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Healthy Behaviors Programs

Good health is important to all of us. We want you to be in the best health and we will encourage you to reach your goals. There are several different Healthy Behaviors programs. Let’s get started on choosing the right program(s) for you.

Get rewarded for reaching your health goals

You can earn rewards by completing a program below. You may complete more than one program if you qualify. As part of your participation in the below three Healthy Behaviors programs, you will be enrolled in case management and will be assigned a Care Manager. These three Healthy Behaviors programs do not have an expiration date for services, and there is no deadline for returning your completion form.

  • Weight loss. This program requires a primary care provider (PCP) signature on the form.
  • Smoking cessation.
  • Alcohol and substance use recovery.

In addition to the above three programs, we are pleased to support additional Healthy Behaviors programs below. For the following programs, you will need to fill out and return a completion form to be considered. These programs have a completion form return deadline of January 31, 2021. The last day for completing services is December 31, 2020, which is also when these programs expire.

There are many different programs available. Learn more below.

Well-child visits (for members who have turned 15 months old during 2020)

If your child completes six or more well-child visits from 31 days to 15 months old, you can receive up to $50 in gift cards. The visits must be on or before December 31, 2020 and your child must turn 15 months old during the year from January 1 to December 31, 2020.

Well-child visits (ages 3 to 6 years)

If your child completes at least one well-child visit and is 3 to 6 years old in 2020, you can receive up to $20 in gift cards. Members will receive a $20 reward for having a well-child visit on or between January 1 and June 30, 2020, or a $10 reward for having a well-child visit on or between July 1 and December 31, 2020.

Adolescent well-care visits (ages 12 to 21)

If your child completes at least one well-care visit and is 12 to 21 years old in 2020, you can receive up to $20 in gift cards. Members will receive a $20 reward for having a well-care visit on or between January 1 and June 30, 2020, or a $10 reward for having a well-care visit on or between July 1 and December 31, 2020.

Adult access to preventive or ambulatory services

If you are a member age 20 or older in 2020 and you complete at least one ambulatory (outpatient) or preventive care visit, you can receive up to $20 in gift cards. Members can earn a $20 reward for having a care visit on or between January 1 and June 30, 2020, or a $10 reward for having a care visit on or between July 1 and December 31, 2020.

Behavioral health follow-up

Members who have a follow-up visit with a mental health care provider can earn a $20 gift card. Members must be age 6 or older in 2020. The follow-up visit must be within seven days of discharge from an acute behavioral/mental health inpatient setting. The visit must be on or between January 1 and December 31, 2020.

Breast cancer screening

Female members can earn a $10 gift card for completing one mammogram screening for breast cancer. The screening must be on or between January 1 and December 31, 2020. Members must be ages 50 to 74 in 2020.

Cervical cancer screening

Female members can earn a $10 gift card for completing one cervical cytology screening for cervical cancer. The screening must be on or between January 1 and December 31, 2020. Members must be ages 21 to 64 in 2020.

Diabetes eye exam

Members ages 18 to 75 who have diabetes can earn a $20 gift card for completing a retinal or dilated annual eye exam. The visit must be on or between January 1 and December 31, 2020.

Diabetes testing

Members ages 18 to 75 who have diabetes can earn a $30 gift card for completing both of the following tests:

  • Hemoglobin (HbA1c) blood test.
  • Microalbumin urine test (kidney disease screening).

The tests must be on or between January 1 and December 31, 2020.

Lead screening

If your child completes one or more capillary or venous lead blood tests for lead poisoning in 2020, you will receive a $10 gift card. Your child must have turned 2 years old on or between January 1 and December 31, 2020, to qualify.

Maternity

Pregnant members who complete prenatal visits and a postpartum visit can earn a $50 gift card. The member must complete 10 out of 13 prenatal visits. The postpartum visit must be 21 to 42 days after the member gives birth. Members must have delivered a child on or between November 6, 2019, and November 5, 2020, to qualify.

Postpartum

Pregnant members who complete a postpartum visit will get a $20 gift card. The postpartum visit must be 21 to 42 days after the member gives birth. (Not available for members who complete the Maternity reward program.) Members must have delivered a child on or between November 6, 2019, and November 5, 2020, to qualify.


How to join a Healthy Behaviors program

STEP 1. Bring a Healthy Behaviors Completion Form (PDF) to your next PCP or treating provider visit. Your provider can show you the programs for which you qualify.

STEP 2. Once the completed form is signed by you and your provider (if required), return the form to us. The form can be faxed to the Quality department at 1-855-358-5854. You can also mail the signed Completion Form in the prepaid envelope provided with this letter to:

Prestige Health Choice
P.O. Box 7181
London, KY 40742

Please note any program deadlines for services and form returns.

STEP 3. After we receive the completed form, a Care Manager may reach out to you. The Care Manager will discuss the program(s) you have selected in more detail. You will complete the program according to defined milestones or required services. The Care Manager will call your PCP to confirm you kept all of your appointments, or we will check claims for services.

STEP 4. Once your participation or claims have been verified, you will receive a gift card in the mail. If the services cannot be verified, you must provide documentation to show you completed each milestone or requirement.


Contact us to learn more

We are here to help. If you would like to learn more or join a Healthy Behaviors program, call Member Services toll-free at 1-855-355-9800 (TTY 1-855-358-5856). Rewards for members who are under age 18 will be mailed to the member’s parent/guardian. Member rewards cannot be used for certain products. These include alcohol, tobacco, gambling (including lottery), drugs (except over-the-counter drugs), firearms, or ammunition purchases. Incentives and rewards are non-transferable.