I collaborated with the Product Strategy and Clinical teams, and successfully managed the project from concept to production. The objective was to engage/motivate members to get their annual exams and preventive tests during 2015, with the goal of increasing HOS and CAHPS scores, and ultimately, the Star rating from CMS.

1. PO Box 52
Minneapolis MN 55440-0052
Health and wellness or
prevention information
Healthy Living
Rewards for
U Picture Yourself Healthy … for Life!
Complete your annual checkup in 2015 and receive
a coupon book with more than 100 coupons offering
valuable discounts and savings. Look inside for details
and sample coupons.
Why is this important?
Making even small changes can make a big difference
when it comes to your health. Talk to your doctor to learn
ways you can live healthier by improving three things:
your balance, emotional well-being, and physical activity.
What happens at my annual checkup?
Bring the Annual Checkup Checklist (enclosed) to your
appointment so you and your doctor can create a personal
prevention plan to help you stay healthy. If you don’t have
a primary care physician, visit ucare.org and click “Find
a Doctor” to choose from a large network of physicians,
clinics, and other providers.
Will this visit cost anything?
No. Your annual checkup is covered by UCare once every
12 months (11 full months must pass since your last visit).
If your doctor recommends additional tests or services,
ask whether you will have to pay for any of it. Customer
Services can answer your questions about coverage and
benefits. Call the number on the back of your UCare
Member ID card. We’re here for you 24 hours a day, seven
days a week.
Want to Know How
One Doctor Visit
Can Pay Off
All Year Long?
You can improve your health, and live happier
and healthier in 2015 and beyond. UCare can help.
We’re as serious about protecting your privacy as we are about protecting your health.
Your confidential checklist will be used only to verify your clinic visit.
Health care that starts with you.®
U6069 (11/14)

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Receiving your coupon book is
as easy as 1, 2, 3!
Detach the Annual Checkup
Checklist, review it with
your doctor, and ask a clinic
representative to sign it.
Send us your completed
and signed checklist before
December 31, 2015 in the
postage-paid envelope
included in this mailing.
Receive your coupon book and
start enjoying your discounts
and savings!
Annual Checkup Checklist
Add any personal health concerns or questions you may have to this checklist. When making
your appointment, ask your clinic to reserve enough time for you to talk with your doctor. It
may be helpful to take notes during this visit.
Topics to Review:
 Personal and family health history
 Review of current medicines/
refills needed
 Review of other providers
Measures:
 Blood Pressure
 Body Mass Index
 Blood Draw/Lab Panel
Topics to Discuss:
 Physical health: Any changes from
last year?
 Physical activity: Are you active at
least 20 minutes each day?
 Balance/Falls: Have you fallen or
lost your balance?
 Mental health: How is your mood?
 Cognition: Any confusion or loss
of memory?
 Social and emotional support:
Are your needs being met?
 Nutrition: Did you lose or gain weight
in the last month?
 Sleep: Do you have trouble falling or
staying asleep?
 Urine leakage
 End of life plan
Name:
UCare ID Number: Date of Visit:
Clinic Representative Name
and Signature:
 Healthy habits: Do you use:
 Tobacco?  Alcohol?  Seat belts?
Screenings to Discuss:
 Pain Level (one is lowest)
1 2 3 4 5
 Colorectal Screening
 Completed
Date Completed:
 Referral
 Mammogram
 Completed
Date Completed:
 Referral
 Bone Density Test
 Completed
Date Completed:
 Referral
 Cholesterol Test
 Completed
Date Completed:
 Referral
 Vaccines: Flu, pneumonia, shingles,
Tdap, other?
 Other: Eye exam, skin exam, dental
visit, etc.
 Diabetes Care (if applicable)
 A1c test
 Dilated eye exam
 Kidney function screening
Questions?
Call Customer Services at the numbers on the back of your UCare Member ID card.
We’re here for you 24 hours a day, seven days a week.
H2459 H4270_120114 CMS Accepted (12082014)