Faa'iidooyinka iyo Adeegyada Dheeraadka ah

Hel faa'iidooyin iyo taageero dheeraad ah. Waxaad isku hallayn kartaa un.

• Healthy Rewards. Earn rewards for completing important preventive services.
• Health Education. Free coaching to help improve your health.
• Language Help. Connect to a translator through Member Services.
• Interpreters. Have an interpreter with you at your child's doctor visits.
• Programs for Kids and Teens. Free Boys & Girls Club memberships.
• Quitting Tobacco. Coaches and supplies to help you quit using tobacco.
• Member Services. Your benefit questions are answered 24/7.
• Dental. Services and annual exams are covered separately.
• WISe. Wraparound with Intensive Services (WISe)
• Applied Behavior Analysis. Autism (ABA) dedicated phone number 1-866-456-5376

Taageerada neefta iyo Neefsasha oo adkaato (COPD)

Individual care to help control your child's asthma.

Does your child have trouble managing asthma or COPD symptoms? A nurse who specializes in breathing issues can really help. Your child will get a customized treatment plan and medicine to:

• Manage flare-ups.
• Reduce symptoms.
• Let your child stay active.

Choose a Birth Center

Where you have your baby is an important choice. That's why you can pick from large network of hospitals all across Washington.

We also encourage you to tour the hospital's birthing center. This way you will be familiar with it. And you'll be more relaxed when you have your baby.

Dooqa dhakhtarka

You will have a primary care physician (PCP) who will be your main doctor. Your PCP is the person you should see for most of your care. Tan waxaa ku jira baaritaannada, daweynta, tallaallada, dhaawacyada fudud iyo walaacyada caafimaad. Talk to your PCP about any behavioral health concerns you may have. PCP-gaaga ayaa kaa caawin kara inuu kuu go’aamiyo xulashooyinka kugu habboon.

PCP-gaaga ayaa ah dhakhtarkaaga ugu muhiimsan ee loogu tala galay:

• Preventive care.
• Treatment if you are sick or injured.
• Referrals to specialists for certain conditions.

Isticmaal Qalabka Raadinta Dhakhtarka si aad u aragto in dhakhtarkaagu ku jiro shabakadeena. Haddii aanad lahayn dhakhtar ama haddii dhakhtarkaagu aanu ku jirin shabakadayada, waxaanu kaa caawin karnaa inaad hesho mid cusub oo kuu dhow.

Taageerada Sonkorowga

Haddii aad qabto sonkorow, waxaanu kaa caawin doonaa inaan nolosha kuugu fududeyno. Waxaad heli doontaa daawo, sahay iyo waxbarasho kaa caawiya inaad gaadho oo aad sida ugu fiican u ahaato. Waxa kale oo lagugu abaalmariyay kaarar hadyad ah qaadashada tillaabooyin fudud oo lagu maareeyo sonkorowgaaga awgeed.

Our diabetes program also includes self-care training and classes focused on:

• Planning healthy meals.
• Managing stress.
• Living a healthy lifestyle.

Qalabka iyo agabyada caafimaadka

Caafimaadkaaga iyo badbaadadaada guriga waa muhiim

Our plan covers medical equipment ordered by your doctor or case manager. Tan waxaa ka mid noqon kara agabka sida:

• Hospital beds.
• Oxygen tanks.
• Wheelchairs or walkers.

Daryeelka cagaha

Haddii aad qabto sonkorow ama xaalada wareegga dhiigga, daryeelka cagaha ee wanaagsan ayaa kaa caawin kara inaad ka hortagto dhibaatooyin ka sii daran. Waxaan bixinaa imtixaanada loo baahan yahay si ay kaaga caawiyaan in cagahaagu ay qaab fiican leeyihiin.

Our podiatry coverage includes:

• Routine foot exams.
• Tips about foot care and choosing the right shoes.
• Information about nerve damage warning signs.

Waxbarashada caafimaadka

Free coaching to help improve your health or to address a condition.

Our plan includes coaching on diabetes, nutrition and more. You can even get a ride, if needed, to and from the class at no cost to you.

Healthy First Steps™

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. 

Waan ku caawin doonaa:

• Choose a pregnancy provider and a pediatrician (child’s doctor).
• Schedule visits and exams and arrange rides to your visits.
• Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
• Get supplies, including breast pumps for nursing moms.
• Ku xirirannashaha dhigaalada bulshada sida adeegyada Haweenka, Dhallaanka iyo Carruurta (WIC).

Hearing Care

Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect your hearing.

We cover exams and testing, as well as hearing aids for enrollees.

Daryeelka caafimaadka ee guriga

Qalitaanka ka dib ama jirro halis ah-ama haddii aad naafo tahay-waxaa laga yaabaa inaad u baahato caawimo dheeraad ah oo ku saabsan hawl maalmeedka. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:

• An in-home medical visit.
• Medical equipment like hospital beds, walkers or wheelchairs.
• Disposable medical supplies.
• Help with personal care or housekeeping.

Isbitaal Dhigista

This plan pays for all expenses related to a hospital stay, so you can rest and heal.

Qorshahayagu waxa uu daboolaa:

• Nursing care.
• Room and board.
• Supplies and equipment.
• Treatment and therapies.
• Diagnostic tests and exams.

Ka dib markaad isbitaalka ka baxdo, keligaaga ma tihid. We make sure you get follow-up care to continue healing at home.

Interpreters

Your doctor and you need to understand each other. In aan si fiican loo hadlin Ingiriisi ayaa tan ka dhigaysa mid adag. Waxaan kuu diyaarin karnaa turjumaan inuu joogo ballamahaaga.

We also have people in member services who speak more than one language. Waxay aad ugu dhawdahay inaan haysano qof ku hadla luqadaada, ama wuxuu kugu xiri karaa adeegayaga turjubaanka kaas oo daboolaya in ka badan 170 luuqado.

Daryeelka Cudurka Kelyaha

Cudurka kelyuhu waa xaalad caafimaad oo halis ah. Ka dib marka kelyuhu joojiyaan shaqada, daaweyn joogto ah, oo loo yaqaan sifeynta kelyaha ama xubin beerid loo baahan yahay si loo noolaado. Sifeyntu waxay isticmaashaa mishiin si ay dhiiga ugu nadiifiso si sax ah

Qorshahayagu waxa ka mid ah:

• Kelyo-sifaynta.
• Daawooyinka.
• Waxbarashada iyo taageerada caafimaadka.
• Tallaalitaanka xubinta haddii loo baahdo.

Lab and X-rays

Ogaanshaha waxa khaldan iyo in la helo goor hore ayaa wax walba samayn karta. Qorshahayagu waxa uu daboolaa:

• Shaybaarada iyo tijaabada.
• Raajooyinka, iskaangaraynta iyo sawir-qaadista kale.

Waxaan kaa caawin doonaa inaad hesho macluumaadka loo baahan yahay si aad u hormariso caafimaadkaaga ama aad u noqoto sida kuugu fiican.

Ka caawin Luqad

You can receive information in your preferred language. Adigu un weydii. We also have people at our customer service centers who speak more than one language. Waxay aad ugu dhawdahay inaan haysano qof ku hadla luqadaada, ama wuxuu kugu xiri karaa adeegayaga turjubaanka kaas oo daboolaya in ka badan 170 luuqado.

Member Services

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call. We’ll answer your questions simply and completely.

We can also help you find:

• Home care providers.
• Dentists and vision providers.
• Adult Day Health Centers.

Daawooyinka

Our plan includes prescription drugs and refills with no copays. We also cover over-the-counter medicines with a written order from your doctor.

And we make getting your medicine easy. You can fill your prescriptions at:

• Local pharmacies.
• Services that deliver routinely right to your door.

Mental Health Services for Children and Youth

Problems such as depression and anxiety can also be challenging for children and teens.

There are no costs for covered services. We have therapists and doctors for youth and teens that can address their specific behavioral health or substance use. Help get them extra support to live a heathier life.

Look for behavioral health providers or call 1-877-542-8997, TTY 711

Additional Resources

Teens can connect with teens during specific hours: 866-833-6546, teenlink@crisisclinic.org, www.866teenlink.org

No Cost for Covered Services

Get the quality health care you deserve at no cost for covered services. You get:

• Care from highly skilled and compassionate doctors.
• Treatments at respected hospitals and clinics.
• Home medical equipment and supplies to help you be at your best.

Khadka Taleefanka Kalkaaliyaha

Su'aalaha iyo xaaladaha caafimaad waxay mararka qaarkood ku soo aadaan waqtiyo aan habboonayn. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week: 1-877-543-3409 (TTY 711).

Kalkaaliyeyaasheena way:

• Dhageysan doonaan astaamaha.
• Kaa caawin doonaan is-daryeelka.
• Kaala talin doonaan ku helida daryeel booqashada dhakhtarka ama xarunta daryeelka degdegga ah.
• Kaa caawin doonaan inaad ogaato goorta aad aadi doonto qolka gargaarka degdega ah.

Nurse Visits

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

• Provide medical care.
• Answer any questions and concerns.

Daryeelka gaarka ah

Sometimes the basics are hard to do yourself after an illness or injury.

If needed, we provide someone to help with:

• Dressing.
• Bathing.
• Feeding.

Personal Care Manager

Do you or a family member have a serious health problem? If your health needs qualify then our care managers are in your corner. They will:

• Help manage your physical and mental health care needs.
• Work with your physician, behavioral health specialists and outside agencies.
• Coordinate your doctor appointments.
• Provide your care team with your medical records.

Your care manager will stay with you throughout the medical journey. He or she will:

• Make sure you have support at home.
• Connect you to the social services you may need.

Programs for Kids and Teens

Kids with positive role models make more healthy choices. That's why we provide free memberships to the Boys & Girls Clubs in your area.

Along with fun and games, these clubs offer help with:

• Homework.
• Mentoring.
• Coaching.

Prenatal Visits

Your pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN. With our plan, you will also be rewarded with gift cards for prenatal and postpartum doctor visits.

All recommended prenatal clinical visits and tests are covered by our plan.

At these visits, the clinic will:

• Make sure both you and your baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.

Residential Care

After a serious illness, surgery or injury you may need extra nursing and therapy.  If needed, our plan covers short stays in a rehabilitation center where you can heal.  Included are:

• Nursing home services.
• 24-hour nursing care.
• Help with activities of daily living.
• Physical, occupational and speech therapy.

Joojinta Tubaakada iwm

You know the bad health effects of smoking. You know you need to quit. We support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture. Call 1-866-QUIT-4-LIFE (1-866-784-8454) Or visit www.quitnow.net.

Xabado iyo Tallaal

Tallaabooyinka caadiga ah waxay kaa caawinayaan inay jirro kaa difaacdo.

So, our plan covers:

• Recommended shots and vaccines.
• Influenza shots.

Adeegyada Daawaynta.

Daaweynta jirka, shaqada iyo hadalka waxay kaa caawin kartaa inaad ka soo kabsato dhaawac halis ah ama jirro, ama si fudud u gaarto awooddaada buuxda.

Our plan provides:

• Occupational therapy.
• Physical therapy.
• Speech therapy.
• In-home therapy.

Gaadiid-raaca

Get a ride – at no cost to you - to and from health care locations. That includes trips to:

• Doctor or therapy visits.
• Vision clinics.
• Urgent care centers.

Apple Health (Medicaid) pays for transportation services to and from needed non-emergency health care appointments. If you have a current ProviderOne Services Card, you may be eligible for transportation. Call the transportation provider (broker) in your area to learn about services and limitations. Your regional broker will arrange the most appropriate, least costly transportation for you. See the list of brokers

Daryeelka Aragga

You'll get the care and treatment that let you see life more clearly. Coverage includes:

• Eye exams every twenty-four months for adults and once every twelve months for children and age 21. Eyeglasses, contact lenses, and hardware fittings are covered separately under Apple Health (Medicaid) coverage without a managed care plan (also known as fee-for-service).
• Annual eye exams for members to age 21.

Booqashooyinka Wanaagsan

Booqashooyinka wanaagsan ee dhakhtarkaaga ayaa kaa caawin kara inaad caafimaad qabtid. Booqashooyinkani waxay ku dhici karaan dhibaatooyin caafimaad goor hore, si loo daweeyo. Adeegyada ka hortagga waxaa ka mid ah:

• Checkups children.
• Screenings for adults.
• Daryeelka ilmaha wanaagsan.
• Daryeelka haweenka uurka leh.
• Tallaalada joogtada ah iyo tijaabooyinka.
• Raajada naaska.

Ma jirto wax lacagta caymiska ee go'an ah oo laga bixiyo daryeelka ka hortagga ah.

Wellhop for Mom & Baby

Connect with other expectant moms. Get support and information during your pregnancy and after you deliver. This program is part of your health plan and there is no extra cost to you.
Here’s how it works:

• Join video conversations every other week with women who have similar due dates and a group leader.
• Chat and share experiences with moms from your group on the Wellhop app or website.
• Visit the Wellhop library. You’ll find articles, videos and more.