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<?xml-stylesheet type="text/xsl" href="https://connect.bcbsmt.com/cfs-file/__key/system/syndication/rss.xsl" media="screen"?><rss version="2.0" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:slash="http://purl.org/rss/1.0/modules/slash/" xmlns:wfw="http://wellformedweb.org/CommentAPI/"><channel><title /><link>https://connect.bcbsmt.com/</link><description>Connect With Us! Log in to our community to ask questions, rate articles, comment and more. Search articles and watch videos; ask questions and get answers. Topics include everything from improving your well-being to explaining health coverage.</description><dc:language>en-US</dc:language><generator>Telligent Community 12</generator><item><title>Blog Post: Immunize to Keep Your Kids Safe and Healthy</title><link>https://connect.bcbsmt.com/health-and-wellness/b/weblog/posts/no-need-to-overanalyze-just-immunize</link><pubDate>Thu, 23 Jul 2026 10:58:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:1f9d7a4e-6aab-46d8-b438-05b471466b4f</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>It’s hard to keep your children safe every minute of the day. Still, there’s one thing you can do that helps protect them 24/7. Make sure they get all the recommended childhood vaccines. What Shots Do Kids Need? From birth, babies and young children need certain shots to help them stay healthy as they grow. Older children — even busy preteens and teens — need vaccines from time-to-time. Your child&amp;#39;s doctor will remind you about them during an annual well-child visit . Why Are Vaccines So Important? When your children don’t get their needed shots, they have a greater risk for many diseases. They can also spread these diseases to their friends and family. Vaccines are a reliable way to prevent many diseases that were once deadly. They expose the body to a very small amount of weak or dead germs and viruses. The immune system then builds up the ability to fight these bugs in the future. Vaccines have slowed or stopped the spread of polio, measles, mumps and other diseases in the U.S. The Centers for Disease Control and Prevention has put together a quick-reference chart . It lets you know what shots your child needs and when. The safety of vaccines has at times been questioned. Some parents worry and refuse shots for their children. A common fear is an alleged link between autism and vaccines. Research has found no such link. In fact, the Centers for Disease Control and Prevention reports that vaccines do not cause autism. Measles Makes a Comeback One rare disease made a comeback due to a small number of parents who decided not to get their children vaccinated. It started when several children who visited an amusement park in 2014 came down with measles. That hadn’t happened in the U.S. in 15 years. Another outbreak related to air travel happened in 2019. And the trend has continued for the last several years. Each year has seen numerous outbreaks adding up to over 2,100 cases in 2025 and again in 2026. It’s estimated that 93% of the people who have gotten infected, particularly children, have not been vaccinated. While we are lucky that some diseases no longer exist in the U.S., they are often only a plane ride away. Polio is one example. It still affects some children in certain Middle-Eastern, African and Pacific Island countries. People who are infected with it can spread the disease for weeks — before and after symptoms appear. These examples highlight why the CDC says, “we could soon find ourselves battling epidemics of diseases we thought we had conquered decades ago.” Keeping Everyone Healthy When kids and adults get the recommended vaccines, they help protect whole communities. Along with preventing the spread of disease to friends and family, they help safeguard others, too. Very young babies, pregnant women, cancer patients, people with HIV and other conditions can all have vulnerable immune systems. If you have concerns or questions about vaccines, talk to your doctor or your child’s doctor. That way, you can make the best decision for the health of your family and your community. Sources: AAP Schedule of Well-Child Care Visits , American Academy of Pediatrics, 2026; Recommended Vaccines for Young Children , Centers for Disease Control and Prevention, 2025; Common Vaccine Safety Questions and Concerns , Centers for Disease Control and Prevention, 2024; Measles Cases and Outbreaks , Centers for Disease Control and Prevention, 2026; Global Polio Eradication Initiative , Polio Eradication.org, 2026</description><category domain="https://connect.bcbsmt.com/tags/Vaccines">Vaccines</category><category domain="https://connect.bcbsmt.com/tags/Health%2band%2bWellness">Health and Wellness</category><category domain="https://connect.bcbsmt.com/tags/Public%2bHealth">Public Health</category><category domain="https://connect.bcbsmt.com/tags/Children_1920_s%2bHealth">Children’s Health</category><category domain="https://connect.bcbsmt.com/tags/Caring%2bfor%2bBaby">Caring for Baby</category><category domain="https://connect.bcbsmt.com/tags/Immunizations">Immunizations</category></item><item><title>Blog Post: 5 motivos por los que puede rechazarse una reclamación</title><link>https://connect.bcbsmt.com/espanol/b/tucobertura/posts/motivos-rechazarse-reclamacion</link><pubDate>Thu, 16 Jul 2026 22:24:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:2263fd6b-ac36-4fee-8e93-a890e2a70179</guid><dc:creator>EquipoConnect</dc:creator><description>Aunque no lo creas, existen cinco motivos que pueden hacer que un servicio m&amp;#233;dico no sea aprobado o que una reclamaci&amp;#243;n no se pague. Estos se clasifican en estas cinco categor&amp;#237;as: La reclamaci&amp;#243;n tiene errores. El motivo de rechazo m&amp;#225;s com&amp;#250;n de una reclamaci&amp;#243;n son los peque&amp;#241;os errores en los datos. A veces, un prestador de servicios m&amp;#233;dicos puede: codificar la reclamaci&amp;#243;n de forma incorrecta; dejar informaci&amp;#243;n incompleta; escribir mal tu nombre; o tener la fecha de nacimiento incorrecta. La Explicaci&amp;#243;n de Beneficios (EOB, en ingl&amp;#233;s) te dar&amp;#225; pistas, as&amp;#237; que, rep&amp;#225;sala. Si encuentras un error, p&amp;#237;dele al prestador de servicios m&amp;#233;dicos que corrija la informaci&amp;#243;n y env&amp;#237;e de nuevo la reclamaci&amp;#243;n. Acudiste a un prestador de servicios m&amp;#233;dicos que no participa en la red de tu cobertura m&amp;#233;dica. Algunas coberturas solo cubren el costo de la atenci&amp;#243;n m&amp;#233;dica si acudes a profesionales y centros m&amp;#233;dicos que forman parte de la red de tu cobertura. Si recibes servicios fuera de la red, es posible que la cobertura no cubra ninguno de los costos. Otras coberturas quiz&amp;#225;s solo cubran algunos costos fuera de la red, y t&amp;#250; tendr&amp;#225;s que pagar la diferencia. Se requer&amp;#237;a la aprobaci&amp;#243;n con antelaci&amp;#243;n para los servicios m&amp;#233;dicos. Algunos procedimientos, como las tomograf&amp;#237;as computarizadas, las im&amp;#225;genes por resonancia magn&amp;#233;tica y ciertas cirug&amp;#237;as, normalmente, requieren autorizaci&amp;#243;n previa. Si una reclamaci&amp;#243;n no tiene cobertura porque alg&amp;#250;n servicio no se aprob&amp;#243; previamente, habla con el profesional m&amp;#233;dico que solicit&amp;#243; el procedimiento. Quiz&amp;#225;s pueda enviar los expedientes m&amp;#233;dicos que demuestren que necesitabas el servicio. Recibes servicios de atenci&amp;#243;n m&amp;#233;dica que no tienen cobertura. Es posible que tu cobertura m&amp;#233;dica no incluya ciertos servicios. Por ejemplo, la cobertura puede no cubrir una cirug&amp;#237;a de p&amp;#233;rdida de peso. En ese caso, la reclamaci&amp;#243;n no se somete a una revisi&amp;#243;n m&amp;#233;dica. Si la cobertura no cubre el costo del servicio m&amp;#233;dico, el procedimiento no ser&amp;#225; aprobado. Esto se denomina l&amp;#237;mite de cobertura o exclusi&amp;#243;n por contrato. Si perdiste la cobertura m&amp;#233;dica, es posible que la reclamaci&amp;#243;n no tenga cobertura. Esto puede ocurrir si no pagas las primas mensuales o si se agota el plazo de cobertura por medio de COBRA (la Ley &amp;#211;mnibus Consolidada de Reconciliaci&amp;#243;n Presupuestaria). La reclamaci&amp;#243;n tambi&amp;#233;n puede haberse rechazado por alg&amp;#250;n motivo m&amp;#233;dico. Los tipos de rechazos pueden incluir los siguientes motivos: Los servicios que no se consideran una necesidad m&amp;#233;dica. No se prest&amp;#243; el nivel adecuado de atenci&amp;#243;n seg&amp;#250;n el estado m&amp;#233;dico o enfermedad. No se demostr&amp;#243; que el tratamiento fuera efectivo o se consider&amp;#243; experimental para tu enfermedad. La reclamaci&amp;#243;n se envi&amp;#243; a la compa&amp;#241;&amp;#237;a de seguros equivocada. Si tienes dos coberturas m&amp;#233;dicas, por ejemplo, una por medio de tu empleador y otra por medio del empleador de tu c&amp;#243;nyuge, es posible que el prestador de servicios haya facturado a la compa&amp;#241;&amp;#237;a incorrecta. O bien, puede ocurrir que cambiaste de aseguradora y el prestador de servicios m&amp;#233;dicos no cuente con la informaci&amp;#243;n actualizada. Cuando recibas la Explicaci&amp;#243;n de Beneficios, rep&amp;#225;sala para ver si proviene de la compa&amp;#241;&amp;#237;a de seguros correcta. De no ser as&amp;#237;, comun&amp;#237;cate con el prestador de servicios m&amp;#233;dicos. Fuentes: Reasons for Health Claim Denials and What You Should Do , VeryWellHealth, 2023; What to Do When Health Insurance Won’t Pay , Insurance.com, 2023; Apelar una decisi&amp;#243;n del plan de salud , CuidadodeSalud.gov</description><category domain="https://connect.bcbsmt.com/tags/Espa_26002300_241_3B00_ol">Espa&amp;#241;ol</category><category domain="https://connect.bcbsmt.com/tags/Reclamo%2bde%2bsalud">Reclamo de salud</category><category domain="https://connect.bcbsmt.com/tags/EOB">EOB</category><category domain="https://connect.bcbsmt.com/tags/Tu%2bCobertura">Tu Cobertura</category></item><item><title>Blog Post: Qué debe hacer si su reclamación es rechazada</title><link>https://connect.bcbsmt.com/espanol/b/tucobertura/posts/reclamo-no-aprobado</link><pubDate>Thu, 16 Jul 2026 21:48:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:c8c3b6e1-5458-46dc-b751-41cbec281195</guid><dc:creator>EquipoConnect</dc:creator><description>La gerente de enfermer&amp;#237;a, Lenzy Mixon, recibi&amp;#243; una llamada de un asegurado sobre una factura con costos altos por su estad&amp;#237;a en un centro de enfermer&amp;#237;a especializado. El asegurado primero consult&amp;#243; con su m&amp;#233;dico, quien determin&amp;#243; que la estad&amp;#237;a hab&amp;#237;a sido previamente aprobada por su cobertura m&amp;#233;dica. Y luego nos llam&amp;#243;. Mixon expres&amp;#243; que estaba segura de que fue un error, as&amp;#237; que se comunic&amp;#243; con un enfermero de revisi&amp;#243;n de utilizaci&amp;#243;n y con un especialista en Servicio al Cliente. Juntos, encontraron el error que caus&amp;#243; la reclamaci&amp;#243;n rechazada, modificaron los registros y la enviaron de nuevo para el pago. “El asegurado se sinti&amp;#243; aliviado y feliz al enterarse de que la reclamaci&amp;#243;n se modific&amp;#243; tan r&amp;#225;pidamente”, expres&amp;#243; Mixon. Aunque no todas las reclamaciones rechazadas se solucionan tan f&amp;#225;cilmente, hay veces en que adem&amp;#225;s de que la cobertura m&amp;#233;dica no incluya los servicios m&amp;#233;dicos, una reclamaci&amp;#243;n puede no aprobarse por distintas razones. &amp;#191;Sabe qu&amp;#233; hacer si una reclamaci&amp;#243;n es rechazada? Primero, consulte las razones Si tiene una reclamaci&amp;#243;n que fue rechazada, puede consultar la explicaci&amp;#243;n de beneficios (EOB, en ingl&amp;#233;s) de la reclamaci&amp;#243;n para averiguar el motivo. Para cada reclamaci&amp;#243;n se genera una EOB con el fin de ayudarle a rastrear los servicios m&amp;#233;dicos que su seguro m&amp;#233;dico incluye y el monto que necesitar&amp;#237;a pagar, como un copago o coaseguro. Si se rechaza una reclamaci&amp;#243;n, la EOB explica el motivo de la denegaci&amp;#243;n. Descubra los pr&amp;#243;ximos pasos &amp;#191;La fecha de nacimiento es incorrecta? &amp;#191;La direcci&amp;#243;n que su m&amp;#233;dico present&amp;#243; es diferente de la que tenemos registrada? Si la reclamaci&amp;#243;n no se aprob&amp;#243; debido a un error de informaci&amp;#243;n, revertir la denegaci&amp;#243;n puede ser bastante r&amp;#225;pido y f&amp;#225;cil. Comun&amp;#237;quese con Servicio al Cliente al n&amp;#250;mero en su tarjeta de asegurado. Puede darle al especialista en Servicio al Cliente la informaci&amp;#243;n correcta para corregir su archivo. Si el consultorio de su profesional m&amp;#233;dico cometi&amp;#243; el error, puede llamar a la oficina de facturaci&amp;#243;n para corregir la informaci&amp;#243;n. Si el servicio no est&amp;#225; preautorizado o se niega el pago por otro motivo, es posible que tenga que solicitar que la reclamaci&amp;#243;n sea revisada. Esto se conoce como “apelaci&amp;#243;n de decisi&amp;#243;n”. Tanto usted, como su m&amp;#233;dico u otra persona que haya nombrado para representarlo pueden apelar, ya sea por tel&amp;#233;fono o por correo postal. Entienda el proceso de apelaci&amp;#243;n Si cree que una reclamaci&amp;#243;n se rechaz&amp;#243; por error, puede seguir el proceso de apelaci&amp;#243;n de varios pasos incluido en su EOB. Tambi&amp;#233;n lo puede encontrar en la informaci&amp;#243;n de sus beneficios y servicios m&amp;#233;dicos. Si nuestro revisor negara un servicio como m&amp;#233;dicamente innecesario, su m&amp;#233;dico recibir&amp;#225; una notificaci&amp;#243;n. Esa notificaci&amp;#243;n incluir&amp;#225; la opci&amp;#243;n de programar una llamada con el revisor. Y as&amp;#237;, su m&amp;#233;dico podr&amp;#225; revisar el caso por tel&amp;#233;fono con nosotros para tratar de resolver el problema. Si el problema no se resuelve y la reclamaci&amp;#243;n se rechaza, entonces puede apelar. Una apelaci&amp;#243;n est&amp;#225;ndar es una revisi&amp;#243;n interna de su reclamaci&amp;#243;n. Deber&amp;#225; llamar o enviar una carta para solicitar que se revise la reclamaci&amp;#243;n con el fin de consultar si se puede hacer algo para revertir la negativa. Si una reclamaci&amp;#243;n se rechaza por un motivo de salud, un doctor en medicina la revisar&amp;#225;. Si una apelaci&amp;#243;n est&amp;#225;ndar no resuelve el problema, entonces puede solicitar que un segundo revisor m&amp;#233;dico revise la solicitud. Este segundo nivel de apelaci&amp;#243;n lo realiza una organizaci&amp;#243;n de revisi&amp;#243;n independiente y externa. Su EOB explicar&amp;#225; qu&amp;#233; tipos de negativas pueden enviarse para una revisi&amp;#243;n externa. La revisi&amp;#243;n externa es sin costo para usted. &amp;#161;Comience ya! Deber&amp;#225; proporcionar tanta informaci&amp;#243;n como le sea posible para respaldar la reclamaci&amp;#243;n. Tal vez el evaluador de la reclamaci&amp;#243;n no ten&amp;#237;a las im&amp;#225;genes de su resonancia magn&amp;#233;tica (MRI, en ingl&amp;#233;s) que demostraban que necesitaba la cirug&amp;#237;a que solicit&amp;#243; su m&amp;#233;dico. Puede ser que se solicit&amp;#243; un referido pero que no se archiv&amp;#243;. La necesidad de obtener m&amp;#225;s informaci&amp;#243;n es otra raz&amp;#243;n que, a menudo, hace que no se apruebe una reclamaci&amp;#243;n. La revisi&amp;#243;n m&amp;#233;dica requerir&amp;#225; m&amp;#225;s informaci&amp;#243;n. Por ejemplo, podr&amp;#237;a necesitar lo siguiente: una carta de su m&amp;#233;dico explicando las razones por las que se debe aprobar el tratamiento solicitado; las notas para el paciente de parte de su m&amp;#233;dico sobre otros cuidados m&amp;#233;dicos que haya tenido para tratar la enfermedad; los resultados de otras pruebas o procedimientos relacionados con la solicitud; art&amp;#237;culos m&amp;#233;dicos actuales o resultados de estudios que respaldan la eficacia del tratamiento; su propia carta explicando las razones por las que cree que el tratamiento es necesario. Permanezca a la espera Para cuestiones como informaci&amp;#243;n incorrecta, se puede hacer una correcci&amp;#243;n r&amp;#225;pida y volver a presentar la reclamaci&amp;#243;n para su aprobaci&amp;#243;n. Sin embargo, otras revisiones toman tiempo. Una apelaci&amp;#243;n est&amp;#225;ndar toma aproximadamente 30 d&amp;#237;as para que se realice la revisi&amp;#243;n para obtener la aprobaci&amp;#243;n previa. Otras apelaciones pueden tomar hasta 60 d&amp;#237;as. Estos per&amp;#237;odos de tiempo comienzan cuando usted presenta la apelaci&amp;#243;n (no abarca el per&amp;#237;odo de tiempo en que recibi&amp;#243; el tratamiento ni desde que la reclamaci&amp;#243;n fue negada). Tiene 180 d&amp;#237;as para presentar una apelaci&amp;#243;n desde la fecha en que la reclamaci&amp;#243;n fue negada. Una revisi&amp;#243;n externa toma aproximadamente 45 d&amp;#237;as. Si es elegible para una revisi&amp;#243;n urgente, la organizaci&amp;#243;n de revisi&amp;#243;n externa tomar&amp;#225; una decisi&amp;#243;n dentro de las 72 horas. Tiene cuatro meses desde la fecha de la notificaci&amp;#243;n de decisi&amp;#243;n de revisi&amp;#243;n interna para presentar una solicitud de revisi&amp;#243;n externa. Consulte su EOB Siempre debe consultar su EOB para asegurarse de que la informaci&amp;#243;n de su reclamaci&amp;#243;n sea correcta. Cada EOB tiene instrucciones sobre qu&amp;#233; hacer si se neg&amp;#243; una reclamaci&amp;#243;n. Puede recibir su EOB por correo. Si se inscribi&amp;#243; para recibir comunicados de manera digital, puede encontrar su EOB en su cuenta en l&amp;#237;nea . Sources: Engaging with Insurers: Appealing a Denial , Patient Advocate Foundation</description><category domain="https://connect.bcbsmt.com/tags/Espa_26002300_241_3B00_ol">Espa&amp;#241;ol</category><category domain="https://connect.bcbsmt.com/tags/Reclamo%2bde%2bsalud">Reclamo de salud</category><category domain="https://connect.bcbsmt.com/tags/EOB">EOB</category><category domain="https://connect.bcbsmt.com/tags/Tu%2bCobertura">Tu Cobertura</category></item><item><title>Blog Post: 5 Reasons a Claim May Be Denied</title><link>https://connect.bcbsmt.com/my-coverage-explained/b/weblog/posts/reasons-claim-denied</link><pubDate>Thu, 16 Jul 2026 10:22:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:68e51613-3361-4807-b15b-ab382494c641</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>Believe it or not, there are only a handful of reasons that may lead to a health care service not getting approved or a claim not being paid. They fall into these five buckets. The claim has errors. Minor data errors are the most common culprit for claim denials. Sometimes, a provider may code the submission wrong, leave information out, misspell your name or have your birth date wrong. Your explanation of benefits (EOB) will give you clues, so check it first. If you find an error, ask your provider to correct the information and submit your claim again. You used a provider who isn’t in your health plan’s network. Some plans only cover care if you use providers and facilities in your plan’s network. If you go out of network, your plan may not cover any of the costs. Other plans may only cover some of the out-of-network costs, and you have to pay the difference. Your care needed approval ahead of time. Some procedures, like CT scans, MRIs and certain surgeries, usually require prior authorization. If a claim isn’t covered because it wasn’t authorized in advance, talk to the provider who ordered it. Your provider may be able to submit patient records that show you needed the service. You get care that isn’t covered. Your health plan may not provide that benefit. For example, your plan may not cover weight-loss surgery. In that case, it doesn’t undergo medical review. If your plan doesn’t cover it, the procedure won’t be approved. This is called a coverage limit or contract exclusion. If you lost health plan coverage, your claim may not be covered. This may happen if you don’t pay your monthly premiums or run out of COBRA. The claim could also be denied for a medical reason. These types of denials may include: The services are not considered medically necessary. The right level of care wasn&amp;#39;t provided given your condition. The treatment hasn’t been proven effective or is considered experimental for your condition. The claim went to the wrong insurance company. If you have a second health plan, like one from your employer and one from your spouse’s employer, the provider may have billed the wrong company. Or your care provider may have outdated information if you changed insurers. When you get your EOB, check to see if it is from the right health plan, then contact your provider. Sources: Reasons for Health Claim Denials and What You Should Do , VeryWellHealth, 2023; What to Do When Health Insurance Won’t Pay , Insurance.com, 2023; Appealing a Health Care Decision , HealthCare.gov</description><category domain="https://connect.bcbsmt.com/tags/How%2bHealth%2bInsurance%2bWorks">How Health Insurance Works</category><category domain="https://connect.bcbsmt.com/tags/Medical%2bClaims">Medical Claims</category><category domain="https://connect.bcbsmt.com/tags/Understanding%2bInsurance">Understanding Insurance</category><category domain="https://connect.bcbsmt.com/tags/Appeals">Appeals</category><category domain="https://connect.bcbsmt.com/tags/Explanation%2bof%2bBenefits">Explanation of Benefits</category><category domain="https://connect.bcbsmt.com/tags/Health%2bCare%2bCosts">Health Care Costs</category></item><item><title>Blog Post: What to Do if Your Claim Is Not Approved</title><link>https://connect.bcbsmt.com/my-coverage-explained/b/weblog/posts/claim-not-approved</link><pubDate>Thu, 16 Jul 2026 09:32:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:6de2a026-62f8-40f8-8036-573a6805de6f</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>Nurse care manager Lenzy Mixon got a call from a member about a large bill he received for a stay at a skilled nursing facility. He checked with his doctor, who assured him the stay had been pre-approved by his health plan. His next call was to us. Mixon said she was sure it was a mistake, so she reached out to a utilization review nurse and a customer advocate. Together, they found the error that caused the claim to be denied, adjusted the records and sent it through again for payment. “He was relieved and happy hearing that the claim was being adjusted so quickly,” Mixon said. While not every claim denial is so easily fixed, there are times a claim doesn’t get approved for reasons other than the service not being covered by a member’s health plan. Do you know what to do if a claim isn’t approved? First, Ask Why If you have a claim that isn’t approved, you can look at the explanation of benefits (EOB) for the claim to find out why. An EOB is generated for your medical claims to help you track what your insurance is covering and what amount you may need to pay, such as a copay or coinsurance. If a claim is denied, the EOB will explain the reason for the denial. Find Out Your Next Steps Do they have the wrong birth date listed for you? Is the address your doctor listed different from what we have on file? If the claim wasn’t approved because of an information error, reversing the denial may be fairly quick and easy. Call customer service at the number on your member ID card. You can give the customer advocate the right information to correct your file. If your provider’s office made the mistake, you can call the billing office to get the information corrected. If the service isn’t preauthorized or is denied for payment for another reason, you may need to ask that the claim be reviewed. This is called appealing the decision. You can appeal by phone or by mail. You, your doctor or another person you’ve named to represent you can appeal. Understand the Appeals Process There is a multi-step process in place that can help you if you think a claim has been denied in error. It is outlined in an insert included with your EOB. It is also explained in your benefit information. I f our reviewer is going to deny a service as not medically necessary, your doctor will receive a notification. That notification will include the option to schedule a call with the reviewer. Your doctor can review the case over the phone with us to try to resolve the issue. If the issue is not resolved and the claim is denied, you can appeal. A standard appeal is an internal review of your claim. You’ll call or send a letter to ask that the claim be reviewed to see if something can be done to reverse the denial. If a claim is denied for a medical reason, a medical doctor will review the claim. If a standard appeal does not resolve the issue, you can request to have a second medical reviewer look at the request. This second level of appeal is done by an outside, independent review organization. Your EOB will explain what types of denials can be sent for external review. There is no cost to you for an external review. Get Started You’ll need to provide as much information as you can to support the claim. Maybe the claim reviewer didn’t have the films from your MRI that showed you needed the surgery your doctor requested. It may be that a referral was required, and the referral wasn’t documented. The need for more information is another reason that often leads to a claim not getting approved. Medical review will require more information. For example, you may need: A letter from your doctor explaining why the requested treatment should be approved Patient notes from your treating physician on other care you have had for your condition The results of other tests or procedures related to the request Current medical articles or study results that support the treatment’s effectiveness Your own letter explaining why you believe the treatment is needed Hang in There For things like wrong information, a quick correction can be made and the claim refiled for approval. But other reviews take time. A standard appeal takes about 30 days for review for getting care pre-approved. Other appeals may take up to 60 days. These timeframes start when you file the appeal, not from the time of your treatment or from when the claim wasn’t approved. You have 180 days to file an appeal from the date the claim wasn’t approved. An external review takes about 45 days. If you qualify for urgent review, the outside review organization will give you a decision within 72 hours. You have four months from the date of your internal review decision notice to file a request for external review. Check Your EOB You should always check your EOB to make sure your claim information is correct. Every EOB has instructions on what to do if a claim has been denied. You may get your EOB in the mail. If you are signed up for paperless communications, your EOB can be found in your online account. Sources: Engaging with Insurers: Appealing a Denial , Patient Advocate Foundation</description><category domain="https://connect.bcbsmt.com/tags/How%2bHealth%2bInsurance%2bWorks">How Health Insurance Works</category><category domain="https://connect.bcbsmt.com/tags/Medical%2bClaims">Medical Claims</category><category domain="https://connect.bcbsmt.com/tags/Understanding%2bInsurance">Understanding Insurance</category><category domain="https://connect.bcbsmt.com/tags/Appeals">Appeals</category><category domain="https://connect.bcbsmt.com/tags/Explanation%2bof%2bBenefits">Explanation of Benefits</category><category domain="https://connect.bcbsmt.com/tags/Health%2bCare%2bCosts">Health Care Costs</category></item><item><title>Blog Post: El colesterol alto duplica tu riesgo de enfermedad cardíaca</title><link>https://connect.bcbsmt.com/espanol/b/tusalud/posts/el-colesterol-alto-duplica-su-riesgo-de-enfermedad-cardiaca</link><pubDate>Wed, 15 Jul 2026 15:02:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:eaae5a96-fe70-4f94-93a3-cab5381369d2</guid><dc:creator>EquipoConnect</dc:creator><description>Millones de estadounidenses tienen colesterol alto, el cual puede obstruir los vasos sangu&amp;#237;neos y provocar graves problemas de salud. Las personas con colesterol total alto corren un mayor riesgo de padecer enfermedades card&amp;#237;acas y derrames cerebrales, dos causas principales de muerte en los Estados Unidos. Junto con los antecedentes familiares, la dieta poco saludable, el aumento de peso y la falta de ejercicio son factores que contribuyen a la mayor&amp;#237;a de las personas con colesterol alto. &amp;#191;Qu&amp;#233; es el colesterol? El colesterol es la sustancia grasosa en la sangre que se adhiere a part&amp;#237;culas llamadas lipoprote&amp;#237;nas. &amp;quot;Lipo&amp;quot; significa &amp;quot;grasa&amp;quot; o &amp;quot;grasoso&amp;quot;. Los m&amp;#233;dicos analizan la sangre para detectar tres tipos principales: Lipoprote&amp;#237;na de alta densidad (HDL): este es el tipo &amp;quot;bueno”. El HDL ayuda a eliminar el colesterol de tu cuerpo. Le da a tus arterias una mejor oportunidad de no ser afectadas. Lipoprote&amp;#237;na de baja densidad (LDL): este es el tipo &amp;quot;malo&amp;quot;. Ldl es el tipo de colesterol da&amp;#241;ino. Puede acumularse y bloquear las arterias. Tu riesgo de ataque card&amp;#237;aco o accidente cerebrovascular aumenta a medida que aumenta tu nivel de LDL. Triglic&amp;#233;ridos: esta es otra grasa mala. Los niveles altos a menudo se encuentran con otros factores de riesgo de enfermedad card&amp;#237;aca. El colesterol total es una mezcla de los tres. Un n&amp;#250;mero total m&amp;#225;s alto significa que corres riesgo de padecer enfermedades card&amp;#237;acas. El objetivo del tratamiento es aumentar el colesterol HDL y, al mismo tiempo, reducir el colesterol LDL y los triglic&amp;#233;ridos. &amp;#191;Sabes qu&amp;#233; significan los n&amp;#250;meros de colesterol? Lo que se considera un n&amp;#250;mero saludable puede variar de persona a persona. Pero en general, los Centros para el Control y la Prevenci&amp;#243;n de Enfermedades dicen que las personas que est&amp;#225;n saludables y que tienen un riesgo promedio de padecer enfermedades card&amp;#237;acas deben tener como objetivo los siguientes niveles : HDL: 40 mg/dL o superior para los hombres, 50 mg/dL o superior para las mujeres LDL: 100 mg/dL o menos Triglic&amp;#233;ridos: menos de 150 mg/dl Colesterol total: Alrededor de 150 mg/dL. El colesterol total por encima de 200 mg/dl se considera alto. Pero recuerda que los objetivos para el colesterol LDL (malo) y el colesterol total var&amp;#237;an de persona a persona, seg&amp;#250;n la Asociaci&amp;#243;n Americana del Coraz&amp;#243;n. Tu m&amp;#233;dico puede decirte cu&amp;#225;les deben ser tus niveles ideales de colesterol. Mantener tu colesterol bajo control Aqu&amp;#237; hay algunas maneras de ayudar a controlar el colesterol: Si tienes sobrepeso, pierde el exceso de libras. Haz ejercicio durante al menos 30 minutos la mayor&amp;#237;a de los d&amp;#237;as de la semana. Evita las grasas saturadas. Se encuentra en carnes, productos l&amp;#225;cteos de leche entera y algunos alimentos preparados. Limita el consumo de alcohol. Los hombres no deben tomar m&amp;#225;s de dos bebidas por d&amp;#237;a, y las mujeres no deben tomar m&amp;#225;s de una. Deja de fumar. Si tienes colesterol alto, tu m&amp;#233;dico puede recomendar medicamentos junto con estos cambios. T&amp;#250; y tu m&amp;#233;dico decidir&amp;#225;n si necesitas medicamentos verificando los resultados de tus an&amp;#225;lisis y todos los otros factores de riesgo. Si necesitas medicamentos, ten en cuenta que no todos los medicamentos de marca est&amp;#225;n cubiertos por tu cobertura m &amp;#233; dica . Para tratar de mantener tus costos m&amp;#225;s bajos, pregunta si hay disponible una versi&amp;#243;n gen&amp;#233;rica de un medicamento recetado. Tambi&amp;#233;n es una buena idea revisar la lista de medicamentos de tu cobertura m &amp;#233; dica para ver qu&amp;#233; medicamentos para el colesterol est&amp;#225;n cubiertos y compartir esa informaci&amp;#243;n con tu m&amp;#233;dico. Hacerte las pruebas de detecci&amp;#243;n recomendadas es una parte importante del control de tu colesterol. Los asegurados de Blue Cross and Blue Shield pueden aprovechar de estos ex&amp;#225;menes importantes de salud sin costo alguno cuando los servicios son proporcionados por un professional m&amp;#233;dico de la red.* Los antecedentes familiares pueden ser cr&amp;#237;ticos Algunas personas tienen un v&amp;#237;nculo familiar con una forma grave de colesterol alto. Seg&amp;#250;n la Asociaci&amp;#243;n Americana del Coraz&amp;#243;n, este problema hereditario, llamado hipercolesterolemia familiar, afecta a 1 de cada 200 personas en Estados Unidos. Cerca del 90 por ciento de ellas no sabe que lo tiene. Las personas con esta afecci&amp;#243;n tienen colesterol alto desde el nacimiento, pero es posible que no tengan s&amp;#237;ntomas hasta que ya hayan desarrollado problemas card&amp;#237;acos graves. Este estudio y otros muestran el valor de conocer el historial m&amp;#233;dico de tu familia y compartirlo con tu doctor. *Los servicios preventivos sin costo son aplicables &amp;#250;nicamente a los asegurados inscritos en coberturas m&amp;#233;dicas sin derechos adquiridos. Es posible que tengas que pagar el costo total o parcial de la atenci&amp;#243;n m&amp;#233;dica preventiva si tu cobertura m&amp;#233;dica tiene derechos adquiridos. Comun&amp;#237;cate con Servicio al Cliente al n&amp;#250;mero en tu tarjeta de asegurado para confirmar si tienes o no una cobertura m&amp;#233;dica con derechos adquiridos. Fuentes: About Cholesterol , Centers for Disease Control and Prevention, 2024; High Cholesterol Facts , CDC, 2024; Preventing High Cholesterol , CDC; 2024; What is Familial Hypercholesterolemia , American Heart Association, 2024; Cholesterol test , Mayo Clinic, 2025</description><category domain="https://connect.bcbsmt.com/tags/Espa_26002300_241_3B00_ol">Espa&amp;#241;ol</category><category domain="https://connect.bcbsmt.com/tags/Card_26002300_237_3B00_aco">Card&amp;#237;aco</category><category domain="https://connect.bcbsmt.com/tags/Salud%2bdel%2bcoraz_26002300_243_3B00_n">Salud del coraz&amp;#243;n</category><category domain="https://connect.bcbsmt.com/tags/Tu%2bSalud">Tu Salud</category><category domain="https://connect.bcbsmt.com/tags/Colesterol">Colesterol</category><category domain="https://connect.bcbsmt.com/tags/Enfermedades%2bcardiovasculares%2bDieta%2by%2bsalud">Enfermedades cardiovasculares Dieta y salud</category><category domain="https://connect.bcbsmt.com/tags/Coraz_26002300_243_3B00_n">Coraz&amp;#243;n</category><category domain="https://connect.bcbsmt.com/tags/La%2bsalud%2bcardiovascular%2by%2bla%2bdieta">La salud cardiovascular y la dieta</category></item><item><title>Blog Post: ¿Qué es el trastorno por déficit de atención e hiperactividad?</title><link>https://connect.bcbsmt.com/espanol/b/tusalud/posts/que-es-tdah</link><pubDate>Tue, 14 Jul 2026 16:37:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:c1bb7a94-4267-4f40-a2a8-11bb9a4d4be6</guid><dc:creator>EquipoConnect</dc:creator><description>Prestar atenci&amp;#243;n, sentarse quietos y controlar los impulsos son buenas habilidades que los ni&amp;#241;os deber&amp;#237;an aprender. Pero estas actividades son dif&amp;#237;ciles para ni&amp;#241;os que padecen el trastorno por d&amp;#233;ficit de atenci&amp;#243;n e hiperactividad ( Attention-Deficit/Hyperactivity Disorder , ADHD, en ingl&amp;#233;s). Estas son algunas de las se&amp;#241;ales del trastorno: dificultad para prestar atenci&amp;#243;n; altos niveles de actividad (hiperactividad); y actuar antes de pensar (impulsividad). Los ni&amp;#241;os con ADHD presentan estas se&amp;#241;ales con mayor frecuencia que otros ni&amp;#241;os de su edad. Algunos ni&amp;#241;os con ADHD solo presentan problemas con la atenci&amp;#243;n, mientras que otros, batallan &amp;#250;nicamente con la hiperactividad e impulsividad. La mayor&amp;#237;a tiene problemas con las tres se&amp;#241;ales. Ten en cuenta que todos los ni&amp;#241;os tienen per&amp;#237;odos cortos de atenci&amp;#243;n. Algunos ni&amp;#241;os son m&amp;#225;s activos que otros. Esto es normal y no significan que un ni&amp;#241;o tenga ADHD. Para diagnosticar ADHD, se necesita una evaluaci&amp;#243;n completa. Pide ayuda Habla con el m&amp;#233;dico si tienes alguna preocupaci&amp;#243;n con el ADHD. No hay ninguna prueba para detectarlo, pero una evaluaci&amp;#243;n completa ayudar&amp;#225; con el tratamiento. Los ni&amp;#241;os con ADHD pueden llevar una vida normal, pero, es indispensable que sepan de su padecimiento y c&amp;#243;mo tratarlo. Algunas opciones de tratamiento: Terapia conductual. Ayuda a los ni&amp;#241;os a aprender acciones positivas y limitar los comportamientos problem&amp;#225;ticos. Tratamiento mediante medicaci&amp;#243;n. Ayuda a los ni&amp;#241;os a manejar los s&amp;#237;ntomas del ADHD y controlar algunos de los problemas de comportamiento. Una combinaci&amp;#243;n de ambos es una forma de ayuda para ni&amp;#241;os a partir de los 6 a&amp;#241;os . Es necesario supervisar el tratamiento. El seguimiento a largo plazo es vital para tratar con &amp;#233;xito el ADHD. Hay estudios que demuestran que los ni&amp;#241;os con ADHD que no se atienden corren riesgos mayores de desarrollar problemas m&amp;#225;s graves a futuro. Otras medidas que pueden adoptarse consisten en entrenar a padres e hijos, programas o apoyo escolares y terapia infantil o familiar. Consejos para los padres: Fijar una rutina . Intenta seguir el mismo horario cada d&amp;#237;a, desde la hora de levantarse hasta la hora de irse a dormir. Organizars e. P&amp;#237;dele a tu hijo que coloque sus mochilas, ropa y juguetes todos los d&amp;#237;as en un mismo lugar, para que tenga menos probabilidades de perderlos. Evitar distracciones. Apaga la televisi&amp;#243;n, limita el ruido y proporci&amp;#243;nale un espacio de trabajo limpio para que haga sus tareas. Moverse o escuchar m&amp;#250;sica ayuda en el aprendizaje de algunos ni&amp;#241;os con ADHD. Observa al ni&amp;#241;o e identifica lo que le funciona. Limitar opciones. Ofrece opciones limitadas para que el ni&amp;#241;o no tenga que elegir de entre muchas. Claridad y especificidad. Hazle saber al ni&amp;#241;o que lo escuchas repiti&amp;#233;ndole lo que lo escuchaste decir. Usa instrucciones claras y breves cuando le pidas que haga algo. Objetivos y elogios. Usa una tabla para enumerar objetivos y registrar los comportamientos positivos. Hazle saber al ni&amp;#241;o cuando haya hecho algo bien. Premiar esfuerzos. Aseg&amp;#250;rate de que los objetivos sean realistas. Crear posibilidades positivas . A los ni&amp;#241;os con ADHD pueden parecerles estresantes ciertas situaciones. Identifica actividades en las que el ni&amp;#241;o se desempe&amp;#241;e bien, ya sean escolares, deportivas, art&amp;#237;sticas, musicales o recreativas. Esto puede ayudarte a crearle experiencias positivas. Brindar una vida saludable . Es importante que haya alimentos nutritivos, mucha actividad f&amp;#237;sica y que duerma adecuadamente. A veces, esto ayuda con los s&amp;#237;ntomas de ADHD. &amp;#191;Qu&amp;#233; pasa con los adultos con ADHD? Los adultos tambi&amp;#233;n pueden tener ADHD. El Instituto Nacional de la Salud Mental (National Institute of Mental Health, en ingl&amp;#233;s) dice que los adultos pueden organizar su vida al: Apegarse a las rutinas Hacer listas para actividades Usar un calendario para eventos Configuraci&amp;#243;n de recordatorios Guardar cosas como llaves y papeles en un espacio asignado Dividir las tareas grandes en pasos m&amp;#225;s peque&amp;#241;os &amp;#191;Qu&amp;#233; otras cosas puedes hacer? Visita el sitio web Children and Adults with Attention Deficit/Hyperactivity Disorder (enlace en ingl&amp;#233;s). Pide ayuda de un profesional en salud mental. Si necesitas ayuda (incluso para buscar prestadores de servicios m&amp;#233;dicos), ll&amp;#225;manos al n&amp;#250;mero de servicio al cliente en tu tarjeta de asegurado de BCBSMT. Estamos para ayudarte. Fuentes: Treatment of ADHD , Centers for Disease Control and Prevention, 2026; The A.D.D. Resource Center , 2019; Attention-Deficit/Hyperactivity Disorder (ADHD) , National Institutes of Mental Health, 2024</description><category domain="https://connect.bcbsmt.com/tags/Espa_26002300_241_3B00_ol">Espa&amp;#241;ol</category><category domain="https://connect.bcbsmt.com/tags/Salud%2by%2bBienestar">Salud y Bienestar</category><category domain="https://connect.bcbsmt.com/tags/Tu%2bSalud">Tu Salud</category><category domain="https://connect.bcbsmt.com/tags/Qu_26002300_233_3B00_%2bes%2bla%2bsalud%2bmental">Qu&amp;#233; es la salud mental</category><category domain="https://connect.bcbsmt.com/tags/TDAH">TDAH</category><category domain="https://connect.bcbsmt.com/tags/ADHD">ADHD</category><category domain="https://connect.bcbsmt.com/tags/Trastorno%2bpor%2bd_26002300_233_3B00_ficit%2bde%2batenci_26002300_243_3B00_n%2be%2bhiperactividad">Trastorno por d&amp;#233;ficit de atenci&amp;#243;n e hiperactividad</category><category domain="https://connect.bcbsmt.com/tags/Salud%2bMental">Salud Mental</category></item><item><title>Blog Post: Ahora es el momento para ponerse al día con las vacunas infantiles</title><link>https://connect.bcbsmt.com/espanol/b/tusalud/posts/ponerse-al-dia-con-las-vacunas-infantiles-</link><pubDate>Mon, 13 Jul 2026 19:43:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:118cd3e5-0909-46d7-82d4-e1d5ea483ed3</guid><dc:creator>EquipoConnect</dc:creator><description>Es importante que los ni&amp;#241;os se vacunen a tiempo. Si no lo hacen, tienen una mayor probabilidad de contraer enfermedades graves que podr&amp;#237;an propagarse a sus amigos y familiares. No lo pospongas Ahora es el momento para ponerse al d&amp;#237;a con las vacunas, antes del ajetreo del regreso a clases. Los ni&amp;#241;os necesitan vacunas para mantenerse saludables, desde que son beb&amp;#233;s hasta la adolescencia. Durante la infancia es fundamental que reciban las vacunas a tiempo. Las vacunas otorgan inmunidad antes de que los ni&amp;#241;os est&amp;#233;n expuestos a enfermedades. Adem&amp;#225;s, se requiere que los ni&amp;#241;os reciban ciertas vacunas antes de empezar el a&amp;#241;o escolar. Los ni&amp;#241;os en Estados Unidos reciben vacunas que los protegen de m&amp;#225;s de una docena de enfermedades, incluidas las siguientes: Sarampi&amp;#243;n Polio T&amp;#233;tanos Difteria Tos ferina En la actualidad, la mayor&amp;#237;a de estas enfermedades est&amp;#225;n por los niveles de frecuencia m&amp;#225;s bajos de la historia gracias a las medidas de vacunaci&amp;#243;n que se han tomado por a&amp;#241;os. Sin embargo, en Estados Unidos todav&amp;#237;a mueren ni&amp;#241;os cada a&amp;#241;o por enfermedades que pueden prevenirse con vacunas. Las vacunas son una parte vital de la atenci&amp;#243;n preventiva para los ni&amp;#241;os y ayudan a prevenir el brote de enfermedades. &amp;#191;Por qu&amp;#233; se administran las vacunas a una edad temprana? Es m&amp;#225;s probable que las enfermedades, las cuales las vacunas infantiles intentan prevenir, se manifiesten cuando los ni&amp;#241;os son peque&amp;#241;os y, a su vez, la posibilidad de que ocurran complicaciones es mayor. Esto hace que la vacunaci&amp;#243;n temprana, incluso justo despu&amp;#233;s de nacer, sea fundamental. &amp;#191;Las vacunas son seguras para los ni&amp;#241;os peque&amp;#241;os? S&amp;#237;, las vacunas son muy seguras. Las vacunas pasan por a&amp;#241;os de pruebas de seguridad realizadas por la Administraci&amp;#243;n de Alimentos y Medicamentos (FDA, en ingl&amp;#233;s) para asegurarse de que sean seguras. Muchas de ellas funcionan exponiendo al cuerpo a una cantidad muy peque&amp;#241;a de versiones d&amp;#233;biles o inactivas de g&amp;#233;rmenes o virus. Es entonces cuando el sistema inmunitario desarrolla los recursos para combatir esos virus en el futuro. Las vacunas han disminuido o detenido la propagaci&amp;#243;n de polio, sarampi&amp;#243;n, paperas y otras enfermedades graves. Los efectos secundarios m&amp;#225;s frecuentes son muy leves, como dolor, enrojecimiento o hinchaz&amp;#243;n en el lugar de la inyecci&amp;#243;n. &amp;#191;Las vacunas causan autismo? Los investigadores no han encontrado un v&amp;#237;nculo entre el autismo y las vacunas infantiles. El estudio que propici&amp;#243; esa discusi&amp;#243;n fue retirado hace a&amp;#241;os. Cu&amp;#225;ndo recibir vacunas Los Centros para el Control y la Prevenci&amp;#243;n de Enfermedades (CDC, en ingl&amp;#233;s) recomiendan que los ni&amp;#241;os y adolescentes se vacunen a ciertas edades: Infantes hasta los 2 a&amp;#241;os: Comenzar la vacunaci&amp;#243;n desde el nacimiento puede ayudar a proteger a tu hijo contra el virus sincicial respiratorio (RSV, en ingl&amp;#233;s), la COVID-19, la hepatitis A y B, el rotavirus, la difteria, el t&amp;#233;tanos, la tos ferina, el hib (haemophilus influenzae tipo b) , lla enfermedad neumoc&amp;#243;cica, la polio, la influenza, el sarampi&amp;#243;n, las paperas, la rub&amp;#233;ola y la varicela. Entre 3 y 6 a&amp;#241;os: Contin&amp;#250;a con las vacunas que protegen contra la polio, la difteria, el t&amp;#233;tanos, la tos ferina, el sarampi&amp;#243;n, las paperas, la rub&amp;#233;ola y la varicela, adem&amp;#225;s de la vacuna anual contra la gripe. Habla con el pediatra de tu hijo sobre la vacuna contra la COVID-19. Entre 7 y 13 a&amp;#241;os: Las vacunas para los preadolescentes pueden ayudar a proteger contra el virus del papiloma humano (VPH), la meningitis, el t&amp;#233;tanos, la difteria y la tos ferina. Tambi&amp;#233;n debes continuar administr&amp;#225;ndoles la vacuna anual contra la gripe. Habla con el pediatra de tu hijo sobre la vacuna contra la COVID-19. Entre 14 y 18 a&amp;#241;os: Recibir las vacunas recomendadas y la vacuna anual contra la gripe hasta los 18 a&amp;#241;os puede ayudar a tu hijo a mantenerse saludable. Habla con el pediatra de tu hijo sobre la vacuna contra la COVID-19. Habla con el m&amp;#233;dico Preg&amp;#250;ntale al pediatra de tu hijo sobre las vacunas, incluida la vacuna contra el COVID-19. Es preferible obtener la informaci&amp;#243;n que necesitas de un profesional m&amp;#233;dico en quien conf&amp;#237;es. No tomes decisiones m&amp;#233;dicas basadas en las historias que hayas visto en la televisi&amp;#243;n o en Internet, o que hayas escuchado de otros padres. Encuentra m&amp;#225;s informaci&amp;#243;n en nuestras recomendaciones para el bienestar Cada a&amp;#241;o ofrecemos nuevas recomendaciones para el bienestar que incluyen consejos espec&amp;#237;ficos sobre la atenci&amp;#243;n preventiva, las vacunas y las pruebas de detecci&amp;#243;n para los adultos y los ni&amp;#241;os. Revisa las Recomendaciones para el bienestar para encontrar informaci&amp;#243;n sobre la atenci&amp;#243;n m&amp;#233;dica preventiva que tu familia necesita para mantenerse saludable. Fuentes: Meningococcal Vaccination , CDC, 2026; Children’s Vaccines: The Basics , WebMD, 2026; Childhood Vaccines , MedlinePlus, 2024; Reasons to Vaccinate , CDC, 2024; Hib Vaccine VIS , CDC, 2021; Recommended Child and Adolescent Immunization, Schedule for Ages 18 Years or Younger , American Academy of Pediatrics, 2026</description><category domain="https://connect.bcbsmt.com/tags/Espa_26002300_241_3B00_ol">Espa&amp;#241;ol</category><category domain="https://connect.bcbsmt.com/tags/Salud%2by%2bBienestar">Salud y Bienestar</category><category domain="https://connect.bcbsmt.com/tags/Tu%2bSalud">Tu Salud</category><category domain="https://connect.bcbsmt.com/tags/Vacunas">Vacunas</category><category domain="https://connect.bcbsmt.com/tags/Ni_26002300_241_3B00_os">Ni&amp;#241;os</category><category domain="https://connect.bcbsmt.com/tags/Servicios%2bPreventivos">Servicios Preventivos</category></item><item><title>Blog Post: What is ADHD?</title><link>https://connect.bcbsmt.com/health-and-wellness/b/weblog/posts/what-is-adhd</link><pubDate>Fri, 10 Jul 2026 23:09:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:67cc99ce-b725-49cb-8a0a-b7c53bd671b9</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>Paying attention, sitting still and curbing urges are good skills for children to learn. But those things are hard for children with Attention-Deficit/Hyperactivity Disorder (ADHD). Some signs of the disorder are: Trouble paying attention High levels of action (hyperactivity) Acting before thinking (impulsivity) For children with ADHD, these behaviors happen more often than what is considered normal for children their age. Some children with ADHD only have problems with attention, while others deal only with hyperactivity and impulsivity. Most have problems with all three. Keep in mind that all children have short attention spans. And some kids are more active than others. These things are normal and don’t mean that a child has ADHD. A full assessment needs to be done to diagnose ADHD. Get Help Talk to your doctor if you have concerns about ADHD. There is no single test for it, but a full evaluation will help with treatment. Children with ADHD can thrive, but diagnosis and knowing how best to treat it are critical, says the National Resource Center on ADHD . Treatment choices include: Behavior therapy to help children learn positive actions and limit problem behaviors. Medication therapy to help children handle symptoms and control some of the behavioral problems. Blend of both to help children six years of age and older . Treatment must be monitored. Long-term monitoring is vital to successfully handling ADHD. Studies show that children with ADHD who stop treatment are at a greater risk for more serious problems later. Other steps to take may involve parent and child training, school programs that support kids with ADHD and family therapy. Tips for Parents: Set a routine. Try to follow the same schedule each day, from wake-up time to bedtime. Get organized. Encourage your child to put schoolbags, clothing and toys in the same place each day so your child will be less likely to lose them. Handle distractions. Turn off the TV, limit noise, and give a clean workspace when your child is doing homework. Some children with ADHD learn well if they are moving or listening to music. Watch your child and see what works. Limit choices. Offer choices between a few things so that your child doesn’t have too many to choose from. Be clear and specific. Let your child know you are listening by repeating what you heard them say. Use clear, brief directions when they need to do something. Use goals and praise. Use a chart to list goals and track positive behaviors. Let your child know when they have done well. Reward their efforts. Be sure the goals are realistic. Create positive chances. Children with ADHD may find certain situations stressful. Find what your child does well — whether it’s school, sports, art, music or play. That can help create positive experiences. Provide a healthy life. Healthy food, physical activity and sufficient sleep are important. They can sometimes help with ADHD symptoms. What about Adults with ADHD? Adults can also have ADHD. The National Institute of Mental Health says adults can organize their life by: Sticking to routines Making lists for activities Using a calendar for events Setting reminders Keeping things like keys and papers in an assigned space Breaking down large tasks into smaller steps Other Things You Can Do? Visit the Children and Adults with Attention Deficit/Hyperactivity Disorder site for facts. Seek help from a mental health professional. If you need any help (including finding a provider), please call us at the customer service number on your BCBSMT member ID card. We are here to help. Sources: Treatment of ADHD , Centers for Disease Control and Prevention, 2026; The A.D.D. Resource Center , 2019; Attention-Deficit/Hyperactivity Disorder (ADHD) , National Institutes of Mental Health, 2024</description><category domain="https://connect.bcbsmt.com/tags/Health%2band%2bWellness">Health and Wellness</category><category domain="https://connect.bcbsmt.com/tags/Understanding%2bBehavioral%2bHealth">Understanding Behavioral Health</category><category domain="https://connect.bcbsmt.com/tags/Mental%2bHealth">Mental Health</category><category domain="https://connect.bcbsmt.com/tags/Healthy%2bMind">Healthy Mind</category><category domain="https://connect.bcbsmt.com/tags/ADHD">ADHD</category><category domain="https://connect.bcbsmt.com/tags/Attention_2D00_Deficit%2bHyperactivity%2bDisorder">Attention-Deficit Hyperactivity Disorder</category></item><item><title>Wiki Page: Korean Chili Green Beans</title><link>https://connect.bcbsmt.com/nutrition/w/recipe-book/316/korean-chili-green-beans</link><pubDate>Fri, 10 Jul 2026 21:31:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:d1fdfcdd-f6bf-4e43-9cf3-d0613cab179b</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>Ingredients: Makes 7 servings 3 cups Green Beans, fresh, snapped 1 TBSP + 1 tsp Canola Oil 2 tsp Garlic, fresh, minced 1 cup Red Onion, julienned 1 cup Red Bell Pepper, julienned 1 TBSP Gochujang (Korean Hot Red Pepper Paste) 1/8 tsp Kosher Salt Directions: Bring a large pot of water to a boil. While waiting to boil, take a large bowl and fill with ice and water. When water is boiling, add the green beans and cook for about 2 minutes, until bright green and slightly tender. Immediately transfer blanched beans to the bowl of ice water to stop the cooking. Drain well and set aside. In large skillet or wok, heat canola oil until it’s shimmering and just starting to smoke. Add the chopped garlic and sliced onions. Stir-fry for about 30 seconds, until fragrant. Add in the bell peppers and blanched green beans. Stir-fry for 2–3 minutes, until the peppers start to soften but still have some crunch. Stir in the gochujang and Kosher salt. Mix well so everything is coated. Cook for another minute, then serve hot. Serving Size: Serving Size: 1/2 cup Nutritional Information: Per serving: 60 calories, 3 g fat, &amp;lt;1 g saturated fat, 90 mg sodium, 8 g carbohydrates, &amp;lt;1 g sugar, 2 g fiber, 1 g protein Recipe Source: Recipe provided by FLIK Hospitality Group</description><category domain="https://connect.bcbsmt.com/tags/Recipe%2bBook">Recipe Book</category><category domain="https://connect.bcbsmt.com/tags/Vegetarian">Vegetarian</category><category domain="https://connect.bcbsmt.com/tags/General%2bHealthy%2b_2D00_%2bHealth%2bConscious">General Healthy - Health Conscious</category><category domain="https://connect.bcbsmt.com/tags/Side%2bDishes">Side Dishes</category><category domain="https://connect.bcbsmt.com/tags/Asian">Asian</category><category domain="https://connect.bcbsmt.com/tags/Heart%2bDisease%2b_2D00_%2bHeart%2bConscious">Heart Disease - Heart Conscious</category><category domain="https://connect.bcbsmt.com/tags/Appetizer">Appetizer</category><category domain="https://connect.bcbsmt.com/tags/Diabetes_2F00_prediabetes%2b_2D00_%2bCarb%2bConscious">Diabetes/prediabetes - Carb Conscious</category><category domain="https://connect.bcbsmt.com/tags/High%2bblood%2bpressure%2b_2D00_%2bSodium%2bConscious">High blood pressure - Sodium Conscious</category></item><item><title>Wiki Page: Spicy Korean Braised Sesame Tofu (Dubu-Jorim)</title><link>https://connect.bcbsmt.com/nutrition/w/recipe-book/315/spicy-korean-braised-sesame-tofu-dubu-jorim</link><pubDate>Fri, 10 Jul 2026 21:30:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:e39e4042-1d2b-4793-b630-e64d8404b53d</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>Ingredients: Makes 4 servings 4 cups Tofu, Extra Firm, fresh 3 TBSP Canola Oil 1/4 cup Soy Sauce, less sodium 1/4 tsp Kosher Salt 2 tsp Granulated Sugar 2 TBSP Korean Chili Pepper Powder 1 cup Water 3 TBSP Canola Oil 2 tsp Garlic, fresh, minced 1 cup Yellow Onion, diced 1/4 cup Green Onion, fresh sliced 2 tsp Sesame Oil 2 tsp Sesame Seeds 1/4 cup Green Onion, fresh, sliced as garnish Directions: Drain tofu, then pat dry with paper towels. Slice into 1/4-inch thick pieces. Heat 3 TBSP of canola oil in a nonstick skillet over medium-high heat. Add the tofu slices and cook for about 7 minutes per side, until golden brown and crisp. Remove from the pan and set aside. In a small bowl, whisk together soy sauce, kosher salt, granulated sugar, Korean chili powder, and water. Set aside. Return the pan to medium heat and add 3 TBSP canola oil. Stir in minced garlic, yellow onion, and 1/4 cup sliced green onions. Cook until the onions are soft and caramelized. Pour the sauce into the pan and simmer for a few minutes until slightly thickened. Add the tofu back to the pan along with sesame oil. Simmer until most of the liquid is absorbed. Sprinkle with sesame seeds and extra green onions. Serve hot. Serving Size: Serving size: 4 ounces Nutritional Information: Per serving: 235 calories, 18 g fat, 2 g saturated fat, 300 mg sodium, 8 g carbohydrate, 1 g sugar, 4 g fiber, 12 g protein Recipe Source: Recipe provided by FLIK Hospitality Group</description><category domain="https://connect.bcbsmt.com/tags/Recipe%2bBook">Recipe Book</category><category domain="https://connect.bcbsmt.com/tags/Vegetarian">Vegetarian</category><category domain="https://connect.bcbsmt.com/tags/General%2bHealthy%2b_2D00_%2bHealth%2bConscious">General Healthy - Health Conscious</category><category domain="https://connect.bcbsmt.com/tags/Asian">Asian</category><category domain="https://connect.bcbsmt.com/tags/Heart%2bDisease%2b_2D00_%2bHeart%2bConscious">Heart Disease - Heart Conscious</category><category domain="https://connect.bcbsmt.com/tags/Diabetes_2F00_prediabetes%2b_2D00_%2bCarb%2bConscious">Diabetes/prediabetes - Carb Conscious</category><category domain="https://connect.bcbsmt.com/tags/High%2bblood%2bpressure%2b_2D00_%2bSodium%2bConscious">High blood pressure - Sodium Conscious</category><category domain="https://connect.bcbsmt.com/tags/Entree">Entree</category></item><item><title>Blog Post: Your Smartphone Can Help Protect Your Skin</title><link>https://connect.bcbsmt.com/health-and-wellness/b/weblog/posts/smartphone-protect-skin</link><pubDate>Fri, 10 Jul 2026 18:37:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:1628be69-72f8-4117-9288-140f22241b7b</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>We use technology in most parts of our lives now. But have you thought about using it to protect your skin? The Skin Cancer Foundation says healthy skin can be as close as your smartphone. Skin cancer is the most common cancer in the U.S. When caught and treated early, skin cancers are usually curable. And you can use your phone to help you protect your skin and catch any problems early. 7 Ways Your Phone Can Help The Skin Cancer Foundation offers seven easy ways to use your phone to monitor your skin to keep it healthy. Add an alarm . If you’re outdoors, set a reminder to reapply sunscreen. Aim for every two hours — more often if you’re sweating. And reapply right after you get out of the water. Set reminders . Set a reminder to do a monthly skin self-exam. That will help you keep an eye on your skin. Don’t forget to set up a reminder for a yearly exam so your doctor can check your skin. Use your flashlight. Aim the light at any suspicious skin spots to take a good, close look. Get ready for your close-up . Use your phone’s camera to take close-up photos of moles, freckles or spots that stand out . It can help you keep track of their appearance over time. It can even help you see areas like your back that are hard to see clearly in a mirror. Monitor monthly. During your monthly self-exam, take new photos and compare to previous ones. Use your photos to track the way your moles, freckles or spots look over time. You can also show the photos to your doctor. Save the photos with a detailed file name, such as left shoulder mole and the date. Hunt for an app. Check out apps that help you look at, track and monitor skin issues. Just don’t count on an app to protect your health. Reach out to your doctor for help. Share skin safety. You can use your phone to text family and friends, to support them doing regular skin checks of their own. Catch It Early You may think you’re not at risk. But everyone needs to protect their skin and pay attention to any changes. Skin cancer is most easily treated when caught early. Remember, in a self-check, you’re looking for: New moles or skin growths Moles, freckles or growths that have started to change or grow A lesion that itches, bleeds or doesn’t heal See your doctor if you spot anything troubling. Reduce Your Risk Too much sun can raise your risk for skin cancer. That’s why many serious melanoma cancers are found on the face, neck and arms. Those areas get a lot of sun exposure. Here’s what to do to reduce your risk. First, remember that protection from ultraviolet (UV) radiation is important all the time. But it’s good to be extra careful when you’re outdoors a lot, including those long summer days. Second, know that the hours between 10 a.m. and 4 p.m. in the late spring and summer are the most hazardous for UV exposure outdoors in the U.S. Easy choices for protection: Find shade, especially during midday hours. Wear clothing to cover your legs and arms. Wear a hat with a wide brim. Make sure it shades not only your face but also your neck and ears. Wear sunglasses that block both UVA and UVB rays. Ones that wrap are best. Use sunscreen with a sun protection factor (SPF) of 15 or higher. Make sure it has both UVA and UVB (broad spectrum) protection. Avoid indoor tanning. Sources: Healthy Skin in Your Pocket , Skin Cancer Federation, 2023; Reducing Risk of Skin Cancer , Centers for Disease Control and Prevention, 2026; Sun Safety Facts , CDC, 2026; What’s New in Melanoma Skin Cancer Research? , American Cancer Society, 2024</description><category domain="https://connect.bcbsmt.com/tags/Skin%2bHealth">Skin Health</category><category domain="https://connect.bcbsmt.com/tags/Health%2band%2bWellness">Health and Wellness</category><category domain="https://connect.bcbsmt.com/tags/Cancer">Cancer</category><category domain="https://connect.bcbsmt.com/tags/Summer%2bSafety">Summer Safety</category><category domain="https://connect.bcbsmt.com/tags/Safety">Safety</category></item><item><title>Blog Post: Help Your Skin Help You</title><link>https://connect.bcbsmt.com/health-and-wellness/b/weblog/posts/help-your-skin-help-you</link><pubDate>Fri, 10 Jul 2026 14:53:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:b5419453-b5c0-4496-a80a-c1e46547729d</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>Your skin has a big job. It shields your body and keeps out germs. And that’s just the start. It’s your body’s largest organ, and it deserves careful attention. Help Your Skin Help You Taking care of your skin is taking care of your health. Your skin is vital to your body in several ways: It holds in fluids to prevent dehydration. It keeps out germs. It helps control body temperature. It shields your body from light and heat. Since your skin protects your body in many important ways, it&amp;#39;s important to keep it healthy. To do that, the National Institutes of Health suggests that you: Prevent or treat dry skin by using lotions and creams. Use mild cleansers and wash gently — don’t scrub. And use warm water, not hot, for baths and showers. Consider long sleeves and pants for protection against bug bites and cuts and scrapes. Use insect repellant to avoid bites and stings. Prevent cuts and scrapes with protective gear like gloves. Care for a scrape or cut right away. Clean it and cover with a bandage while it heals. Use sunscreen. Sun Smarts Too much sun is dangerous for your skin. You can get a painful burn and raise your risk for skin cancer later. To protect yourself from skin cancer, the American Academy of Dermatology Association (AAD) recommends that you: Choose sunscreen that has an SPF of 30 or higher. Look for water resistant, broad-spectrum protection. Apply sunscreen generously before going outside. It takes about 15 minutes for your skin to soak it up. Remember your neck, face, ears and the tops of your feet. If you have thinning hair, either apply sunscreen to your scalp or wear a wide-brimmed hat. Don’t forget a lip balm with a SPF of at least 15. Reapply sunscreen at least every two hours and after swimming or sweating. Care for Burns, Cuts and Insect Bites Caring for skin injuries correctly is vital. Burns Burns on the skin can be caused by heat, chemicals, electricity, sun or radiation. Scalds from hot liquids and steam, building fires and flammable liquids and gases are the most common causes of burns, says the National Institute of General Medical Sciences. Burns can cause swelling, blistering and scarring. Burns also can lead to infections because they damage your skin&amp;#39;s protective barrier. Treatment for burns depends on the cause of the burn, how deep it is, and how much of the body it covers. For mild burns that cover a small area, the AAD says to: Cool the burned area. Put petroleum jelly on the burn two to three times a day. Don’t put ointments, toothpaste or butter on the burn. They may cause an infection. Cover the burn with a nonstick, sterile bandage. If blisters form, let them heal on their own while keeping the area covered. Don’t pop the blisters. If needed, you can take over-the-counter pain medicine. Acetaminophen or ibuprofen can help relieve the pain and reduce inflammation. Protect the area from the sun. For more serious burns, seek medical treatment. Cuts and Scrapes Injuries that break the skin include cuts, scrapes and punctures. Minor wounds usually aren&amp;#39;t serious, but it is important to clean them. Rinse the wound with cool water. Wash the area around it with soap, but don’t get soap in the wound. To stop minor bleeding, apply firm but gentle pressure using gauze. If blood soaks through, add more gauze, keeping the first layer in place. Continue to apply pressure until the bleeding stops. Serious and infected wounds may require medical help. You should also seek medical attention if the wound is deep, you can’t close it yourself, you can’t stop the bleeding, you can’t get the dirt and debris out, or it does not heal. Stings and Bites Stay safe from stinging insects by avoiding scented soaps and shampoos and brightly colored clothing. All can attract insects. When you’re outdoors, try to avoid being too close to things that draw insects, including stagnant water, food and blooming flowers. Use insect repellent. And wash it off with soap and water when outdoor fun is done. Products with DEET can be used on the skin, but you may also want to try products without it. And be sure to look for kid-friendly products for children. Headed out for a hike? To avoid ticks, stay on cleared trails as much as possible. Cover up your head, arms and legs. Wear close-toed shoes. When you’re back indoors, check for ticks on the skin. They may hide behind the ears or along the hairline. Be sure to remove them the right way . Help relieve the itch from various insect bites with ice and a calamine lotion or 1 percent hydrocortisone cream. Rashes Some common causes of a rash include: Eczema: A red, scaly rash. It’s common in people with allergies or asthma. Psoriasis: Scaly, red plaques forming over joints or along the scalp. Impetigo: Children commonly have this infection from bacteria on the top layers of the skin. It shows up as red sores or blisters that later crust over. Poisonous plants: Plants like poison ivy, poison oak and sumac can cause allergic skin reactions. Symptoms include redness, swelling, blisters and itchiness. Childhood illnesses: Chickenpox, measles, roseola, rubella, hand-foot-mouth disease and fifth disease all cause rashes. Shingles: Caused by the same virus as chickenpox, shingles is a painful, usually itchy, rash that develops on one side of the face or body. You can care for many rashes at home by using gentle cleansers and avoiding hot water and scrubbing. Then let the area air dry and consider an oatmeal bath product or medicated lotion or cream. Talk to your doctor if the problem continues. See your doctor right away if you: Have fever, sore throat or joint pain along with the rash Have streaks of redness or swelling Are taking a new medicine that causes a rash Think you may have a tick bite Sources: Skin Conditions , National Institutes of Health, 2024; How to Prevent Skin Cancer , American Academy of Dermatology Association (AAD), 2025; How to treat a first-degree, minor burn , AAD; 12 Common Summertime Skin Rashes in Children , American Academy of Pediatrics, 2025; Rashes , Penn Medicine, 2024; Shingles Symptoms and Complications , Centers for Disease Control and Prevention, 2024</description><category domain="https://connect.bcbsmt.com/tags/Skin%2bHealth">Skin Health</category><category domain="https://connect.bcbsmt.com/tags/Health%2band%2bWellness">Health and Wellness</category><category domain="https://connect.bcbsmt.com/tags/Cancer">Cancer</category><category domain="https://connect.bcbsmt.com/tags/Summer%2bSafety">Summer Safety</category></item><item><title>Blog Post: High Cholesterol Raises Your Risk for Heart Disease and Stroke</title><link>https://connect.bcbsmt.com/health-and-wellness/b/weblog/posts/cholesterol-doubles-risk</link><pubDate>Wed, 08 Jul 2026 22:00:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:29b4db4a-9809-4281-9f9d-9c66e8765d70</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>Millions of Americans have high cholesterol, which can clog blood vessels and lead to serious health problems. People with high total cholesterol are at higher risk for heart disease and stroke, two leading causes of death in the U.S. Along with family history, unhealthy diet, weight gain and lack of exercise are contributing factors for most people with high cholesterol. What Is Cholesterol? Cholesterol is the fatty substance in your blood that latches on to particles called lipoproteins. “Lipo” means “fat” or “fatty.” Doctors test the blood for three main types: High-density lipoprotein (HDL) — this is the “good” kind. HDL helps take cholesterol out of your body. It gives your arteries a better chance of being unaffected. Low-density lipoprotein (LDL) — this is the “bad” kind. LDL is the main type of harmful cholesterol. It can build up and block the arteries. Your risk for heart attack or stroke rises as your LDL level rises. Triglycerides — this is another bad fat. High levels are often found with other heart disease risk factors. Your total cholesterol is a blend of the three. A higher total means a greater risk for heart disease. The aim of treatment is to boost HDL while lowering LDL and triglycerides. Confused about what your cholesterol numbers mean? What is considered a healthy number can vary from person to person. But in general, the Centers for Disease Control and Prevention says those who are healthy and have an average risk of heart disease should aim for these levels : HDL: 40 mg/dL or higher for men, 50 mg/dL or higher for women LDL: 100 mg/dL or lower Triglycerides: Less than 150 mg/dL Total cholesterol: About 150 mg/dL. Total cholesterol over 200 mg/dL is considered high. But remember, targets for LDL (bad) cholesterol and total cholesterol vary from person to person, according to the American Heart Association. Your doctor can tell you what your ideal cholesterol numbers should be. Keeping Your Cholesterol in Check Here are some ways to help manage cholesterol: If you’re overweight, make an effort to shed excess pounds. Exercise for at least 30 minutes on most days of the week. Avoid saturated fat. It is found in meats, whole milk dairy products and many prepared foods. Limit or avoid alcohol intake. Quit smoking. If you have high cholesterol, your doctor may recommend medicine along with these changes. You and your doctor will decide if you need medicine by checking your test results and all your other risk factors. If you do need medicine, be aware that your health plan may not cover all brand name drugs. To try to keep your costs lower, ask if a generic version of a prescribed drug is available. It&amp;#39;s also a good idea to check the drug list for your health plan to see what cholesterol drugs are covered and share that information with your doctor. Getting your recommended screenings is an important part of managing your cholesterol. You can take advantage of some important health screenings available at no cost when services are provided by a network provider.* Family History Can Be Critical Some people have a family tie to a severe form of high cholesterol. The American Heart Association says this inherited condition, called familial hypercholesterolemia, affects 1 in 200 people in the United States. About 90 percent of them don&amp;#39;t know they have it. People with this condition have high cholesterol from birth but may have no symptoms until they have already developed serious heart problems. If left untreated, people with the condition have 20 times higher than average risk of developing heart disease. Inherited conditions like this show the value of knowing your family medical history and sharing it with your doctor. *Preventive services at no cost applies only to members enrolled in non-grandfathered health plans. You may have to pay all or part of the cost of preventive care if your health plan is grandfathered. To find out whether your plan is grandfathered or non-grandfathered, call the customer service number on your Blue Cross and Blue Shield of Montana member ID card. Sources: About Cholesterol , Centers for Disease Control and Prevention, 2024; High Cholesterol Facts , CDC, 2024; Preventing High Cholesterol , CDC; 2024; What is Familial Hypercholesterolemia , American Heart Association, 2026; Cholesterol test , Mayo Clinic, 2025</description><category domain="https://connect.bcbsmt.com/tags/Heart%2bHealth%2b_2600_amp_3B00_%2bDiet">Heart Health &amp;amp; Diet</category><category domain="https://connect.bcbsmt.com/tags/Health%2band%2bWellness">Health and Wellness</category><category domain="https://connect.bcbsmt.com/tags/Cholesterol">Cholesterol</category><category domain="https://connect.bcbsmt.com/tags/Risk%2bfor%2bHeart%2bDisease">Risk for Heart Disease</category><category domain="https://connect.bcbsmt.com/tags/Heart%2bDisease%2bDiet%2band%2bHealth">Heart Disease Diet and Health</category><category domain="https://connect.bcbsmt.com/tags/High%2bCholesterol">High Cholesterol</category></item><item><title>Blog Post: Este avance médico es esencial para una vida sana</title><link>https://connect.bcbsmt.com/espanol/b/tusalud/posts/vacunas-para-mantenerse-sano</link><pubDate>Wed, 08 Jul 2026 19:30:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:bdb822d0-5fc1-4153-bd22-489487d610b1</guid><dc:creator>EquipoConnect</dc:creator><description>Es probable que &amp;#250;ltimamente hayas escuchado mucho sobre las vacunas. Es un buen recordatorio para que t&amp;#250; y tu familia se pongan al d&amp;#237;a con todas las vacunas de rutina. &amp;#191;Qui&amp;#233;n necesita vacunarse? Las vacunas no son solo para beb&amp;#233;s o ni&amp;#241;os peque&amp;#241;os. Seg&amp;#250;n los Centros para el Control y la Prevenci&amp;#243;n de Enfermedades (CDC, en ingl&amp;#233;s), todos necesitamos vacunas a lo largo de nuestras vidas para ayudar a protegernos contra enfermedades graves. Se recomiendan diferentes vacunas para ni&amp;#241;os, adolescentes y adultos. Las vacunas adecuadas en el momento oportuno pueden ayudar a mantener saludables a personas de todas las edades. Las vacunas que necesitas dependen de factores como la edad, los problemas de salud, el empleo y los viajes. Aglunos ejemplos: Los ni&amp;#241;os y adultos j&amp;#243;venes deben recibir la vacuna contra el VPH, que protege contra algunos c&amp;#225;nceres. Los adultos sanos de 50 a&amp;#241;os o m&amp;#225;s necesitan la vacuna contra la culebrilla. Tambi&amp;#233;n protege contra las complicaciones de la enfermedad. La vacuna contra la neumon&amp;#237;a se recomienda para los adultos mayores y todos los adultos que tienen un problema de salud que debilita su sistema inmunol&amp;#243;gico. Tambi&amp;#233;n es un paso vital para proteger a quienes tienen un mayor riesgo, como los muy j&amp;#243;venes, los muy mayores y las personas con sistemas inmunol&amp;#243;gicos d&amp;#233;biles o con enfermedades graves. Algunas personas que est&amp;#225;n en riesgo no pueden vacunarse. Cuantas m&amp;#225;s personas puedan vacunarse, m&amp;#225;s protegidos estaremos todos. Obten m&amp;#225;s informaci&amp;#243;n sobre las enfermedades de los adultos que las vacunas pueden ayudar a prevenir. Los g&amp;#233;rmenes viajan por todo el mundo Las enfermedades prevenibles por vacunaci&amp;#243;n siguen existiendo, incluso las que no son comunes actualmente en los Estados Unidos, y pueden ser transmitidas a personas que no se han vacunado. Un viajero que no se ha vacunado puede contagiarse y traer la enfermedad de vuelta a los EE.UU., donde se puede propagar a otros. &amp;#191;Son seguras las vacunas? Antes de aprobar una vacuna para usarse en los EE.UU., es sometida a pruebas para confirmar que es segura y funciona bien. La Administraci&amp;#243;n de Alimentos y Medicamentos de los Estados Unidos (FDA, en ingl&amp;#233;s) eval&amp;#250;a los resultados de los estudios cl&amp;#237;nicos. Durante su uso se observa la seguridad. Al igual que otros medicamentos, las vacunas pueden causar efectos secundarios. Generalmente, son leves. &amp;#191;Qu&amp;#233; vacunas necesitan los adultos? Consulta nuestras Recomendaciones para el bienestar para ver las vacunas recomendadas para adultos. Las recomendaciones est&amp;#225;n disponibles en ingl&amp;#233;s y espa&amp;#241;ol en formato PDF para facilitar su descarga o impresi&amp;#243;n. Obten las recomendaciones de bienestar para adultos mas recientes: Ingl&amp;#233;s Espa&amp;#241;ol Tambi&amp;#233;n hay recomendaciones de bienestar infantil y perinatal. Puedes ver las recomendaciones m&amp;#225;s recientes en cualquier momento inicia sesi&amp;#243;n en tu cuenta en l&amp;#237;nea . Haz clic en la pesta&amp;#241;a Mi salud y desplazate hacia abajo hasta Recomendaciones de bienestar .  Los adultos con problemas de salud cr&amp;#243;nicos como el asma, la enfermedad pulmonar obstructiva cr&amp;#243;nica, las enfermedades card&amp;#237;acas y la diabetes tienen m&amp;#225;s probabilidades de sufrir complicaciones por ciertas enfermedades. Si tienes problemas de salud cr&amp;#243;nicos, confirma qu&amp;#233; vacunas necesitas. No dejes a los ni&amp;#241;os desprotegidos Desde la infancia hasta el preescolar y m&amp;#225;s all&amp;#225;, mant&amp;#233;n a tu hijo sano siguiendo un programa de vacunaci&amp;#243;n. Est&amp;#225; dise&amp;#241;ado para proteger contra enfermedades graves, como polio, tos ferina y paperas. Esas enfermedades pueden resultar en hospitalizaciones o, incluso, la muerte. Es importante asegurarte de que tu hijo est&amp;#233; completamente vacunado contra estas enfermedades que se pueden prevenir a trav&amp;#233;s de la vacunaci&amp;#243;n. Esto significa completar la serie de vacunas recomendadas. No pospongas las vacunas. Habla con tu m&amp;#233;dico si tienes alguna duda. Fuentas: Vaccine-Preventable Adult Diseases , Centers for Disease Control and Prevention, 2024; 5 Reasons It Is Important for Adults to Get Vaccinated CDC, 2024; Preventing Seasonal Flu , CDC, 2025; RSV Vaccine Guidance for Older Adults , CDC, 2026</description><category domain="https://connect.bcbsmt.com/tags/La%2bgripe">La gripe</category><category domain="https://connect.bcbsmt.com/tags/Espa_26002300_241_3B00_ol">Espa&amp;#241;ol</category><category domain="https://connect.bcbsmt.com/tags/Tu%2bSalud">Tu Salud</category><category domain="https://connect.bcbsmt.com/tags/Vacunas">Vacunas</category></item><item><title>Blog Post: TDAH y regreso a la escuela: consejos para las padres</title><link>https://connect.bcbsmt.com/espanol/b/tusalud/posts/vuelta-a-clases-con-tdah</link><pubDate>Wed, 08 Jul 2026 19:20:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:f3eb8f7f-0e8a-4612-bb39-be3ad8905aa9</guid><dc:creator>EquipoConnect</dc:creator><description>El nuevo a&amp;#241;o escolar ofrece un nuevo comienzo y la oportunidad de aprender y crecer. Pero para muchos ni&amp;#241;os, los primeros d&amp;#237;as o semanas de clase traen cambios que causan preocupaci&amp;#243;n y estr&amp;#233;s. El cambio es dif&amp;#237;cil para muchos ni&amp;#241;os, pero puede ser a&amp;#250;n m&amp;#225;s dif&amp;#237;cil para aquellos que padecen trastorno por d&amp;#233;ficit de atenci&amp;#243;n e hiperactividad. El cambio en los horarios y las tareas, as&amp;#237; como la atenci&amp;#243;n necesaria que se debe prestar durante la jornada escolar, pueden ser especialmente desafiantes. Pero con un poco de planificaci&amp;#243;n, este a&amp;#241;o escolar puede ser un &amp;#233;xito. &amp;#191;Qu&amp;#233; es el TDAH? Los ni&amp;#241;os que padecen TDAH pueden tener problemas para prestar atenci&amp;#243;n, pueden poseer altos niveles de acci&amp;#243;n (hiperactividad) y pueden actuar sin pensar (impulsividad). O pueden tener los tres problemas al mismo tiempo. Estos comportamientos se presentan con m&amp;#225;s frecuencia en los ni&amp;#241;os con TDAH que en otros ni&amp;#241;os de su edad. Sin embargo, muchos ni&amp;#241;os con TDAH mejoran con el tratamiento. La terapia conductual puede ayudarles a aprender acciones positivas y a limitar los comportamientos problem&amp;#225;ticos. La terapia con medicamentos puede ayudarles a manejar los s&amp;#237;ntomas y a controlar algunos de los problemas de comportamiento. El &amp;#233;xito comienza en casa Los Centros para el Control y la Prevenci&amp;#243;n de Enfermedades se&amp;#241;alan que la participaci&amp;#243;n de los padres es vital para el tratamiento del TDAH. Los ni&amp;#241;os a menudo no son lo suficientemente maduros para cambiar su comportamiento y dependen de los padres para reforzar las acciones positivas. A continuaci&amp;#243;n, presentamos algunos consejos para que ayudes a tu hijo a tener un a&amp;#241;o escolar exitoso. Tener una rutina matutina Trata de seguir el mismo horario cada d&amp;#237;a. Las ma&amp;#241;anas pueden ser especialmente desafiantes. As&amp;#237; que establece una rutina matutina y s&amp;#237;guela. Mant&amp;#233;n todos los &amp;#250;tiles escolares en un lugar espec&amp;#237;fico para evitar la tarea de tener que buscarlos en las primeras horas de la ma&amp;#241;ana. Los mensajes visuales pueden ser &amp;#250;tiles. Crea una lista o un cuadro de las tareas necesarias para prepararse para ir la escuela. Tu hijo puede entonces marcarlas a medida que las va completando. Otra opci&amp;#243;n es usar un cron&amp;#243;metro para tareas espec&amp;#237;ficas, lo que le ayuda a saber cu&amp;#225;ndo continuar con la siguiente tarea. Establecer sistemas de organizaci&amp;#243;n simples para las tareas escolares Si tu hijo tiene problemas para llevar un registro de las tareas escolares, hay maneras de ayudarle a mantenerse organizado. Por ejemplo, establece un sistema que sea lo suficientemente f&amp;#225;cil para que tu hijo pueda seguirlo en la escuela y en el hogar. Prueba usar una carpeta con compartimentos, con un lado para las tareas completadas; y el otro lado, para las tareas aun por terminar. Usa carpetas de diferentes colores para cada tipo de tarea o asignatura. Crear un m&amp;#233;todo para hacer las tareas Define una hora espec&amp;#237;fica para hacer las tareas. Es mejor si esto ocurre dentro de la primera hora en que tu hijo llega a casa. Trata de mantener esta rutina lo m&amp;#225;s consistente posible. Elige un lugar que no tenga distracciones. Comienza por revisar las indicaciones de las tareas con tu hijo. Luego, h&amp;#225;blale sobre los pr&amp;#243;ximos pasos que debe seguir. Los cron&amp;#243;metros tambi&amp;#233;n pueden usarse para mantener a los ni&amp;#241;os encaminados. Incorpora descansos cortos para que tu hijo se mueva cada 20 minutos de trabajo. Acude al pediatra Si tu hijo toma medicamentos, considera la posibilidad de programar una cita con el pediatra antes de que comience el a&amp;#241;o escolar. Es posible que sea necesario cambiar los medicamentos a medida que crece o que los estudios se vuelven m&amp;#225;s dif&amp;#237;ciles. Una consulta antes del a&amp;#241;o escolar le da tiempo al pediatra para hacer cualquier cambio que sea necesario. Aseg&amp;#250;rate de acudir a las consultas de seguimiento recomendadas y de compartir cualquier comentario de los maestros. Esto ayudar&amp;#225; a asegurarte de que tu hijo tenga el mejor plan de medicamentos. Conoce los recursos escolares que est&amp;#225;n disponibles Si tu hijo con TDAH tiene dificultades en la escuela con sus comportamientos o estudios, puede ser elegible para un Programa de educaci&amp;#243;n individualizado (IEP, en ingl&amp;#233;s) o un plan 504 . Si tu hijo cuenta con un IEP o un plan 504, t&amp;#243;mate tiempo para revisarlos. Conoce los componentes espec&amp;#237;ficos del plan. Habla con los maestros para asegurarte de que conozcan los detalles del plan. Tambi&amp;#233;n puedes compartir cualquier comentario sobre los desaf&amp;#237;os o &amp;#233;xitos que tu hijo tuvo el a&amp;#241;o pasado. Mant&amp;#233;n una comunicaci&amp;#243;n abierta con los maestros. Comparte cualquier inquietud que puedas tener sobre el progreso de tu hijo durante el a&amp;#241;o. Visita el sitio web de National Resource Center on ADHD (NRC) para obtener m&amp;#225;s informaci&amp;#243;n y consejos para los padres de ni&amp;#241;os con TDAH. El grupo tambi&amp;#233;n ofrece recursos para adultos con TDAH. Ayuda a que el a&amp;#241;o escolar transcurra sin problemas con planificaci&amp;#243;n y comunicaci&amp;#243;n abierta. Establecer un plan y tener una comunicaci&amp;#243;n clara con tu hijo, los maestros y los pediatras, puede ayudarle a prepararse para tener un buen a&amp;#241;o. Fuentas: Your Most Important Back-to-School List: 10 Conversations Every Parent Should Have , ADDitudemag.com, 2022; What Is an IEP? Everything You Need to Know About IDEA, IEPs, and 504 Plans , ADDitudemag.com, 2025; When Your ADHD Medication Stops Working , PsychCentral, 2022; Parent Training in Behavior Management , Centers for Disease Control and Prevention, 2026; School Mornings Without the Stress, Child Mind Institute, 2025</description><category domain="https://connect.bcbsmt.com/tags/Espa_26002300_241_3B00_ol">Espa&amp;#241;ol</category><category domain="https://connect.bcbsmt.com/tags/Tu%2bSalud">Tu Salud</category><category domain="https://connect.bcbsmt.com/tags/Ni_26002300_241_3B00_os">Ni&amp;#241;os</category><category domain="https://connect.bcbsmt.com/tags/TDAH">TDAH</category><category domain="https://connect.bcbsmt.com/tags/Salud%2bMental">Salud Mental</category></item><item><title>Blog Post: ADHD and Back to School: Tips for Parents</title><link>https://connect.bcbsmt.com/health-and-wellness/b/weblog/posts/adhd-back-to-school</link><pubDate>Wed, 08 Jul 2026 16:08:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:91863127-3f6e-46ec-8d2e-c7755dda8edc</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>New school years offer new beginnings. A chance to learn and grow. But for many children, the first few days or weeks bring change, causing worry and stress. Change is hard for many people, but it can be even more difficult for children with Attention Deficit Hyperactivity Disorder. The change in schedules and tasks and the attention needed throughout a school day can be especially challenging. But with some planning, this school year can be a success. What Is ADHD? Children with ADHD may have trouble paying attention. They may have high levels of action (hyperactivity) and acting before thinking (impulsivity). Or they may have all three issues. For children with ADHD, these behaviors happen more often than for others their age. Many children with ADHD thrive with treatment. Behavior therapy can help children learn positive actions and limit problem behaviors. Medication therapy can help children handle symptoms and control some of the behavioral problems. Success Starts at Home The Centers for Disease Control and Prevention says parent involvement is vital to ADHD treatment. Children are often not mature enough to change their own behavior. Your child relies on you to reinforce helpful actions. Here are some ways to help your child have a successful school year. Have a Morning Routine Try to follow the same schedule each day. Mornings can be especially challenging. So set a morning routine and stick with it. Keep all school-related items in a specific place. This takes the guess work out of finding them in the morning rush. Visual prompts can be helpful, so make a list or chart of tasks needed to get ready for school. Your child can then check them off as they go. Another option is to use a timer for specific tasks, which helps them know when to move on to the next task. Set Up Simple Organizational Systems for Schoolwork If your child has trouble keeping track of schoolwork, there are ways to help them stay organized. Set up a system that is easy enough for your child to do at school and home. Try a pocket folder with one side for completed work and one for unfinished work. Use different colored folders for each type of work or subject. Create a System for Getting Homework Done Plan a set time for homework. It is best if this is within an hour of your child getting home. Try to keep this routine as consistent as possible. Find a place that is free from distractions. Start by reviewing assignments with them. Then talk about what next steps they need to take. Timers can also be used to keep kids on track. Build in short movement breaks after each 20 minutes of work. Visit the Doctor If your child is on medication, consider scheduling an appointment with your child’s doctor before the school year starts. Medicines may need to be changed as your child gets older or as school becomes more challenging. A visit before the school year gives the doctor time to make any needed changes. Be sure to go to recommended follow-up visits and share any feedback from teachers. This will help make sure your child is on the best medication plan. Learn What School Resources Are Available If your student with ADHD is struggling in school with behaviors and/or academics, they may be eligible for an Individualized Education Program or 504 plan . If your child has an IEP or 504 plan, take some time to review it. Know the specific components of your plan. Talk to your child’s teachers to make sure they are aware of the plan details. You can also share any feedback from the challenges or successes your child had last year. Keep open communication with the teachers. Share any concerns you may have about your child’s progress throughout the year. Visit the National Resource Center on ADHD (NRC) for more information and advice for parents with children who have ADHD. The group also offers resources for adults with ADHD. Help the school year go smoothly with planning and open communication. Making a plan and having clear communication with your child and their teachers and doctors can help set your child up for a good year. Sources: Your Most Important Back-to-School List: 10 Conversations Every Parent Should Have , ADDitudemag.com, 2022; What Is an IEP? Everything You Need to Know About IDEA, IEPs, and 504 Plans , ADDitudemag.com, 2025; When Your ADHD Medication Stops Working , PsychCentral, 2022; Parent Training in Behavior Management , Centers for Disease Control and Prevention, 2026; School Mornings Without the Stress, Child Mind Institute, 2025</description><category domain="https://connect.bcbsmt.com/tags/Health%2band%2bWellness">Health and Wellness</category><category domain="https://connect.bcbsmt.com/tags/Mental%2bHealth">Mental Health</category><category domain="https://connect.bcbsmt.com/tags/Healthy%2bMind">Healthy Mind</category><category domain="https://connect.bcbsmt.com/tags/ADHD">ADHD</category></item><item><title>Blog Post: Recovery Doesn’t Stop When You Get Home from the Hospital</title><link>https://connect.bcbsmt.com/health-and-wellness/b/weblog/posts/recovery-home-from-hospital</link><pubDate>Wed, 08 Jul 2026 15:53:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:6be8cee7-61ca-41f7-8a12-21548866f8ec</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>Whether you’re being treated for physical or mental health issues, it’s vital to continue your health care after discharge from the hospital. Follow-up care is an important part of getting better. What Should I Do After Being Discharged from the Hospital? When you get home after any hospital stay, it’s time to focus on your health. To recover fully, be sure to stay on top of your care: Don’t wait too long to schedule follow-up visits with your doctor. Review your post-discharge care instructions. Watch for signs that could mean you need urgent care (see your post-discharge instructions). Make sure you get any drugs or equipment that have been prescribed for you. Work with your doctor to schedule home health care if needed. Know who to call with questions and concerns. The Family Caregiver Alliance offers tips for caregivers and patients to ease the shift from hospital to home. Many cities have a wide range of resources, such as support groups for caregivers. Help is available if you need it to get the recommended follow-up care. Continue Your Recovery After Mental Health or Substance Use Hospitalization The journey to better mental health doesn’t end with your hospital stay. Health issues like depression, anxiety, and substance use disorder do not go away or get better on their own. It’s important to continue your recovery. Professional care, including therapy and medication management, and connecting with supportive resources in your community can help. Continue your care with an outpatient therapist or psychiatrist. This type of follow-up care can: Make you feel better Improve your relationships with friends and family Help you take less time away from work Help you have more energy to do the things you love Lower the chance of another crisis Schedule mental health or substance use follow-up care within 30 days of discharge from the hospital. That will help you maintain the progress you made in the hospital. Bring your hospital discharge paperwork to your follow-up doctor visit so your doctor has the most up-to-date information on your health. To find mental health providers and support groups in your area, make use of resources like findtreatment.gov or SAMHSA’s National Helpline 800-662-HELP (4357). And make sure your family knows they also have options for getting support . Sources: Taking Good Care of Yourself , Mental Health America; Findtreatment.gov , Substance Abuse and Mental Health Services Administration (SAMHSA); SAMHSA’s National Helpline , SAMHSA, 2023; Helping Families Cope with Mental Health and Substance Use Disorders , SAMHSA, 2025; Hospital Discharge Planning: A Guide for Families and Caregivers , Family Caregiver Alliance; Hospital Discharge , Johns Hopkins Medicine</description><category domain="https://connect.bcbsmt.com/tags/Health%2band%2bWellness">Health and Wellness</category><category domain="https://connect.bcbsmt.com/tags/Mental%2bHealth">Mental Health</category><category domain="https://connect.bcbsmt.com/tags/Healthy%2bMind">Healthy Mind</category><category domain="https://connect.bcbsmt.com/tags/After%2bHospital%2bCare">After Hospital Care</category></item><item><title>Blog Post: HIPAA: What More Do You Need to Know?</title><link>https://connect.bcbsmt.com/my-coverage-explained/b/weblog/posts/hipaa-what-more-do-you-need-to-know</link><pubDate>Wed, 08 Jul 2026 14:17:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:3859a220-70e0-4aed-ac09-45125aa87477</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>When you go to a doctor, dentist or eye doctor, you are asked to sign that you’ve seen their privacy statement. What does that mean? Thanks to the Health Insurance Portability and Accountability Act ( HIPAA ), you are reminded at each visit that your health information will be private and used only for making sure you get the care you need. Privacy Before HIPAA Before HIPAA, a University of Illinois study found, more than one-third of Fortune 500 companies looked at health records or health information as part of their employment decisions. Imagine worrying that a potential employer could refuse to hire you or your current employer could fire you if they found out that: You’re a recovering addict You may need to take extra time to handle your cancer treatment You have HIV, Hepatitis C, or another health issue You receive care for mental health issues Before HIPAA, this happened. It happened to FBI agents. It happened to truck drivers. It may have happened to you or someone you know. Since HIPAA was signed into law in 1996, employers have not been allowed to see your health information. Privacy with HIPAA Have you: Been told to stand well back from the pharmacy counter? Signed a privacy form when you see a new doctor or go to a hospital? Found it impossible to get health information about a family member? Though these steps may sometimes frustrate you, they are needed to protect your health information and that of others. Things to Consider with HIPAA Your adult child . Do you have a child going off to college? If your child is 18 or over, you may not be able to receive their health information as you had in the past. If you want to know about the health care services your child receives, you’ll need to fill out an authorization form — with your child’s written permission. Helping loved ones with HIPAA . You notice an elderly family member having odd spells or memory issues. You want to know about their care and if there is anything you should be doing to help them. You’ll need an authorization or a power of attorney for health care from your family member before you can help. Completing one of these documents ahead of time can reduce the stress when an issue happens. Your spouse has a serious illness . Cancer, ALS, renal failure. These and other health problems can get critical fast. Make sure you can make decisions that will honor their wishes. Maybe they want to donate their body to science or to be an organ donor. Maybe they want a Do Not Resuscitate order on file. Be sure to complete the necessary forms so you can make or enforce those decisions if your spouse isn’t able to. Privacy laws like HIPAA have made a difference in making sure your health problems are kept private. Make sure you know how they work and what you may need to do if you want others close to you to know more.</description><category domain="https://connect.bcbsmt.com/tags/HIPAA">HIPAA</category><category domain="https://connect.bcbsmt.com/tags/Understanding%2bInsurance">Understanding Insurance</category><category domain="https://connect.bcbsmt.com/tags/PHI">PHI</category><category domain="https://connect.bcbsmt.com/tags/Standard%2bAuthorization">Standard Authorization</category></item><item><title>Blog Post: Staying In-Network Can Help Cut Costs</title><link>https://connect.bcbsmt.com/my-coverage-explained/b/weblog/posts/in-network-health-care</link><pubDate>Wed, 08 Jul 2026 13:58:00 GMT</pubDate><guid isPermaLink="false">6e104328-2028-43b6-bb31-8401437dc51f:4805c6cb-e4b3-4315-9ed7-d4254fceb2b6</guid><dc:creator>BCBSMT Connect Team</dc:creator><description>When you shop, you probably keep an eye on costs. You want to buy the things you need at a fair price. What about when you’re shopping for health care? Using providers in your health plan’s network can help you save money. A network includes hospitals, clinics, doctors, pharmacies and others who take part in your health plan. These network providers agree to work with your health plan. That helps keep your costs down. Providers who do not have a contract in place with your health plan are out-of-network . In-Network, Out-of-Network — What’s the Difference? By staying in your network, you can take advantage of discounted rates and avoid surprise charges. That’s because in-network health care providers and your health plan have agreed to a set price for each treatment or procedure in advance. A provider who is not in your plan&amp;#39;s network can charge higher prices for the same care. You may also have to pay a higher copay or deductible for out-of-network care. In some cases, you may even have to pay the full cost. Before you go anywhere for care, make sure the provider or facility is in your health plan network. You’ll receive the same quality health care you should expect from any provider at the most affordable cost to you. Try these tips: Once you find a provider, check to see if they are in-network for your specific health plan. Simply asking if they take Blue Cross and Blue Shield insurance is not enough. Give them the information on your member ID card — including the full name of your plan — to make sure. If your primary care provider gives you a referral to another doctor, ask for one who is in your plan’s network. Then make sure that the new doctor is in your network. If you need surgery or other health services, check to make sure each facility where you will get care is in your network. It’s a good idea to see if each provider for the service or procedure is also in your network. But if you get care from an out-of-network provider while you’re at an in-network facility, you may be protected from unexpected costs, called balance billing or surprise billing. To find providers in your health plan’s network, log in to your account and select Find Care. Don’t Forget Pharmacies When you use a pharmacy that is in your network, you’ll save money. With some prescription drug plans, there can be another consideration. Along with in-network and out-of-network pharmacies, there may be a value participating pharmacy network in your plan benefits. If so, you’ll save the most money when you fill your prescriptions at value participating pharmacies. To find an in-network pharmacy, log in to your account and look under Pharmacy. On the Pharmacy page, search for retail or home delivery pharmacies. If you’ve been using a pharmacy that isn’t in-network, it’s easy to switch. You can take your prescription bottle/bag to the new in-network pharmacy. Or you can call the new pharmacy and ask them to contact your current pharmacy. You can also ask your health care provider to contact your new pharmacy. Make sure to ask your provider to send any new prescriptions to your network pharmacy. You may need to take your BCBSMT member ID card with you if it’s your first visit to the pharmacy or if you’ve changed health insurance plans. Plan in Advance Remember, whether it’s a doctor, clinic, hospital, therapist or other provider, you may pay less for care when you visit an in-network provider. That’s why it’s good to learn about your choices before you need care. It will help you be better prepared to take care of your health.</description><category domain="https://connect.bcbsmt.com/tags/Benefits%2band%2bCoverage">Benefits and Coverage</category><category domain="https://connect.bcbsmt.com/tags/Using%2bHealth%2bInsurance">Using Health Insurance</category><category domain="https://connect.bcbsmt.com/tags/Health%2bInsurance%2bNetwork">Health Insurance Network</category><category domain="https://connect.bcbsmt.com/tags/Health%2bCare%2bCosts">Health Care Costs</category><category domain="https://connect.bcbsmt.com/tags/In_2D00_Network">In-Network</category></item></channel></rss>