Protect what you treasure

Your son and daughter-in-law have been struggling to pay their bills. They tell you not to worry, but you know they can't afford health insurance. More than anything else, you are concerned that your grandchildren are not getting regular medical checkups, and worse, what if one of them should break a bone while playing or get seriously ill?

The Pennsylvania Children's Health Insurance Program (CHIP), brought to you by UPMC for Kids, may be "just what the doctor ordered" to remedy this all-too-common situation.

CHIP is available to all uninsured children and teens (up to age 19) who are not eligible for Medical Assistance, regardless of family income. CHIP provides comprehensive health insurance coverage, including medical, prescription drug, dental, and other services. UPMC for Kids CHIP members also have access to our large network of quality doctors, hospitals, and other providers.

Call us at 1-800-987-8762 for more information about CHIP and how to apply. TTY users should call 1-800-361-2629. Or visit us online at www.upmchealthplan.com/upmcforkids.

For more general information about the CHIP program, visit the Pennsylvania CHIP website at www.chipcoverspakids.com.

Social media contest: Win an iPod nano!

Our Facebook and Twitter accounts are great ways for you to get the latest health and benefit news. And now we're using them to offer you a chance to win an iPod nano (grand prize) or Pittsburgh Zoo & PPG Aquarium tickets (runner-up prize).

There are two easy ways to enter the drawing!

Facebook
Visit and "like" our Facebook page (http://www.facebook.com/upmchealthplan), then click on the contest tab and fill out and submit the brief form.

Twitter
Follow us on Twitter (@UPMChealthplan) and mention us in a Tweet with the hashtag #healthysociallife.

We'll randomly select and contact the prize winners during the first week of November.

Giving you the health care cost and quality information you want

It's important for you to know the quality and cost of your health care. UPMC Health Plan encourages you to take advantage of the variety of online resources we have to help you make the best decision about where to receive your health care.

To find information on quality:

Hospital Quality — Use Hospital Advisor to compare the quality of hospitals for specific procedures and conditions. Go to www.upmchealthplan.com and log in. Click on "Maximize Your Health & Wellness" and select "Compare Hospital Quality" from the menu on the left.

Hospital Accreditation Status — Find the accreditation status of network hospitals. Select "Find a Doctor" and then "Search for a hospital or facility."

Quality and Safety — Select "About Us" at the bottom of the homepage. Then select "Quality and Safety" from the menu on the left to find helpful information on all aspects of quality and safety at UPMC Health Plan.

Physician Quality — Find physician quality information. Select the "Find a Doctor" link to locate network doctors who:

• Are board certified.
• Have received recognition from the National Committee for Quality Assurance (NCQA) for providing excellent care for diabetes, heart disease, stroke, and back pain.
• Practice in offices recognized by NCQA as being patient-centered medical homes.

To find information on cost:

Treatment Cost Estimator — Go to www.upmchealthplan.com and log in. Then click on "Manage Your Health Care Spending" and select the "Treatment Cost Estimator" link from the menu on the left.

Prescription Drug Cost — Use the "Compare different price options for my prescription" feature to see if you can save money by using another, lower-cost drug or home delivery service. Log in to www.upmchealthplan.com and select the "Manage Your Prescriptions" link.

Historical Medical Cost Data — You can access detailed information about your UPMC Health Plan medical and pharmacy claims. Go to www.upmchealthplan.com and log in. Then select the "Review your claims and EOBs" link.

MyHealth Community updates

As a member of UPMC Health Plan, you can receive discounts and other benefits from local businesses through a program called MyHealth Community. And it's easy to participate — you don't have to do anything to join! Your member ID card is all you need to take advantage of great opportunities to save.

Recent additions include:
G&G Fitness and The Fitness Store — UPMC Health Plan members receive a 10% discount on a wide variety of fitness equipment and supplies, from treadmills and free weights to an all-new outside elliptical machine.

To find out about other discounts and benefits, go to www.upmchealthplan.com and log in to MyHealth OnLine. Click the MyHealth Central button and then the Health Tools tab. Then select MyHealth Community. You can filter your search by facility name, category, and ZIP code.

Enjoy the sights — and the savings — at the Heinz History Center this fall!

Limited-time offer: 40% off annual memberships for UPMC Health Plan members, families, and friends through December 21!

As chilly weather returns to Pittsburgh, you'll find delightful indoor exercise for your body and mind at the Senator John Heinz History Center, 1212 Smallman Street in Pittsburgh's Strip District.

Six floors of original artifacts and interactive exhibits highlight our region's past 250 years. A new exhibit, Stars & Stripes: An American Story, features the people behind our nation's flag. Take the stairs between floors to view SmartSteps, a fit and fun exhibit in the stairwells created by UPMC Health Plan and the History Center. Climb to all six floors and receive a genuine Heinz pickle pin!

Now through December 21, UPMC Health Plan members and their families and friends can save 40% on Heinz History Center individual and family memberships. Memberships include admission to all Smithsonian museums, including the History Center; subscriptions to Smithsonian and Western Pennsylvania History magazines; and museum shop discounts. Call 412-454-6436.

Our Quality Improvement Program works for you

UPMC Health Plan combines the resources of the region's premier hospitals, doctors, and a behavioral health organization to provide the highest quality health care for our members. We continually work to improve care and service by:

• Carefully selecting a network of qualified providers by checking their credentials and evaluating their performance.
• Working with you and your providers to promote wellness and to manage your care if you have multiple health needs or chronic conditions like asthma and diabetes.
• Measuring the number of members who receive:
  • Preventive care
  • Prenatal and postpartum care
  • Childhood and adolescent immunizations
  • Care for chronic conditions like heart disease and diabetes
  • Medication management
  • Behavioral health care

Our recent successes show that our members are getting the right care for diabetes, that women are receiving appropriate maternity care, and that adults and children are accessing their PCPs more.

We also review your responses with the annual satisfaction survey. Recent numbers show that our members are happy with their communication with their personal doctor and specialists. They are also pleased with the Health Plan's superior customer service.

Learn more about UPMC Health Plan's Quality Improvement Program by visiting www.upmchealthplan.com to:

• Find a doctor or hospital.
• Learn about a provider's credentials, including specialty, board certification, and participation in national recognition programs. You can also see what languages the provider speaks and get a list of all office locations.
• Learn about a local hospital's quality and safety record.
• Find a local pharmacy, review your pharmacy benefits, and check for coverage of a specific prescription.
• Manage your health with self-directed wellness tools, access your claims status, and calculate your health care costs.
• Discover discounts for fitness centers, health food stores, beauty salons, and other services through the MyHealth Community discount program.

If you would like a paper copy of the website information, or if you would like more information about the UPMC Health Plan Quality Improvement Program, call your Member Advocate.

Save the date for Drug Take Back Day — October 29 from 10 a.m. to 2 p.m.

More than seven million Americans currently abuse prescription drugs, according to the 2009 Substance Abuse and Mental Health Administration's National Survey on Drug Use and Health. Each day, approximately, 2,500 teens use prescription drugs to get high for the first time according to the Partnership for a Drug Free America. Studies show that most of abused prescription drugs are obtained from family and friends, including the home medicine cabinet.

In an effort to address this problem the Drug Enforcement Agency (DEA) in conjunction with state and local law enforcement agencies throughout the United States, recently conducted two National Prescription Drug Take Back Days. These efforts were a huge success in removing potentially dangerous prescription drugs, particularly controlled substances, from our nation's medicine cabinets.

DEA has scheduled another National Prescription Drug Take Back Day, which will take place on Saturday, October 29, 2011, from 10 a.m. — 2 p.m. Multiple drop-off locations will be available throughout western Pennsylvania. For more information, visit www.zerowastepgh.com or call the Pennsylvania Resources Council at 412-488-7452 for specific locations.

Pharmacy formulary updates

The goal at UPMC Health Plan is to improve the value and affordability of our health care benefits. Making the most of these benefits sometimes means that we have to change how we cover certain medications. The list of medications we cover and how we cover them is called our "formulary." Every change we make to the formulary is made with the help of doctors and pharmacists. The table below shows a few recent changes to the formulary, which became effective July 1, 2011.

Provider directory on the Web

You can quickly and easily search our large network of doctors, hospitals, and other health care providers online. Go to www.upmchealthplan.com and click on the "Find a Doctor" link on the right side of the screen.

You can search for a doctor by name, office location(s), specialty, hospital or medical group affiliation, gender, languages spoken, and whether the doctor is accepting new patients. You can also see if the doctor's office has any restrictions. In addition, the listing includes the doctor's office hours and board certifications, if any. When a doctor is board certified, that means he or she has additional education.

If you're looking for a hospital, you can search by name, location, and accreditation status. The hospital listing includes the address, phone number, and services offered, for example, on- site lab or dialysis services.

For help finding a doctor or hospital, or to have any of the information on our website sent to you in printed form, call your Member Advocate.