လဲၤလဲၤပတာ်ဆူ တၢ်ဂ့ၢ်ခိၣ်တီမိၢ်ပှၢ်
တၢ်ဂ့ၢ်ခိၣ်တီမိၢ်ပှၢ်

UnitedHealthcare Health & Home Connection ၀ီၢ်သြဲတဖၣ်

A

  • တၢ်နဲၣ်ကျဲၤတီၢ်ထီ

    A decision about your health care that you make ahead of time in case you are ever unable to speak for yourself. This will let your family and your doctors know what decisions you would make if you were able to.

  • တၢ်ပတံသကွံာ်ကညး

    You can file an appeal if you are not happy with a decision we made ("denial"). A denial is when we say no to a service you or your doctor asked us to give you. It could also be when we don't give you as much of a service you wanted. For example, you can file an appeal if your doctor wanted a drug we do not allow. You can also file if we didn't approve a hospital stay. If you are not happy but it is not because we said no to what you asked for, you can file a grievance.

  • ASC/SPU

    Ambulatory surgical center/short procedure unit.

  • Authorization

    An approval for a service.

B

  • တၢ်န့ၢ်အဘျုးတဖၣ်

    Services, procedures and medications that UnitedHealthcare will cover for you.

C

  • Clinical Care Management

    One-on-one help by a nurse providing education and coordination of UnitedHealthcare benefits, tailored to your needs.

D

  • Disenrollment

    To stop your membership in UnitedHealthcare.

E

  • ဂ့ၢ်ဂီၢ်အူ

    When you reasonably believe that your health is in serious danger.

F

  • တၢ်လီတၢ်၀့ၤ

    An untruthful act (example: if someone other than you uses your member ID card and pretends to be you).

G

  • တၢ်ကအုကစွါ

    You can file a grievance when you are not happy. This can be when you are not happy with our plan, or our providers, or anything other than an "action". For example, you may file a grievance if you have a problem making an appointment with a provider or have trouble finding a provider. You can file if you think you are not getting good care. You can also file if a doctor is sending you bills for services you get with our Plan. You can file an appeal If you are not happy with a decision we made (an 'action') (see Appeal).

H

  • Home Health Agency

    A company contracted by UnitedHealthcare to provide care for you in your home.

I

  • ID Card

    Identification card – a card that says you are a UnitedHealthcare member. You should have this card with you at all times.

  • Informed Consent

    Doctors give you information about a particular treatment or test in order for you to decide whether or not you wish to have the treatment or test.

  • ပှၤဆါလၢအထီၣ်တၢ်ဆါဟံၣ်

    When you are admitted into a hospital for a length of time.

M

  • Medical Necessity

    Your health care provider decides if a treatment, admission, procedure, medical supply, equipment, service or supply is medically necessary.

  • ကရူၢ်ဖိ

    A person who is eligible for UnitedHealthcare.

O

  • ပှၤဆါလၢတထီၣ်တၢ်ဆါဟံၣ်

    When you have a procedure done that does not require a hospital stay overnight. In some cases, you may stay overnight in the hospital but not be admitted as an inpatient.

P

  • ပှၤကွၢ်ထွဲဖံးမၤတၢ်မိၢ်ပှၢ် (PCP)

    A doctor you choose to be your family physician. They have their own private practices.

  • Prior Authorization

    The process for any service that needs an approval from UnitedHealthcare before it can take place.

  • ပှၤမၤစၢၤဖံးမၤတၢ်

    Any medical professional that UnitedHealthcare has contracted with to take care of you.

  • ပှၤမၤစၢၤဖံးမၤတၢ်အတၢ်နဲၣ်ကျဲၤ

    A list of providers who participate with UnitedHealthcare Community Plan to help take care of your healthcare needs.

R

  • တၢ်ဆှၢခီ

    When you and your primary care doctor agree you need to see another doctor, your primary care doctor will send you to a UnitedHealthcare specialist.

S

  • Self-Referred Services

    Services for which you do not need to see your primary care provider for a referral.

  • ကသံၣ်သရၣ်ကူၣ်သ့စဲၣ်နီၤ

    A doctor that has specific, detailed training in one certain medical field.

T

  • Treatment

     The care that you may receive from doctors and facilities.

U

  • တၢ်ကွၢ်ထွဲသတူၢ်ကလာ်

    When you need care, treatment or medical advice within a 24-hour time period.

W

  • WIC

    Supplemental Food Program for Women, Infants and Children which provides nutrition counseling, nutrition education, and nutritious foods to pregnant and postpartum women, infants and children up to the age of 2. Children deemed nutritionally deficient are covered up to age 5 if they are low income and are determined to be at nutritional risk.

က့ၤကဒါက့ၤဆူ လံာ်ကဘျံးပၤအဖီခိၣ်ကတၢၢ်

For more information on Florida Medicaid, download the Florida Medicaid Reference Guide.

တၢ်ဂ့ၢ်တၢ်ကျိၤလၢတၢ်ဆဲးလီၤမံၤအဂီၢ်

The Health & Home Connection plan specialists can answer questions about this plan. 

Step 1: Call Choice Counseling at their toll-free help line at 1-877-711-3662.

Step 2: Talk with Health & Home Connection Customer Service toll-free.

ဆဲးကျိးဆူပအိၣ် −
1-800-791-9233 / TTY: 711

8−ဂီၤ 00 နၣ်ရံၣ်တုၤဟါ 5:00 နၣ်ရံၣ် လီၢ်ကဝီၤတၢ်ဆၢကတီၢ်, မုၢ်ဆၣ် – မုၢ်ဖီဖး

If you’re ready to join, or just want to know more call and speak to a Medicaid Choice Counselor toll free at 1-877-711-3662. TTY/TDD users please call 1-866-467-4970. You can also enroll online at flmedicaidmanagedcare.com.

တၢ်ပတီၢ်တဖၣ်လၢ တၢ်ကဆဲးလီၤမံၤအဂီၢ်
Get the details

Eligibility for enrollment in the UnitedHealthcare Health and Home Connection plan is determined by CARES (Comprehensive Assessment and Review of Long-Term Care Services).

To find out if you are eligible, or to locate a CARES unit near you, call the Elder Helpline: 1-800-963-5337.

ကရူၢ်ဖိတၢ်ကစီၣ်

ကဲထီၣ်ကရူၢ်ဖိတဂၤလံဧါ. နဒိးန့ၢ်ခွဲးလၢကနုာ်လီၤဆူ ပကရူၢ်ဖိ−ဧိၤ ပှာ်ယဲၤသန့လီၤႉ Print ID cards, chat with a nurse online, and more.

ကရူၢ်ဖိပှာ်ယဲၤသန့


Individual & Family ACA Marketplace Plans Disclaimer
(သုးထီၣ်သုးလီၤလၢ တလါအံၤအပူၤဒ်သိးကကွၢ်တက့ၢ်)

တၢ်န့ၢ်ဘျုးအဂ့ၢ်လၢဘၣ်တၢ်ပာ်ဖျါဒုးနၢ်ပၢၢ်အီၤ တမ့ၢ်လၢကအိၣ်ဘၣ်လၢတၢ်ရဲၣ်တၢ်ကျဲၤတဖၣ်ခဲလၢာ်အပူၤ မ့တမ့ၢ် လၢကီၢ်စဲၣ်ခဲလၢာ်အပူၤဘၣ်န့ၣ်လီၤႋ တၢ်ရဲၣ်တၢ်ကျဲၤတနီၤနီၤ ကလိၣ်ဘၣ် တၢ်ဟ့ၣ်ပှဲၤန့ၢ်တၢ်အုၣ်ကီၤဘူးလဲ တၢ်ဟ့ၣ်ဆိတၢ်အုၣ်ကီၤဘူးလဲ ဒီး/မ့တမ့ၢ် တၢ်ဟ့ၣ်သဃဲၤတၢ်အုၣ်ကီၤဘူးလဲလၢတၢ်န့ၢ်ဘျုးတဖၣ်န့ၣ်အဂီၢ်သ့န့ၣ်လီၤႋ ကျဲသနူအံၤ အိၣ်ဒီးတၢ်ပျဲပူၤလီၤဆီ တၢ်ပာ်ပနီၣ်အဆၢ တၢ်ထုးစှၤလီၤတၢ်န့ၢ်ဘျုး ဒီးတၢ်သိၣ်တၢ်သီတဖၣ်အိၣ်လၢကျဲသနူအံၤအပူၤ ကဘၣ်တၢ်ဆဲးမၤအီၤဆူညါ မ့တမ့ၢ် ဆိကတီၢ်ပာ်ကွံာ်အီၤသ့န့ၣ်လီၤႋ For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. တၢ်ရဲၣ်တၢ်ကျဲၤအဂ့ၢ်လီၤတံၢ်လီၤဆဲးဒီးတၢ်န့ၢ်ဘျုးတဖၣ် လီၤဆီလိာ်သးခီဖျိအတၢ်အုၣ်ကီၤလုၢ်ဘၢအတကွီၣ်ဒီးခီဖျိတၢ်ရဲၣ်တၢ်ကျဲၤအကလုာ်န့ၣ်လီၤႋ ၀ံသးစူၤကွၢ်သမံသမိးလီၤတံၢ်ဘၣ်တၢ်ရဲၣ်တၢ်ကျဲၤအဂ့ၢ်လီၤတံၢ်လီၤဆဲးလၢကသ့ၣ်ညါအါထီၣ်တၢ်ဂ့ၢ်တက့ၢ်ႋ

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.- Rocky Mountain Health Maintenance Organization Incorporated လၢ CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.- UnitedHealthcare Insurance Company in AL, KS, LA, MO, NJ, and TN; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.- UnitedHealthcare of Ohio, Inc.- UnitedHealthcare of Oklahoma, Inc.- UnitedHealthcare of South Carolina, Inc.- UnitedHealthcare of Texas, Inc.- UnitedHealthcare of Oregon, Inc. in WA; and UnitedHealthcare of Wisconsin, Inc.  Administrative services provided by United HealthCare Services, Inc. or its affiliates.

This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. လၢတၢ်အုၣ်ကီၤလုၢ်ဘၢအတၢ်ဘူးတၢ်လဲဒီးတၢ်ဂ့ၢ်တၢ်ကျိၤအလီၤတံၢ်လီၤဆဲးအဂီၢ် ကိးလီတဲစိ မ့တမ့ၢ် ကွဲးလံာ်ပရၢဆူ နတၢ်အုၣ်ကီၤအခၢၣ်စး မ့တမ့ၢ် ခီပနံာ် လၢမၤအသ့တမံၤမံၤန့ၣ်တက့ၢ်ႋ By responding to this offer, you agree that a representative may contact you.

1 Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. Services may not be available at all times, or in all locations, or for all members. Check your benefit plan to determine if these services are available. တၢ်ဘူးလဲပတီၢ်တဖၣ်ကဘၣ်ထွဲဃုာ်သ့န့ၣ်လီၤႋ Certain prescriptions may not be available and other restrictions may apply.

2 Tier 2 prescriptions for $5 or less not available on all medications. 3-month fills apply to select maintenance medications only. Applicable formulary requirements such as prior authorization and quantity limits may apply to your pharmacy benefits. Walgreens ထုးစှၤလီၤတၢ်အပှ့ၤတုၤလၢ 12/31/24 န့ၣ်လီၤႋ Discount valid only for in-store purchases of eligible Walgreens brand health and wellness products by current members eligible for the UnitedHealthcare discount program. တၢ်ထးစှၤလီၤတၢ်အပှ့ၤစူးကါသးလၢပှာ်ယဲၤကျိၤကျဲတသ့ဘၣ်န့ၣ်လီၤႋ လၢကကွၢ်ဘၣ် Walgreens ဆူၣ်ချ့ ပနံာ်ကၤမံၤဒီးတၢ်အိၣ်ဒီးတၢ်အိၣ်ဆူၣ်အိၣ်ချ့ အပနံာ်ကၤတဖၣ်ဒီးတၢ်ပျဲပူၤလီၤဆီအဂီၢ်န့ၣ်, ဝံသးစူၤ ကွၢ်ဖဲ www.walgreens.com/smartsavings တက့ၢ်.

တၢ်မၤသီထီၣ်က့ၤအီၤအလီၢ်ခံကတၢၢ် - 04.18.2024 at 12:11 AM CDT

တၢ်တဟံးန့ၢ်မူဒါ တၢ်ကစီၣ်ဂ့ၢ်ကျိၤ
(သုးထီၣ်သုးလီၤလၢ တလါအံၤအပူၤဒ်သိးကကွၢ်တက့ၢ်)

နကွၢ်ဃုကီၢ်စၢဖှိၣ်ပဒိၣ် အ Medicaid ပှာ်ယဲၤသန့ဧါ. ကွၢ်ဖဲအံၤဖဲ Medicaid.gov တက့ၢ်.

UnitedHealthcare တၢ်တိာ်ကျဲၤလၢပှဲၤခံမံၤ

တၢ်တိာ်ကျဲၤတဖၣ်န့ၣ် တၢ်အုၣ်ကီၤအီၤခီဖျိ UnitedHealthcare တၢ်အုၣ်ကီၤခီပနံာ် (UnitedHealthcare Insurance Company) မ့တမ့ၢ် ခီဖျိခီပနံာ်တမံၤလၢဘၣ်ထွဲဒီးအီၤတမံၤ, Medicare တၢ်န့ၢ်အဘျုး (Medicare Advantage) ကရၢကရိတမံၤ လၢအိၣ်ဒီး Medicare တၢ်ဃံးဃာ်တမံၤ ဒီး တၢ်ဃံးဃာ်တမံၤဒီး ကီၢ်စဲၣ် Medicaid တၢ်ရဲၣ်တၢ်ကျဲၤန့ၣ်လီၤ. တၢ်ဆဲးလီၤမံၤ လၢတၢ်တိာ်ကျဲၤအပူၤန့ၣ် ဒိးသန့ၤသးလၢ တၢ်မၤသီထီၣ်တၢ်တိာ်ကျဲၤအလံာ်ဃံးဃာ်လၢ Medicare န့ၣ်လီၤ. တၢ်တိာ်ကျဲၤအံၤန့ၣ်အိၣ်လၢ ပှၤတဂၤဂ့ၤတဂၤဂ့ၤ လၢအိၣ်ဒီးဆူၣ်ချ့တၢ်တိစၢၤမၤစၢၤ လၢကီၢ်စဲၣ် ဒီး Medicare တၢ်န့ၢ်ဘျုးခံခါလၢာ်အဂီၢ်, တၢ်န့ၢ်ဘျုး တၢ်ဂ့ၢ်တၢ်ကျိၤ ဒီး/မ့တမ့ၢ် တၢ်ပီးတၢ်လီ လီၤဆီလိာ်အသးလၢ တၢ်တိာ်ကျဲၤ/လီၢ်က၀ီၤ န့ၣ်လီၤ. တၢ်ကစူးကါ တၢ်ပာ်ပနီၣ်တဖၣ်, တၢ်ကွၢ်ကပာ်ကွံာ်တဖၣ် ဒီး/မ့တမ့ၢ် ပှာ်ဘျးစဲ တၢ်တြီဃာ်တဖၣ် လီၤ. တၢ်န့ၢ်အဘျုးတဖၣ်, တၢ်ဟ့ၣ်တၢ်အုၣ်ကီၤအပှ့ၤတဖၣ် ဒီး/မ့တမ့ၢ် တၢ်ဟ့ၣ်သဃဲၤအဘူးအလဲတဖၣ်/တၢ်အုၣ်ကီၤသဃဲၤ န့ၣ်ဘၣ်သ့ၣ်သ့ၣ် ကဆီတလဲလၢ တနံၣ်ဘၣ်တနံၣ် လါယနူအါရံၤ 1သီ န့ၣ်လီၤ.

တၢ်ပာ်ဖျါထီၣ် ဖြံၣ်မံယၢၣ်အတၢ်တဟံးန့ၢ်မူဒါ

Dual Special Needs တၢ်တိာ်ကျဲၤအိၣ်ဒီး $0 ဖြံၣ်မံယၢၣ်လၢ ကရၢဖိလၢအိၣ်ဒီး Extra Help (တၢ်မၤစၢၤအဂၤ) (တၢ်ဟဲနုာ်စှၤ စ့ဆီၣ်ထွဲ) အဂီၢ်လီၤ.

တၢ်ပာ်ဖျါထီၣ် တၢ်န့ၢ်ဘျုးအတၢ်တဟံးမူဒါ

တၢ်န့ၢ်ဘျုး, တၢ်မၤအသးနီၢ်နီၢ်, ဒီး/မ့တမ့ၢ် ပီးလီတဖၣ် လီၤဆီလိာ်သး လၢတၢ်တိာ်ကျဲၤ/လီၢ်က၀ီၤအဖီခိၣ်လီၤ. တၢ်ကစူးကါ တၢ်ပာ်ပနီၣ်တဖၣ်, တၢ်ကွၢ်ကပာ်ကွံာ်တဖၣ် ဒီး/မ့တမ့ၢ် ပှာ်ဘျးစဲ တၢ်တြီဃာ်တဖၣ် လီၤ.

တၢ်တဟံးန့ၢ်မူဒါဘၣ်ဃး မုၣ်ကွၢ်ပှၤဆါဂ့ၢ်ဂီၢ်အူလီတဲစိကျိၤ

တၢ်တိစၢၤမၤစၢၤအံၤန့ၣ် ပှၤတကြၢးစူးကါအီၤလၢ ဂ့ၢ်ဂီၢ်အူ မ့တမ့ၢ်တၢ်လိၣ်ဘၣ်တၢ်ကွၢ်ထွဲချ့ချ့တဖၣ်အဂီၢ်ဘၣ်. လၢဂ့ၢ်ဂီၢ်အူတၢ်ဂ့ၢ်အပူၤန့ၣ်, ကိး 911 မ့တမ့ၢ် လဲၤဆူဂ့ၢ်ဂီၢ်အူဒၢးလၢ အဘူးကတၢၢ်တက့ၢ်. တၢ်ကစီၣ်ဂ့ၢ်ကျိၤလၢတၢ်ဟ့ၣ်အီၤခီဖျိတၢ်တိစၢၤမၤစၢၤအံၤန့ၣ် မ့ၢ်ထဲဒၣ်လၢ တၢ်ဟ့ၣ်တၢ်ကစီၣ်ဂ့ၢ်ကျိၤတၢ်ပညိၣ်အဂီၢ်န့ၣ်လီၤ. ကသံၣ်သရၣ်မုၣ်ကွၢ်ပှၤဆါတဖၣ် ဃုထံၣ်သ့ၣ်ညါတၢ်ဆါအတၢ်ဂ့ၢ်ကီတဖၣ် မ့တမ့ၢ် ဟ့ၣ်ကူၣ်ဟ့ၣ်ဖး တၢ်ကူစါယါဘျါ တသ့ဘၣ် ဒီးအ၀ဲသ့ၣ်တဖၣ် မၤပှဲၤန့ၢ်တၢ်လီၢ်လၢ နပှၤဟ့ၣ်တၢ်မၤစၢၤအတၢ်ကွၢ်ထွဲအဂီၢ် တသ့ဘၣ် န့ၣ်လီၤ. နဆူၣ်ချ့တၢ်ကစီၣ်ဂ့ၢ်ကျိၤန့ၣ် ဘၣ်တၢ်ပာ်ခူသူၣ်အီၤ ဒ်သဲစးတၢ်သိၣ်တၢ်ဘျၢအသိးန့ၣ်လီၤ. တၢ်မၤစၢၤဝဲအံၤ တမ့ၢ်တၢ်အုၣ်ကီၤအတၢ်ရဲၣ်တၢ်ကျဲၤတခါဘၣ် ဒီးပတုာ်ကွံာ်အသးသ့ ကိးဆၢကတီၢ်ဒဲးန့ၣ်လီၤ. ပှၤကွၢ်ထွဲပှၤဆါအဂ့ၢ်ဂီၢ်အူလီတဲစိန့ၣ် တဘၣ်စူးကါအီၤလၢ ဂ့ၢ်ဂီၢ်အူတၢ်ဂ့ၢ်အဂီၢ်ဘၣ်, ထဲဒၣ်လၢတၢ်ဟ့ၣ်ခီဟ့ၣ်နီၤတၢ်ဂ့ၢ်တၢ်ကျိၤအဂီၢ်ဧိၤလီၤ.

UnitedHealthcare Connected® လၢ MyCare Ohio (Medicare-Medicaid တၢ်တိာ်ကျဲၤ) အဂီၢ်

UnitedHealthcare Connected® လၢ MyCare Ohio (Medicare-Medicaid တၢ်တိာ်ကျဲၤ) အဂီၢ်မ့ၢ်ဝဲ ဆူၣ်ချ့တၢ်တိာ်ကျဲၤ တမံၤလၢမၤလံာ်ဃံးဃာ်ဒီး Medicare ဒီး Ohio Medicaid ခံမံၤလိာ် ဒ်သိးကဟ့ၣ် တၢ်ရဲၣ်တၢ်ကျဲၤခံမံာ်လိာ် အတၢ်န့ၢ်အဘျုးတဖၣ် ဆူပှၤဆဲးလီၤမံၤတဖၣ်အအိၣ်န့ၣ်လီၤ. 

UnitedHealthcare Connected® (Medicare-Medicaid တၢ်တိာ်ကျဲၤ)

UnitedHealthcare Connected® (Medicare-Medicaid တၢ်တိာ်ကျဲၤ) မ့ၢ်ဝဲ ဆူၣ်ချ့တၢ်တိာ်ကျဲၤ တမံၤလၢ မၤလံာ်ဃံးဃာ်ဒီး Medicare ဒီး Texas Medicaid ခံမံၤလၢာ် ဒ်သိးကဟ့ၣ် တၢ်တိာ်ကျဲၤခံမံၤလၢာ် အတၢ်န့ၢ်ဘျုးတဖၣ် ဆူပှၤဆဲးလီၤမံၤတဖၣ်အအိၣ်န့ၣ်လီၤ.

UnitedHealthcare Connected® လၢ One Care (Medicare-Medicaid တၢ်တိာ်ကျဲၤ) အဂီၢ်

UnitedHealthcare Connected® လၢ MyCare Ohio (Medicare-Medicaid တၢ်တိာ်ကျဲၤ) အဂီၢ် မ့ၢ်ဝဲ ဆူၣ်ချ့တၢ်တိာ်ကျဲၤ တမံၤလၢ မၤလံာ်ဃံးဃာ်ဒီး Medicare ဒီး MassHealth (Medicaid) ခံမံၤလိာ် ဒ်သိးကဟ့ၣ်တၢ်ရဲၣ်တၢ်ကျဲၤခံမံာ်လိာ် အတၢ်န့ၢ်အဘျုးတဖၣ် ဆူပှၤဆဲးလီၤမံၤတဖၣ်အအိၣ်န့ၣ်လီၤ. 

UnitedHealthcare Connected® ဂံၢ်ခီၣ်ထံးထီရီၤတၢ်န့ၢ်ဘျုးတၢ်ဟံးန့ၢ်မူဒါ

အဝဲန့ၣ်တမ့ၢ်စရီလၢအလၢအပှဲၤဘၣ်. တၢ်န့ၢ်အဘျုးတၢ်ကစီၣ်ဂ့ၢ်ကျိၤန့ၣ် မ့ၢ်ဒၣ်တၢ်ကွဲးဖျါကျၢၢ်တံၢ်အဖုၣ် ဒီးတမ့ၢ်တၢ်န့ၢ်အဘျုးတၢ်ပာ်ဖျါ လၢအလၢအပှဲၤဘၣ်. လၢတၢ်ကစီၣ်ဂ့ၢ်ကျိၤအဂၤတဖၣ်အဂီၢ် ဆဲးကျိးတၢ်တိာ်ကျဲၤ မ့တမ့ၢ် ဖးကရူၢ်ဖိလံာ်ဟံးဃာ်တက့ၢ်. တၢ်ပနီၣ်တဖၣ်, တၢ်ဟ့ၣ်သဃဲၤအဘူးအလဲတဖၣ် ဒီးတၢ်တြီတဖၣ်န့ၣ် ဘၣ်သ့ၣ်သ့ၣ်ကအိၣ်ဝဲလီၤ. လၢကမၤန့ၢ်အါထီၣ် တၢ်ကစီၣ်ဂ့ၢ်ကျိၤအဂၤတဖၣ်အဂီၢ်, ကိး UnitedHealthcare Connected® ကရၢဖိတၢ်တိစၢၤမၤစၢၤတဖၣ် (Member Services) မ့တမ့ၢ်ဖး UnitedHealthcare Connected® ကရၢဖိလံာ်ဟံးဃာ်တက့ၢ်. 

UnitedHealthcare တၢ်ကွၢ်ထွဲပှၤသးပှၢ်တၢ်ဃုထၢတဖၣ် (Senior Care Options) (HMO SNP) တၢ်တိာ်ကျဲၤ

UnitedHealthcare ပှၤသးပှၢ်တၢ်ကွၢ်ထွဲအတၢ်ဃုထၢ (SCO) မ့ၢ်ဝဲ ဆူၣ်ချ့တၢ်ကွၢ်ထွဲတၢ်တိာ်ကျဲၤ သကိးဒီး Medicare တၢ်ဃံးဃာ် ဒီးအိၣ်ဒီးတၢ်ဃံဃာ်တမံၤဒီး Commonwealth of Massachusetts Medicaid တၢ်ရဲၣ်တၢ်ကျဲၤန့ၣ်လီၤ. တၢ်ဆဲးလီၤမံၤ လၢတၢ်တိာ်ကျဲၤအပူၤန့ၣ် ဒိးသန့ၤသးလၢ တၢ်မၤသီထီၣ်တၢ်တိာ်ကျဲၤအလံာ်ဃံးဃာ်လၢ Medicare န့ၣ်လီၤ. တၢ်တိာ်ကျဲၤအံၤ မ့ၢ်ဒ်တၢ်အိၣ်သးတၢ်ရဲၣ်တၢ်ကျဲၤ လၢပှၤမတၤဂ့ၤမတၤဂ့ၤ 65 ဒီးပှၤသးပှၢ်တဖၢ်လၢ တုၤထီၣ်ထီၣ်ဘးလၢ MassHealth Standard ဒီး Original Medicare ဒီးတအိၣ်ဒီး ဆူၣ်ချ့တၢ်အုၣ်ကီၤလၢကျၢၢ်ဘၢန့ၢ်အဂီၢ်လၢလၢပှဲၤပှဲၤဘၣ်တဖၣ်, လၢတပၣ်ဃုာ်ဒီး Medicare ဘၣ်န့ၣ်လီၤ. နမ့ၢ်အိၣ်ဒီး MassHealth Standard ဘၣ်ဆၣ် တတုၤထီၣ်ထီၣ်ဘးလၢ Original Medicare န့ၣ် ဘၣ်သ့ၣ်သ့ၣ်နကကြၢးဘၣ်လၢ ကဆဲးလီၤမံၤ လၢပ MassHealth ပှၤသးပှၢ်တၢ်ကွၢ်ထွဲတၢ်ဃုထၢတၢ်တိာ်ကျဲၤ ဒီးဒိးန့ၢ် န MassHealth တၢ်န့ၢ်အဘျုးခဲလၢာ် ခီဖျိ ပ ပှၤသးပှၢ်တၢ်ကွၢ်ထွဲအတၢ်ဃုထၢ (SCO) တၢ်ရဲၣ်တၢ်ကျဲၤန့ၣ်လီၤ.

တၢ်ဟ့ၣ်ဆၣ်အယီၣ် တၢ်တဟံးန့ၢ်မူဒါ

ကိးနံၣ်ဒဲး, Medicare သမံထံဝဲ တၢ်တိာ်ကျဲၤတဖၣ် လၢအိၣ်ဒီးအခီၣ်ထံးခီၣ်ဘိလၢ ဆၣ် 5 ဖျၢၣ်တၢ်ဟ့ၣ်အယီၣ်တၢ်မၤကျဲန့ၣ်လီၤ. တၢ်ဟ့ၣ်ဆၣ် 5 ဖျၢၣ်န့ၣ် ဘၣ်တၢ်စူးကါအီၤလၢတၢ်တိာ်ကျဲၤအနံၣ် 2024န့ၣ်လီၤ.

ပှၤမၤစၢၤဖံးမၤတၢ်အကါဒိၣ်တၢ်ကစီၣ်ဂ့ၢ်ကျိၤ

တၢ်ဃုထၢန့ၣ်အိၣ်လၢနစုပူၤလီၤ

ပကဟ့ၣ်နၤတၢ်ကစီၣ်ဂ့ၢ်ကျိၤ ဒ်သိးကမၤစၢၤနၤလၢ တၢ်ဃုထၢလၢအကြၢးအဘၣ် ဒ်သိးဒီး ကသံၣ်သရၣ်ထီရီၤ ဒီး ပှၤသ့ပှၤဘၣ်လၢဆူၣ်ချ့တၢ်ကွၢ်ထွဲတၢ်မၤတဖၣ်အလံာ်အုၣ်ကီၤသးတဖၣ်န့ၣ်လီၤ. ဘၣ်ဆၣ် တၢ်ကစီၣ်ဂ့ၢ်ကျိၤအံၤန့ၣ် တမ့ၢ်တၢ်အၢၣ်လီၤမၤဂၢၢ်မၤကျၢၤ ကသံၣ်သရၣ်ထီရီၤ မ့တမ့ၢ်ပှၤသ့ပှၤဘၣ်လၢဆူၣ်ချ့တၢ်ကွၢ်ထွဲတၢ်မၤတဂၤ အတၢ်ကြၢးဘၣ်လၢ နတၢ်လိၣ်ဘၣ်တဖၣ်အဂီၢ်ဘၣ်.

ပှၤမၤစၢၤဖံးမၤတၢ် လၢပှၤဒိးန့ၢ်အီၤသ့ခီဖျိ တၢ်ပတံထီၣ်အံၤန့ၣ် တမ့ၢ်ကပာ်ဖျါ UnitedHealthcare အပှၤမၤစၢၤဖံးမၤတၢ်တဖၣ်လၢတၢ်ဃံးဃာ်အီၤအပှာ်ဘျးစဲ လၢလၢပှဲၤပှဲၤဘၣ်. ဖဲန့ၣ်ကအိၣ်ဒီး ပှၤမၤစၢၤဖံးမၤတၢ်တဖၣ် မ့တမ့ၢ် တၢ်ဂ့ၢ်လီၤဆီတဖၣ် လၢတပၣ်ဃုာ်လၢ တၢ်ပတံထီၣ်ဝဲအံၤ လၢအဘၣ်ထွဲဒီးပပှာ်ဘျးစဲဘၣ်န့ၣ်လီၤ. နမ့ၢ်တထံၣ်ပှၤမၤစၢၤဖံးမၤတၢ်လၢနကွၢ်ဃုန့ၣ် ကဆဲးကျိးပှၤမၤစၢၤဖံးမၤတၢ်လိၤလိၤသ့ ဒ်သိးကပာ်ဂၢၢ်ပာ်ကျၢၤတၢ်မၤသကိးတၢ်ဒီး UnitedHealthcare အပှာ်ဘျးစဲ မ့တမ့ၢ်ဆဲးကျိး ပှၤပှ့ၤတၢ်ဖိအဂီၢ်တၢ်တိစၢၤမၤစၢၤ လၢ လီတဲစိအပှ့ၤကလီနီၣ်ဂံၢ် လၢတၢ်ပာ်ဖျါအီၤလ၏ န UnitedHealthcare တၢ်ကွဲးနီၣ်ကွဲးဃါမံၤခးက့တက့ၢ်. ပဟ့ၣ်ကူၣ်နၤစ့ၢ်ကီးလၢ တချုးလၢနထံၣ်ကသံၣ်သရၣ်ထီရီၤတဂၤဂ့ၤတဂၤဂ့ၤ, ပၣ်ဃုာ်ဒီးကသံၣ်သရၣ်ကူၣ်သ့စဲၣ်နီၤတဖၣ်န့ၣ်, ကိးကသံၣ်သရၣ်ထီရီၤအဝဲၤလီၢ် ဒ်သိးကပာ်ဂၢၢ်ပာ်ကျၢၤအဝဲသ့ၣ် အတၢ်မၤသကိးတၢ်ဒီး အတၢ်ဟ့ၣ်ဆၢကတီၢ်သ့န့ၣ်တက့ၢ်.

ပှာ်ဘျးစဲပှၤမၤစၢၤဖံးမၤတၢ်တနီၤန့ၣ် ဘၣ်သ့ၣ်သ့ၣ်ကဘၣ်တၢ်ထၢနုာ် မ့တမ့ၢ်ထုးထီၣ်အီၤ လၢပပှာ်ဘျးစဲဖဲလံာ်နဲၣ်န့ၣ်ဘၣ်တၢ်မၤသီထီၣ်အီၤဝံၤန့ၣ်လီၤ. ပတအၢၣ်လီၤအီလီၤလၢ ပှၤမၤစၢၤဖံးမၤတၢ်ကိးဂၤဒဲးန့ၣ် တူၢ်လိာ်ကရူၢ်ဖိအသီတဖၣ်တုၤခဲအံၤန့ၣ်ဘၣ်.

မ့တမ့ၢ်လၢ ဂ့ၢ်ဂီၢ်အူတၢ်အိၣ်သးတဖၣ်အပူၤန့ၣ် ပှာ်ဘျးစဲအချၢ/ ပှၤမၤစၢၤဖံးမၤတၢ်လၢတၢ်အၢၣ်လီၤအီလီၤတအိၣ်န့ၣ် မူဒါတအိၣ်လၢ ကကူစါယါဘျါ UnitedHealthcare တၢ်တိာ်ကျဲၤကရူၢ်ဖိတဖၣ်ဘၣ်. ဝံသးစူၤကိးပပှၤပှ့ၤတၢ်ဖိအဂီၢ်တၢ်တိစၢၤမၤစၢၤနီၣ်ဂံၢ် မ့တမ့ၢ်ကွၢ် တၢ်အုၣ်ကီၤစ့မၤစၢၤတၢ်အုၣ်သး လၢတၢ်ကစီၣ်ဂ့ၢ်ကျိၤအါထီၣ်အဂီၢ်, ပၣ်ဃုာ်ဒီးတၢ်ဟ့ၣ်သဃဲၤအဘူးအလဲ လၢဘၣ်ထွဲဒီးတၢ်တိစၢၤမၤစၢၤလၢပှာ်ဘျးစဲအချၢတဖၣ်န့ၣ်တက့ၢ်.

အမဲရကၤပှၤနီၢ်ခိက့ၢ်ဂီၤတလၢပှဲၤတဖၣ်တၢ်သိၣ်ဘျၢတၢ်ဒုးသ့ၣ်ညါ

ဒ်ကီၢ်စၢဖှိၣ်ပှၤအမဲရကၤဖိတဖၣ်လၢနီၢ်ခိက့ၢ်ဂီၤတလၢပှဲၤတဖၣ်တၢ်သိၣ်ဘျၢ လၢ 1990 ဒီး သနၢၣ် 504 လၢတၢ်တၢ်မၤဂ့ၤထီၣ်ကဒါက့ၤတၢ်သိၣ်ဘျၢလၢ 1973 ("ADA") အသိး UnitedHealthcare တၢ်အုၣ်ကီၤခီပနံာ်န့ၣ် ဟ့ၣ်ဝဲတၢ်ဒိးန့ၢ်ခွဲးအလၢအပှဲၤဒီးထဲသိးသိး ဆူတၢ်တိစၢၤမၤစၢၤတဖၣ်လၢတၢ်အုၣ်ကီၤဃာ်အီၤ ဒီးတကွၢ်မဲာ်ဘၣ်ပှၤတဂၤဘၣ်တဂၤလၢနီၢ်ခိက့ၢ်ဂီၤတလၢပှဲၤ လၢတုၤထီၣ်ထီၣ်ဘး လၢနီၢ်ခိက့ၢ်ဂီၤတလၢပှဲၤအဖီခိၣ် လၢအဝဲအတၢ်တိစၢၤမၤစၢၤ,တၢ်ရဲၣ်တၢ်ကျဲၤ ဒီးဟူးဂဲၤတဖၣ်ဘၣ်.

တၢ်ဆှၢခီတဖၣ်

ပှာ်ဘျးစဲပှၤမၤစၢၤဖံးမၤတၢ်တဖၣ်န့ၣ် မၤစၢၤနၤဒီးနဟံၣ်ဖိဃီဖိတဖၣ်လၢ တၢ်အုၣ်ကီၤဃာ် ဒ်သိးကဒိးန့ၢ်တၢ်ကွၢ်ထွဲလၢအလိၣ်ဘၣ်န့ၣ်လီၤ. တၢ်ထံၣ်လိာ်သးဒီး ကသံၣ်သရၣ်ကူၣ်သ့စဲၣ်နီၤတဖၣ်န့ၣ် ကဘၣ်တၢ်မၤဘၣ်လိာ်ဖိးဒ့ လၢန ပှၤကွၢ်ထွဲဖံးမၤတၢ်မိၢ်ပှၢ်န့ၣ်လီၤ.

စးခိလံာ်နဲၣ်တၢ်ဃ့ကညးတဖၣ်

ပှာ်ဘျးစဲပှၤမၤစၢၤဖံးမၤတၢ်အလံာ်နဲၣ် အစးခိလံာ်ဒိတဖၣ်န့ၣ် ပှၤဒိးန့ၢ်အီၤသ့အပှ့ၤကလီ လၢကရူၢ်ဖိတဖၣ်အဂီၢ် ခီဖျိတၢ်ကိးပှၤပှ့ၤတၢ်ဖိအဂီၢ်တၢ်တိစၢၤမၤစၢၤနီၣ်ဂံၢ် လၢန တၢ်ကွဲးနီၣ်ကွဲးဃါမံၤခးက့အလီၢ်ခံန့ၣ်လီၤ. ပှၤတမ့ၢ်ကရူၢ်ဖိတဖၣ်န့ၣ် ထဲးလီၤဟံးဃာ် ဒီးစဲကျံးထုးထီၣ်တၢ်ကွၢ်ဃုအစၢတဖၣ် လၢအ့ၣ်ထၢၣ်နဲးလံာ်နဲၣ်သ့န့ၣ်လီၤ.

တၢ်ကစီၣ်ဂ့ၢ်ကျိၤလၢကမၣ်

လၢကပာ်ဖျါထီၣ်တၢ်ဂ့ၢ်တၢ်ကျိၤလၢအကမၣ်အဂီၢ်, ဆှၢအံမ့(လ)ဆူ provider_directory_invalid_issues@uhc.com တက့ၢ်. အံမ့(လ)တလါအံၤန့ၣ် မ့ၢ်ကရူၢ်ဖိတဖၣ်အဂီၢ် ဒ်သိးကဒုးသ့ၣ်ညါတၢ်လၢဘၣ်ကမၣ်သ့တဖၣ် လၢနီၣ်ဂံၢ်နီၣ်ဒွးတၢ်ဂီၤပာ်ဖျါ (အိၣ်ဆိးလီၢ်,လီတဲစိ, ဒီးအဂၤတဖၣ်) တၢ်ကစီၣ်ဂ့ၢ်ကျိၤလၢ အ့ၣ်ထၢၣ်နဲးအလိၤ မ့တမ့ၢ်စးခိလံာ်နဲၣ်တဖၣ်န့ၣ်လီၤ. တၢ်ဒုးသ့ၣ်ညါတၢ်ကီတၢ်ခဲတဖၣ် ခီဖျိအံမ့(လ)တလါ န့ၣ်ကဆှၢအီၤဆူ ပှၤမၤစၢၤဖံးမၤတၢ်အဝဲၤလီၢ် ဒ်သိးကပာ်ဂၢၢ်ပာ်ကျၢၤ လံာ်နဲၣ်နီၣ်ဂံၢ်နီၣ်ဒွးတၢ်ဂီၤပာ်ဖျါတၢ်ဂ့ၢ်ထၢဖှိၣ်ခဲလၢာ် လၢအယံာ်ဝဲသ့ 30 သီန့ၣ်လီၤ. ပှၤတဂၤဘၣ်တဂၤစ့ၢ်ကီး ဒုးသ့ၣ်ညါတၢ်လၢဘၣ်ကမၣ်သ့တဖၣ် ခီဖျိလီတဲစိသ့န့ၣ်လီၤ. UnitedHealthcare ကရူၢ်ဖိတဖၣ်န့ၣ် ကြၢးကိးနီၣ်ဂံၢ်အိၣ်လၢ အဝဲသ့ၣ်အတၢ်အုၣ်သး ID ခးက့အလီၢ်ခံ, ဒီးပှၤလၢတမ့ၢ် UnitedHealthcare ကရူၢ်ဖိတဖၣ်န့ၣ် ကိး 1–888638-6613TTY 711, မ့တမ့ၢ် စူးကါတၢ်ဖီၣ်န့ၢ်ဆှၢခီတၢ်ကလုၢ်တၢ်မၤစၢၤ လၢနဘၣ်သးသ့န့ၣ်လီၤ.

တၢ်ဘိးဘၣ်ရၤလီၤဘၣ်ဃးဒီး တၢ်တတၢာ်တနါ မ့တမ့ၢ် ဂ့ၢ်ဂီၢ်အူ

နမ့ၢ်ဘၣ်ဒိလၢတၢ်တတၢာ်တနါ မ့တမ့ၢ် ဂ့ၢ်ဂီၢ်အူတၢ်ဘိးဘၣ်ရၤလီၤလၢ ကီၢ်ခိၣ် မ့တမ့ၢ် ကီၢ်ရ့ၣ်ခိၣ်, မ့တမ့ၢ် တၢ်ဘိးဘၣ်ရၤလီၤလၢကမျၢၢ်တၢ်အိၣ်ဆူၣ်အိၣ်ချ့ဂ့ၢ်ဂီၢ်အူ လၢ တၢ်အိၣ်ဆူၣ်အိၣ်ချ့ဒီးပှၤဂ့ၢ်ဝီတၢ်မၤစၢၤနဲၣ်ရွဲၣ် (Secretary of Health and Human Services) န့ၣ်, အိၣ်ဒီးတၢ်ဆီၣ်ထွဲမၤစၢၤအါထီၣ်အဂၤလီၤတံၢ်လီၤဆဲး တဖၣ်လၢနမၤန့ၢ်အီၤသ့န့ၣ်လီၤ.

  • အကူာ် A, အကူာ် B, ဒီးတၢ်မၤပှဲၤထီၣ်စၢၤတၢ်အကူာ် C တၢ်တိာ်ကျဲၤတၢ်န့ၢ်ဘျုး တဖၣ်န့ၣ်ကဘၣ်တၢ်ဟ့ၣ်လီၤဖဲ တၢ်ကရၢကရိလၢတအိၣ်ဒီးတၢ်မၤလံာ်ဃံးဃာ်တဖၣ် (ပာ်သူၣ်ပာ်သးလၢအကူာ် A ဒီးအကူာ် B တၢ်န့ၢ်ဘျုးတဖၣ်တၢ်ကမၤန့ၢ်အီၤဖဲ Medicare အုၣ်ကီၤတၢ်ကရၢကရိတဖၣ်)-
  • တၢ်လီၢ်လၢအကြၢးဝဲဘၣ်ဝဲန့ၣ်, တၢ်လိၣ်ဘၣ်တဖၣ်လၢပှၤခိးတြဲၤတၢ်ဆှၢထီၣ်ဆူညါ တတီၤတဖၣ်န့ၣ် တၢ်မၤစၢ်လီၤန့ၢ်အီၤလၢလၢပှဲၤပှဲၤ-
  • တၢ်တိာ်ကျဲၤ-အုၣ်ကီၤ ပှာ်ဘျးစဲအချၢတၢ်ဟ့ၣ်သကိးတၢ်အပှ့ၤတဖၣ် ဆူ ပှာ်ဘျးစဲ တၢ်ဟ့ၣ်သကိးတၢ်အပှ့ၤတဖၣ်န့ၣ် စှၤလီၤတစိၢ်တလီၢ်, ဒီး
  • တၢ်ဘိးဘၣ်သ့ၣ်ညါတၢ်လိၣ်ဘၣ် 30- သီဆူကရၢဖိတဖၣ်န့ၣ်ဘၣ်တၢ်မၤစၢ်လီၤအီၤ, ဖဲတၢ်ဆီတလဲခဲလၢာ် (ဒ်အမ့ၢ် တၢ်မၤစှၤလီၤတၢ်ဟ့ၣ်သကိး-တၢ်ဟ့ၣ်လီၤကွံာ်တၢ် စိတၢ်ကမီၤ) န့ၢ်ဘျုးကရၢဖိအခါန့ၣ်လီၤ.

CMS မ့ၢ်တဟ့ၣ်လီၤဘၣ်ဒံးမုၢ်နံၤအကတၢၢ်လၢတၢ်တတၢာ်တနါ မ့တမ့ၢ် ဂ့ၢ်ဂီၢ်အူအဂီၢ် န့ၣ်, တၢ်တိာ်ကျဲၤတဖၣ် ကမၤကဒါက့ၤတၢ်ဖံးတၢ်မၤဒ်အညီနုၢ် 30 ဖဲတၢ်မၤတၢ်ဘိး ဘၣ်ရၤလီၤအခီၣ်ထံးတဘျီ ဝံၤအလီၢ်ခံအသီတဖၣ်န့ၣ်လီၤ.

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