ISSUE 3 / FALL 2023
Don’t Let Your Medicaid Benefits Expire. Keep Your Maryland Physicians Care Coverage.
Maryland Medicaid requires
you to renew your coverage.
Medicaid renewals will not be automatic this year. Check in 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 to renew your coverage.
Keep your coverage with MPC.
To keep your info current, here’s what to do:
- Watch for your Renewal Notice. A renewal notice will be sent to you by Maryland Health Connection. You will receive your notice by mail or online through your Maryland Health Connection account. This notice will tell you to complete your renewal.
- When you receive your notice from Maryland Health Connection, log into your account at MarylandHealthConnection.gov/Checkin or call 855-642-8572.
- Renew your coverage as soon as you receive your notice.
- If you have moved, log into your account at MarylandHealthConnection.gov/Checkin or call 855-642-8572 to update your contact information so that you will receive your notice when it is time to renew.
If you do not renew, you will lose your health benefits.
- Don’t wait.
- Don’t let your MPC Medicaid coverage expire.
- Complete your renewal when you receive it!
- Call Maryland Health Connection at 855-642-8572. Help is available in more than 200 languages, including deaf and hard of hearing.
- Call or visit your local Department of Social Services.
- Call or visit your local Health Department.
- Connect with a broker or navigator.
Are you having a baby?
You may get free health care if you are not a U.S. citizen.
House Bill 1080 (Healthy Babies Equity Act) requires the Maryland Department of Health (MDH) to provide comprehensive medical care and other health care services to non-citizen pregnant women who would qualify for Medicaid but for their immigration status and their children up to the age of 1 year.
As of July 1, 2023, non-citizen pregnant Marylanders who would otherwise be eligible for Medicaid but for their immigration status may now be eligible for coverage. Pregnant women who meet the other Medicaid enrollment requirements, except for citizenship, are now eligible for full Medicaid coverage. This includes those who are undocumented or are on visas that would otherwise not allow them to apply for Medicaid. For more information, please visit https://www.marylandphysicianscare.com/wp-content/uploads/2023/07/Healthy-Babies-Equity-Act-Flyer_English.pdf and https://www.marylandphysicianscare.com/members/health-and-wellness/pregnancy/ for additional information on pregnancy care.
Getting the care you need when you need it
MPC wants to ensure you receive the care you need timely. We offer a large network of primary care providers, specialists, labs, radiology centers, urgent care centers, hospitals, and other medical services. We also provide an app called MyVirtualMPC that connects you with local doctors 24 hours a day, seven days a week, to answer your health questions on your phone or computer.
Getting the care you need when you need it
MPC wants to ensure you receive the care you need timely. We offer a large network of primary care providers, specialists, labs, radiology centers, urgent care centers, hospitals, and other medical services. We also provide an app called MyVirtualMPC that connects you with local doctors 24 hours a day, seven days a week, to answer your health questions on your phone or computer.
If you have problems getting the care you need within these timeframes, please contact Customer Service at 1-800-953-8854. MPC has Customer Service Representatives, Case Managers, Special Needs Coordinators, and Outreach Staff available to help you.
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 is provided by Maryland Healthy Smiles Dental Program (MHSDP).
What Type of Emergency Is it?
Choosing the right place for care at the right time is important. When you can’t see your doctor, you may think your only option for help is a hospital emergency department. The hospital is the best place to go if you have a true medical emergency. But for less serious situations, you have other choices. You can use your MyVirtualMPC app or go to an urgent care center.
HERE ARE SOME HELPFUL TIPS:
- Emergent Care: If you require immediate medical attention to avoid serious impairment to your health, call 9-1-1 or go to the closest hospital emergency department. You can self-refer to any emergency department, and pre-authorization is not required.
- Urgent Care: If you have an illness or injury that could become an emergency within 48 hours if not treated, go to an in-network urgent care center. Pre-authorization is not required, but the center must participate with Maryland Physicians Care, or you may be billed.
- MyVirtualMPC: If you need non-emergency care and cannot see your PCP, you can use the free MyVirtualMPC mobile app for a quick video visit with a local doctor 24/7. Visit www.myvirtualmpc.com for information and to register or download the app from your smartphone’s app store.
If you have problems getting the care you need within these timeframes, please contact Customer Service at 1-800-953-8854. MPC has Customer Service Representatives, Case Managers, Special Needs Coordinators, and Outreach Staff available to help you.
Join Belong, the Membership Rewards Program from Maryland Physicians Care, for:
- A chance to win prizes, such as Fitbits, Blenders, Air Fryers, and Plush Blankets
- Valuable Coupons for Grocery Stores
- Free Gifts at MPC Well on Wheels Community Events
- Healthy Recipes
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!
Baked Fish Tacos with Avocado
Instead of deep-frying, the fish fillets in this quick-and-easy 5-ingredient recipe are coated with a flavorful seasoning blend and baked. Several varieties of flaky white fish can be used for these tacos. When you go to the market to purchase fish, the best strategy is to be flexible and choose the freshest variety that day.
Nutrition Information Per serving: Serving Size 2 tacos
(see full recipe for more information)
Prep time: 20 min / Additional time: 5 min / Servings: 4 / Yields 8 tacos
Overdose Awareness
August 31 was International Overdose Awareness Day. In 2022, over 107,000 people lost their lives to drug overdoses in the United States. Efforts to save lives from drug overdose are continuing to evolve. On this day and any day during the year:
- Let people in recovery know that they are valued.
- Tell people about the risks of a drug overdose.
- Share information on support services available.
Be a part of someone’s recovery by learning how to give naloxone or attend one of the many free events near you. Most Overdose Awareness Day events have fun activities for all ages, speakers who share their stories, and many local agencies sharing resource information.
If you or someone you know is ready for recovery, we want you to know that there are people in your community who want to help you on your road to recovery.
For information on connecting with addiction services, visit the CDC website Recovery Is Possible. Know that someone is always available to help you if you are distressed. You can:
- Dial the numbers 9-8-8 on your phone to get connected, or
- Contact Optum Maryland, Maryland’s behavioral health provider, at 1-800-888-1965.
With Virtual Doctor Visits, You Can Skip the Waiting Room!
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.
The Importance of Physical Activity
Time to get active! Exercise and physical activity can benefit long-term health in many ways. Along with burning calories to maintain a healthy weight, exercise can help prevent illnesses and recover from falls by strengthening your body.
Exercise has also been shown to:
- Lower your risk for heart disease, diabetes, and other long-term health problems.
- Make your lungs and muscles stronger.
- Help you sleep better.
- Reduce the risk of falling or recover better from a fall.
Talk with your doctor before starting a new exercise program. Add 30-60 minutes of exercise or physical activity to your routine at least one to two days a week. As you get used to a certain amount of exercise, consider doing more to continue strengthening your body.
You can do workouts anywhere – in your home, at the park, in a studio – you name it! Try these 5 Minute, Feel Good, Anytime, Anywhere Workouts for quick workouts designed to enrich your body and mood. https://www.marylandphysicianscare.com/members/well-being/
Utilization Management Overview
Utilization Management (UM) is a way to evaluate health care services for medical necessity. This includes outpatient and home care, pharmacy, and inpatient hospital services. Some health care services and medications may require Prior Authorization (PA). This is when your provider requests a service or a drug that requires us to approve it before you can get the services. Your provider is responsible for getting the PA and cannot bill you when they fail to do so.
Utilization Management decision making is based only on the appropriateness of the care and service provided. Maryland Physicians Care does not reward health care providers or other individuals for issuing denials of coverage or service. There are no financial incentives for UM decision-makers to encourage denials.
Staff can receive inbound communication regarding UM issues after normal business hours. Providers can fax requests to the applicable number or call 1-800-953-8854 and follow the Authorization/Concurrent Review prompts to leave a voice message. Communications received after normal business hours are returned the next business day. Communications after midnight Monday-Friday are returned the same business day.
For more information about Utilization Management, please call 1-800-953-8854, then follow the prompts. Staff is available at least eight (8) hours a day during normal business hours for inbound collect or toll-free calls regarding utilization management issues. Maryland Physicians Care TDD/TTY (Telecommunications Device for the Deaf/Teletypewriter) services are provided for members who need this service at 1-800-735-2258. Language assistance is also available, free of charge.
Benefits of Good Sleep
Healthy sleep habits are important because of how essential getting good sleep is for your mental and physical health and overall quality of life. Your behaviors during the day – not just before you go to bed – can affect how well you sleep. Your food and drink choices, schedule, evening routine, and many other activities all affect your sleep.
If you don’t sleep well, you can take several steps, both during the day and before you go to bed, to improve your sleep:
- Keep a consistent sleep schedule. Try to go to sleep and wake up at about the same time every day – even on weekends. This reinforces your body’s sleep cycle (your internal clock), making it easier to fall asleep and wake up every day.
- Create a relaxing bedtime routine – and stick with it. A relaxing bedtime routine helps you unwind, so you’re ready to sleep. And keeping a consistent routine allows your body to recognize that it’s bedtime when you start the routine. This may help you fall asleep more quickly. The best time to start your routine is about 30 to 60 minutes before you go to bed.
- Turn off electronic devices before you go to sleep. Electronic devices like your phone emit blue light, which can reduce the melatonin levels in your body. Melatonin is a chemical that controls your sleep/wake cycle. When melatonin levels dip, falling asleep can be more difficult. Devices that emit blue light can also distract you, keeping your brain alert. This may make it harder to fall asleep. You might think that not looking at your phone close to bedtime is enough, but keeping it near your bed can disrupt your sleep, even if you’re unaware of it. The message notifications, buzzing, and light that can suddenly pop on in the middle of the night can wake you up momentarily, leading to interrupted sleep.
- Limit your caffeine intake. The effects of caffeine can last 3 to 7 hours after you consume it. This means that your afternoon cup of coffee may keep you awake and alert longer than you’d like. Although it’s usually best to limit your caffeine intake to the morning hours, remember that everyone has a different tolerance to caffeine. Some people may be able to stretch their consumption to midafternoon, while others might need to cut themselves off much earlier to fall asleep easily. The less caffeine you consume, the more sensitive you may be to its effects.
Falls Prevention Awareness Week
Exercise has also been shown to help with:
- Decreasing arthritis pain
- Difficulty maintaining balance
- Improving reflexes
- Improving muscle strength and tone
Older adults may also take medications contributing to dizziness, confusion, or slower reflex responses. This includes medicines for high blood pressure, heart disease, and sleeping. Diuretics and muscle relaxants may also increase your risk of falling. You should not stop taking these medications without a doctor’s supervision.
Make lifestyle changes to prevent falls. Regular activities to improve balance and enhance muscle tone can help reduce fall risks. See the Importance of Physical Activity article for more information.
HELP PREVENT
FRAUD AND ABUSE
Maryland Physicians Care (MPC) needs your help to prevent fraud and abuse! Fraud and abuse are against the law. We encourage you to report anything suspicious, and you can report fraud and abuse without the fear of retaliation. MPC reports all suspected incidences of fraud and/or abuse to the Maryland Department of Health, Office of Inspector General for further investigation, which may result in criminal penalties.
Examples of fraud and abuse include:
- Someone using an ID card that does not belong to them
- Providers billing for services or supplies that were not provided
- Providers giving too many tests and services or unneeded tests and services
- Selling prescription medications or making changes to a written prescription
- Falsely reporting household income
- Not living in Maryland, but receiving Maryland Medicaid
To report fraud and abuse:
- CALL MPC’s Compliance Hotline at 1-866-781-6403 and leave a detailed message.
- GO ONLINE at https://www.marylandphysicianscare.com/fraud-abuse/ and complete the Fraud and Abuse Form.
- WRITE to the Compliance Officer at MPC: 1201 Winterson Road, 4th Floor, Linthicum Heights, MD 21090.
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 important 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 CAB 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.
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.
VISIT OUR WEBSITE
To Find Helpful Information on:
- Quality Improvement Program
- Case 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.
WHO TO CALL
