LA0485 03/08

Get Involved with L.A. Care P. 3

Tips to Control Asthma at Home P. 5

Get Rewarded for Regular Checkups P. 6

Why are Shots Important for my Child? P. 7

S P R I N G 2 0 0 8

PRSRT STD

U.S. POSTAGE

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PERMIT NO. 555

SAN DIEGO CA

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Go to www.lacare.org and click on the words “Find a Doctor.” Next, click on the circle next to the name of your program. If you already know the name of a doctor you want, click “Search by name.” Or, if you want to find a doctor by your home, work, or school, click “Search near my home.”

You will be able to see a list of:• PCPdoctorsthatwill

see new patients• PCPdoctorsorspecialists• Doctorsandofficestaffthatspeakyourlanguage.

When you joined L.A. Care, you chose a doctor for each member of your family in our health plan. If you didn’t, we picked one for you. This doctor is called a “primary care physician” or “PCP” doctor. Your PCP doctor gives you most of your care, unless it is an emergency or you need to see a specialist.

Most members are happy with their PCP doctor, but if you want, you can change. You can pick a different PCP doctor for each member of your family who is an L.A. Care member.

Step 1. Pick the type of doctor you want. Use this chart to help you pick the right type of doctor:

Type of Doctor Who Will They See?Family Practice… will see anyone, any ageGeneral Practice… will see anyone, age 16 or olderInternal Medicine… will see anyone, age 16 or olderOb/Gyn… will see women only, age 16 or olderPediatrics… will see anyone, age 21 or younger

Step 2. Pick your doctor from the provider directory.The L.A. Care provider directory is a book that lists all of the doctors and clinics that you can choose from. The provider directory is mailed to you every year. If you have Internet access, you can also find our provider directory online. Visit our Web site at www.lacare.org, and click “Find a Doctor.”

You can pick a PCP doctor:

By location: You can pick a doctor near your home or school.

By clinic: You can choose to get your health services from a clinic.

By name: If you already know of a good doctor, you can check to see if that doctor works with L.A. Care.

Step 3. Call L.A. Care.Once you know the PCP doctor you want, call our Member Services department at 1-888-839-9909 and give us the code number shown in the directory. We will check to see if that doctor is taking new patients, and will help you make an appointment. You want to get to know your PCP doctor, and have them get to know you and your family. This helps you get the best care.

How to Choose a Doctor

Do you have access to the Internet? Find a doctor online!

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Doyouhavesomething tosayabouthealthcare inyour community? L.A. Care wants to hear from you.

Several times a year, L.A. Care members, doctors, and commu-nity leaders meet to discuss health care and what is happening in their own communities. These groups are called Regional Com-munity Advisory Committees (RCACs). There are 11 groups throughout L.A. County. There is sure to be one near you!

At these meetings, you can:• Shareideas about getting better health care in

your community.

• Learnabout important health topics such as asthma and diabetes.

• Helpplanworkshopsand events that help your community.

• Askquestionsabout Medi-Cal, Healthy Families, Healthy Kids, and Medicare Advantage for people with Medi-Cal and Medicare.

• TellL.A.Carewhatyouneedto help your family stay healthy.

RCAC members can affect how L.A. Care operates. Volunteer-ing on a RCAC is a great way to get to know your neighbors and what's going on in your community. To find a RCAC in your area and find out when it meets, call L.A. Care's Commu-nity Outreach and Education department at 1-888-LACARE2 (1-888-522-2732).

“I like to help other people and try to make a difference,” says Demetria Saffore. She serves on RCAC 1 in the Antelope Valley.

L.A. Care now has an option for people with both Medi-Cal and Medicare. It is called “L.A. Care’s Medicare Advantage Special Needs Plan.”

This plan is for people who are at least 65 years old, and for some people under 65 with disabilities. This plan offers many benefits:

• Doctor visits, including specialists: $0

• Prescription drugs: $0 copay for generics; low copay for brand*

• Non-emergency transportation, 12 one-way trips: $0

• Unlimited chiropractic

And more! If you are a member with L.A. Care for Medi-Cal already, and you have Medicare, this might be a good plan for you. Call 1-888-4LA-CARE (1-888-452-2273), or TTY 1-866-LACARE1 (1-866-522-2731). To our new members, welcome to L.A. Care and Member News! We look forward to serving you for your health care needs.

*The prescription drug benefit is available only to members of a Medicare Advantage Part D plan. Plan Prescription drugs are available through the plan network. You pay $0 for generics until your total yearly drug costs reach $2,270. Once your total drug costs reach $2,270, you pay $1.05 for generic drugs, and $1.05 or $3.10 for brand name drugs.

L.A. Care contracts with the Federal Government to offer the L.A. Care Medicare Advantage Special Needs Plan.

Welcome, Medicare Advantage Plan Members!

“I wanted to be more informed about the Medi-Cal program and the services that are available,” says Maria E. Nunez. She serves on RCAC 6 in South Los Angeles.

Meet RCAC Members

Get Involved with L.A. Care

What are Allergies?When you are allergic to something, your eyes, nose, throat or skin reacts when you are exposed to it. You might get:

•arunnynose

•itchyeyes

•sneezing

•asorethroat

•arash

•coughing

What Causes Allergies?Some things that can cause them are:

•pollen

•dust

•animaldander

•certainfoods

Sometimes Allergies Can Start Asthma.An allergy can sometimes lead to asthma. Asthma is a serious disease. It can make your lungs and airways stop working prop-erly. Th is makes it harder to breathe. Other symptoms include:

•sneezingorcoughingthatwon’tstop

•awhistling(wheezing)soundwhenyou breathe

•feelingtightnessinyourchest

•painwhenyoubreathe

What to Do If You Think You Have an Allergy or Asthma.If you think you or your child has allergies or asthma, see your PCP doctor.

If your PCP thinks your symptoms are caused by allergies or asthma, they will help you learn how to:

• reducesymptomsnaturally.Th esemayincludedrinkingclear fl uids and using salt-water (saline) drops for a stuff y nose.

• stayawayfromthingsthatcausesymptoms.

• quitsmokingandlearnhowtokeepyourhomeandcarsmoke-free.

• take medicines properly. You will learn how to use aninhaler and spacer, if needed. Your doctor may also pre-scribe other drugs to help keep your allergies or asthma in control.

• useanasthmaactionanddailycontrolplan.Th isplancantell you what medicines to take, when to take them, and when and how to get help for an asthma fl are-up.

• useapeakflowmeter.Ifyouhaveasthma,thiscanshowyou how well your lungs are working.

Allergies and asthma can be hard to live with, but, if your doctor has recommended it, taking your medicine every day (even when you don’t have symptoms) can help you feel well and stay active.

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Do You Have Allergies or Asthma?

Asthma Disease Management Program Doesyourchildhaveasthma?L.A.Carehasaprogramthathelps kids keep their asthma in control and stay healthy. It is called “L.A. Care’s About Asthma.” Children with asthma in Healthy Kids, Healthy Families, or Medi-Cal with L.A. Care are automatically enrolled!

As a part of the program, you get health education resources to help you learn ways to control your child’s

asthma. A nurse or educator may also call to talk about concerns you may haveaboutyourchild’sasthma.

If you would like more details about this program please call our asthma line at (213) 438-5835.

It may be hard to tell the difference. The symptoms can seem to be related. Your doctor can tell you what to do for both conditions.

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Tips to Control Asthma at Home Things to RememberAlways keep your ID card with you. Show your ID card whenever you:

• haveadoctor’svisit

• gotothehospital

• needemergencyservices

• pickupaprescription

If you lose or damage your ID card, call L.A. Care at 1-888-839-9909. Do not let anyone use your ID card. Th at is considered fraud.

You have the right to receive service and information in a language or format you understand. If you need an interpreter for a doctor’s visit, or materi-als in another language or format (like Braille, large print, or audio), call L.A. Care at 1-888-839-9909 (TTY 1-866-522-2731).

You can talk to a nurse for free, anytime day or night, 7 days a week.Members in L.A. Care’s Medi-Cal, Medicare, Healthy Kids or Healthy Families Programs can call our free Nurse Advice Line at 1-800-249-3619. Members in Medi-Cal with one of our Medi-Cal plan partners can call their nurse advice lines. Th e number is on your ID card.

Th e nurse advice line also provides pre-recorded informa-tion on many health topics. Th ere is a list of these topics at the end of the member handbook we mailed to you.

Visit our Web site at www.lacare.org. You can:

• Findadoctor

• Learnaboutyourbenefits

• Learnabouthealtheducationservices

• Findoutaboutyourrightsandresponsibilities

• Fileacomplaint(calleda“grievance”)

Doyouhavequestions?L.A.Careisheretohelpyougetthe care and service you need. Call our Member Services department at 1-888-839-9909.

Never allow anyone to smoke in your home or car!

Wipe off dust in your home with a damp cloth regularly.

Talk to your PCP doctor for more tips.

Wash sheets and blankets in hot water at least once a week.

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Getting to the doctor isn’t always easy. But if your children are enrolled in Healthy Kids, Medi-Cal, or Healthy Families with L.A. Care, we will reward you for the eff ort.

You can get a $20 Target GiftCard for every three checkups your baby receives in his or her fi rst 15 months of life. Bring your well-baby checkup card you get in the mail to your L.A. Care doctor. Th e doctor must stamp or sign the card after every visit. Once your baby has made three visits, mail the card back to L.A. Care. No postage is needed. You can get up to two GiftCards for completing six or more well-care visits before your child turns 15 months old!

GiftCards or movie tickets are also available for older children and teens! Checkup rewards are also available if you or your child are age 2 to 18 years old and enrolled in Healthy Kids or Healthy Families with L.A. Care, or between 12 and 21 years of age and enrolled in Medi-Cal. L.A. Care now sends eligible members a birthday card just before their next birth-day. When you or your child go in for a well-care checkup, bring this card along. After the doctor signs or stamps it, mail it back to L.A. Care. You can choose between a $20 Target GiftCard or two free movie tickets. Each member can get one well-care award per calendar year.

Checkup cards are sent automatically to all eligible L.A. Care members.Ifyouhavequestions,pleasecallMemberServicesat 1-888-839-9909.

Bringing your children to the doctor for regular checkups helps keep them healthy.

Get up to two $20 GiftCards for well-baby visits for children 0–15 months of age.

Keeping You and Your Baby HealthyIf you think you are pregnant, or as soon as you know you are pregnant, call your PCP doctor for an appointment right away. You are taking the fi rst step for a healthy baby!

Member Incentives Rewards

Age 0–15 Months Age 2–18 Years Age 12–21 Years

Medi-Cal*, Healthy Kids and L.A. Care’s Healthy Families Members

Healthy Kids and L.A. Care’s Healthy Families Members

Medi-Cal* Members

1. First 3 well-baby visits = $20 Target GiftCard with completed well-baby checkup card.

2. Second 3 well-baby visits = another $20 Target GiftCard with completed well-baby checkup card.

Annual well-care visit = $20 Target GiftCard OR 2 movie tickets with completed well-care checkup card.

Annual well-care visit = $20 Target GiftCard OR 2 movie tickets with completed

* Includes members who have Medi-Cal with L.A. Care’s Plan Partners: Blue Cross of California, Care1st Health Plan, Community Health Plan, and Kaiser Permanente

Get Rewarded for Regular Checkups

Keeping If you think you are pregnant, or as soon as you know you are pregnant, call your PCP doctor for an appointment right away. You are taking the fi rst step for a healthy baby!

Plan, Community Health Plan, and Kaiser Permanente

Age 12–21 Years

Medi-Cal* Members

well-care checkup card.

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Q: Why are shots important for my child?

A: Nothing is more important than guarding your children’s health. Help keep them healthy by making sure they get their requiredshots.

Shots help protect your children from serious diseases. Making sure they get all of their shots on time also makes your life easier. Most day care centers and schools will not enroll your children without proof that they have been vaccinated.

Thechartbelowshowsyouwhat’srequiredandwhen.

Age Your child should get these shots:

2 Months

DTaP (#1) Diphtheria, Tetanus, and Pertussis (Whooping Cough)Hepatitis B (#1) Some infants may get their first shot at birthHib (#1) Haemophilus influenzae type b (Hib Meningitis)PCV (#1) Pneumococcal diseasePolio (#1)Rotavirus (#1)

4 MonthsDTaP (#2)Hepatitis B (#2)Hib (#2)

PCV (#2)Polio (#2)Rotavirus (#2)

6 MonthsDTaP (#3)Hepatitis B (#3)Hib (#3)

PCV (#3)Polio (#3)Rotavirus (#3)

12 Months*

MMR (#1) Measles, Mumps, and RubellaVaricella-Chickenpox (#1)Hib (#4)PCV (#4)Hepatitis A (#1)

15 Months* DTaP (can be given as early as 12 months)

18 Months* Hepatitis A (#2)

Before Kindergarten

(age 4 to 6)

DTaP (#4)Polio (#4)MMR (#2)Varicella-Chickenpox (#2)Get these shots if they were missed before: Hep B Series – Hep A Series – Hib

Before 7th Grade(age 11 to 12)

MCV4 (Meningitis)Tdap (Tetanus, diphtheria, pertussis)HPV (3 doses) Human Papilloma Virus – for girlsGet these shots if they were missed before: Hep B series – Hep A series – Polio series MMR #2 – Pneumococcal series – Varicella

Age 13 to 18

If shots not received at ages 11 to 12: MCV4 (at age 15) HPV (3 doses) Human Papilloma Virus – for girls Tdap

L.A. Care makes it easy for your children to get their shots at no cost to you. Just call your doctor to schedule an appointment for shots or a well-care visit if it’s time for a checkup.

Notonlyareallrequiredshotsandwell-carevisitsforyourchildfree, but L.A. Care rewards you for getting them. If your baby is enrolled in Healthy Kids, Medi-Cal, or Healthy Families with L.A. Care, you can receive up to $40 in Target GiftCards for getting important well-care visits in your child’s first 15 months of life.

Eligible members will receive a well-care checkup card in the mail. Bring this card every time you take your child to the doctor, and have it stamped or signed in the office. More well-care rewards are available for L.A. Care members between the ages of 2 and 21, depending on your child’s program. If you have questions about well-care rewards, call our Member Servicesdepartment at 1-888-839-9909.

Children may not like shots, but your family will be healthier and happier with them than without!

Ask the Doc: Why are shots important for my child?

Things to Ask About Your MedicineThe more you know about your medicines, the healthier and safer you will be. Never share your medicines with family or friends.

Every time you get a new medicine, ask your doctor or pharmacist:

• WhatisthenameofthemedicineIwillbetaking?

• Whatdoesthismedicinedo?

• HowandwhendoItakethismedicine?

• HowlongdoItakeit?

• WhatshouldIdoifIforgettotakemymedicine?

• Doesthismedicinehavesideeffects?

• WhatshouldIdoifIhavethosesideeffects?

• Whatfoods,drinksandactivitiesshouldIavoidwhile I take this medicine?

• Iamtakinganherbalsupplement.CanItakethisnew medicine with my supplement safely?

It’s your doctor’s or pharmacist’s job to take time to answer these questions.

* Check with your doctor to see if your child needs any “catch-up” shots.**Children 5 years or older may get flu shots based on their own health, the age of their siblings and the supply of vaccine.

Elaine Batchlor, MD

Member News is a publication formembersofL.A.CareHealthPlan. Published two times ayearbyL.A.Care,Member News goes to members in Medi-Cal,Medicare, Healthy Kids andHealthyFamiliesPrograms.

If you want the information contained in this newsletter in another language or in large print, Braille, or audio (cassette or CD) call L.A.Care at 1-888-839-9909 or TTY 1-866-LA-CARE1(1-866-522-2731).

©2008 L.A. Care Health Plan. All rights reserved.

Important Phone NumbersDo you have questions aboutyour health plan or your bene-fits?CallyourhealthplandirectlyorcallL.A.CareHealthPlan.

The Family Resource Center offers free classes in weight and asthma management, parenting, nutrition and exercise. Most classes are in English and Spanish, and are also available for children.

Come visit us!L.A.CareHealthPlanFamily Resource Center atPlazaMexicoShoppingCenter3180 E. Imperial HighwayLynwood, CA 90262

Monday to Friday10 a.m. to 6:30 p.m.

Saturday9 a.m. to 2 p.m.

1-888-525-9693

All are welcome!

Visit L.A. Care’s Family Resource Center

Healthy Families and Healthy Kids Members

L.A.CareHealthPlan 1-888-839-9909

L.A. Care Fraud and Abuse Hotline

1-800-400-4889

BlueCrossofCalifornia1-888-285-7801

Care1stHealthPlan1-800-605-2556

CommunityHealthPlan1-800-475-5550

KaiserPermanente1-800-464-4000

L.A.CareHealthPlan1-888-839-9909

Medi-Cal Members