Lòt Avantaj ak Sèvis Anplis

Jwenn benefis ak sipò siplemantè. Ou ka konte sou:

• 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

Sipò pou Opresyon ak COPD

Individual care to help control your child's asthma.

Does your child have trouble managing asthma or COPD symptoms? Yon enfimye(è) ki espesyalize nan pwoblèm respirasyon ka ede w reyèlman. Your child will get a customized treatment plan and medicine to:

• Jere rechit yo.
• Diminye sentòm.
• Let your child stay active.

Choose a Birth Center

Kote ou fè tibebe w lan se yon chwa ki enpòtan. 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. Nan fason sa a, ou pral abitye avèk li. And you'll be more relaxed when you have your baby.

Chwazi Doktè

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. Sa gen ladan tchekòp, tretman, vaksen, blesi minè ak pwoblèm sante. Talk to your PCP about any behavioral health concerns you may have. Your PCP can help you decide the right options for you.

PCP w la se doktè prensipal ou pou:

• Swen prevantif.
• Tretman si w malad oswa blese.
• Rekòmandasyon kay espesyalis pou sèten pwoblèm medikal.

Itilize zouti pou chèche Doktè a, pou wè si doktè ou nan rezo nou a. Si ou pa gen yon doktè oswa si doktè w pa nan rezo nou an, nou ka ede w chèche yon nouvo doktè ki toupre w.

Sipò pou moun ki gen dyabèt

Si w gen dyabèt, n ap ede rann lavi a yon jan pi fasil pou ou. W ap jwenn medikaman, founiti ak edikasyon pou ede w rive ak rete nan pi bon eta w. Ou jwenn rekonpans ak kat kado tou poutèt ou pran dispozisyon senp pou jere dyabèt ou.

Pwogram dyabèt nou an gen ladan tou fòmasyon pou pran swen pwòp tèt ou ak klas ki konsantre sou:

• Planifikasyon repa nitritif.
• Jesyon estrès.
• Viv yon mòd devi ki sen.

Ekipman ak Founiti Medikal

Sante ak sekirite lakay ou enpòtan.

Plan nou an garanti ekipman medikal doktè w oswa manadjè dosye w mande. Sa ka gen ladan founiti tankou:

• Kabann lopital.
• Tank oksijèn.
• Chèz woulant oswa wòkè.

Swen pou Pye

Si ou gen dyabèt oswa yon pwoblèm sikilasyon san, bon swen pye yo ka ede anpeche pwoblèm ki pi grav toujou. Nou fè egzamen ki nesesè yo pou ede kenbe pye w an trè bon fòm.

Our podiatry coverage includes:

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

Edikasyon Lasante

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®

Bati yon lavni ki ansante pou ou ak tibebe ou an epi resevwa gwo rekonpans ak Healthy First Steps. Pwogram nou an pral ede ou pran bon mezi yo pou kenbe ou ak tibebe ou an ansante. Met sou sa ou ka resevwa $20 jis paske ou enskri. 

N ap ede ou:

• Chwazi founisè swen pou gwosès ak yon pedyat (doktè timoun).
• Planifye vizit ak egzamen yo ak òganize transpò pou vizit ou yo.
• Resevwa rekonpans dèske ou ale nan vizit yo pandan tout gwosès ou ak 15 premye mwa lavi tibebe a.
• Jwenn materyèl, tankou ponp tete pou manman nouris yo.
• Konekte avèk resous kominotè yo tankou sèvis pou Fanm, Tibebe ak Timoun (Women, Infants and Children, WIC).

Swen oditif

Pwoblèm pou tande ka afekte lavi toulejou ou nan anpil sans. Plan nou an gen ladan sèvis ak sipò pou ede pwoteje kapasite pou w tande (odisyon).

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

Swen sante adomisil

Apre yon operasyon oswa yon maladi grav—oswa si ou gen yon andikap—ou ka bezwen èd siplemantè pou travay toulejou yo. 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.

Ospitalizasyon

Plan sa a peye pou tout depans ki gen rapò avèk yon sejou lopital, konsa ou ka repoze epi geri.

Plan nou an kouvri:

• Swen enfimyè.
• Chanm ak manje.
• Materyèl ak ekipman.
• Tretman ak terapi.
• Tès dyagnostik ak egzamen.

Apre ou fin kite lopital la, ou pa poukont ou. Nou asire ou jwenn swen swivi pou w kontinye geri lakay ou.

Entèprèt

Doktè ou ansanm avèk oumenm, youn dwe konprann lòt. Lè w pa pale Anglè byen sa fè l pi difisil. Nou ka fè aranjman pou yon entèprèt medikal la nan randevou ou yo.

Nou gen moun tou nan depatman sèvis pou manm yo ki pale pliske yon lang. Gen bon chans ke nou gen yon moun ki pale lang ou an, oswa yo ka konekte ou avèk sèvis entèprèt nou an ki kouvri plis pase 170 lang.

Swen pou Maladi Ren

Maladi ren se yon pwoblèm medikal grav. Apre ren yo sispann fonksyone, tretman regilye ke yo rele dyaliz ren oswa grèf ògàn nesesè pou viv. Dyaliz la itilize yon machin pou netwaye san an menm jan ak ren ki an sante yo fè li.

Plan nou an gen ladan:

• Dyaliz.
• Medikaman.
• Edikasyon ak sipò pou lasante.
• Grèf ògàn si sa nesesè.

Laboratwa ak Radyografi

Lè w konnen kisa pwoblèm lan ye e lè w detekte l bonè, sa ka fè tout yon diferans. Plan nou an kouvri:

• Laboratwa ak tès.
• Radyografi, eskanografi, ak lòt tès imajri.

N ap ede w jwenn enfòmasyon ki nesesè pou amelyore sante w oswa pou w nan pi bon fòm ou.

Èd nan domèn lang

Ou ka resevwa enfòmasyon nan lang ou pi pito a. Mande tousenpleman. We also have people at our customer service centers who speak more than one language. Gen bon chans ke nou gen yon moun ki pale lang ou an, oswa yo ka konekte ou avèk sèvis entèprèt nou an ki kouvri plis pase 170 lang.

Sèvis pou Manm

Gen dèfwa ou ka bezwen èd pou konprann opsyon swen sante w yo. Lè w avèk nou, ou gen yon moun ou ka rele. N ap reponn kesyon w yo konplètman e avèk yon langaj ki senp.

Nou ka ede w tou pou jwenn:

• Home care providers.
• Dantis ak founisè pou vizyon.
• Adult Day Health Centers.

Medikaman

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. Ou ka egzekite preskripsyon ou nan:

• Famasi lokal.
• 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

Lòt resous anplis

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.

Liy Dirèk pou Enfimyè

Pafwa, kesyon ak sitiyasyon medikal prezante a dè moman ki pa apwopriye. 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).

Enfimye/enfimyè nou yo pral:

• Koute sentòm yo.
• Ede pou swen pèsonèl.
• Ba w konsèy sou kijan pou jwenn swen kay yon doktè oswa nan yon sant swen dijans.
• Ede w konnen kilè pou w ale nan sal dijans.

Vizit enfimye(è)

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.

Swen pèsonèl

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. Yo pral:

• 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. Li pral:

• 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.

Nan vizit sa yo, klinik la ap:

• Make sure both you and your baby are healthy.
• Eksplike kisa pou w atann nan chak etap gwosès ou.
• Reponn kesyon w yo.

Swen Rezidansyèl

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:

• Sèvis mezon retrèt.
• Swen enfimye 24-èdtan.
• Èd avèk aktivite lavi toulejou.
• Terapi fizik, okipasyonèl, ak pou lapawòl.

Sispann itilize tabak

Ou konnen move efè fimen gen sou sante w. Ou konnen fòk ou kite fimen. Nou ba w sipò pandan w ap kite avèk akonpayatè ak founiti. 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.

Piki ak Vaksen

Piki woutin pou ede pwoteje ou kont maladi.

Kidonk, plan nou an kouvri:

• Piki ak vaksen yo rekòmande.
• Piki kont lagrip.

Sèvis Terapi

Terapi fizik, okipasyonèl ak terapi lapawòl ka ede ou refè apre yon blesi oswa maladi grav, oswa tou senpleman reyalize tout sa ou kapab fè.

Our plan provides:

• Terapi okipasyonèl.
• Terapi fizik.
• Terapi lapawòl.
• In-home therapy.

Sèvis Transpò

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

• Vizit ka doktè oswa nan terapi.
• Klinik pou vizyon.
• Sant swen ijan yo.

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

Swen pou vizyon

You'll get the care and treatment that let you see life more clearly. Plan an kouvri:

• 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.

Vizit pou moun ansante

Vizit konsiltasyon pou moun ansante kay doktè ka ede w rete ansante. Vizit konsiltasyon sa yo ka ede detekte pwoblèm sante bonè, pou yo sa trete yo. Sèvis prevantif gen ladan yo:

• Checkups children.
• Screenings for adults.
• Swen pou tibebe ki ansante.
• Swen pou fanm ki pral fè yon tibebe.
• Piki ak tès woutin.
• Mamogram.

Pa gen okenn kopeman pou swen prevantif yo.

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.