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Chronic Condition Management

It’s important to take care of chronic conditions like heart disease and diabetes. Your doctor can help you prevent or delay complications from these common conditions. Your CarePlus plan covers certain tests and benefits designed for chronic condition care. Select the name of each condition to see covered test and benefits. Ask your primary care physician if these activities are right for you.1

Diabetes

  • Controlling your blood sugar level is key to managing diabetes. You should also watch for high blood pressure, high cholesterol, eye diseases, and kidney issues. Ways to help control, prevent, and overcome diabetes and related complications may include:3

Self-Test

  • Measure and track your blood sugar and glucose level on your own.

    CarePlus covers and makes available diabetic monitoring supplies (e.g., lancets, blood glucose strips, glucometers, etc.) through your plan’s retail network pharmacies, via your plan’s preferred mail-order pharmacy, or through other pharmacies in our network. Authorization rules may apply. Refer to your Evidence of Coverage for more information.

A1C Test

  • Measures your average blood glucose level over previous three-month period.
  • Performed at doctor’s office to help determine if your diabetes care plan is working or needs an adjustment.
  • Complete an A1C test at least once per year with your physician.

Diet and Exercise

Blood Pressure Test

  • People with diabetes are at greater risk of developing high blood pressure. As many as two in three people with diabetes report that they have high blood pressure.1
  • People with diabetes and high blood pressure have an increased risk for many heart and circulation problems, including stroke and heart failure.1
  • Your primary care physician should check your blood pressure every time you visit. You may also check your blood pressure at home on a regular basis.

Cholesterol Screening

  • Cholesterol comes in two forms: Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL).
  • LDL is considered “bad” cholesterol. It can build up in your arteries and may increase your risk for heart attack.
  • Your physician can advise you about your target cholesterol goal.
  • Diabetes is a known risk factor for heart disease. Your physician should check your cholesterol at least once per year.

Medication Adherence

  • Medication can play an important role in managing diabetes and potentially in preventing certain complications.
  • A medication regimen is successful only if you follow your physician’s instructions.

Dilated Retinal Eye Exam

  • People with diabetes have an increased risk of developing several eye conditions, including cataracts, glaucoma, and diabetic retinopathy, which can result in vision loss.
  • Your physician should conduct a dilated retinal eye exam at least once per year.

Kidney Disease (Nephropathy) Screening

  • High blood sugar levels can damage kidneys and cause nephropathy. Nephropathy means kidneys can’t properly filter waste and extra fluids from blood.
  • Keep your blood sugar levels and blood pressure under control to lower the chance of getting kidney disease.4
  • Your doctor should check your kidneys at least once per year.5

22Diabetes Complications: Diabetes and High Blood Pressure. (2022). Retrieved 26, 2022, from American Diabetes Association, https://diabetes.org/diabetes/high-blood-pressure (link opens in new window)

Almost 50 percent of American adults suffer from high blood pressure. It can be difficult to detect because it has no obvious symptoms. Undetected high blood pressure can adversely affect your health and injure vital organs like your heart, brain, and kidneys. You and your doctor should check your blood pressure regularly.2

Blood Pressure Category Systolic Mm Hg (Upper Number) Diastolic Mm Hg (Lower Number)
Normal Less than 120 And Less than 80
Elevated 120-129 And Less than 80
High Blood Pressure (Hypertension): Stage 1 130-139 Or 80-89
High Blood Pressure (Hypertension): Stage 2 140 or Higher Or 90 or Higher
Hypertensive Crisis: CONSULT YOUR PHYSICIAN IMMEDIATELY 180 or Higher And/Or 120 or Higher

Cholesterol is a waxy substance that your liver produces. It is also found in many foods. Cholesterol plays an important part in keeping your body working, but having too much (or high) cholesterol is bad.6

Cholesterol 101

  • Having high cholesterol can clog your blood vessels and increase your risk for heart disease, heart attack, and stroke.
  • Many people don’t know they have high cholesterol.
  • The only way to know if your cholesterol is high is to ask your physician to check your cholesterol.

The Three Parts of Cholesterol

  • LDL Cholesterol – Often called “bad” cholesterol1, LDL cholesterol can cause clots in your blood vessels.
  • HDL Cholesterol – Often called “good” cholesterol, HDL cholesterol helps keep your blood vessels clean by returning cholesterol to your liver for removal from the body.2
  • Triglycerides – Another type of fat made by your liver, triglycerides are found in food you eat.

Controlling Cholesterol

  • High cholesterol is caused by a number of factors. You can’t control all of these factors, but you can control your lifestyle and habits.3

What You CAN Control: What You CANNOT Control:
Avoid eating foods high in fat, like pre-packaged baked goods and processed meat (e.g., hot dogs, sausage, bologna, etc.). Family history – Genetics plays a large role in your health.
Eat healthy food, like fruit, vegetables, whole grains, and food high in fiber. Age – As a person ages, LDL cholesterol levels tend to rise.
Exercise regularly – the American Heart Association recommends between 30 and 45 minutes of moderate-intensity activity at least three times every week.

Cholesterol Goals

  • Lowering your LDL “bad” cholesterol has been proven to lower your risk for heart disease and stroke.1
  • Your physician can advise you on your target cholesterol goals.

Cholesterol Medication

  • Taking statins may help lower LDL “bad” cholesterol and increase HDL “good” cholesterol.
  • Your physician may want you to take the statin (a pill) once a day, usually at night before bedtime. Always follow your physician’s instructions.
  • If you miss a dose of medicine, take it as soon as you remember. DO NOT take two doses within 12 hours of each other.
  • Wait at least 2 hours after taking your statin to take an antacid or multivitamin, if you take them.
  • Before starting any new medication, make sure your doctor has a list of all other medications, vitamins, and herbal supplements you take.
  • Side effects of taking a statin may include muscle pain, tenderness, or weakness (known as myopathy). If you experience any side effects, your physician may be able to switch you to a statin with a lower risk of side effects.
  • Your risk for side effects may increase if you:
    • Take medication that interacts with your statin
    • Are of advanced age
    • Have kidney problems
    • Have low thyroid levels that are not controlled
  • Contact your doctor if:
    • You experience muscle pain, tenderness, or weakness that comes on suddenly or gets increasingly worse.
    • You are more tired than usual, especially if you have a fever.
    • Your doctor told you to stop taking your statin and you continue to experience muscle problems.

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