Maryland Physicians Care / Medicaid with a Heart

Edition 2, 2023
MPC Well Aware Member Newsletter
MPC Well Aware Member Newsletter

Don’t Let Your Medicaid Benefits Expire. Keep Your Maryland Physicians Care Coverage.

Maryland Health Connection Website

Changes are coming
to Maryland Medicaid.

Medicaid renewals will not be automatic this year. Check with Maryland Health Connection to ensure your contact information is correct to receive important notices on any changes to your health insurance.

You will receive a notification when it’s your time to renew, and you will have 45 days from that date to respond.

Keep your info current.

Keep your coverage with MPC.

Here’s how to get started:

  1. Make sure Maryland Health Connection has your current mailing address, phone number, and email. They will be able to contact you about your coverage. You can also select how you would prefer to receive your notice.

    To update contact information online, sign into your account at: www.marylandhealthconnection.gov/

  2. Be on alert for communications from Maryland Health Connection.

    Members will be notified at different times. When you get your notification, you will have 45 days to respond. You must open and read these communications to see how you will be affected.

  3. Renew your coverage as soon as you receive your notice.

    You will receive a notice in the mail or on your online account (if you are paperless). This notice will tell you to complete your renewal.

Help Icon

Get help online, in person, or by phone.

Wellness is Within Your Reach

Getting healthier and feeling better is as simple as a website click!

Maryland Physicians Care (MPC) offers access to many free, easy-to-use self-management tools to help you get healthier and/or take better care of a chronic condition. These free online tools can help you with the following:

  • Weight management
  • Quitting smoking and tobacco use
  • Physical activity
  • Healthy eating
  • Managing stress
  • Mental health
Wellness is Within Your Reach
MPC Wellness Topics
MPC Wellness Topics

Find these newly added topics:

  • Screening Tests & Vaccines these tools can help you see which screening tests and vaccines you and your family need to get healthy and stay healthy. You can use the immediate results to ensure you are up to date on preventive services. Results are confidential and not shared with anyone but you!
  • Women’s Health – an interactive Well-Woman Chart can help you explore the prevention services recommended for women based on their age in the following areas: general health, infectious diseases, cancer, pregnancy, and postpartum.
  • Avoiding At-Risk Drinking – this confidential questionnaire is designed to help a member look closer at alcohol consumption and to identify any possible, unseen harm to health and well-being, now and in the future.
  • Prediabetes – this free tool can show you what your prediabetes risk is, when to be screened regularly by your doctor, and which steps you can take to delay or prevent type 2 diabetes.

To access these free online tools, please visit our website at: marylandphysicianscare.com/members/self-management-tools/, or call MPC’s Member Services Department at 1-800-953-8854. You can even contact the Prevention & Wellness team via email at preventionandwellness@mpcmedicaid.com.

Asthma

Has your child been coughing, often clearing his/her throat, or wheezing? Asthma is a common chronic condition among American children – one child out of every 12 has asthma. Wheezing is the most common symptom of asthma. This is a squealing or whistling sound that occurs when you breathe.

There are many types of asthma. Your doctor can determine the kind of asthma your child has. The most common type is allergic asthma, representing 60% of all cases of asthma. Allergic asthma can be triggered by pollen, dust, or pet dander from animals like cats and dogs. Allergic asthma is often seasonal because it goes hand-in-hand with seasonal allergies. Talk to your doctor about your child’s symptoms or call Maryland Physicians Care at 1-800-953-8854 to find a doctor.

Young Boy Coughing - Asthma

Maryland Physicians Care offers medical coverage and health benefits that are close to home. This coverage includes access to primary and urgent care visits, pregnancy and new mother benefits, specialists care, pharmacy coverage, primary mental health services, vision and dental care* (including adults), and more. MPC’s participation in the HealthChoice program is available to Maryland Children’s Health Program or MCHP-qualified recipients. Members can work within MPC’s network of doctors to find the care that is right for them.

*Dental Care through the Maryland Healthy Smiles Dental Program

Maternal Opioid Misuse

Maternal Opioid Misuse Program

MPC’s Maternal Opioid Misuse (MOM) Program focuses on improving care for pregnant and postpartum members with opioid use disorder. Benefits continue for one year following the end of the pregnancy.

The MOM program addresses gaps in care for pregnant and postpartum members by assigning care managers to coordinate care, ensuring that members:

  • Receive needed health care services
  • Have access to appropriate social services in their community
  • Remain connected with the appropriate care

To enroll, members must:

  • Be enrolled with MPC
  • Be currently pregnant
  • Have current or past opioid misuse
Young Mother with Baby

Enrolling in the program is easy. Members can contact MPC’s Special Needs Coordinator at MPCSNC@MPCmedicaid.com or 800-953-8854. Members can also submit a self-referral here: Maryland MOM (Maternal Opioid Misuse) Case Management Services.

Join Belong, the Membership Rewards Program
from Maryland Physicians Care, for:

Heart / HBP / Hypertension

Obese Family Jogging

Hypertension is quite common and sometimes called High Blood Pressure (HBP). When the guidelines changed in 2017, nearly half of American adults could now be diagnosed with this condition. Hypertension may develop over several years. You may not even notice any symptoms. Even without symptoms, high blood pressure can cause damage to your blood vessels and organs, especially the brain, heart, eyes, and kidneys. Early detection is important. Regular blood pressure checks can help you and your doctor notice any changes. Treatment for hypertension includes both prescription medication and healthy lifestyle changes. If the condition is not treated, it could lead to health issues, including heart attack and stroke.

Food and Asthma

Eating Healthy

What is a Low-Sodium Diet? Sodium is an essential mineral needed for many important bodily functions. Sodium is found in most foods you eat, although whole foods like vegetables, fruits and poultry contain much lower amounts. Sodium is most concentrated in processed and packaged foods like chips, frozen dinners, and fast food, where salt is added during processing to enhance flavor. Healthcare professionals typically recommend low-sodium diets to treat certain medical conditions. Sodium levels are usually restricted to less than 2-3 grams (2,000-3,000 mg) per day. For reference, one teaspoon of salt contains about 2,300 mg of sodium. When practicing a low-sodium diet, check the food labels and use a measuring spoon. Keep your salt intake to 1-2 teaspoons per day.

MPC Health and Wellness Icon

Visit the MPC Health and Wellness Resource Center

Maryland Physicians Care wants to help our members make healthy choices for a happy life. We offer several tools and resources to help you live a happy and healthy life. The goal of Health and Wellness is to provide you with information to make the best choices for you and your children.

Ready, Set, Cook!

Pecan-Crusted Chicken Breast

Pecan-Crusted Chicken Breast

This chicken dish takes just 8 minutes of prep time, 20 minutes in the oven, and voila! The result is impressive enough to serve for a special occasion but casual enough to pair with your comfy clothes. You’ll enjoy the homestyle crunchiness from the pecans, along with a hint of natural sweetness and spiciness. Serve it with a harvest salad and sweet potato fries.

Calories

300

Total Fat

15 g

Saturated Fat

2 g

Trans Fat

0 g

Cholesterol

95 mg

Sodium

270 mg

Carbohydrates

3 g

Dietary Fiber

2 g

Total Sugars

2 g

Protein

37 g

Potassium

370 mg

Prep time: 8 min / Cook time: 20 min / Servings: 4 / Serving size: 1 breast (about 5 oz)

Are You Aware?

Black pregnant women have higher risks for complications during pregnancy. Did you know that Black women are more likely to:

  • Have diabetes, high blood pressure, and heart disease, which can make both mom and baby sick during pregnancy
  • Have fibroids in the uterus which can cause sudden heavy bleeding and affect their ability to stay pregnant or have a healthy pregnancy
  • Show signs of preeclampsia earlier in pregnancy
    Preeclampsia can cause high blood pressure and other serious problems that could lead to death.

Don’t worry – there are things you can do to have a healthier pregnancy!

  1. Communicate with your doctors. They want to know if you have any of these things when you’re pregnant and after the baby is born:
  • Bad headaches
  • Swollen hands or face
  • Trouble breathing
  • Heavy bleeding
  1. Eat healthy food. Choosing healthier options is important when you’re pregnant. You should eat plenty of fresh fruits and veggies and avoid salty, sugary, and processed foods. A balanced diet can help you and your baby stay healthy.
  1. Exercise safely under your doctor’s care. If you are pregnant, you should be under the care of a doctor who can monitor the progress of the pregnancy.
  • Consult your doctor about whether or how to adjust your physical activity during and after your pregnancy.
  • Moderate-intensity physical activity, such as brisk walking, keeps your heart and lungs healthy during and after pregnancy.
Pregnancy - complications
PACIFY APP

After you have your baby, exercise also helps maintain a healthy weight, and when combined with eating fewer calories, it helps with weight loss. MPC wants all moms to be healthy and has several programs to help pregnant women in Maryland.

  • The free Pacify app connects you to Care Managers to help with benefits, find a doctor, schedule appointments, or gain access 24/7 to Lactation Consultants. These consultants offer breastfeeding support and answer other feeding-related questions.
  • Home Visiting Services provide support to pregnant women during pregnancy and childbirth and support for parents and children during the postpartum period through three years of age.
  • Visit the MPC website to learn more about our pregnancy-related support services, or call Customer Service at 1-800-953-8854.

Maryland Physicians Care is here to support you and your baby!

Hear From You Icon

Population Health Management Overview

Each year MPC evaluates the needs of its members and uses that information to create new programs or make changes to existing ones offered through Population Health Management (PHM). Our cervical cancer and child lead screening programs focus on keeping you healthy. If you are at risk for asthma or substance abuse, we have programs to help you. When you are hospitalized, our Transition Care Team may contact you to coordinate needed care and help prevent readmission. Members with multiple chronic conditions may also benefit from our programs and can work with our Care Managers to better manage their health care needs and reduce frequent emergency room visits.

Call member services at 1-800-953-8854 to find out more.

Care Management Overview

Is your health condition or illness worrying you? Were you recently in the hospital or expecting a baby? Do you have a child and would like to know more about their diagnosis or need more help? We can assist with all these concerns or questions through our free Care Management Program at MPC!

Care Management is a team-based approach designed to assist you and your family in managing your medical conditions effectively. We have highly trained Nurses, Health Educators, Community Health Workers, Care Coordinators, and Social Workers who would love to work with you or your family.

Our team can help provide education about your health conditions, such as high blood pressure, diabetes, COPD, asthma, heart problems, or even cancer. We can help you understand your health problems, teach you how to manage your illness and medications, help you locate a doctor, or change your primary care doctor or specialist. Our team can also assist you with any transportation issues you may have getting to your appointments and help provide resources in your community that might benefit you.

At MPC, we want to ensure you have the support and assistance to manage your health-related issues. Our team is highly trained in various areas, and we would love to be able to help you. We are just one call away! Our programs are free, and we will work with you and your doctors on all your health-related needs and questions. You can talk to your provider about Care Management or call us for more information!

You can choose to join our Care Management Program at any time. Whenever you feel ready, call Member Services at 1-800-953-8854 to learn more! We look forward to hearing from you.

MPC Health and Wellness Icon

Pharmacy Benefit Coverage

Maryland Physicians Care ensures that the preferred drug list (PDL) is available here: MPC Approved Medication Benefits. Members can search for their drugs using our search tool here: MPC Formulary Search Tool to find out if the drug is available on the formulary drug list. Maryland Physicians Care also provides a full list of the covered Over-the-Counter (OTC) medications and medical supplies here: MPC OTC Covered Medications. Members can also see if their medication(s) requires prior authorization before their pharmacy can fill the prescription. If the medication is not on the formulary and is needed in an emergency, your doctor or pharmacy can call MPC 24 hours a day at 1-800-953-8854 to obtain a limited drug supply.

Your Medicaid coverage through Maryland Physicians Care means you don’t have to go to the doctor to be seen by one. Skip the waiting room and text with a local medical doctor for FREE with MyVirtualMPC. All you need is an internet connection and a smartphone, tablet, or computer. Doctors are available 24 hours, seven days a week. Download MyVirtualMPC today.

Quality Management

Quality Management Program

Maryland Physicians Care’s (MPC’s) Quality Management Program monitors members’ quality of care and services. Goals are set, data is collected, and with input from our members, providers, staff, and others, MPC takes action to make improvements. We measure all parts of the Quality Management Program, including clinical and service activities such as:

  • Promoting health care safety with member and provider education.
  • Establishing preventive health and clinical practice guidelines. These help members understand what kind of services they need and how often they’re needed.
  • Making sure members have access to qualified health care professionals.
  • Ensuring members receive appropriate preventive care. Examples of preventive care are:
  • Annual flu shots
  • Child immunizations (shots)
  • Eye tests
  • Cholesterol tests
  • Breast Cancer screenings
  • Care for women before and after the baby is born
  • Evaluating members’ quality of care concerns and taking action when needed.
  • Conducting surveys to see if members are satisfied with the services they receive from their doctors.

For more information about our Quality Management Program and the latest member satisfaction survey results, please visit MPC Quality Improvement or contact Customer Service at 1-800-953-8854.

Advisory Board Icon

You Can Make a Difference

The Consumer Advisory Board (CAB) is made up of members who share feedback on the programs and services provided by MPC. During these meetings, MPC staff provide essential information on benefits, health education, and program activities while members share their opinions and help to make plan improvements.

You are eligible to become a Consumer Advisory Board member if you meet the following criteria:

  • You are an MPC Member
  • You can attend six meetings each year by phone or computer
  • You are at least 21 years old

If you are a young mom, a member with a chronic illness, or a member with multiple health concerns, we would like to hear from you to ensure our programs and services meet your needs.

Make a difference today by applying for a position on our Consumer Advisory Board!

Fraud Alert Icon

HELP PREVENT
FRAUD AND ABUSE

MPC needs your help to prevent fraud and abuse! We encourage you to report anything suspicious you may have seen. You may report fraud and abuse without the fear of retaliation by calling MPC’s Compliance Hotline at 1-866-781-6403 or going online at: marylandphysicianscare.com/fraud-abuse/.

You Have Rights Icon

You Have Rights and Responsibilities

RIGHTS are things you can expect from your health plan. They include:

  • Getting information about the services we provide
  • Being treated with respect, dignity, and privacy
  • Privacy of your medical information
  • Getting a copy of your medical records
  • Being included in decisions about your care. This includes the right to refuse treatment.

RESPONSIBILITIES are things your health plan expects from you. They include:

  • Asking questions if you do not understand your rights
  • Keeping your scheduled appointments
  • Having your member ID card with you at all appointments
  • Telling your doctor if you had care in an emergency room

You can find more rights and responsibilities in your member handbook. Read it on our website at marylandphysicianscare.com/rights-and-responsibilities/

Call 1-800-953-8854 to ask for a paper copy.

Internet icon

VISIT OUR WEBSITE

To Find Helpful Information on:

  • Quality Improvement Program
  • Care Management Programs
  • Population Health Management Programs
  • Health and Wellness
  • Clinical Practice Guidelines
  • Utilization Management
  • Pharmacy and Prescription Drug Management
  • Benefits and Coverage
  • Member Rights and Responsibilities
  • Protected Health Information
    Use and Disclosure
  • Member Handbook
  • Provider Directory

If you do not have internet service, you can reach us by phone (numbers listed in “Who to Call” – below) for more information.

Phone icon

WHO TO CALL

MEMBER SERVICES

Benefits, ID cards, appeals, PCP changes, etc.

1-800-953-8854

MARYLAND HEALTHY SMILES DENTAL PROGRAM

PUBLIC MENTAL HEALTH SERVICES

SUPERIOR VISION

UTILIZATION MANAGEMENT

CARE MANAGEMENT

HEALTH EDUCATION REQUESTS