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The SWHP Heart Beat
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Metabolic Syndrome May Pose Even Greater Danger To The Heart Than Previously Recognized
by Dr. Marylou Buyse
Have you heard about or been diagnosed with a condition known as “metabolic syndrome’?
If you are overweight, especially around your middle, and have high cholesterol and high blood pressure, you could be at risk for a combination of health risks known to the medical profession as “metabolic syndrome”.
Why should you care about this?
People who have these risk factors, which when added up constitute the metabolic syndrome, have a greater risk for heart disease, stroke, and type 2 diabetes (sugar diabetes). If you believe you have any of these, talk to your doctor.
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What's Happening at the Health Plan?
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MyPlan is now MyBenefits
We are upgrading! Our former MyPlan portal is going through some changes. The first change is its name – now MyBenefits.
Currently, Members can log in and find claim information, explanations of benefits, and plan summaries.
New screens and improved functionality will be available in 2012.
Watch for it!
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Don't forget about the new generics for 2012.
As a rule, generic drugs are about 30 to 80 percent less expensive than brand name drugs. In the next two years, six of the nation’s 10 best-selling drugs are expected to be available as a generic.
Read about which drugs you can expect to pay less for as a generic.
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Announcing the SWHP Online Cost Estimator
Now you can estimate the cost of care before seeking treatment with our new online Cost Estimator Tool.
To start, you'll need a Diagnosis Code or CPT/HCPCS Code from your doctor. You can print out a copy of your estimate to help you budget for upcoming procedures so you know what to expect.
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 From the Medical Director’s Desk:
As we have started this New Year, we now have universal free access to preventive care when it is the sole reason for the visit.* It is important to know which preventive services are now available to all members without any co-pay or co-insurance. However, if there is another diagnosis for the visit or additional services provided at that same visit, this financial advantage is lost.
We want to call your attention to the need for these high value preventive services. Financial barriers to these services have been removed. You and your physician need to understand how to maximize this important health benefit. There is good reasoning behind this, as preventive services can improve health, and in some cases save lives. See a list of the preventive services that come under this part of the Accountable Care Act (ACA) (otherwise known as Health Care Reform) please visit swhp.org/news.
*This information is being provided for information purposes only and should not be construed as an addendum to the EOC.
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 SCAM ALERT!
BEWARE!! SWHP has learned that members have received calls from someone with a thick foreign accent saying that they are employees of Scott and White. They are asking members to verify their banking information for a new ID card. THIS IS A SCAM!! Do not engage them in conversation…just hang up the phone! If you receive a call from the following number, 347-418-0487, hang up immediately and call our hotline number to report this scam at 888-800-1096.
Scott and White Health Plan is committed to protecting your personal health information.
You can protect yourself from Medicare fraud by following these tips.
- NEVER give your personal information such as Medicare or Social Security Card, Bank Accounts or credit card numbers to anyone who calls on the phone or comes to the door.
- Use caution with anyone who offers FREE meals, products, vacations or says Medicare will pay for it.
- If someone calls and tries to threaten or pressure you into something, just hang up the phone. Remember, Medicare does not sell anything.
- Sign up for the National DO NOT CALL Registry at 1-888-382-1222 or www.donotcall.gov.
If you SUSPECT FRAUD...REPORT it.
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Did you know?
Members no longer need a referral to see a specialist. SWHP is now an Open Access Health Plan. A member can go to any network provider without a referral. Members may choose a network primary care physician (PCP) if they would like, but PCP designation is no longer required by the SWHP. Due to the nature of some specialties, some physician offices may require a referral from a PCP prior to making your appointment. This is the choice of that physician’s office and not a requirement of SWHP.
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How can the Dialog Center help you?
The SWHP online Dialog Center not only off ers a
vast knowledgebase of medical informati on, but
access to our Shared Decision Making resources.
Our resources give you reliable tools and
informati on to help you make important medical
decisions. Use them to become bett er informed
about your conditi on, so you can work more closely with your doctor when discussing your treatment.
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Diabetes Day Update
SWHP Quality Improvement Department offers a Diabetes Day once a month on Saturdays in Temple, TX for our members who have Diabetes. Other areas offer a Diabetes Day 1-4 times a year for our Diabetic members.
Select "Read More" to see schedule of dates for Diabetes Day.
If you would like more information, please contact the SWHP Quality Department at (254) 742-7420.
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