INSIDE We value your input 2 Beware of scams 3 Presbyterian Health Plan, Inc. P.O. Box 27489 Albuquerque, NM 87125-7489 www.phs.org Important plan information NACC Standard U.S. Postage PAID Presbyterian Health Plan Your Fall 2023 for Native American communities New myPRES App To make your experience with myPRES even better, try downloading the new app. It has all the same great features that you now can take with you on the go. You can download the new app by searching “myPRES” in the Google Play store or Apple Store for your mobile device. Create a myPRES account If you don’t have a myPRES account, registration is quick and easy. You can register at https://mypres .phs.org/Pages/registration.aspx. There are more online tools for members. There is also a tool for requesting non-emergency transportation services (NEMT). To see all the tools, please visit www.phs.org. myPRES When you need to view your benefits, rewards, and other health plan resources, myPRES is the best way to get fast and easy access. We recently improved the myPRES platform. You now have access to what you need most as soon as you log in. From the homepage, you will find benefits, rewards, resources, and the items you use the most, like your ID card. You can also access MyChart to schedule visits and make telehealth appointments. Quick access to what you need Centennial Care for Native Americans: 1-888-977-2333
2 Native American Consumer Advisory Board The Presbyterian Native American Affairs Department hosts Native American Consumer Advisory Board (NACAB) meetings to help us better serve Native American members and communities. These meetings are excellent opportunities for our members to learn about services and benefits available as a Native American Centennial Care member. These meetings rotate around Native American communities throughout the state, allowing for different members to attend each quarterly meeting. These meetings also allow attendees to provide feedback, ask specific questions, and have direct communication with various health plan departments and Native American Affairs. NACAB meetings will be hosted virtually using call-in or online services until further notice. If you are interested in attending or for more information, please call Native American Affairs at (505) 228-1191. Take advantage of Value-Added Services Value-Added Services are offered in addition to the Centennial Care covered benefits. This includes services for pregnant members, babies, physicals, medication reminders, and wellness classes. For Native American members, this also includes the Traditional Medicine Value-Added Service that can help with $300 once per calendar year (Jan. 1 to Dec. 31) for traditional and ceremonial services. Presbyterian Health Plan offers this service to honor and support the culture of our Native American members. You can apply online or by mail or fax. Visit the Centennial Care for Native Americans webpage at www.phs.org/health-plans/ centennial-care-medicaid/native-american-communities and click the “Apply Online” or “Download or Print” links to view the form. Please complete the form fully. It takes about five to six weeks to process applications. You can call the Presbyterian Customer Service Center at (505) 923-5157 or 1-888-806-8793 for help or to check the status of an application.
www.phs.org/centennialcare 3 How our Community Health Workers can help The Presbyterian Health Plan Community Health Worker (CHW) team is an important resource for our members. The CHW team lives and works in our New Mexico communities, and they are trained to help our members find resources within their community, so they stay healthy and receive the support they need. CHWs can help members: • Locate food • Find housing • Help pay utilities • Locate support during pregnancy • Manage their health • Find a new provider The CHW team also supports members with needs related to asthma, diabetes, behavioral health, and addiction. Many CHW team members live in or near Tribal communities. This helps them stay informed of a Native American member’s background, culture, language, and needs. They also work with local Community Health Representative programs so they can better meet our members’ needs. CHW services are private. To speak with someone about the CHW team, please call our CHW line at (505) 923-8567 or 1-866-597-7839. Beware of scams during this holiday season With the holiday season coming, there is more of a chance for you to be exposed to scams. They can be online, by telephone, or even in person. Scams also target people of all ages. Scams can involve money, personal information, or some other benefit. This can include scams for medical help. One of the best ways to avoid scams is to question the offer. Some scams have a short timeline. Do not act quickly for people who make demands. If it sounds too good to be true, then it most likely is. Don’t trust promises of medical help Scams may say that they can help you or a family member with a medical issue. This can be help with rehabilitation services for drug and/or alcohol use. It is best to not accept these offers and not take a ride or meet anyone. If a person needs help, it is best to contact widely known groups for help. Don’t take rides from strangers Services like Uber and Lyft have made it easy to get in a vehicle with a stranger, but you should always question who you are riding with and verify where you are going. Also note how many people are in the vehicle, and do not accept any food or drinks. Use app details to check names, locations, and other ride details. Protect yourself online Email scams are a common way people gain access to personal information. If you get an email or text message that you are not sure about, then you should not open it — and do not click on any links. It is best to delete these messages or report them to a security system. For more tips about avoiding scams, visit the Federal Trade Commission Consumer Advice scams page at www.consumer.ftc.gov/scams.
We’re here for you In addition to your Native American team, you also have access to our Presbyterian Customer Service Center (PCSC). We know you need information about healthcare that is just for you. That is why we are here! The PCSC staff is located in New Mexico and can answer any of your questions in English, Spanish, Navajo/Diné, and other languages. They can help you: • Find community resources • Connect with a care coordinator • Get transportation — we have Native American transportation providers who know our communities and can give you rides to your medical and behavioral health appointments to and from Tribal areas • Understand your benefits • Find translation or interpreter services You can reach our PCSC Monday through Friday, 8 a.m. to 6 p.m. Mountain Standard Time, at: • (505) 923-5200 or 1-888-977-2333 (toll-free); TTY users: 711 • Navajo/Diné members: (505) 923-5157 or 1-888-806-8793 (toll-free) • Email: info@phs.org For additional resources, you can go to Share New Mexico — New Mexico’s largest resource directory — at www.sharenm.org. Find resources by location or topic (food, clothing, shelter). Learn more about Share New Mexico by going to www.sharenm.org. You have a team to help you! The Native American team is here to: • Answer health plan benefit questions • Find resources you might need • Teach you about the benefits and services you can access through Presbyterian Centennial Care • Enroll those who want to join Presbyterian Centennial Care • Teach you about providers who are available in the Presbyterian network • Show you how to apply for the Traditional Medicine Value‑Added Service • And much more Contact us Scott Atole, Director, Native American Affairs Email: satole@phs.org Phone: (505) 228-1191 Loren Allison, Relationship Executive, Provider Network Operations Email: lallison3@phs.org Phone: (505) 923-8289 Mellisa Logg, Supervisor of Education & Outreach, Government Programs Email: mlogg@phs.org Office phone: (505) 923-5377 Mobile phone: (505) 589-8019 Jennifer Sandoval, Tribal Liaison (Albuquerque area), Government Programs Email: jsandoval8@phs.org Office phone: (505) 923-8487 Mobile phone: (505) 415-2989 Charlotte Jameson, Tribal Liaison (Albuquerque area), Government Programs Email: cjameson@phs.org Mobile phone: (505) 554-8935 Roland Todacheenie, Tribal Liaison, Government Programs Email: rtodachee@phs.org Phone: (505) 803-2633 Your Story is published for members of Presbyterian Health Plan, Inc., and Presbyterian Insurance Company, Inc. Information in Your Story comes from a wide range of medical experts. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider. Such services are funded in part with the State of New Mexico. YourstoryP.O. Box 27489 Albuquerque, NM 87125-7489 www.phs.org Managing editor: fluentqc@phs.org 2023 © Coffey Communications, Inc. All rights reserved. FALL 2023 for Native Americans MPC072302 Centennial Care #6059 Like us on Facebook Facebook.com/PresHealth
Presbyterian Health Plan, Inc. P.O. Box 27489 Albuquerque, NM 87125-7489 www.phs.org Important plan information CC Standard U.S. Postage PAID Presbyterian Health Plan INSIDE Be sure to renew your benefits 3 Sign up to help avoid diabetes 7 Your Fall 2023 With every school year, there come new experiences. You might have a list of things to talk about with your children. Vaping should be near the top of your list. As many as 16.5% of high school students and 4.5% of middle school students report having used vape products (electronic cigarettes) each month. It’s illegal to sell these products to kids under age 21, but they are easy to get online. Smoking electronic cigarettes (e-cigarettes) is a serious health threat for kids and teens. Nearly all e-cigarettes contain nicotine, which is made from tobacco and is very addictive. Plus, nicotine and other toxic chemicals in e-cigarettes may permanently damage the heart, lungs, and brain in growing children. What are e-cigarettes? These devices run on batteries. They heat up a fluid to create a mist that people inhale. That liquid goes by many names: • E-juice • E-liquid • Vape juice • Vape liquid The liquid is flavored, so it can taste good. Although some flavors that are popular with kids are banned, children can still access these products. Talk to your children Peer pressure can be tough for children. Talk to them about vaping. If you think your child is vaping — or may start — bring up the topic. Ask your child what they think about vaping. Tell them you care about their health, and talk about the risks. Here are some facts to know and share: • Nicotine use at a young age may make it hard to focus, learn, and even control mood. It can also impact the way the brain builds stronger links between brain cells. • Nicotine use when you’re young may lead to future use of tobacco and other drugs. • The vapor from e-cigarettes contains harmful chemicals that rank as some of the most serious cardiovascular toxins also found in cigarette smoke. • Secondhand vapor is harmful too. Even if your child doesn’t vape, it’s risky for them to be around any friends who do. If you want to know more about tobacco products and support to quit smoking, please visit www.smokefree.gov. Sources: American Academy of Family Physicians; Centers for Disease Control and Prevention En español: Si usted desea obtener este boletín en español, llame al (505) 923-5200 o al 1-888-977-2333. Talk to your children about vaping
2 Do your children have all their vaccines? When the time comes to go back to school, it is vital that your children get the vaccinations they need. This will help them stay in school, keep up with their school work, and enjoy sports and social events. Vaccinations can also help keep other students healthy. Below is a list of vaccinations that you should ask your provider about for your child: Keeping track of your child’s vaccine status can be tough at times. You can always call your provider to ensure that your child has all their vaccines. For more information, please visit www.cdc.gov/vaccines/ schedules/hcp/imz/child -adolescent.html. Kids ages 7 to 10 • COVID-19 • Flu Kids ages 11 to 12 • COVID-19 • Flu • Meningococcal conjugate vaccine • HPV • Tetanus, diphtheria, and acellular pertussis (TDaP) • COVID-19 • Flu Kids ages 13 to 18 • COVID-19 • Flu • COVID-19 • Flu • Diphtheria, tetanus, and acellular pertussis (DTaP) • Polio • Measles, mumps, rubella (MMR) • Varicella (chickenpox) Kids ages 2 to 3 Kids ages 4 to 6
www.phs.org/centennialcare 3 Be on the lookout for your benefit renewal application In partnership with the New Mexico Human Services Department (HSD), we have some important news to share about your Centennial Care (Medicaid) benefits. Everyone enrolled in Medicaid must renew their benefits. You will receive a turquoise envelope from HSD when it’s time to renew your Medicaid benefits. If you have signed up for HSD electronic notices, watch for email or text updates. When you are notified, log in at www.yes.state.nm.us. Click the “Renew My Benefits” button to complete your renewal application. If HSD requests more information, please provide it right away so you don’t lose your coverage. You must complete your renewal application to check if you are still eligible to keep your benefits. Why do I need to renew? During the COVID-19 public health emergency, your Medicaid and SNAP benefits were automatically renewed. This has changed. Now, everyone will need to renew their Medicaid and/or SNAP benefits when notified. If you do not renew, your coverage will end. What if I am no longer eligible for Medicaid? If you are notified that you are no longer eligible for Medicaid, you can find low- or no-cost coverage through BeWellnm. Check out all your choices online at www.bewellnm.com or by calling 1-833-862-3935. We’re here for you! Presbyterian Health Plan wants to help you through this change. We want to give you the support you need during this change so that you can continue your healthcare journey with us. Feel free to reach out to us with any questions or concerns you have. Call the Presbyterian Customer Service Center at the number on your member ID card: (505) 923‑5200 or 1-888-977-2333. ! ?
4 Sports are a great way for kids to keep moving, learn about teamwork, and make friends. But mishaps do happen — on the soccer and football fields, the gym mat, the basketball court, and other areas of play. Don’t let injuries keep your child on the bench. As a parent, you play a vital role in helping your child stay safe. Make safety part of your family game plan. Help your child try new things. Focusing on one sport early on may lead to overuse injuries, stress, and burnout. Help your child try sports that match their age and stage, and focus on the fun — not on winning, losing, or becoming a star athlete. Make helmets a must. Remind kids and teens who play high-risk sports — such as baseball, football, and hockey — to always wear a helmet during practice and games. The same goes for bike riding, skateboarding, snowboarding, and skiing. A helmet can help protect kids and teens from a serious head injury, such as a concussion, which can happen from a bump or blow to the head. Talk about concussion symptoms. Tell your child to stop playing — even during an important game — if they feel sluggish or hazy or if they have symptoms such as: • Dizziness • Balance problems • Headache or pressure in the head • Nausea or vomiting Remind your child to report symptoms to the coach right away. Supply plenty of water. Send your child to practice and games with a water bottle, and make sure they drink plenty of water before, during, and after play. Team up. If your child has asthma or another medical condition that requires special attention, meet with the coaches before the first practice. That way, they know what to watch for and what to do if symptoms occur. Help your child stay safe during sports
www.phs.org/centennialcare 5 With prices going up for many basic needs, it can be tough for New Mexico families to get the care they need. This can be healthcare for expecting parents, children, and people with special needs. To help families get the care they need, New Mexico started the Centennial Home Visiting (CHV) program in 2020. The program offers services in a home setting to babies, toddlers, children with special healthcare needs, and the parent(s)/ primary caregiver(s). The CHV program is cost-effective and can help moms and babies be healthier and feel safe. Families in the program take steps to better care for themselves. The goal of the program is to: • Help pregnant moms and new parents • Promote infant and child health • Help children with their education and school readiness • Help prevent family trauma Keep these numbers handy The Presbyterian Customer Service Center (PCSC) is available for members Monday through Friday, 8 a.m. to 6 p.m. Members can reach the PCSC at the following numbers: (505) 923-5200 or 1-888-977-2333, TTY: 711 Navajo/Diné members: (505) 923-5157 or 1-888-806-8793, TTY: 711 Other important numbers PresRN: (505) 923-5677 or 1-888-730-2300, TTY: 711 Routine transportation (for nonemergency medical transportation): 1-855-774-7737 New Mexico Crisis and Access Line (for a behavioral health crisis): 1-855-662-7474 (1-855-NMCRISIS) Presbyterian Centennial Care Ombudsman: Phone: (505) 923-5780 Email: ombudsman@phs.org Centennial Home Visiting program: Supporting New Mexico families How to enroll The CHV program is provided at no cost to members. If you would like more details or want to take part in the program, please email chvmailbox@phs.org. Be sure to ask if the program is in your area.
6 has a new look and features The new myPRES app The myPRES app is a great way for you to stay connected to your resources and access all the information regarding your health. To download the app, go to the Apple Store or Google Play store on your mobile device and search for “myPRES.” myPRES is one of the best tools we offer to you. myPRES serves as a one-stop shop for your most important resources. We are happy to share that we have made improvements to the platform that make navigation and use easier, so you can take full advantage of your benefits. One of the biggest improvements we made is access to your ID card. You can now access your ID card on the homepage of your myPRES account. Some other improvements include: • Easier access to your Healthcare Team, including your primary care provider • Simpler ways to schedule appointments using Get Care • Streamlined access to Centennial Rewards In addition, your Health and Wellness Resources are all at your fingertips. This includes transportation, Presbyterian Health Plan Video Visits, and Value-Added Services. We hope you find the new myPRES platform helpful in managing your care. To get the full benefit of myPRES, visit www.phs.org/myPRES. myPRES
www.phs.org/centennialcare 7 Is one of your goals to lose weight and build on healthy habits? If so, you may be eligible for the Path for Wellness Diabetes Prevention Program. The program is offered at no additional cost to eligible members with prediabetes or certain risk factors for Type 2 diabetes. It is designed to help eligible members: • Build healthy habits • Lose or manage weight • Be more active • Reduce their risk of Type 2 diabetes Find out if the program is right for you: • Visit www.phs.org/ preventionprogram. • Call 1-855-249-8587. Good measures: Diabetes prevention program It’s easy and fun to participate — the program is all by phone or online. The classes are also in Spanish. What’s included? When you sign up for the program, you get: • Your own lifestyle coach, a person who helps you build healthy habits • Access to your lifestyle coach by phone or online • Online or phone group classes • An app that helps you choose healthy foods • A scale to track your weight and send data to your phone app
8 Making a reservation When you make an appointment, it is best to arrange your transportation needs at the same time. Please give Secure Transportation at least a two-day notice before your appointment. You can also download the Secure Transportation app to make reservations. This will make it easier to change and cancel rides. If you need to cancel a ride, please do so at least four hours before the appointment. To download the app, please visit your app store and choose the Itineris Passenger app. For questions, please call Secure Transportation at 1-877-566-9144. Did you know that your benefits cover more than one way to get you to your medical appointments? When you set up an appointment, it is also vital to plan a way to get there. If you need help getting to your appointment, think about using your benefits with Secure Transportation. Secure Transportation offers many ways for you to get to the doctor’s office. These include: • Getting a ride from Secure Transportation • Getting a ride from a friend or neighbor • Getting a daily, weekly, or monthly bus pass When you get a ride from a friend or neighbor, they can be reimbursed for it. Ask a Secure Transportation agent about Member Mileage Reimbursement, and they can ensure that you get a check to reimburse your friend or neighbor. If you are interested in a bus pass, talk to a Secure Transportation agent about the options for public transportation. Your non-emergency transportation benefits
www.phs.org/centennialcare 9 ▶ Invited to a party? Bring your own dish. Take something healthy that fits within your diabetes meal plan. Enjoy small bites of other foods. ▶ Plan for dessert. Want to enjoy a dessert? You still can if you: • Keep the portion small • Cut back on other carbs — such as bread and potatoes — during the main part of the meal ▶ Try a sweet swap. Do you make your own desserts? When a recipe calls for sugar, try using a sugar substitute, like those made from aspartame, saccharin, or stevia. ▶ Fill half your plate with non-starchy veggies. They don’t raise blood sugar like bread, rice, pasta, and other high-carb choices do. Nonstarchy veggies include: • Broccoli • Cabbage • Carrots • Cauliflower • Green beans Also be sure to have some lean proteins — like skinless turkey or chicken, beans, tofu, or eggs — during your meal. ▶ Don’t skip breakfast or lunch. Skipping meals might seem like a good way to enjoy more of your favorite foods at the big feast. But that may cause your blood sugar to go too low, which can make you feel bad and harm your health. And you might get so hungry that you’ll end up overeating. ▶ Walk off dessert and other treats. Take a walk with family and friends. Even short bouts of exercise can help with diabetes control. Source: Centers for Disease Control and Prevention It can be hard to resist all those delicious treats that can be found everywhere. But when you have diabetes, it’s worth trying to keep your food choices in line with your meal plan. Straying off course may make your blood sugar harder to control. To take good care of yourself and still have fun, you need a strategy for eating well. Your diabetes care team can give you advice. These tips may also help: Healthy eating with diabetes
10 You can find more about advance directives on the Presbyterian website or in your Centennial Care handbook. To obtain a paper copy of any of the forms found on our website, please call the Presbyterian Customer Service Center at the number on the back of your ID card. Advance directives Q&A Q What is an advance directive? A: An advance directive is a legal document that informs others of your healthcare choices. It explains what medical support you want, or do not want, if you are ill and cannot respond. It is only used when you are not able to speak for yourself. QWhen should I complete an advance directive? A: Advance directives are for people 18 years of age and older and should be done ahead of time so they can be shared with your doctor or healthcare decision-maker. QWhere can I create an advance directive? A: The best way to prepare your advance directive is by going online to www.phs.org/ tools-resources/patient/Pages/advance-directive.aspx. It will attach your advance directive to your Presbyterian Health Plan electronic medical record. You can create an advance directive on our website at www.phs.org/Pages/member-rights.aspx. QWhat if I cannot express my wishes to create my own advance directive? A: You do not have to complete an advance directive. If you do not complete an advance directive or choose a healthcare decision-maker, New Mexico law decides who will be authorized to make decisions on your behalf if you are unable to make decisions yourself.
www.phs.org/centennialcare 11 Speak with a Presbyterian nurse at any time You have access to PresRN, our local nurse advice line, 24 hours a day, seven days a week, even on holidays. PresRN is an easy way to speak with a Presbyterian nurse if you are not feeling well and need advice. A PresRN nurse will help you and your family, whether you require a trip to the emergency room or self-care at home. Presbyterian nurses are happy to answer any questions. Please call even if you are healthy but need some advice. As part of your Presbyterian Healthcare Team, we let your provider, care coordinator, and health coach know of your health concern so that you will have continued care and follow-up. We are here when you need answers! Call PresRN at (505) 923-5677 (Albuquerque) or 1-888-730-2300 toll-free. If you are having a medical emergency, please call 911. Presbyterian’s translation and interpretation services Communication is important to you and to us. That’s why we offer interpretation services if you need them. We want to make sure you have the information in the language or format you use so you can take charge of your own healthcare. We have bilingual staff and certified interpretation services if you want to use these services. These services are available to help you talk with providers, nurses, and caregivers; learn about your health plan; and much more. Our translation and interpreter services include: • Language translation • Written materials translation • Telephonic interpreters • In-person interpreters • American Sign Language interpreters • Video remote interpreters It’s easy to request these services. Call the Presbyterian Customer Service Center at the number on your member ID card.
Yourstory Your Story is published for members of Presbyterian Health Plan, Inc., and Presbyterian Insurance Company, Inc. P.O. Box 27489, Albuquerque, NM 87125-7489 www.phs.org Managing editor: fluentqc@phs.org Information in Your Story comes from a wide range of medical experts. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider. Such services are funded in part with the State of New Mexico. Presbyterian complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (505) 923-5420, 1-855-592-7737 (TTY: 711). Díí baa akó nínízin: Díí saad bee yáníłti’go Diné Bizaad, saad bee áká’ánída’áwo’d66’, t’áá jiik’eh, éí ná hól=, koj8’ hódíílnih (505) 923-5420, 1-855-592-7737 (TTY: 711). Like us on Facebook Facebook.com/PresHealth 2023 © Coffey Communications, Inc. All rights reserved. MPC072301 Centennial Care #6058 Makes 4 servings. Ingredients Seasoning marinade ½ teaspoon chili powder ¼ teaspoon ground cinnamon ¼ teaspoon ground cumin ¼ teaspoon garlic powder ⅛ teaspoon finely ground coffee ⅛ teaspoon ground black pepper Filling ½ tablespoon canola oil 1 pound turkey cutlets or boneless turkey breast, cut into ¾-inch-by-3-inch pieces 4 taco-size (9-inch) whole-wheat tortillas 1⅓ cups lightly packed baby spinach ½ cup salsa verde 2 (½-inch) slices red onion, halved crosswise 12 (½-inch) strips red bell pepper If using leftover turkey, heat in a microwave or on the stovetop. Directions • In small bowl, whisk together chili powder, cinnamon, cumin, garlic powder, coffee, and black pepper. • Place canola oil and turkey in mixing bowl and add dry seasoning marinade. Using a fork or your hands, mix to coat turkey evenly with marinade. Set aside for 20 to 30 minutes. • Heat medium cast-iron skillet over medium-high heat. Lay a large sheet of foil on your work surface. One at a time, heat tortillas in dry pan until they are flexible, about 1 minute, turning them after 30 seconds. • Stack tortillas on foil, covering them with an inverted plate until all tortillas are warmed, then seal tortillas in foil, and set them aside. • Heat grill-pan or stovetop grill over high heat until a drop of water flicked onto it dances. Using tongs, arrange seasoned turkey pieces in rows on grill, placing them ½-inch apart. This may require cooking turkey in 2 batches. • Grill for 6 minutes, turning pieces every 1 minute so they cook evenly and to avoid burning. Transfer cooked turkey to serving plate. • To assemble fajitas, place warm tortilla on a dinner plate, preferably warm. Arrange ¼ of spinach in center of tortilla. Add ¼ of turkey. Spoon on ¼ of salsa, top with half an onion slice and 4 pepper strips. Fold in top and bottom of tortilla, then sides. Serve immediately. Cook turkey to 165 degrees to help prevent foodborne illness. Nutrition information Serving size: 1 fajita. Amount per serving: 280 calories, 3.5g total fat (0g saturated fat), 29g carbohydrates, 45mg cholesterol, 33g protein, 2g dietary fiber, 430mg sodium. Source: American Institute for Cancer Research Turkey fajitas with baby spinach and red peppers
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