တၢ်န့ၢ်အဘျုးထၢနုာ်အါထီၣ်တဖၣ် ဒီးတိစၢၤမၤစၢၤတဖၣ်

တၢ်န့ၢ်အဘျုးထၢနုာ်အါထီၣ်တဖၣ် ဒီးတၢ်ဆီၣ်ထွဲ. နသန့ၤသးလၢ -

• 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

တၢ်သါအံးဒီး COPD တၢ်ဆီၣ်ထွဲ

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.

တၢ်ဃုထၢကသံၣ်သရၣ်

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. တၢ်အံၤပာ်ဃုာ်ဝဲဒီး တၢ်သမံသမိးကွၢ်တၢ်အိၣ်ဆူၣ်အိၣ်ချ့, တၢ်ကူစါယါဘျါအကျိၤအကျဲ, တၢ်ဆဲးကသံၣ်ဒီသဒၢ, တၢ်ဘၣ်ဒိဘၣ်ထံးလၢအဆံးဒီး တၢ်ဘၣ်ယိာ်လၢဆူၣ်ချ့ဂ့ၢ်ကျိၤတဖၣ်လီၤႉ Talk to your PCP about any behavioral health concerns you may have. န PCP န့ၣ်မၤစၢၤနၤသ့ ဒ်သိးနကဆၢတဲာ်တၢ်ဃုထၢတဖၣ် လၢအဘၣ်လၢနဂီၢ်န့ၣ်လီၤ.

န PCP န့ၣ် မ့ၢ်နကသံၣ်သရၣ်မိၢ်ပှၢ်လၢ -

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

စူးကါ တၢ်ဃုကွၢ်ကသံၣ်သရၣ်ပီးလီ ဒ်သိးကထံၣ်သ့ၣ်ညါဘၣ်ဃး နကသံၣ်သရၣ်န့ၣ်အိၣ်ဝဲလၢပပှဲာ်ဘျးစဲအပူၤဧါန့ၣ်တက့ၢ်. နမ့ၢ်တအိၣ်ဒီးကသံၣ်သရၣ်တဂၤ မ့တမ့ၢ်နကသံၣ်သရၣ်န့ၣ် မ့ၢ်တအိၣ်လၢပပှာ်ဘျးစဲအပူၤန့ၣ် ပမၤစၢၤနၤသ့ ဒ်သိးနကဃုထံၣ်ကသံၣ်သရၣ်တဂၤလၢအိၣ်ဘူးဒီးနၤန့ၣ်လီၤ.

တၢ်ဆီၣ်ထွဲသွံၣ်ဆၢတၢ်ဆါ

နမ့ၢ်အိၣ်ဒီးသွံၣ်ဆၢတၢ်ဆါန့ၣ် ပကမၤစၢၤနၤ ဒ်သိးနတၢ်အိၣ်မူန့ၣ်ကညီဒိၣ်ထီၣ်တစဲးဖိလၢနဂီၢ်န့ၣ်လီၤ. နကဒိးန့ၢ်ကသံၣ်ကသီ, တၢ်ဆှၢဟ့ၣ်တဖၣ် ဒီးတၢ်ကူၣ်ဘၣ်ကူၣ်သ့လၢ ကမၤစၢၤနၤ ဒ်သိးနကအိၣ်မူအဂ့ၤကတၢၢ်အဂီၢ်န့ၣ်လီၤ. နဘၣ်တၢ်ဟ့ၣ်နၤခိၣ်ဖး လၢတၢ်ကနၢခးက့တဖၣ် လၢတၢ်လဲၤအဆီဖှံဖှံညီညီအဆီတဖၣ် ဒ်သိးကပၢဆှၢရဲၣ်ကျဲၤနသွံၣ်ဆၢတၢ်ဆါအဂီၢ်န့ၣ်လီၤ.

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

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

တၢ်ပီးတၢ်လီဒီးဆူၣ်ချ့တၢ်ဖိတၢ်လံၤတဖၣ်

နဆူၣ်ချ့ဒီးတၢ်ဘံၣ်တၢ်ဘၢလၢဟံၣ်န့ၣ် အကါဒိၣ်လီၤ.

Our plan covers medical equipment ordered by your doctor or case manager. အဝဲန့ၣ်ပၣ်ဃုာ်ဒီးတၢ်ပီးတၢ်လီဒ်အံၤတဖၣ်လီၤ -

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

တၢ်ကွၢ်ထွဲခီၣ်လၣ်

နမ့ၢ်အိၣ်ဒီးသွံၣ်ဆၢတၢ်ဆါ မ့တမ့ၢ်သွံၣ်လဲၤကျိၤတၢ်အိၣ်သးတမံၤန့ၣ်, တၢ်ကွၢ်ထွဲခီၣ်လၣ်လၢအဂ့ၤန့ၣ် မၤစၢၤဒီသဒၢတၢ်ဂ့ၢ်ကီဆူၣ်ဆူၣ်နးနးတဖၣ်န့ၣ်လီၤ. ပဟ့ၣ်တၢ်စဲးကွၢ်လၢအလိၣ်ဘၣ်တဖၣ် ဒ်သိးကပာ်နခီၣ်လၣ်တဖၣ်လၢ အက့ၢ်အဂီၤတၢ်အိၣ်သးဂ့ၤဒိၣ်မးန့ၣ်လီၤ.

Our podiatry coverage includes:

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

ဆူၣ်ချ့တၢ်ကူၣ်ဘၣ်ကူၣ်သ့.

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. 

ပကမၤစၢၤနၤလၢ-

• 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.
• မၤဘၣ်ထွဲဒီး ပှၤတဝၢအတၢ်အိၣ်ယၢၤတဖၣ်ဒ်အမ့ၢ် ပိာ်မုၣ််, ဖိသၣ်အီနုၢ်် ဒီး ဖိသၣ် (WIC) အတၢ်တိစၢၤမၤစၢၤတဖၣ်တက့ၢ်ႉ

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.

တၢ်အိၣ်ဆူၣ်အိၣ်ချ့ တၢ်ကွၢ်ထွဲ ဖဲဟံၣ်

ဖဲတၢ်ကွဲးကါ မ့တမ့ၢ်တၢ်ဆါဆူၣ်နးဝံၤ - မ့တမ့ၢ်နမ့ၢ်အိၣ်ဒီးနီၢ်ခိက့ၢ်ဂီၤတလၢပှဲၤန့ၣ် - နကလိၣ်ဘၣ်တၢ်မၤစၢၤအဂၤတဖၣ် လၢတနံၤဘၣ်တနံၤတၢ်မၤအဂီၢ်န့ၣ်လီၤ. 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.

တၢ်တီၣ်ထီၣ်တၢ်ဆါဟံၣ်

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

ပတၢ်တိာ်ကျဲၤန့ၣ်အုၣ်ကီၤဝဲလၢ -

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

ဒီးဖဲနဟးထီၣ်လၢတၢ်ဆါဟံၣ်ဝံၤအလီၢ်ခံန့ၣ် နတမ့ၢ်ထဲတဂၤဘၣ်. We make sure you get follow-up care to continue healing at home.

Interpreters

Your doctor and you need to understand each other. တကတိၤတၢ် အဲကလံးကျိာ် ဂ့ၤဂ့ၤဘၣ်ဘၣ်န့ၣ် မၤကီမၤခဲအီၤန့ၣ်လီၤ. ပသုးကျဲၤန့ၢ်နၤ ပှၤကတိၤကျိာ်ထံဆူၣ်ချ့ ဒ်သိးကအိၣ်လၢနတၢ်သ့ၣ်ဆၢဖးကတီၢ်ထံၣ်လိာ်သးတဖၣ်အဂီၢ်န့ၣ်လီၤ.

We also have people in member services who speak more than one language. တၢ်ခွဲးတၢ်ယာ်လၢအဂ့ၤတဖၣ်မ့ၢ်ဝဲ, ပအိၣ်ဒီးပှၤတဂၤဂၤလၢအကတိၤတၢ်လၢ နကျိာ်နကျာ် မ့တမ့ၢ် အဝဲသ့ၣ်ကတိၤတၢ်ဒီးနၤခီဖျိ ပတၢ်ကျိာ်ထံကတိၤတၢ်တိစၢၤမၤစၢၤလၢ အအိၣ်အါန့ၣ်ဒ်ကျိာ် 170 ခါန့ၣ်လီၤႉ

ကလ့ၢ်တၢ်ဆါတၢ်ကွၢ်ထွဲ

ကလ့ၢ်တၢ်ဆါမ့ၢ် ဆူၣ်ချ့တၢ်အိၣ်သးလၢအဆူၣ်နးန့ၣ်လီၤ. ဖဲနကလ့ၢ်တမၤတၢ်လၢၤဘၣ်န့ၣ် တၢ်ကူစါယါဘျါဘၣ်ဆၢဘၣ်ကတီၢ်တဖၣ် လၢပှၤကိးအီၤလၢ တၢ်သ့စီကလ့ၢ် မ့တမ့ၢ်တၢ်ထၢနုာ်နီၢ်ခိယူာ်ပျဲၤခၢၣ်စးတဖၣ် လိၣ်ဝဲလၢကအိၣ်မူအဂီၢ်န့ၣ်လီၤ. တၢ်သ့စီမၤကဆှီန့ၣ် စူးကါဝဲစဲးတမံၤ လၢကသ့ဆီသွံၣ် ဒ်သိးကလ့ၢ်ဆူၣ်ချ့တဖၣ်မၤတၢ်န့ၣ်လီၤ.

ပတၢ်တိာ်ကျဲၤတဖၣ်န့ၣ်ပၣ်ဃုာ်ဒီး -

• တၢ်မၤကဆှီသွံၣ်.
• တၢ်ဟ့ၣ်ကသံၣ်ကသီတဖၣ်.
• ဆူၣ်ချ့တၢ်ကူၣ်သ့ဒီးတၢ်ဆီၣ်ထွဲ
• တၢ်ကူးကွဲးမၤပှဲၤက့ၤနီၢ်ခိယူာ်ပျဲၤဖဲအလိၣ်ဘၣ်

Lab and X-rays

တၢ်သ့ၣ်ညါတၢ်လၢကမၣ် ဒီးတၢ်ဃုထံၣ်အီၤဆိဆိန့ၣ် ဒုးကဲထီၣ်တၢ်ဆီတလဲခဲလၢာ်သ့န့ၣ်လီၤ. ပတၢ်တိာ်ကျဲၤန့ၣ်အုၣ်ကီၤဝဲလၢ -

• တၢ်မၤကွၢ်ဒၢးတဖၣ် ဒီးတၢ်စဲးကွၢ်
• ယဲၤဖျါ, ကွၢ်နီၢ်ကစၢ်ခီဖျိလီယဲၤဘ့ၣ်ဂီၤဖျါဒီး စဲးဒုးဖျါက့ၢ်ဂီၤအဂုၤအဂၤဖၣ်လီၤႉ

ပကမၤစၢၤနၤ ဒ်သိးနကဒိးန့ၢ်တၢ်ကစီၣ်ဂ့ၢ်ကျိၤလၢလိၣ်ဘၣ် ဒ်သိးကမၤဂ့ၤထီၣ်နဆူၣ်ချ့မ့တမ့ၢ် အိၣ်ဒီးနတၢ်အိၣ်မူအဂ့ၤကတၢၢ်န့ၣ်လီၤ.

ကျိာ်တၢ်မၤစၢၤ

You can receive information in your preferred language. ထဲဒၣ်ဃ့ထီၣ်အီၤတက့ၢ်. We also have people at our customer service centers who speak more than one language. တၢ်ခွဲးတၢ်ယာ်လၢအဂ့ၤတဖၣ်မ့ၢ်ဝဲ, ပအိၣ်ဒီးပှၤတဂၤဂၤလၢအကတိၤတၢ်လၢ နကျိာ်နကျာ် မ့တမ့ၢ် အဝဲသ့ၣ်ကတိၤတၢ်ဒီးနၤခီဖျိ ပတၢ်ကျိာ်ထံကတိၤတၢ်တိစၢၤမၤစၢၤလၢ အအိၣ်အါန့ၣ်ဒ်ကျိာ် 170 ခါန့ၣ်လီၤႉ

ကရၢဖိတၢ်မၤစၢၤတဖၣ်

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.

ကသံၣ်ကသီတဖၣ်

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.

Nurse Hotline (တၢ်ကွၢ်ထွဲပှၤဆါအဂ့ၢ်ဂီၢ်အူလီၤကျိၤ)

ကသံၣ်ကသီတၢ်သံကွၢ်တဖၣ် ဒီးတၢ်အိၣ်သးတဖၣ်န့ၣ် တဘျီတခီၣ်အိၣ်ထီၣ်လၢ တၢ်ဆၢကတီၢ်လၢတဘၣ်ဘျိးဘၣ်ဒါတဖၣ်န့ၣ်လီၤ. 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).

ပနၢး(စ)ကွၢ်ထွဲပှၤဆါတဖၣ်န့ၣ် က -

• ဒိကနၣ်တၢ်ဆါပနီၣ်တဖၣ်.
• မၤစၢၤတၢ်ဒီးနီၢ်ကစၢ်တၢ်ကွၢ်ထွဲ.
• ဟ့ၣ်ကူၣ်နၤဘၣ်ဃး တၢ်ဒိးန့ၢ်တၢ်ကွၢ်ထွဲလၢကသံၣ်သရၣ်ကွၢ်ထွဲပှၤဆါ မ့တမ့ၢ်တၢ်ကွၢ်ထွဲချ့ချ့လီၢ်ခၢၣ်သး.
• မၤစၢၤနၤလၢကသ့ၣ်ညါ တၢ်ဆၢကတီၢ်လၢကဘၣ်လဲၤဆူဂ့ၢ်ဂီၢ်အူဒၢး.

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.

နီၢ်ကစၢ်အတၢ်ကွၢ်ထွဲ

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.

တၢ်ဒုၣ်မိာ်

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.

တၢ်ဆဲးကသံၣ်ဒီးကသံၣ်ဒီသဒၢတဖၣ်

တၢ်ဆဲးကသံၣ်ဘၣ်ဆၢဘၣ်ကတီၢ်တဖၣ်န့ၣ် မၤစၢၤဒီသဒၢနၤလၢတၢ်ဆူးတၢ်ဆါန့ၣ်လီၤ.

So, our plan covers:

• Recommended shots and vaccines.
• Influenza shots.

တၢ်ကူစါယါဘျါတၢ်တိစၢၤမၤစၢၤတဖၣ်

နီၢ်ခိ,တၢ်မၤဒီးတၢ်ကတိၤတၢ်ကူစါယါဘျါန့ၣ် မၤစၢၤနၤသ့ ဒ်သိးနကအိၣ်မုာ်ထီၣ်က့ၤလၢ တၢ်ဘၣ်ဒိဘၣ်ထံး မ့တမ့ၢ်တၢ်ဆါဆူၣ်နး, မ့တမ့ၢ် နတုၤဆူတၢ်လၢနဒိးန့ၢ်သ့န့ၣ်လီၤ.

Our plan provides:

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

တၢ်ဝံစိာ်တီဆှၢ

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

တၢ်ကွၢ်ထွဲမဲာ်တၢ်ထံၣ်

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.

ဆူၣ်ချ့တၢ်ကွၢ်ထွဲပှၤဆါတဖၣ်.

ဆူၣ်ချ့တၢ်ကွၢ်ထွဲပှၤဆါတၢ်ထံၣ်လိာ်သးလၢနကသံၣ်သရၣ်န့ၣ် မၤစၢၤနၤသ့ဒ်သိးနကအိၣ်မူဆူၣ်ချ့အဂီၢ်န့ၣ်လီၤ. တၢ်ကွၢ်ထွဲပှၤဆါဒ်အံၤတဖၣ်န့ၣ် ဃုထံၣ်ဆူၣ်ချ့တၢ်ဂ့ၢ်ကီတဖၣ်ဆိဆိသ့ ဒီးကူစါယါဘျါအီၤသ့န့ၣ်လီၤ. တၢ်ဒီသဒၢတၢ်တိစၢၤမၤစၢၤတဖၣ်န့ၣ် ပၣ်ဃုာ်ဒီး -

• Checkups children.
• Screenings for adults.
• ဖိသၣ်ဆူၣ်ချ့တၢ်ကွၢ်ထွဲ.
• တၢ်ကွၢ်ထွဲလၢမိၢ်လၢကအိၣ်ဖျဲၣ်ဖိတဖၣ်အဂီၢ်.
• တၢ်ဆဲးကသံၣ်ဒီးတၢ်စဲးကွၢ်ဘၣ်ဆၢဘၣ်ကတီၢ်တဖၣ်
• တၢ်သမံသမိးနုၢ်တဖၣ်.

တၢ်ဟ့ၣ်သကိးတၢ်ဘူးတၢ်လဲ တဖၣ် တအိၣ်လၢ တၢ်ဒီသဒၢတၢ်ကွၢ်ထွဲအဂီၢ်ဘၣ်..

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.