WINTER 2007

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Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association.

A newsletter for Blue Choice membersInSIde

• Looking for quality cardiac care? Try a Cardiac Center of excellence (Page 1)

• don’t be afraid to ask questions (Page 2)

• It’s not too late to protect yourself from the flu (Page 3)

• Guide to Good Health (insert)

• nine steps to a healthy attitude (Page 10)

BluePoints Winter 20072 BluePoints Winter 2007

BluePointsEditor: Mintzi Schramm, Member Communications, BCBSM Contributor: Judith Holt, Point of Service Administration, BCBSM Layout and design: Steve Grant, Communications Design Services, BCBSM

BluePoints is published twice a year for Blue Choice members. BluePoints is meant to complement the advice of health care professionals and is not intended to take the place of professional medical care. Your specific contract may not cover every procedure or treatment recommended.

Blue Choice is a product of Blue Cross Blue Shield of Michigan, a nonprofit corporation and independent licensee of the Blue Cross Blue and Shield Association. Blue Cross Blue Shield of Michigan is controlled by a board of directors that includes private citizens, business, labor and health care professionals.

We welcome your letters. Send your letters, mailing changes, requests for additional copies to:

Editor, BluePoints — Mail Code C226 Blue Care Network P.O. Box 5043 Southfield, MI 48086-5043

Articles may be reprinted with permission.

Contents BluePoints Winter 2007

�

Looking for quality cardiac care? Try a Cardiac Center of Excellence

Looking for quality cardiac care? Try a Cardiac Center of Excellence ...................�ESRD network, part of Blue Choice system of care ...............................................................�

Avoid medication complications ........................2Don’t be afraid to ask questions ........................2It’s not too late to protect yourself from the flu ...3

Clean hands prevent disease ............................4See your dentist – it’s good for your health .......4Your Guide to Good Health ........................InsertFruits and vegetables: a recipe for life ...............9Healthy weight + exercise = good health! .........9Nine steps to a healthy attitude .......................�0Is that cough asthma? .....................................��Calling all women — and men: Make time for your health ...............................��Good posture and body mechanics keep the aches away ..............................................�2Preventive care will help your children live long, healthy lives ...........................................�3We help you take care of yourself ..................�3Referrals not needed .........................Back Page

ESRD network, part of Blue Choice system of careIn an effort to provide affordable quality care, Blue Cross Blue Shield of Michigan has created a preferred provider network of freestanding end stage renal disease facilities for BCBSM and Blue Choice members. The TruST network became effective Nov. 1, 2006.

This network allows the Blues the opportunity to work with ESrD providers to improve the quality of care for members in need of renal dialysis services. It also helps lower the cost of health care for groups and individuals by creating uniformity of pricing.

All major dialysis providers in Michigan have agreed to be part of this network. The ESrD network is just one of the many provider networks that form the Blue Choice system of cost-effective, quality care. Other networks cover behavioral health services, durable medical equipment and laboratory services.

• St. John Hospital Macomb Center, Warren

• St. John Hospital & Medical Center, Detroit

• St. Joseph Mercy Hospital, Ann Arbor

• St. Joseph Mercy Oakland Hospital, Pontiac

• university of Michigan Health System, Ann Arbor

• William Beaumont Hospital, royal Oak

To assist members in selecting cardiac care hospitals with records of effective care, BCBSM identifies Cardiac Centers of Excellence. Better outcomes and fewer complications are some of the criteria we use to evaluate a hospital for the Center of Excellence designation.

“The 13 Cardiac Centers of Excellence hospitals stand out as consistently performing at an exemplary level on a wide range of cost and quality measures,” said David Share, M.D., M.P.H., BCBSM senior associate medical director, Health Care Quality.

• Genesys regional Medical Center, Grand Blanc

• Henry Ford Health System, Detroit

• Ingham regional Medical Center, Lansing

• McLaren regional Medical Center, Flint

• Mercy General Health Partners, Muskegon

• Providence Hospital & Medical Center, Southfield

• Spectrum Health, Grand rapids

BluePoints Winter 20072 3BluePoints Winter 2007

Avoid medication complicationsDrugs are great at curing illness and treating disease. However, they are powerful substances that need to be taken with care.

Over-the-counter medications can also be problematic, especially since some contain the same active ingredient as prescription-only alternatives. For example, Aleve® and Advil® have the same active ingredient as Naprosyn® (naproxen) and Motrin® (ibuprofen) — just at a lower strength.

Even vitamins and minerals can sometimes cause trouble. For example, vitamins A and D are stored in fat and the liver, and too much can be as dangerous as too little. Many food supplements interact with prescription drugs. Ginkgo biloba, advertised as improving memory, and ginseng, promoted as a stress reliever, may cause bleeding or interact with blood thinners. St. John’s Wort (often taken for mood elevation) can interact with other drugs used for depression.

Don’t be afraid to ask questionsHealth care starts with health understanding. Don’t be afraid to tell your doctor, nurse or pharmacist that you have questions.

Your medical team wants you to let them know that you need help. Asking questions helps you understand how to stay well or get better.

Every time you talk with a doctor, nurse or pharmacist, ask these three:

1. What is my problem?

2. What do I need to do?

3. Why is it important for me to do this?

In addition to the three basic questions, here are some other to-dos that can help your understanding when you visit the doctor:

• Make a list of health concerns, and bring it with you to your doctor visit.

• Have a friend or family member accompany you to a doctor visit. Another point of view is always helpful. Often someone else can think of a question you may have overlooked.

It’s not too late to protect yourself from the flu February can be the worst month of the year for influenza, according to the Centers for Disease Control. In the past 30 flu seasons, February has been a peak month 13 times.

That’s why the CDC is promoting flu shots in January. The American Academy of Pediatrics is even considering a recommendation that its members offer flu shots as late as May 1 each year.

Getting a flu shot makes sense. It only takes between seven to 10 days after a flu shot is given to become effective, and the flu vaccine prevents illness in about 70 percent to 90 percent of healthy adults under 65 years of age.

What else can you do to prevent the flu? These steps may help prevent the spread of respiratory illnesses such as the flu:

• Cover your nose and mouth with a tissue when you cough or sneeze. use your upper sleeve if you don’t have a tissue.

• Wash your hands frequently with soap and water, especially after you cough or sneeze.

• Avoid close contact with people who are sick. When you’re sick, keep your distance from others to protect them from getting sick, too.

Al Juocys, D.O., a family practice physician in rochester Hills, has seen patients who put their health in danger by taking medications incorrectly. One patient developed kidney problems after taking large quantities of over-the-counter Motrin. Another patient who thought taking large amounts of vitamin B-12 would be good developed significant neurological symptoms.

Take the following precautions with prescription and over-the-counter drugs.

• Know what you’re taking and for what. Make a list of all your drugs, and keep it on you at all times.

• Brown bag your medicines when you visit your doctor. This means bringing in all the medications you are taking. Include prescribed medications, vitamins, over-the counter and herbal remedies. Your physician needs to be aware of all medications you are on, including drugs prescribed by other physicians.

• Call your doctor or pharmacist if you experience any side effects.

• Do not stop taking your medications without talking to your physician, even if you’re feeling better.

Flu symptoms• Fever (usually high)

• Headache

• Extreme tiredness

• Dry cough

• Sore throat

• runny or stuffy nose

• Muscle aches

• Stomach symptoms such as nausea, vomiting and diarrhea can also occur, but are more common in children than adults.

• If you get the flu, stay home from work, school and social gatherings. You’ll help prevent others from catching your illness.

• Try not to touch your eyes, nose or mouth. Germs often spread this way.

Ask your doctor about a pneumonia shot Pneumonia is a serious infection caused by bacteria. When these bacteria invade the lungs, they cause the most common kind of bacterial pneumonia. Symptoms include: high fever, cough, shaking/ chills, shortness of breath or chest pain that gets worse with breathing deeply and coughing.

The pneumonia shot is safe and effective. For most people, one dose will protect for a lifetime. It may be given at the same time as the flu shot. Pneumonia shots, when advised by your doctor, are also covered. To see our Guidelines to Good Health go to Pages 5-8.

BluePoints Winter 20074

Your Guide to Good HealthBlue Choice recommendations for preventive care

Clean hands prevent diseaseAccording to the u.S. Centers for Disease Control and Prevention, the single most important thing we can do to keep from getting sick and spreading illness to others is to wash our hands.

When should you wash your hands? • After you use the bathroom

• Before you eat

• Before, during and after you prepare food

• When your hands are dirty

• After handling animals or animal waste

• More frequently when you or someone else in your home is sick

See your dentist – it’s good for your healthHow important are your teeth? There’s growing evidence that good teeth and gums contribute a lot to your overall health. Dental examinations now include screening for cancers of the mouth as well as symptoms of other conditions. And recent research shows links between some medical conditions and periodontal, or gum, disease.

Did you know? • Conditions such as diabetes

and heart disease seem to speed up the progress of periodontal disease.

• Active periodontal disease, in turn, can increase the severity of heart disease and diabetes.

• The bacteria linked to periodontal disease can get into the bloodstream and affect vital organs of the body. While periodontal treatment doesn’t cure diabetes or heart disease, it gets rid of some of the bacteria and inflammation related to these diseases and may lead to better control over them. Left untreated, periodontal disease can affect your body’s ability to ward off the progress of heart disease or diabetes.

What should you do? • Have your teeth cleaned

regularly to prevent gum disease.

• If you develop gum disease, seek treatment immediately. As with any disease, early treatment can control or eliminate the condition.

How should you wash your hands? 1. Wet your hands and apply liquid, bar or powder

soap. (If soap and water are not available, use wipes or gel formulas to clean your hands.)

2. rub your hands together vigorously and scrub entire hand.

3. Continue for 20 seconds.

4. rinse well under running water.

5. Dry your hands using a paper towel or air dryer.

6. If possible, use your paper towel to turn off the faucet.

Information provided by The Soap and Detergent Association, Washington, D.C., cleaning101.com.

Adult FemAle Preventive HeAltH recommendAtions

Service For Age18–39 Age40–64 Age65+

Healthmaintenance Health history, physical exam, Every 3 – 5 years Age 40 – 49, every 2 – 3 years Every year examination preventive health and depression Age 50-64, every 1 – 2 years assessment, patient education on nutrition, weight mgt., alcohol/drug abuse, tobacco use and injury prevention

Bloodpressurescreening Hypertension Every 2 years Age 40 – 49, every 2 years Every year Age 50-64, every 1 – 2 years

Cardiovasculardisease Cardiovascular disease Every 2 years Every 2 years Every year andstrokeriskassessment and stroke

Cholesterolscreening Level of blood cholesterol Every 5 years Every 5 years Every 5 years

Papsmear Cervical cancer Beginning within 3 years of Age 65-69 every year or every sexual activity or 2-3 years (after 3 negative results) Age 21 – 30 every year Age 70+ discuss with your Age 31 – 64 every 2 – 3 years (after 3 negative results) physician

Pelvicexam Cervical cancer Every 1 – 3 years Every 1-3 years Every 1-3 years, discuss with your physician

Clinicalbreastexamand Breast cancer Every year Every year Every year instructionforbreastself-exam

Mammography Breast cancer Discuss with your physician Age 40 – 49, every 1 – 2 years; Every year; age 75+ at age 50 – 64, every year. patient/physician discretion

Sigmoidoscopy Colorectal cancer Not applicable Every 5 years starting at age 50; or colonoscopy every 10 years; or double contrast barium enema every 5 years

Fecaloccultbloodtest Colorectal cancer Not applicable Every year starting at age 50 Every year (not following colonoscopy) (not following colonoscopy)

Diabetesscreening Diabetes Not applicable Every 3 years starting at age 45 Every 3 years

Pregnancy Maternal and child health First visit before 14 weeks; visits every 4 weeks through Not applicable 30 weeks; every 2 weeks from 30 – 36 weeks; weekly visits after 36 weeks; once to twice per week after 40 weeks. Postnatal checkup 21 – 56 days after delivery.

Guidelines to Good HeAltHpreventive care is the key to good health!Blue Choice encourages members to be active partners in maintaining good health. These health guidelines for all age groups are based on recommendations from national medical organizations and the most current medical and scientific literature. These guidelines are recommended by Blue Choice for healthy adults and children. Blue Choice guidelines are a resource for physicians and may not always apply to every individual. Pleasediscussquestionsyouhaveaboutyourhealthcarewithyourprimarycarephysician.Yourprimarycarephysicianmayrecommendadifferentschedulebasedonyourneeds.

Adult immunizAtions

Service For Age18–39 Age40–64 Age65+

Influenza Flu Annually for certain Every year starting at age 50 Every year chronic conditions — discuss with your physician

Td/Tdap Tetanus/diphtheria Every 10 years Every 10 years Every 10 years — Td only

Pneumococcal Pneumococcal disease Persons at high risk for pneumococcal disease — At age 65 (meningitis and pneumonia) discuss with your physician

Zoster(shingles) Shingles Not applicable Age 60 and older

062242STCM DEC 06

PediAtric Preventive HeAltH recommendAtionsService For 0–15months 16months–5years 6–12years 13–17yearsWell-childexamination History, physical exam, Total of 9 visits including 5 visits 5 visits Annually immunization status, the initial visit A complete health maintenance examination is recommended for all education members. At that time your physician will recommend a health maintenance examination schedule based on your child's health care needs.

* catch up is recommended between 24 months and 5 years

PediAtric immunizAtions

Service For 0–12months 12–18months 4–6years 11–16yearsPolio(IPV/injectable) Polio At 2 and 4 months 3rd dose between 4th dose Not applicable 6 – 18 months (usually at school entry)

DTaP Diphtheria, tetanus At 2, 4 and 6 months 4th dose between 5th dose and acellular pertussis 15 – 18 months (usually at school entry)

Tdap Tetanus, diphtheria and 11-12 years, then Td acellular pertussis booster every 10 years

HiB Haemophilus At 2, 4 and 6 months 4th dose at Not applicable Not applicable influenza type B 12 – 15 months

HepatitisA Hepatitis A At 12 months At 18 months Discuss with Discuss with your physician your physician

HepatitisB Hepatitis B At birth, 1 – 4 months Discuss with Discuss with Discuss with and 6 – 18 months your physician your physician your physician

Meningococcal Meningitis 11-12 years

MMR Measles, mumps Not applicable 12 – 15 months 2nd dose Discuss with and rubella (usually at school entry) your physician

Varicella Chickenpox Not applicable 12 – 18 months Discuss with Discuss with your physician your physician

Influenza Flu 1st dose 6 months Every year (up to Every year for children with chronic conditions. 23 months) Discuss with your physician.

Pneumococcal Pneumonia At 2, 4 and 6 months 4th dose at 12 – 15 Discuss with Not applicable conjugate* months your physician

Adult mAle Preventive HeAltH recommendAtionsService For Age18–39 Age40–64 Age65+Healthmaintenance Health history, physical exam, Every 3 – 5 years Age 40 – 49, every 2 – 3 years Every year examination preventive health and depression Age 50-64, every 1 – 2 years Ages 65 – 75 men who are assessment, patient education or have been smokers should on nutrition, weight mgt., have a one-time ultrasound alcohol/drug abuse, tobacco use to screen for abdominal and injury prevention aortic aneurysm

Bloodpressurescreening Hypertension Every 2 years Age 40 – 49, every 2 years Every year Age 50-64, every 1 – 2 years

Cardiovasculardisease Cardiovascular disease Every 2 years Every 2 years Every year andstrokeriskassessment and stroke

Cholesterolscreening Level of blood cholesterol Every 5 years Every 5 years Every 5 years

Clinicaltesticularexam Testicular cancer As part of routine As part of routine Not applicable andinstructionfor health assessment health assessment testicularself-examination

Prostatescreening Prostate cancer As recommended Age 45 based on race, nationality As recommended or family history Age 50+ as recommended

Sigmoidoscopy Colorectal cancer Not applicable Every 5 years starting at age 50; or colonoscopy every 10 years; or double contrast barium enema every 5 years

Fecaloccultbloodtest Colorectal cancer Not applicable Every year starting at age 50 Every year (not following colonoscopy) (not following colonoscopy)

Diabetesscreening Diabetes Not applicable Every 3 years starting at age 45 Every 3 years

9BluePoints Winter 2007

Fruits and vegetables: a recipe for lifeThe verdict is in! Health experts agree that eating a variety of fruits and vegetables — at least five servings a day — is essential for good health.

Fruits and vegetables are nutritional masterpieces. They’re packed with vitamins, minerals and fiber, not to mention being low in calories, fat and sodium. research shows that they reduce the risk of cancers of the lung, colon, mouth, esophagus, stomach and rectum, and possibly cancers of the breast, bladder and pancreas.

Eating five servings of fruits and vegetables every day is easier than you think Here are ways to get your five a day:

Breakfast • Make a fruit shake.

• Add strawberries or a banana to cereal.

• Have an orange or half a grapefruit with your toast.

Lunch • Pack some carrot sticks or pepper strips in

your lunch.

• Add lettuce, tomatoes and pepper strips to your sandwich.

Dinner • Add zucchini and mushrooms to pasta

sauce.

• Eat a tossed salad.

• Enjoy a baked apple pie for dessert.

Snack • Top frozen yogurt with fruit cocktail or

mandarin orange sections.

• Munch on raisins or mixed dried fruit.

Blue Choice Contacts To call us Our representatives are available 8:30 a.m. to 5 p.m. weekdays.

Area codes 231, 269, 616 800-972-8344

All other area codes 800-645-BLuE (2583)

TTY users 800-526-0844

Foreign language line 800-874-9426

Blue Choice ResourcesBlue HealthConnection®

bcbsm.com Navigate to our Quick Links on the right. Click on “Members, Take Our Free Health Risk Appraisal” for speedy access to online programs that will help you take charge of your health care needs.

800-775-2583 Connect to our health coach hot line to speak to registered nurses and get valuable health tips.

Naturally BlueSM 888-718-7011 Get a list of physicians in your area who provide complementary medicine at a discount to Blues’ members.

Quit the Nic 800-811-1764 Enroll in our proven smoking cessation program and kick your habit.

Blue Choice Web sitebcbsm.com/blue_choice Browse our Web site for valuable resources.

To write us Area code 248, 313, 517, 586, 734, 810, 906 or 989: Blue Cross Blue Shield of Michigan

P.O. Box 341 Detroit, MI 48231-0341

Area code 231, 269 or 616: Blue Cross Blue Shield of Michigan P.O. Box 230495 Grand rapids, MI 49503-0495

Healthy weight + exercise = good health! Exercise and healthy eating are key elements to a healthy lifestyle.

The basic principle is clear: You can lose weight if you use more calories than you eat. And you can keep a healthy weight if you balance your calorie intake with regular exercise.

People who exercise can add more than three years to their lives and their hearts reap benefits from something as simple as brisk walking a half hour a day, according to two studies published in the Archives of Internal Medicine.

People in the National Weight Control registry, a group of 3,000 Americans who have lost an average of 60 pounds and kept their weight stable for up to five years, burn an average of 2,700 calories a week in physical activity. That’s equal to about one hour of moderately intense activity, such as brisk walking, every day.

To begin an exercise program: • Consult your doctor.

• Start slowly. Begin with 10 to 30 minutes of moderately intense activity, such as walking, three days a week. Build up to 45 to 60 minutes on most days.

BluePoints Winter 2007�0 ��BluePoints Winter 2007

Nine steps to a healthy attitudeMaking lifestyle changes is not easy. But there’s good news about behavior changes. A growing body of research shows that people who achieve a healthier lifestyle do so only after a few unsuccessful attempts. Developing and maintaining healthy habits takes time. Here are nine ideas to help you make positive lifestyle changes in your life.

�. Develop your own healthy living plan. People who devise their own eating and

activity plan or adapt an expert’s plan to their lifestyle seem to be more successful at leading a healthier life. Find out what works best for you and do it your way.

2. Get real. Set realistic goals

— ones that work for you! Don’t make it impossible to reach. For example, losing five pounds at a time seems more doable than losing 30 pounds.

3. Activate your life. Physically active

people have a better image of themselves compared to those who are not active. Physical activity is also key to achieving and maintaining a healthy body weight.

4. You can’t change overnight. Don’t expect to redesign your eating or

fitness routine overnight. Changing too much too fast can cause frustration and feelings of failure. Make small, incremental changes to lead to a healthier life.

5. Be positive. Instead of thinking, “I have to exercise

because I am overweight” think, “I’m active because I want to have more energy.” Spend time with people who have a positive attitude and who make you feel good about yourself.

6. Don’t expect perfection. Feeling good about yourself starts by

accepting who you are now and how you look. Healthy bodies come in a variety of shapes and sizes. Don’t make pencil thin models and actors your role models. remember the body weight that’s healthiest

for you is the one that you can comfortably obtain and maintain through sensible eating and an active lifestyle.

7. Reward yourself. Congratulate yourself for all the improvements you’ve made. Soak in a relaxing tub, get tickets to a movie or football game, or buy a new music CD.

8. Believe in yourself. Have faith in your ability to achieve a

healthier life. reaching life’s goals is often a self-fulfilling prophecy. Expect to be successful.

9. Do it for yourself. remember, the most important reason to

maintain your healthy lifestyle is YOu!

Sources: Michigan Department of Community Health and Michigan Public Health Institute

Calling all women — and men: Make time for your health When you’re feeling good, you usually don’t think about seeing your doctor. But that’s when you should be thinking about scheduling your annual exam. For a schedule of screenings, tests and immunizations see Pages 5-8.

Women cancers are curable if caught early Protect yourself against breast cancer by performing a self-breast exam once a month and having a mammogram as recommended. A mammogram can detect breast cancer the size of a seed — well before you can feel the lump.

A quick and easy way to detect cervical cancer is with a Pap smear. If you’re age 25 or younger and sexually active, you may also want to get screened for chlamydia. Because the symptoms of chlamydia can be subtle, many women don’t realize they’re infected. Left untreated,

chlamydia can cause infertility. The easiest way to test for chlamydia is with a swab done the same time as your Pap smear.

Men can reduce risk for prostate cancerProstate cancer is the most common cancer in u.S. men other than skin cancer, and the second leading cause of cancer death in men.

Prostate cancer can often be found early by testing the amount of PSA (prostate-specific antigen) in the blood. Another way to find prostate cancer early is through a rectal exam. Once found, prostate cancer can be eliminated from the body by surgery or radiation — if diagnosed at an early stage. Men at high risk (with a family history or African-Americans) should start having annual tests at age 45; everyone else can start getting tested at age 50.

Is that cough asthma?When most people think of asthma, they think of difficulty breathing or wheezing. But there are other symptoms that could mean asthma.

If you or your child frequently have any of the following symptoms, talk to your doctor.

• Wheezing

• Coughing, especially a cough that awakens you from sleep

• Chest tightness

• Shortness of breath

• Increased mucus

What causes asthma symptoms? Asthma is a chronic disease. Experts agree that certain things in our environment can trigger inflammation in the lungs and lead to asthma. One of the most

common asthma triggers is tobacco smoke. Like other triggers, smoke irritates air passageways in the lungs and makes them swell. The muscles surrounding these passageways tighten and produce more mucus, making it harder to move air in and out of the lungs.

People who have asthma should not smoke or be around others who smoke. For help to quit smoking, Blue Choice members can enroll for free in the Blues’ Quit the Nic program. This telephone support program has helped thousands of smokers quit. In fact its quit rates exceed the national average.

The sooner you quit, the more you reduce your chance of getting cancer and other diseases. Call 800-811-1764.

BluePoints Winter 2007�2 �3BluePoints Winter 2007

Good posture and body mechanics keep the aches awayLow back pain affects just about everyone at some time in life. Most of the time, low back pain isn’t the result of serious illness or injury. It may simply be a result of poor posture, which lead to unnecessary wear and tear on the joints of the spine. Good posture is keeping your spine in a neutral position (not bent, arched or twisted).

Body mechanics is the general term for the way we position our bodies when we sit, stand, bend, lift or lie down. Sitting or standing, especially in a forward, bent or slouched position, can cause muscle fatigue, which can lead to back and leg problems.

Here are some tips on good posture and body mechanics:

Standing • Keep your back straight (avoid arching your

back).

• Tuck your stomach muscles in and tighten your buttocks.

• Don’t lock your knees.

• Keep your head level by slightly tucking your chin.

• Wear comfortable low-heeled shoes that provide good arch support.

• If you’re standing for a long period of time, put one foot on a stool or step and switch legs often.

Sitting • Sit up straight. Avoid

turning or twisting to one side — this throws the spine out of alignment causing fatigue and back strain.

• For the best support, sit so your lower back is touching the back of the chair.

• Keep both feet flat on the floor and your knees at a 90-degree angle. If there’s a problem with your feet reaching the floor, use a foot rest or a stool.

Sleeping/lying down • use a firm mattress. A good night’s sleep can

depend a lot on the correct mattress.

• Sleep on your back or side.

• While sleeping on your side, bend your knees and use a flat pillow between them.

Lifting • use a dolly or cart to help you move heavy

objects.

• Get someone to help you lift heavy or awkward objects.

• use your leg muscles to lift by bending at the knees, grasping the object and then straightening your legs.

We help you take care of yourselfThe more you know the better you can make critical health care decisions and smart choices. We provide a range of programs under our BlueHealthConnection® umbrella that help you prevent illness, manage a chronic disease or recover quickly from illness.

OnlineLog on to bcbsm.com and click the “I am a member” option. In the “Manage your health” quadrant on the Page, you can elect to:

• Take a health risk appraisal

• Create a customized health dashboard and personal health record

• research health and prevention information

• Find facts about a medical condition

To ensure your safe and confidential access to information, you will need to register for some of these interactive programs.

By phoneCall our health coach hot line at 800-775-2583 to speak to registered nurses and health educators who can provide information on a wide range of topics. Supported by board-certified physicians, these coaches assist individuals who may be uncertain about whether to seek medical care. They’ll:

• Discuss at-home treatments for minor illnesses and injuries

• Offer guidance on controlling or effectively managing chronic conditions such as asthma or diabetes

• Answer questions regarding pending surgeries

• Help you understand medical tests

• Suggest available community resources

• Mail health education materials

Preventive care will help your children live long, healthy livesSeeing your child’s primary care physician regularly helps screen for diseases, such as obesity, diabetes and developmental problems. Blue Choice covers well-child visits and immunizations. See the Guidelines for Good Health, Pages 5-8, to see when to schedule appointments with your child’s physician.

At the well-child visit, the physician will do a complete physical exam, a medical history assessment and review your child’s immunizations. Michigan school entry requires the following shots for teens:

• Four doses of diphtheria and tetanus or three doses of the combined Td vaccine if the first dose was given at or after age 7 (one dose must have been given within the last 10 years.)

• Four doses of polio by age 4 and two doses of MMr (measles, mumps, rubella)

• One dose of varicella if given at or after 12 months of age and before age 13, or two doses if initiated at or after the 13th birthday

• Three doses for hepatitis B

use the well-child visit to ask questions and get information about safety, smoking, alcohol, sex, diet and exercise. Older children should also have a chance to talk to their doctors, ask questions and receive confidential advice.

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Blue Choice — Mail Code B599 600 E. Lafayette Blvd. Detroit, MI 48226

PRESORTED STANDARDU.S. POSTAGE

PaidBlue Cross Blue Shield

of Michigan

CF 0935 JAN 07 062704STCM

Referrals not neededYou do not need a referral to receive services from a Blue Choice POS physician or from a hospital in BCBSM’s TruST network of facility providers.

The only time you will need a referral from the Blue Choice physician is if you wish to receive in-network level benefits for services rendered by a physician outside the Blue Choice or TruST facility network. When a referral is required, the referral form must be submitted to BCBSM with the claim. Please do not mail or fax referral forms under separate cover. If you choose to receive services from a doctor who is not in the Blue Choice network and you do not have a referral, your copayment increases. You may also be responsible for the doctor’s charges above the Blue Cross Blue Shield of Michigan-approved amount, generally a discounted rate that physicians in our network agree to.

In addition, some services may not be payable when rendered by a non-POS provider. For example, the following services are covered only when provided by a network physician:

• Well baby care

• Immunizations

• routine physicals