New Mexico Health Connections | my connection | Spring 2019

{ MY CONNECTION } 3 Facebook “f”Logo CMYK / .ai Ask Me 3: Good questions for good health Ask Me 3 ® is an educational program that encourages patients and families to ask their doctors three questions to better understand their health concerns and what they need to do to stay healthy. •   What is my main problem? •   What do I need to do? •   Why is it important for me to do this? Ask Me 3 is meant to help patients become more active members of their healthcare team and provide a platform to improve communication among patients, families and healthcare professionals. You can find printable forms to take with you on your next doctor’s visit on our website at mynmhc.org/community-wellness -resources.aspx . ‘Pleasant surprises’ withNMHC coverage G ail Womack chose an NMHC health plan in 2015 for herself and her husband, Richard, for practical reasons. She found the premiums and out-of-pocket costs competitively priced. Their providers were in our network. The medications Gail took were covered. Gail also liked the fact that NMHC is a nonprofit with local roots. What she didn’t expect was a health plan that would partner with her to improve her health for the long term. A smooth transition Gail, who has complex health needs, is savvy about self-care, but the medication that helped her manage her condition left her with unpleasant side effects. With her doctor’s guidance, she switched medications, but the side effects worsened. Months later, Gail began a new course of treatment—and it clicked. She felt great, and the drug helped her manage her condition effectively. Before Gail moved to the new medication, our prior authorization team talked with her doctor to ensure that her medical needs were being met and to ease the switch. “NMHC fully supported my journey to find the treatment that enabled me to be my best self,” she says. Changing to a new drug therapy wasn’t stress-free, however. Shortly after Gail and her doctor decided to try the new medication, she was set to leave on a month-long vacation abroad and needed a quick turnaround for her prior authorization. “I worked with Frieda [NMHC’s Director of Pharmacy], who was superb,” Gail says. “She understood my urgency and was able to secure a prior authorization in less than two days before I left the country. I was literally biting my nails, but she came through for me.” Gail received her prior authorization just in time and enjoyed a symptom-free trip. Simple self-service tools It isn’t only the personal service Gail received fromNMHC that has made her a member for the past four years. “I received some other pleasant surprises too,” she says. “I love the easy online payment methods. I need receipts showing that I’ve paid my premium in order to access reimbursements through my retire- ment medical account. NMHC’s online system makes receipts easy to obtain.” Helping members like Gail improve their health and lower their costs is our mission. If you have complex health needs, learn how we can help you coordinate your care at mynmhc.org/ case-management-services.aspx . Give us a shoutout Do you have a positive experience as an NMHC member that you’d like to share with us? We’re always looking for member testimonials. Please complete this brief member survey at research.net/r/ nmhc-member-sat , and we will be in touch with you. SPRING 2019 MY CONNECTION is published as a health and wellness service for the members of NEW MEXICO HEALTH CONNECTIONS. Information comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your primary care provider. Models may be used in photos and illustrations. 2019 © Coffey Communications, Inc. All rights reserved. ID0679-0219 Find us online: mynmhc.org Contact us: Customer Service : 855-769-6642 mynmhc.org/contact_us.aspx Michelle McRuiz, editor michelle.mcruiz@mynmhc.org Facebook “f”Logo CMYK / .ai Important health plan benefits for women Know your mastectomy benefits Your health plan provides benefits for mastectomy- related services. This includes all stages of reconstruction and surgery to achieve symmetry between the breasts. It also includes prostheses and complications resulting from a mastectomy, including lymphedema. These benefits are required by the Women’s Health and Cancer Rights Act of 1998. Call Customer Service at 855-769-6642 to learn more. Delivery requires a minimum hospital stay New Mexico law requires at least 48 hours of inpatient care after a vaginal birth and at least 96 hours after a cesarean section. Only the doctor in charge of the mother’s and baby’s care can decide to reduce the period of inpatient care for the mother or baby. The doctor must talk with the mother before making that choice. To learn more, please see the “Maternity Care” section of your Member Handbook (also called an Evidence of Coverage). Gail Womack with her husband and son in Scotland leaning on “standing stones.” { M E M B E R B E N E F I T S }