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Your Journey to Wellness

At Health First Health Plans, we believe in a population health approach. In this approach, we assess our membership for opportunities and develop programs, services, and resources. We do this to improve the health and quality of life of our members. We want to partner with you to:

  • Help keep you healthy
  • Assist in managing new and existing health conditions
  • Assist with safe transitions across care settings
  • Help you manage chronic illnesses

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The seasonal flu vaccine is the best way to help protect you against flu and keep your loved ones safe. Vaccines are available August - March. Flu vaccines can be obtained from a participating pharmacy, urgent care, or provider office. For additional questions or to see if the flu vaccine right for you please contact your provider.

Members receive a Personalized Health Report twice a year based on age and recommended screenings to help you keep track of which recommended screenings have been completed and which ones are still needed each calendar year. The Personalized Health Reports also has a removable section which can be brought to office visits to help members keep information current, track completed services and upcoming appointments. A Pediatric scorecard of Pediatric and Adolescent Wellness Recommendations is mailed based on age ranges to assist parents with informing them about the recommended appointments and vaccinations for their child as well as providing them a method to track appointments and vaccinations dates. The guidelines in this tool were developed using guidelines based on data from the Centers for Disease Control and Prevention and the American Academy of Pediatrics.

Medicare

Group/Individual

Pediatric

Medicare members are eligible to receive a Comprehensive Health Assessment (CHA) once a year. The CHA is a 60-minute visit, in office or home, from a clinician with the goal of updating medical history, providing information to the primary care physician, and care coordination. Upon completing your Comprehensive Health Assessment, member can earn a $50 reward.

For further assistance scheduling your appointment contact us by calling 321.434.6712 (TTY/TDD relay: 1.800.955.8771)

We offer no-cost fitness membership to our members through a program called Silver&Fit to promote a healthy lifestyle through a variety of exercise options. The Silver&Fit Exercise & Healthy Aging Program provides members access to a broad network of participating fitness centers and YMCAs. Home Fitness programs are also offered through Silver&Fit where members are given a choice of up to two home fitness kits per benefit year. In addition, all enrolled Silver&Fit members may view Healthy Aging materials online or request that they be mailed.

This program is available to eligible Medicare members. To register visit SilverandFit.com or call 1-877-427-4788(TTY/TDD: 1-877-710-2746)

Members are eligible to receive an annual physical which serves as an opportunity to discuss personal health and medications, review family history, and address any other health concerns. An annual physical also provides an opportunity to assess preventative health indicators such as vaccines, colonoscopies, and eye exams. Early signs of health concerns can be detected and addressed to help prevent them from becoming worse.

Our Chronic Kidney Disease (CKD) program seeks to slow the progression of CDK to End Stage Renal Disease (ESRD) or prevent it all together. This program is available to eligible Medicare & Commercial members with stages 3 and 4 Chronic Kidney Disease (CKD). Eligible members will be contacted bya Health Plan nurse who will work to ensure care is coordinated between your primary care provider, Nephrologist, and other specialists as indicated. An individualized plan of care will be developed in addition to providing members with resources and education on medications, nutrition, lifestyle changes and behavior modifications.

Our Condition Management program is offered to eligible members with chronic conditions such as Diabetes or Heart Failure. Members will receive ongoing collaboration with our care team to help ensure the most appropriate goal-oriented treatment plan, tools, and resources are in place to successfully manage their condition. These include education, self-monitoring techniques, support coordinating health care needs, and identifying community resources. The goal is to help members with these chronic conditions recognize danger signs early and improve their quality of life through self-management skills to help promote wellness and health.

Health Plan Pharmacists work with eligible members and providers to conduct outreach calls and education on the benefits of Statins (cholesterol medicine) to reduce the risk of a heart attack or stroke. This program aims to identify diabetic members that were not prescribed a Stain to help ensure the most effective cholesterol-lowering drugs are being prescribed.

Statin Use in Persons with Cardiovascular Disease identifies members with heart disease to help ensure they get the most effective drugs to treat high cholesterol and lower their risk of developing heart disease. Health Plan Pharmacists complete outreach calls to members who have been prescribed a Statin. The pharmacist's goal is to provide members with education and assistance help to resolve any barriers with getting prescriptions filled.

Medical Nutrition Therapy is a program that helps members choose the right foods to eat for specific health conditions with a focus on members who are overweight, underweight or have: diabetes, severe kidney disease, high blood pressure, congestive heart failure or high cholesterol. The program includes an appointment with a registered dietician, an initial nutrition and lifestyle assessment, nutrition counseling, diet management and follow up sessions to monitor progress. This program is available to eligible Medicare & Commercial members through a provider referral.

Prescription medications can be lifesaving when taken properly but can also cause problems if not taken as prescribed or if taken with other medications. We provide professional counseling from a licensed pharmacist to help members follow doctor's orders and to ensure the medications you are prescribed can be taken together safely. This program is available to eligible Medicare Members with multiple health conditions who also take multiple medications.

During the call, the pharmacist is also available to help answer any questions as well as offer helpful guidelines about current medications such as:

  • Side effects or other drug-related problems- Information on over-the-counter drugs and how they could interact with prescriptions.
  • For further assistance scheduling an appointment contact us by calling 321.434.6712(TTY/TDD relay: 1.800.955.8771)

Health First Heath Plans contracts with Health First Private Duty to offer Medicare members a 1-hour in-home safety assessment after being discharged from a hospital stay. This service is available once per calendar year. During the visit, a Registered Nurse performs a safety assessment that includes, but is not limited to: reviewing for risk factors associated with falls, a home safety check to identify and remove potential harmful items in the home that may lead to a fall, and assess the need for home modifications including the need for in-home safety devices as appropriate. A comprehensive plan of care is created with the member to help prevent falls.

Our Transitions of Care team is made up of nurses who provide personalized assistance to members who are discharged from a hospital or Skilled Nursing Facility (SNF) to a self-care setting such as home or an Assisted Living Facility. The goal of this service is to ensure our members have safe transition home. A safe transition to home will help ensure our members have the best possible clinical outcome as well as prevent a readmission to the hospital and any unnecessary emergency room visits. Our case managers work with members to ensure they receive medication as prescribed and understand how to take themafter being discharged. They will also make sure follow up appointments have been scheduled, and ensure other treatments or services ordered at discharge are being received and understood.

Our program is focused on engaging with and assisting pregnant mothers who have been identified as high risk. Services will continue should the infant need NICU or specialized care for any condition identified at birth. Clinicians support parents during pregnancy, provide resources, support group information, guidance with clinical questions and assistance navigating the healthcare system. This program is available to eligible Medicare and Commercial members who areat risk for having premature births or low birth weight infants based on various risk factors.

This outreach service is focused on engaging with new mothers after delivery to address any concerns during the immediate postpartum period, identify any potential signs of postpartum depression and assist in getting timely treatment as needed. Our team helps to ensure postpartum follow up and pediatric care is set up and completed. This service is available to eligible Medicare and commercial members. If you have recently delivered and are interested in being contacted by a nurse, please contact our Customer Service Department.

A dedicated multidisciplinary team that works to improve the wellness and health of enrollees by providing proactive and coordinated care. This program complements the care a member currently receives from a primary care physician (PCP) and offers short-term, high-intensity services for patients who have more needs, require more time or need to be seen prior to a PCP available access. The ICP team works to stabilize a member's chronic conditions which will reduce the need for urgent care visits or other emergency services and better position a member to be successful in managing their health. This program is available to eligible Medicare & Commercial Members. For specific eligibility requirements or to see if you qualify please call us at 321.434.4113/ toll-free 877.228.0861(TTY/TDD relay: 1.800.955.8771)

Complex Case Management is a service for members with serious or complex health needs who may need extra help navigating the healthcare system, learning about their condition, or accessing community support. Our team is led by a skilled nurse Case Manager and works one-on-one with members to assess needs and supplement the services of healthcare providers with the goal of helping members achieve optimal health. This program is available to eligible Medicare & Commercial members who have been identified as having 2 or more chronic conditions with unmanaged healthcare needs.

Acute and Catastrophic Transitions is a highly specialized team of Nurse Case Managers that are available to assist eligible members in the most stressful times when facing difficult medical conditions such as certain cancers, transplant services, traumatic neurological injury, or complex pediatric condition(s). Case Managers provide support, education, guidance, and assistance navigating the healthcare system to help you get the appropriate care, tests, or treatments needed. The goal is to help members improve their quality of life though education and self-management skills.

Nurse Case Managers conduct outreach calls to members with multiple chronic conditions who are identified as having unmet care needs following an Emergency Department visit. Our goal is to help ensure members have access to a Primary Care Provider (PCP), receive education on the importance of regular provider visits to help manage chronic conditions, understand and follow the discharge plan provided, and get the additional support or resources needed to help manage their condition.

We partner with Magellan Healthcare to provide a member-focused behavioral health program to our members that focuses on early intervention and prevention services to positively impact overall well-being. Magellan Healthcare also offers Welcome-home calls, online tools, and resources, integrated medical and behavioral care and ongoing support to ensure a successful recovery. Magellan's clinical staff works together with primary care providers in coordinating prevention interventions, care plans, community support and resources for members. Magellan is available anytime, day or night for members. This program is available to eligible Medicare & Commercial members.

Magellan Healthcare # 800.424.4347 (TTY:800.424.1694)

As we develop, it becomes important to properly manage health conditions. These tools categorize symptoms into three zones, much like a traffic light. Additionally, the logs can be printed out and tracked at home. Such resources may help you continue to focus on improving your overall wellness and health at home.

Health First Health Plans is an HMO plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract renewal. For accommodations of persons with special needs at meetings call 1.800.716.7737 or TTY/TTD relay 1.800.955.8771.


Y0089_EL7846_M | Accepted date: 10/5/2019

Last updated: 04/13/2021