phone

  1. Orders can be placed by calling 1-888-628-2770 (TTY: 1-877-672-2688). You can speak to a live agent Monday to Friday, from 9 am to 8 pm EST. Language support services are available, if needed.
  2. Have you Member ID number ready to give the agent.

In store

  1. You can pick up your OTC items at any OTC Health Solutions participating CVS Pharmacy. To find the nearest location, go to com/otchs/virginiapremier/storelocator.
  2. How to use your OTC Health Solutions benefits in store:
    1. Identify approved items in the catalog and make a list, take catalog with you to the store.
    2. Look for blue “OTC Health Plan Benefit Approved Item” label in the store.
    3. Take items to the register and show your Virginia Premier insurance card.

Get to Know Your Prescriptions

It’s important that you know all the medications you take, the reason for taking them, and that you keep a list of all your medications and doses.  When meeting with your doctors, don’t forget to tell them everything that you take, even over-the-counter medications and vitamins.

If you have any questions about your medications, speak to your doctor or pharmacist. Don’t take a medication you are unsure of without talking to someone first.

If you have problems remembering when to take your medications, use an alarm or find an app on your mobile phone to remind you. Remember, if you don’t take your medications, they won’t help you.

If you notice any side effects from your medications, take note of how you’re feeling and speak to your doctor or pharmacist.

90-Day Home Delivery

There is no need to go the pharmacy every month to get a prescription refill. Your Virginia Premier plan covers a 90-day supply of most medications through two options: home delivery or at your local pharmacy.

To participate:

  • Talk with your doctor.
    Ask your doctor for a new 90-day prescription.
  • Talk to your pharmacist.
    Your pharmacist can call your doctor to get you a 90-day prescription.

Did you Know? Medications eligible for the 90-day home delivery usually require daily use and are commonly used to treat chronic or long-term conditions like high blood pressure, heart disease, asthma, and diabetes.

90-day home delivery can help with:

  • Lowering overall medication costs
  • Making fewer visits to the pharmacy
  • Taking medication on time and regularly

Dental Health

Ways to Keep Your Mouth Healthy

  1. Brush your teeth before going to bed. Brushing before bed gets rid of the germs and plaque that accumulate throughout the day.
  2. Brush properly. Take your time using a circular motion.
  3. Brush your tongue. Plaque can also build up on your tongue.
  4. Use a fluoride toothpaste. Fluoride is a leading defense against tooth decay.
  5. Flossing is as important as brushing. You should floss at least once a day to get rid of germs that your toothbrush can’t get to.
  6. Use mouthwash. Mouthwash helps in three ways – reduces acid in your mouth, cleans hard-to-brush areas, and repairs and strengthens weakened tooth enamel.
  7. Limit sugary and acidic foods and beverages. These can erode the enamel on your teeth.
  8. Drink more water. Drinking water after every meal can help wash away the effects of sticky, sugary, and acidic foods, and beverages.
  9. See a dentist twice a year. Schedule an appointment with your dentist twice a year for cleanings and checkups.

Source: mayoclinic.org

Using Your Virginia Premier Dental Benefit

Virginia Premier offers preventive services at $0 copay for exams, cleanings, and X-rays twice a year.  Plus, we offer a $3,000 comprehensive benefit that cover fillings, extractions, crowns, dentures, and more. You must use an in-network provider for these services. To find participating providers, go to dentaquest.com/home/ and follow the instructions below. 

  1. Click Members tab
  2. Search by Virginia
  3. Click Find a Dentist
  4. Select Virginia Premier Advantage Elite (HMO DSNP)
  5. Enter Zip Code under Geographic Area
  6. Search

Or, you can call DentaQuest directly for help at 1-844-822-8115. You can also call Virginia Premier Member Services at 1-877-739-1370 (TTY 711) to find a particular dentist or a list of dentists in your area.

Please refer to your Evidence of Coverage for specific benefit limits.

 

Where To Go To Seek Care

Care Management 1-877-739-1370 (TTY 711).
Your Care Coordination team is only a phone call away to help schedule doctor appointments for those concerns that don’t require immediate care. They can also help you take the right steps to stay healthy with medication reviews, chronic condition education, and prevention care education. Hours of operation are Monday-Friday, 8 a.m. – 8 p.m.

Provider’s Office.
Your doctor provides routine or preventive care. It’s important to build a relationship with your doctor who will help keep track of your medications and overall health. If available, your primary care physician should be your first call for any non-life-threatening symptoms you are experiencing. If your doctor is not available, you have several options including calling our 24/7 Nurse Advice Line or going to your local Urgent Care.

24/7 Nurse Advice Line 1-800-256-1982 (TTY 711).
If your doctor is not available and you’re not sure what to do, call the 24/7 Nurse Advice Line. The 24/7 Nurse Advice Line is staffed by registered nurses who can help you understand medical topics and guide you through making good health decisions.

Urgent Care.
Go to your local Urgent Care for non-life-threatening conditions requiring immediate attention. For your convenience, they are open days, evenings, weekends, and holidays. If you go to an Urgent Care for non-life-threatening conditions your wait time will typically be shorter than going to an emergency room.

Emergency Room (ER).
The ER is where you go for serious or life-threatening conditions that require treatment right away. The ER usually has a longer wait time if you go there for non-life-threatening conditions.

Fun in the Sun

Use these tips to keep your skin healthy this summer

 

  • Pick the right sunscreen.
    Make sure it’s a “broad spectrum” sunscreen with a sun protection factor (SPF) of 15 or higher.
  • No days off.
    You still need to wear sunscreen on cloudy or overcast days. Clouds don’t cover up UV rays, and they can reflect off the ground.
  • Get some shade.
    The sun is most intense between 10 a.m. and 4 p.m., so limit your exposure during this time.
  • Stay cool.
    Being safe in the sun isn’t just about protecting your skin. Summers in Virginia are hot and humid, which makes it a lot harder for your body to cool down. Make sure you’re drinking plenty of water and staying away from sugary drinks.
  • Think outside the bottle.
    The sunscreen bottle, that is! While using sunscreen correctly is the gold standard, you can take protection to the next level by wearing:
    • Sunglasses with UV protection
    • Wide brimmed hats
    • Lip balms and makeup with SPF 15 or higher

Know the Signs of Heat Exhaustion and Heat Stroke


Heat Exhaustion

  • Heavy sweating
  • Cold, pale, and clammy skin
  • Fast, weak pulse
  • Nausea or vomiting
  • Muscle cramps
  • Tiredness or weakness
  • Dizziness
  • Headache
  • Fainting

Heat Stroke

  • Hot, red, dry, or damp skin
  • Fast, strong pulse
  • Headache
  • Dizziness or nausea
  • Confusion

If you or someone you know experience any of these symptoms move to a cool place, loosen your clothes, apply cool wet towels, and sip water. Get medical help right away if you’re throwing up, your symptoms get worse, or if your symptoms last longer than an hour.

Source: cdc.gov

Using Your Virginia Premier OTC Benefit

Don’t forget to use your quarterly allowance and order items to help you get through the summer months like sunscreen, aloe vera cream, moisturizing body lotion, and insect repellent.