Fall 2024

Welcome to our latest edition of Whole You, a newsletter from CMS Health Plan. The weather is cooling down and the holidays are here – hooray!

Read on to learn about protecting your family from the flu and how to set up a doctor’s appointment from home. Get tips for reducing stress and staying active through the holidays, plus learn how CMS Health Plan supports caregivers.

In case you missed it, check out our summer 2024 newsletter.

For some, the flu shows up with mild symptoms. For others, the flu can lead to serious illness or even death. The best way to protect yourself and loved ones from the flu is to get a vaccine every year. Hundreds of millions of Americans have safely received it for decades.

Why does my child need a flu shot every year?

Flu viruses are always changing. Scientists predict which virus will be the most common each year, then flu vaccines are made to match. Plus, protection from the shot weakens over time, so it’s necessary to reup each year.

Can the flu shot give my child the flu?

Nope! The flu vaccine is made from either inactive flu virus or none at all.

Worried your child has the flu? Here are signs to look out for:

If your child is sick, keep them home from school if possible. Remind them to cover their mouth when they cough or sneeze, and to use tissues. Unless your child has a very high fever or trouble breathing, they do not need to go to the emergency room for the flu.

Unsure what to do? Call the 24-hour Nurse Advice Line at 1-866-799-5321 (TTY 1-800-955-8770). A nurse can help you decide what care your child needs. Or, you can try a telehealth visit anytime, anywhere.

Need help finding out where to get a flu shot? Ask your child’s Care Manager or call Member Services at 1-866-799-5321 (TTY 1-800-955-8770).

Sources

We know that caring for a child with special medical needs can be hard. Sometimes you need support, too. CMS Health Plan is here to help. 

Caregiver-focused benefits

• Therapy for Caregivers*: Individual or group therapy for caregivers of CMS Health Plan members who are not on Medicaid themselves.
• Health and Wellness Coaching: Health and wellness coaching to provide education and guidance to caregivers on healthy choices.
• Financial Counseling: Counseling to help you better understand and manage your finances.
• Nutritional Counseling: Assessment of your child’s nutrition needs with education and guidance to caregivers about healthy eating.
• Benefit Counseling: Counseling to help you better understand your child’s benefits.
• Respite Care*: Temporary rest from caregiving. Up to 200 hours of in-home care and 10 days of out-of-home care.

*Benefit requires prior authorization from CMS Health Plan. Contact your child’s Care Manager for details.

Other ways to get help:

• Search for free and reduced-cost services near you with Sunshine Health Connects
• Call the Community Connections Help Line at 1-866-775-2192

The days are getting shorter, the weather is getting colder and the holidays are here. It’s easy to fall into a routine of staying bundled up inside instead of getting out to exercise. Here are some ways to keep your family active this season:

• Walk the walk. Take your child on a nature walk and enjoy the views.
• Find a buddy. Pair up with a friend or family member for weekly exercise – and bring the kids!
• Get organized. Winter is a great time to get to those tasks you’ve been putting off. Maybe it’s time for a deep clean?
• Workout online. There are plenty of free online workout classes, like Jazzercise or yoga. Search for something you and your child can do together.
• Volunteer. Lend a hand to your community with a beach or park cleanup. The cooler weather will make it a breeze!
• Indoor activities. Bowling, yoga, skating and indoor rock climbing are great options for staying active while staying inside.

Your body and mental health will thank you for staying active this season. You will strengthen bones and muscles, lower blood pressure and sleep better. Exercise also boosts your immunity during cold and flu season. Even a few minutes of activity each day can go a long way. Just don’t forget to stay hydrated!

Source

Germs spread like wildfire in waiting rooms. Sniffles, coughs and fevers are all around, especially this time of year. If your child does get sick, consider telehealth. You can get the care they need fast, over the phone or computer – and without leaving home. All you need is a smartphone, tablet or computer.

CMS Health Plan covers telehealth appointments, so they are free to you. Your child’s primary care doctor may offer telehealth appointments. Call their office to ask. If you can’t get an appointment with them or their office is closed, try these telehealth providers:

KidzDocNow

On-demand video visits with pediatric doctors. Available 24/7, every day of the year. No appointment necessary. KidzDocNow doctors can help with:

• Common injuries and illnesses
• Prescription refills
• Referral to in-person or specialty care

Visit KidzDocNow or download the KidzDocNow mobile app to learn more.

Teladoc

Doctor visits over phone or video for nonemergency health issues. Available 24 hours a day. Teladoc can help with:

• Common injuries and illnesses
• Skin conditions, allergies and more

Visit Teladoc or call 1-800-835-2362 to sign up.

Brave Health

Virtual mental and behavioral health care for CMS Health Plan members 13 and older. Includes therapy, psychiatry and medication management services. Brave Health offers:

• Therapy (one-on-one or group)
• Psychiatry
• Customized mental health treatment plans
• Support groups and specialty programs
• Connection to community supports
• Collaboration with your child’s doctors
• Help setting up your device for telehealth visits
• Medication management

Text or call Brave Health at 1-305-902-6347, Monday through Friday, 8 a.m. to 6 p.m. Eastern. You can also email start@bebravehealth.com or visit the Brave Health website to get started.

This time of year is supposed to be joyful. But for many of us, anxiety can take over. To help you cope with added stresses this time of year, try these five tips: 

1. Whip up some joy. Creative tasks like cooking or baking can help improve your mood. Try a new recipe, or even an old one with a seasonal twist. Simply add some vanilla extract to cinnamon tea, or add dried cranberries and toasted walnuts to coleslaw, for example.
2. Greener gift wrap. Get creative wrapping presents by reusing leftover materials. It’s cheaper than buying wrapping paper, plus better for the environment. Use newspaper, brown paper grocery bags, old maps or leftover fabric.
3. Lend a hand. When you volunteer, it can lower your stress and help you feel a sense of purpose. You may even meet others with similar interests. Giving back your time and talents can help you spread some joy this season and feel good about yourself.
4. Take a break. It’s a busy season, so be sure to schedule some time for yourself. Curl up with a book, listen to music or go for a solo nature walk. Exercise, nature and music have all been shown to lower anxiety.  
5. Make it homemade. You don’t have to spend a lot of money for the holidays to be special. Some of the most meaningful gifts are handmade. Try painting a mug or picture frame, making a homemade sugar scrub or creating your own fridge magnets.

It’s normal to feel lonely sometimes. If your child is feeling lonely this holiday season, it may help them to talk to someone about their feelings and troubles. HAPPY, a national emotional support program, is a great option. It is available to CMS Health Plan members 18 and older.

HAPPY connects members with people called Support Givers, who are there 24/7 to listen and offer compassion and encouragement. All you have to do is download the free HAPPY mobile app on your smartphone or tablet. You can also call HAPPY at 1-855-953-4567 to get help for your child right away.

Lead is all around us – in paint, old furniture, even some children’s toys. Exposure to it can cause long-term health issues for children, like learning problems, hearing loss and speech delays. Here are two ways to protect your child:

1. All children should be tested for lead poisoning by the time they turn 2 years old. A simple blood test is the only way to detect it because other signs don’t show up right away.
2. Keep an eye out for lead in day-to-day life. It can be found in many places, including:
   • Paint used in buildings and homes built before 1978
   • Soil
   • Drinking water
   • Cookware, like pots and pans
   • Painted toys
   • Costume jewelry
   • Imported candy

Get rewarded: CMS Health Plan members earn $20 for a lead screening by age 2 years old. Learn more.

Source

A simple blood test, called the hemoglobin A1c or HbA1c test, is the best way to tell how your child is managing their diabetes. It measures their average blood sugar (glucose) levels over the last three months.

Why does my child need an A1c? This is the only way your child’s doctor can tell how your child is doing with their diabetes. It will help the doctor decide how much insulin your child needs. It will also help them know what your child should eat and how much they should exercise.

How does my child get an A1c test? Your child can get a fingerstick at their doctor’s office. The doctor also may ask you to take your child to a lab for the test if other lab work is needed.

What is a healthy A1c? Doctors recommend an A1c of 7% or lower for children and teens with diabetes. But every child is different. Work with your child’s doctor to set the right A1c target for them.

Why does A1c matter? Keeping your child’s A1c in check will help prevent them from having low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia). It will also reduce their risk for other health issues and complications later in life.

How can my child lower their A1c? Ask your child’s doctor for advice. They can give you tips on your child’s diet, exercise and medications to keep their A1c in the right range.

Remember: Diabetes increases the risk of vision problems. It’s important that your child has diabetic retinopathy screenings at least once a year. Call their doctor if you have questions.

Get rewarded: CMS Health Plan members 13-20 years old can earn $20 a year for completing both an HbA1c test and a retinopathy screening.

Source

If your child has a complex or life-threatening condition, there may be special help available. It’s through a CMS Health Plan program called Partners in Care: Together for Kids, or PIC: TFK.

Only kids enrolled in CMS Health Plan have access to this unique program. It helps children and families get special care focused on giving them the best quality of life possible. To qualify, your child must be a CMS Health Plan member, be diagnosed with a serious condition and live in an area where there is a PIC: TFK provider.

If your child is enrolled into the PIC: TFK program, CMS Health Plan will work with their PIC: TFK provider to give your child and family support to meet physical, emotional and spiritual needs.

Here are some of the services available:

Do you think your child would benefit from the PIC: TFK program? Talk to your child’s CMS Health Plan Care Manager or their doctor.

A new diagnosis is a lot to take in. There can be a lot to learn about how to help your child. Check out the CMS Health Plan diagnosis guides for help.

They give you information on symptoms, treatments, caregiving tips, benefits and more so you can support your child’s health.

If there isn’t a guide for your child’s diagnosis, there are other ways to find support or get answers to your questions:

• Contact your child’s Care Manager
• Call Member Services at 1-866-799-5321 (TTY 1-800-955-8770), Monday through Friday, 8 a.m. to 8 p.m. Eastern. If you need help outside those hours, call the same number and follow prompts for:
  • 24/7 Nurse Advice Line
  • 24/7 Behavioral Health Crisis Line
• Visit Sunshine Health Connects

Is your child pregnant? CMS Health Plan has resources for members who are expecting. Start Smart for Your Baby provides customized support during pregnancy and through their baby’s first year of life.

These services are provided by an experienced and licensed medical staff who will work with you, your child and your child’s doctors to create a safe birth plan.

Start Smart for Your Baby provides:

• Information about pregnancy
• Support with prenatal care
• Education on newborn care
• Breastfeeding support and resources
• Help access housing, food, clothing and other supplies
• Text and emails with health tips for your child and their newborn

CMS Health Plan members ages 13-20 who are pregnant also qualify for free doula services. A doula is a nonmedical professional who can give your child emotional and physical support during pregnancy and childbirth.

Visit Pregnancy and Newborn Services to learn more. Contact your child’s Care Manager with questions.

Animals can do amazing things for us when we feel down or confused. If your child is having trouble with their mental health or needs help coping with their health condition, pet therapy may be an option.

Pet therapy is guided interaction between your child and a trained animal, with the help of the animal’s handler. The benefit is free to CMS Health Plan members.

All you need is a recommendation from your child’s doctor and prior authorization from CMS Health Plan.

Questions? Contact your child’s Care Manager to learn more about pet therapy and other specialized benefits available to your child.