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Your Health & Wellness Resources

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The State Health Plan is committed to helping you reach your best health. All of the resources offered are provided as part of your State Health Plan benefit and are free or provided at a low cost to you as a State Health Plan member. ​

Check out the following health and wellness resources available to State Health Plan members by clicking the boxes below!

Your Health and Wellness Resources

Disease and Case Management

Disease and Case Management

Pursuing its goal to reduce costs and build value, the State Health Plan is streamlining its population health management services. The Plan is eliminating those services already provided by other vendors (such as health coaches). As a result, from September 30 to December  31, 2018, the Plan will not be offering the following services for eligible members:

Disease and Case Management services for those with chronic obstructive pulmonary disease (COPD), congestive heart failure, coronary artery disease, diabetes, asthma, cerebrovascular disease and peripheral artery disease. 

The Personal Health Portal will also be unavailable beginning October 1, 2018.

The Plan is working with Blue Cross NC, its third party administrator, to offer services to eligible members beginning January 1, 2019.

The Plan encourages members to work with their health care provider and community resources during this short time period.

 

 

Nutrition and Weight Management

Nutrition and Weight Management

80/20 Plan Members:

Adult and child (age 6+) nutrition and weight management services are included under the Affordable Care Act’s preventive services, meaning that they are covered at 100% for 80/20 Plan members. These services can be delivered in an in-network* office, urgent care, or outpatient facility settings and include:

  • Nutritional Counseling, which may include counseling specific to achieving or maintaining a healthy weight
  • Obesity Screening
  • Behavioral Intervention

70/30 Plan Members:

In-network* nutritional counseling visits for members with diabetes are covered at 100% for the first 6 visits. After the 6th visit, members will pay 30% after the deductible has been met.

In-network* nutritional counseling visits related to any other condition are limited to a combined in- and out-of-network maximum of 4 visits per benefit period for a $40 copayment per visit.

*For out-of-network costs associated with these services, please see your plan’s Benefit Booklet.
 
To find an in-network dietitian, use our Find a Doctor tool and search under "Specialist" for a licensed dietitian/nutritionist.

FDA-approved weight management medications and bariatric surgery are covered benefits. Refer to your plan’s Benefit Booklet and the Preferred Drug List for additional information and restrictions.

Members eligible for services are members whose primary health coverage is through the State Health Plan. Federal law prohibits the Plan from using your personal health information to discriminate against you in any way or from giving this information to your employing agency/school or other unauthorized third party, unless required by law.

Mental Health Resources

Mental Health Resources

Plan benefits cover mental health and chemical dependency treatment, including office visits for a Primary Care Provider copay.

For information and details regarding mental health, behavioral health, and substance use disorder benefits and services, please refer to your plan’s Benefits Booklet below:

70/30 Plan Benefits Booklet
80/20 Plan Benefits Booklet

As part of your benefit you also have access to several online resources that include information on managing stress, anxiety, depression, drug misuse, or a substance use disorder. Visit Beacon Health Options, the Plan’s mental health case manager’s website, or call 800-367-6143.

Members eligible for services are members whose primary health coverage is through the State Health Plan. Federal law prohibits the Plan from using your personal health information to discriminate against you in any way or from giving this information to your employing agency/school or other unauthorized third party, unless required by law.

Maternity Resources

Maternity Resources

Pregnancy Diagnosis and Maternity Visits
You can expect to pay an initial copay or coinsurance cost for your first pregnancy visit (diagnostic visit), or first visit, however, visits thereafter will be covered at no charge. Your remaining maternity visits are covered by one global fee subject to the inpatient copay, deductible, and coinsurance upon hospital admission/delivery.

Adding Newborns to Your Health Plan
You must take action to add your newborn to your health plan.  Your newborn must be added to your health plan within 30 days of their date of birth.

Remember, if you currently have employee-only or employee-spouse coverage, your coverage will change when you add your newborn to either employee-child or employee-family coverage. As a result, you will have to pay the additional premium for the month in which the child is born.

For more information, please see the Adding Dependents section of your plan’s Benefits Booklet, speak with your Health Benefits Representative or call the Eligbility and Enrollment Support Center at 855-859-0966.

Opportunity for Savings for 80/20 Plan Members:

If you deliver at a Blue Options Designated Hospital you will receive $450 (via check) as an incentive.

For more information regarding maternity benefits and Blue Options Designated Hospitals call Customer Service at 888-234-2416.

Members eligible for services are members whose primary health coverage is through the State Health Plan. Federal law prohibits the Plan from using your personal health information to discriminate against you in any way or from giving this information to your employing agency/school or other unauthorized third party, unless required by law.

Tobacco Cessation Resources

Tobacco Cessation Resources

As a State Health Plan member, you have access to a variety of tobacco cessation resources to help you quit smoking, chewing tobacco, using snuff, or even e-cigarettes (vaping).

  • All plans cover in-person counseling with your provider or behavioral therapist
  • $0 Prescription Medications (80/20 Plan only)
    • Nicotrol (nicotine inhalation system)
    • Nicotrol NC (nicotine nasal spray)
    • Generic bupropion sustained-release 150 mg
    • Chantix for members ≥ 18 years old
      • Chantix is limited to 6-month supply in a 12-month period

 

QuitlineNC offers support by phone and FREE nicotine replacement therapy when you talk to a Quit Coach® and enroll in the multi-call program.

QuitlineNC also offers:

  • FREE one-on-one support from a Quit Coach® by telephone
  • Coaching 24 hours a day, seven days a week
  • Quit Coaches that speak English and Spanish
  • Free nicotine replacement patches, available to members enrolled in the multi-call program.
  • Web coaching at www.QuitlineNC.com
  • Support via text messaging using Text2Quit™

Call 800-QUIT-NOW (800-784-8669). Available 24 hours/7 days a week.  

Visit QuitlineNC for more information.