Cov Nyiaj Pab thiab Cov Kev Pab Ntxiv

Tau cov nyiaj pab thiab kev pab txhawb nqa ntxiv. Koj tuaj yeem tso siab rau:

• 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

Kev Pab Txhawb Nqa Rau Tus Mob Hawb Pob thiab 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.

Kev Xaiv Tus Kws Kho Mob

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. Tej no muaj xws li cov kev kuaj mob, cov kev kho mob, kev txhaj tshuaj tiv thaiv kab mob, kev kho tej qhov raug mob me thiab cov kev txhawj xeeb txog kev noj qab haus huv. Talk to your PCP about any behavioral health concerns you may have. Koj tus PCP yuav pab tau koj txiav txim siab txog cov kev xaiv ua uas zoo rau koj.

Koj tus PCP yog koj tus kws kho mob tseem ceeb rau:

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

Siv peb Lub Cuab Yeej Nrhiav Kws Kho Mob txhawm rau los saib seb koj tus kws kho mob puas nyob hauv peb lub network. Yog koj tsis muaj ib tus kws kho mob los yog hais tias koj tus kws kho mob tsis nyob hauv peb lub network, peb tuaj yeem pab tau koj nrhiav ib tus tshiab nyob ze koj.

Kev Txhawb Tus Mob Ntshav Qab Zib

Yog koj muaj mob ntshav qab zib, peb yuav pab ua kom lub neej yooj yim me ntsis rau koj. Koj yuav tau txais tshuaj, cov khoom siv thiab kev kawm los pab koj kom noj qab nyob zoo. Koj tseem yuav tau txais cov npav khoom plig rau ntawm qhov kev ua cov kauj ruam los tswj hwm koj tus mob ntshav qab zib.

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

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

Cuab Yeej thiab Cov Khoom Siv Kho Mob

Koj txoj kev noj qab haus huv thiab kev nyab xeeb nyob tom tsev yog qhov tseem ceeb.

Our plan covers medical equipment ordered by your doctor or case manager. Qhov no muaj xam nrog rau cov khoom siv xws li:

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

Kev Kho Mob Ko Taw

Yog tias koj muaj mob ntshav qab zib los yog teeb meem kev xa ntshav mus thoob lub cev, kev tu txhais taw kom zoo tuaj yeem pab tau koj tiv thaiv kom txhob mob loj ntxiv. Peb muab cov kev kuaj uas koj xav tau los mus pab kom koj ob txhais taw txhob muaj mob.

Our podiatry coverage includes:

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

Kev Kawm Txog Kev Noj Qab Haus Huv

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.

Noj qab nyob zoo yog ua ntej tshaj plaws®

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. 

Peb yuav pab koj:

• 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.
• Txuas nrog cov peev txheej hauv zej zog xws li Cov Kev Pab cuam Poj Niam, me nyuam mos thiab me Nyuam (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.

Kev saib xyuas kho mob rau fab kev noj qab haus huv nyob rau tom vaj tom tsev

Tom qab phais mob los yog muaj ib tus mob hnyav—los yog hais tias koj muaj ib tus mob xiam oob khab—tej zaum koj kuj yuav xav tau kev pab ntxiv rau tej dej num hnub dhau hnub. 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.

Kev kho mob hauv tsev kho mob

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

Peb daim phiaj them rau:

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

Thiab tom qab koj tawm hauv tsev kho mob mus lawm, koj tsis nyob ib leeg. We make sure you get follow-up care to continue healing at home.

Interpreters

Your doctor and you need to understand each other. Hais lus tsis tau Lus Askiv zoo ua rau qhov no nyuaj tuaj. Peb tuaj yeem npaj tau ib tus kws pab txhais lus rau fab kev kho mob tuaj rau thaum koj tuaj ntsib kws kho mob.

We also have people in member services who speak more than one language. Qhov zoo ces, peb muaj ib tus uas hais tau koj hom lus los yog nws txuas tau koj rau peb qhov kev pab txhais lus uas muaj ntau tshaj 170 hom lus.

Kev Kho Tus Mob Raum

Mob raum yog ib qho teeb meem mob loj heev. Tom qab ob lub raum tsis ua hauj lwm lawm, cov kev kho tus mob, hu ua lim ntshav los yog hloov raum tshiab yuav tau muaj kom thiaj muaj txoj sia nyob. Kev lim ntshav yog siv ib lub tshuab los tu cov ntshav kom huv li thaum lub raum tsis tau muaj mob ua.

Peb daim phiaj muaj xws li:

• Kev lim ntshav.
• Cov tshuaj.
• Kev kawm txog kev noj qab haus huv thiab kev pab txhawb.
• Hloov qhov khoom nrog cev tshiab yog hais tias yuav tau ua.

Lab and X-rays

Kev paub tias dab tsi tsis yog lawm thiab nrhiav pom qhov ntawd thaum ntxov yuas ua rau muaj kev pab tau. Peb daim phiaj them rau:

• Kuaj kab mob thiab kev kuaj.
• Xoos fais fab X-rays, yees duab thiab lwm yam kev yees duab.

Peb yuav pab koj kom tau txais tej ntaub ntawv qhia paub uas yuav tsum tau kho koj txoj kev noj qab haus huv zoo dua qub los yog nyob rau ntawm qhov koj ua tau zoo tshaj plaws.

Kev Pab Txhais Lus

You can receive information in your preferred language. Tsuav yog koj thov txog xwb. We also have people at our customer service centers who speak more than one language. Qhov zoo ces, peb muaj ib tus uas hais tau koj hom lus los yog nws txuas tau koj rau peb qhov kev pab txhais lus uas muaj ntau tshaj 170 hom lus.

Cov Kev Pab Tswv Cuab

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.

Cov Tshuaj

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.

Tus Xov Tooj Hu Rau Kws Tu Neeg Mob (Nurse Hotline)

Cov lus nug thiab cov xwm txheej kev kho qee zaum tshwm sim thaum lub sij hawm tsis yooj yim. 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).

Peb cov kws tu neeg mob yuav:

• Mloog txhua cov tsos mob.
• Pab rau kev saib xyuas tus kheej.
• Qhia rau koj txog kev kho mob thaum mus ntsib kws kho mob los sis chaw kho mob ceev.
• Pab kom koj paub tias yuav tau mus rau tom chav kho mob xwm txheej kub ceev thaum twg.

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.

Kev saib xyuas tus kheej

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.

Txiav Kev Haus Luam Yeeb

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.

Cov Koob Tshuaj thiab Tshuaj Txhaj Tiv Thaiv Kab Mob

Kev txhaj tshuaj raws sij hawm yuav pab tau koj tiv thaiv kom txhob muaj mob.

So, our plan covers:

• Recommended shots and vaccines.
• Influenza shots.

Cov Kev Pab Cuam Kho Mob

Kev kho mob rau lub cev, ua taus hauj lwm thiab hais tau lus yuav pab tau koj kom zoo los ntawm ib qho raug mob los yog ib tus mob loj, kom mus txog rau qhov koj muaj peev xwm ua tau.

Our plan provides:

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

Tsheb Thauj Mus Los

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

Kev Saib Xyuas Kho Mob Ntsig Txog Qhov Muag

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.

Cov Kev Mus Ntsib Kws Kho Mob Kom Noj Qab Nyob Zoo

Cov kev mus ntsib kws kho mob kom noj qab nyob zoo yuav pab tau koj nyob tsis muaj mob. Cov kev mus ntsib kws kho mob no yuav txhom tau tej teeb meem mob thaum tseem ntxov, kom thiaj kho tau. Cov kev tiv thaiv kom txhob muaj mob muaj xws li:

• Checkups children.
• Screenings for adults.
• Kev tu xyuas rau cov me nyuam mos liab kom noj qab nyob zoo.
• Kev tu xyuas rau cov poj niam cev xeeb tub.
• Cov kev txhaj tshuaj thiab kev kuaj mob li ib txwm ua.
• Cov kev kuaj mis.

Nws tsis muaj feem yus nrog them (co-payments) rau kev tiv thaiv kom txhob muaj mob.

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.