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Tag Archives: Wisconsin

Leave the Worries at Home

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You don’t plan on getting injured while on a trip, but because vacations sometimes turn into unexpected adventures, Network Health has you covered when you’re away from home.

In Case of Emergency

 If you have a medical emergency when you’re out of the service area, call 911 or get to the nearest emergency room. You have health care benefits for emergency situations such as heart attacks, excessive bleeding, head traumas, broken bones or seizures.

When out of the network area, you’re covered for an emergency hospitalization until you can be moved to a participating Network Health facility, as long as you let us know about your emergency within 48 hours of entering the hospital. Just be sure to show your Network Health ID card when being seen for care.

Urgent Care

 If you cannot travel safely to get care from your primary doctor, you’re covered for urgent care situations like a minor injury, stitches, possible strep throat or an ear infection.

 If you are outside of Network Health’s service area and you need to see a doctor, but it isn’t an emergency, you can still visit a hospital or an urgent care clinic. However, if the doctor or facility is not in our network, you’ll need to notify us within 48 hours of receiving care. To do so, simply contact our customer service department at 800-826-0940 or 920-720-1300 to request an authorization. Our call center is open from 8 a.m. to 5 p.m. Monday, Wednesday, Thursday and Friday, and from 8 a.m. to 4 p.m. on Tuesday.

Follow-Up Care

Your primary doctor, or other in-network providers, must be seen for your follow-up care. If this is not possible, and you visit a doctor or hospital not in our network, you’ll need to call us for approval within 48 hours of treatment.

 Payment of Care

Some out-of-area medical facilities (not in Network Health’s service area) may require you to pay for your care when it is provided. To get reimbursed, send itemized bills and proof of payment within 90 days of receiving care. Send this information to

Network Health, Attn: Claims  

1570 Midway Pl.,

Menasha, WI 54952.

Eating Out without Blowing Your Diet

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When you’re trying to eat right, eating out can be tricky. Meals that sound healthy may have twice the amount of calories as similar dishes you cook for yourself. Instead of swearing off restaurants, try the tips below to help save your waistline.

Start with a salad

One of the best ways to make sure you don’t over eat is to get your fill of nutritious foods first. Ordering a small side salad before your entrée can help keep your appetite in check. Just be sure to leave off the cheese and use low-calorie dressing.

Everything in moderation

Most people eat more when served bigger portions. Unfortunately, restaurants tend to double or even triple recommended serving sizes. To help you stick to your diet, try asking your server for a to-go box right away with the meal. Cutting your portion in half and saving it for another day is not only a good way to cut calories but also to save money. Not a fan of leftovers? Then, try splitting a meal with a friend. You’ll get half the calories and half the bill.

Check the fine print

Every restaurant prepares meals differently.  To make sure you know what you’re ordering, carefully read the menu descriptions. Be aware of words that are not diet friendly, such as: fried, sautéed, rich and creamy. Instead look for meals described as: broiled, grilled, roasted and steamed.

Be aware of liquid calories

One of the best parts of the restaurant experience is often the wine or cocktail with your dinner. Unfortunately, alcohol packs a lot of empty calories. One glass of red wine contains around 150 calories. One pint of craft beer can range anywhere from 120 to 200 calories.

Avoid dessert

Like alcohol, desserts contain a lot of calories without much benefit. For a healthier option, try fruit after dinner. If it’s not enough to satisfy your craving, try just a couple of bites of your favorite dessert. Often your sweet tooth can be satisfied with a very small serving.

Do you have tips to keep your diet on track? We want to hear them. Be sure to leave a comment below.

The Dos and Don’ts of a Happy Life

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As you take steps to improve your wellbeing, you’ll also need to be careful to avoid some common happiness killers. Read the points below to learn what actions to take and how to avoid setbacks.

Dos

Reach out. Maintaining social relationships is vital to living a happy life. Studies have shown that maintaining strong relationships can lengthen life, boost immunity and reduce the risk of depression. Use social media to stay in touch. It is quick, easy and free.

Cross something off your to-do-list. Conquering that nagging task can give you a rush of elation. Think about how good it feels to finish an irritating project. That feeling of accomplishment is a valuable reward for your time.

Looking for some tips for time management? The Creativity Post has some great suggestions for working smarter, not harder and conquering that to-do-list. Their list starts with completing the most important tasks first, learning how to say ‘no,’ getting plenty of sleep and even eating well.

Get moving. An active lifestyle can have many positive benefits in your life—better overall health, improved fitness, better posture and balance, positive self-esteem, healthy weight, improved mood, stronger muscles and bones, increased energy and reduced stress.

Not sure where to start? Start slow and try these tips.

  • Choose activities you enjoy.
  • Limit your ‘screen time.’ Turn off the electronics.
  • Walk whenever you can. Choose stairs over the elevator. Park in the furthest spot in the parking lot. When watching TV, walk during commercials. It all adds up.
  • Take time to participate in activities as a family, such as cycling or hiking.
  • Make it social and invite a friend.

Don’ts

Compare yourself to others.  This is easier said than done. When you see your friend pull up in a shiny new car, it’s natural to compare it to your own well-worn grocery getter. But make a conscious effort to stop yourself. Comparing your car, home or even your family will leave you feeling dissatisfied. Instead of thinking about what others have, remind yourself of the positive things in your own life. This can be hard, especially for competitive people (you know who you are) but it’s worth it.

Procrastinate. Anxiety or nervousness is a huge obstacle to happiness. By taking time to adequately prepare for the day or week ahead, you can help eliminate stress. Anxiety typically comes when we don’t feel ready to tackle the challenge in front of us. So, to get and stay happy, make sure not to procrastinate.

Sweat the small stuff. Are you a worrier? If so, it’s probably hindering your ability to get happy. When you focus on what could go wrong, you’re not allowing yourself to appreciate what’s going right. It’s especially important not to waste your emotional energy on small things that are out of your control. So when you hit that third red light in a row, just take a deep breath and accept that it might take a few extra minutes to get to work that day.

Top 5 Tips for Surviving Spring Allergies

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Following the winter thaw, as we get further into Wisconsin’s spring, flowers bloom and trees begin to bud. Most of us can’t wait to get outside and enjoy the warmer weather. But if you have seasonal allergies, the coughing, sneezing and congestion can leave you indoors and miserable. Here are some tips to help you relieve the symptoms of spring allergies without a trip to the doctor’s office.

1 Avoid Allergy Triggers

This may seem obvious, but there are certain steps you can take to avoid allergy triggers, including:

• Avoid hanging laundry on the clothesline to dry

• Remove clothes and shower after coming in from outside

• If possible, have someone else mow the lawn and tend to the garden

• Stay indoors on dry, windy days; the best time to go outside is after it rains

• Wear a dust mask when doing outdoor chores

2 Watch Pollen Counts

Make sure to watch the news for pollen forecasts. If the forecast calls for high pollen counts, try taking allergy medication before you show any symptoms. Plus, remember to close your windows and doors when pollen counts are high. If you have to go outside, avoid venturing out in the mornings, when pollen is highest.

3 Keep Indoor Air Clean

There really is no way to keep all pollens out of your home, but you can reduce their presence by running your air conditioning. Also, try to use high-efficiency filters and change them regularly. Remember, running the air conditioning in your car will help reduce your exposure to pollens, too.

4 Rinse Your Sinuses

For effective and inexpensive relief from congestion, rinse your nasal passages with distilled, sterile saline solution. Rinsing will flush out mucus and allergens from your nose. Try using a squeeze bottle or Neti pot, usually found at any local pharmacy.

 5 Try Over-the-Counter Medication

Several nonprescription medications can help ease allergy symptoms, including antihistamines, decongestants and nasal sprays. For many people, over-the-counter medications are enough to help ease symptoms. If you can’t seem to clear up your allergies, talk to your doctor. He or she will help you find additional treatment options for your seasonal allergies.

Get a Move On

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If your exercise routine went dormant over the long Wisconsin winter, take advantage of spring’s warmer weather and get outside. You don’t have to sign up for a marathon to get in shape, just do something that gets you off the couch. Here are some ideas to help you get started.

Landscaping and Gardening – According to the Centers for Disease Control and Prevention, in just 30 minutes of gardening you can burn 150 calories. Gardening will also provide you with fresh, healthy foods that will improve your nutrition, too.

Exercise at Lunch – Even if you only get a 30-minute lunch break, trying implementing a daily exercise routine. Taking a short walk can be beneficial and it can make you feel better, too.

Biking – You can get the whole family involved by taking a bike ride through the neighborhood or a local park. Biking is a great way to get aerobic exercise, even if it is only at a leisurely pace.

Participate in a Community Walk or Run – If you’d like to get active and give back this spring, consider a community walk or run. Find one that supports a charity you feel passionate about and sign up. It’s a great way to get fit while supporting a good cause.

Take up Golf – Whether you are an avid golfer or just looking for something to do, golf is a great way to get some walking in while competing against family and friends.

Try a Pedometer – Counting your steps can be a great way to track your daily activity level. You can find motivation by setting weekly goals or by competing against your past totals.

Walk the Dog – If you have a dog, get into a daily routine of taking your pet for a walk. Even playing Frisbee or fetch with your dog is an excuse to get outside and get some fresh air that will benefit you both.

Shoot Hoops – Get your competitive juices flowing with a game of basketball. You can challenge friends or get your family involved. It’s fun, and it’s great exercise.

Whatever you decide to do this spring, make sure you choose an activity you like. Anything that keeps you interested and moving for at least 30 minutes a day will benefit your health.

Winter Car Safety and Traveling Tips

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As the winter months and colder temperatures approach, it’s important to be ready when Mother Nature bears down on us. This includes adequate preparation for traveling in winter weather. Here are some tips to make sure you and your family are ready for winter travel this year.

1. Ensure your vehicle is in good working order. A breakdown in cold weather can mean headaches and exposure to potentially hazardous conditions. Take your car in for regular maintenance and address recommendations, including wipers and defrost capabilities. Tires should be in good condition – this is not an area to cut corners. Tires provide traction and keep you on the road in slick conditions.

2. Supplies. Whether in your trunk or the inside of your car, make sure you pack the following items:

  • Blankets
  • Warm clothes (boots, gloves and hat)
  • Hand/foot warmers
  • Car safety kit (includes jumper cables, stopped vehicle flares or reflectors and a flashlight)
  • Extra container of windshield wiper fluid
  • Ice/snow scraper
  • Protein bars or other non perishable food
  • Phone charger

3. Communicate. When travelling, make sure someone knows where you are going and when to expect you.

4. Plan route. Know how long it will take you to travel, and allow extra time for inclement weather. Take the roads most likely to be clear. Preferably, avoid traveling altogether during bad weather.

5. Drive only if fit. If you are too tired, ill or have had alcohol, it is not a good idea to drive. Winter conditions may call for sharp reaction time, which may be reduced if you don’t feel 100 percent. If possible, rotate driving responsibility to keep the drivers fresh.

6. Drive cautiously. It should seem obvious, but many people don’t make adjustments to their driving habits for the winter. Allow extra room for stopping, drive at reduced speeds to account for conditions, don’t change lanes frequently and use your turn signals.

For most of the year, we simply jump into our cars and take off with little pre-planning. But as the temperatures drop, taking simple precautions can help protect you and your family from harm.

Falls Prevention

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Falls are a major cause of injury and hospitalization to older adults, but most falls are preventable. The National Council on Aging (NCOA) gives the following tips to avoid accidental falls.

1) Find a good balance and exercise program to build balance, strength and flexibility. This is key to reducing falls.

2) Talk to your doctor. Ask for a falls risk screening, and talk about your falls or fear of falling.

3) Review your medications with your doctor or pharmacist to make sure the drugs are not increasing your risk of falling.

4) Get your vision and hearing checked annually, your eyes and ears help keep you on your feet.

5) Keep your home safe by removing tripping hazards, increasing lighting, making stairs safe and installing grab bars. Also, remember to wear appropriate footwear.

6) Talk to your family. Enlist their support to help keep you safe.

A recent study showed the importance of balance and strength exercises. The study indicated that the most frequent cause of falls among older adults was not slipping or tripping, but problems with weight shifting. Much of the time, people were unable to get in a stable, final position while rising, or couldn’t stop their forward momentum after taking a misstep. The study also reported that falls were just as likely to occur when people were lowering themselves into a seated position or even when standing, due to being bumped or losing balance while turning or reaching. 

For information about falls prevention workshops in your area, and to learn about ways to stay safe, call Network Health at 920-720-1655 or 800-769-3186, extension 1655.

Rights and Protections of the Health Care Law

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Whether you need health coverage or have it already, the health care law offers new rights and protections that make coverage fairer and easier to understand.

Some rights and protections apply to plans in the Health Insurance Marketplace or other individual insurance, some apply to plans offered through an employer and some apply to all health coverage. 

These rights and protections provide even more choice and control over your health coverage when key parts of the law take effect in 2014. Here are some of the rights and protections offered to you through health care reform. 

How the health care law protects you

  • Creates the Heath Insurance Marketplace, a new way for individuals, families and small businesses to get health coverage
  • Requires insurance companies to cover people with pre-existing conditions
  • Helps you understand the coverage you’re getting
  • Holds insurance companies accountable for rate increases
  • Makes it illegal for health insurance companies to arbitrarily cancel your health insurance just because you get sick
  • Protects your choice of doctors
  • Covers young adults under age 26
  • Provides free preventive care
  • Ends lifetime and yearly dollar limits on coverage of essential health benefits
  • Guarantees your right to appeal

Sandy Goltz

Network Health is a Star

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In my last post, I explained that the Centers for Medicare and Medicaid Services (CMS) rate all health plans on a scale of one to five, with five being the highest rating.

CMS recently released the annual star rating for Medicare Advantage plans. In the rankings, Network Health achieved a five-star rating for the pharmacy (Part D) benefit and a four and a half-star rating for the medical coverage (Medicare Part C) benefit.  

What does CMS measure?

There are 15 different measures in the Part D benefit and 36 measures in the Part C benefit. The measures fall under categories or “Domains”. The Part C categories include:

  • Staying Healthy
  • Managing Chronic Conditions
  • Member Experience with the Health Plan
  • Member Complaints and Problems
  • Health Plan Customer Service

We put our members first and the ratings show us that our members know this. I am proud to say that Network Health achieved a five-star rating in all measures under Member Experience with the Health Plan category. This category’s measures include:

  • Getting Needed Care
  • Getting Appointments and Care Quickly
  • Customer Service
  • Overall Rating of Health Care Quality
  • Overall Rating of the Health Plan
  • Care Coordination

I am even prouder that Network Health was ranked in the 97th percentile of all of the Medicare Advantage plans in the nation. This means we performed better than or equal to 97 percent of the other Medicare Advantage plans in the nation. 

We took a moment to enjoy this success but then quickly looked at the opportunities to serve our members even better. We know that it is a privilege that our members choose our Medicare Advantage plan and we continually look to improve on our service.