UnitedHealthcare Community Plan - Heritage Health

Asthma, Allergy and COPD Care

Do you or a family member have trouble managing asthma or COPD symptoms?
You will get a customized treatment plan and medicine to:

• Manage flare-ups.
• Reduce symptoms.
• Help you stay active.

တၢ်ကွၢ်ထွဲတၢ်ပၢဆှၢရဲၣ်ကျဲၤ

When a member has complex health care needs, a care manager can really help. He or she will:

• Work with you and family members and friends on a plan of care.
• Explain medical terms in plain language.
• Coordinate your doctor appointments.
• Provide your care team with your medical records. 
• Make a referral to community social service programs.
• Offer rewards like a gift card for chronic care checkups or well care visits.

Cell Phone Program

Eligible members can get health support with mobile phone service at NO COST to you from select Lifeline service providers. We want to help you stay connected!  Apply Now! Call Member Services at 1-800-641-1902, TTY 711 for assistance.. 

Children's Health Support

• Rewards program for well-child visits.
• Dr. Health E. Hound® provides nutritional education and promotes fitness and healthy habits.

Chiropractic Care (တၢ်ကူစါယါဘျါလၢတၢ်စံၢ်ဘၣ်တၢ်အကျိၤအကျဲ)

Medicaid limits coverage of chiropractic services to: (i) Certain spinal X-rays; (ii) Manual manipulation of the spine; (iii) Certain evaluation and management services; (iv) Traction; (v) Electrical stimulation; (vi) Ultrasound; and (vii) Certain therapeutic procedures, activities, and techniques designed and implemented to improve, develop, or maintain the function of the area treated.

Choice of Birth Center

Where you have your baby is an important choice. That’s why you can pick from our large network of hospitals or Birthing Center.

We also encourage you to tour the hospital’s birthing center. This way you will be familiar with it and be better informed when you have your baby.

တၢ်ဃုထၢကသံၣ်သရၣ်

Each member can choose a primary care provider (PCP). စူးကါ တၢ်ဃုကွၢ်ကသံၣ်သရၣ်ပီးလီ ဒ်သိးကထံၣ်သ့ၣ်ညါဘၣ်ဃး နကသံၣ်သရၣ်န့ၣ်အိၣ်ဝဲလၢပပှဲာ်ဘျးစဲအပူၤဧါန့ၣ်တက့ၢ်.

န PCP န့ၣ် မ့ၢ်နကသံၣ်သရၣ်မိၢ်ပှၢ်လၢ -

• Preventive care.
• Treatment if you are sick or injured.
• Care coordination with specialists.

For members who don’t have a doctor or whose doctor is not in our network, Member Services can help find a new one close by.

မဲတၢ်ကွၢ်ထွဲ

တၢ်ဟံးန့ၢ် တနံၣ်ဘၣ်တနံၣ်မဲတၢ်ခံကွၢ်စီကွၢ်န့ၣ် အကါဒိၣ်လၢနတၢ်အိၣ်ဆူၣ်အိၣ်ချ့အဂီၢ်န့ၣ်လီၤ. နတၢ်အုၣ်ကီၤစ့မၤစၢၤန့ၣ်ပၣ်ဃုာ်ဒီး -  

• Two exams and cleanings per year for children and adults.
• Bitewing X-ray once every 12 months and one complete set of X-rays every three years. 
• Minor restorations such as filling. 
• Major restorations such as crowns and root canals (one of each per 12 months). 
• Deep cleanings and surgical treatment for gum disease. 
• Partial or full dentures, and repairs to partials or full dentures. 
• Sedation and nitrous oxide (known as laughing gas) if medically necessary.

တဘျီတခီၣ်န့ၣ် ပှၤကညီသ့ၣ်တဖၣ်ကီဒိၣ်မးလၢကလဲၤထံၣ်လိာ်သးဒီး မဲကသံၣ်သရၣ်န့ၣ်လီၤ. အဝဲသ့ၣ်တဖၣ်န့ၣ် ပှၤမ့ၢ်ဖီၣ်ဘၣ်အီၤန့ၣ် အဘၣ်အီၤတမုာ်ဘၣ်န့ၣ်လီၤ. အဝဲသ့ၣ်ကလိၣ်ဘၣ်အါထီၣ်တၢ်ဆၢကတီၢ် မ့တမ့ၢ် တၢ်ဟုကယာ်လၢအကဖီယီဖိန့ၣ်လီၤ. ပျဲမၤစၢၤပှၤလၢကဟုဘၣ်န့ၢ်နၤမဲကသံၣ်သရၣ်အဘၣ်လၢနၤဒီးနဟံၣ်ဖိဃီဖိအဂီၢ်န့ၣ်လီၤ. ကိး ကရၢဖိတၢ်မၤစၢၤတၢ်မၤ (Member Services) ဖဲ 1-800-641-1902, TTY 711.

Diabetic Support

နမ့ၢ်အိၣ်ဒီးသွံၣ်ဆၢတၢ်ဆါန့ၣ် ပကမၤစၢၤနၤ ဒ်သိးနတၢ်အိၣ်မူန့ၣ်ကညီဒိၣ်ထီၣ်တစဲးဖိလၢနဂီၢ်န့ၣ်လီၤ. You'll get medicine, supplies and education to help you reach and stay your best. Our diabetes program also includes self-care training and classes focused on:

• Managing stress.
• Living a healthy lifestyle.
• Wellness Rewards for getting needed exams.

တၢ်ဆါတၢ်ပၢဆှၢရဲၣ်ကျဲၤ

If you have chronic or high-risk illnesses, our disease management services may help you. We provide support for:

• Congestive heart failure.
• Asthma.
• HIV.
• Chronic obstructive pulmonary disease (COPD).
• Coronary artery disease.

တၢ်အပီးအလီတဖၣ်ဒီးတၢ်ဆှၢဟ့ၣ်တဖၣ်

Our member’s health and safety at home are important.

Our plan covers medical equipment ordered by the doctor or care manager. အဝဲန့ၣ်ပၣ်ဃုာ်ဒီးတၢ်ပီးတၢ်လီဒ်အံၤတဖၣ်လီၤ -

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

တၢ်ကွၢ်ထွဲခီၣ်လၣ်

We provide the exams you need to help keep your feet in great shape. And if you have diabetes, good foot care can help prevent much more serious problems.

Our podiatry coverage includes:

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

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. 

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. 

ပအုၣ်ကီၤတၢ်လၢ -

• Exams, aids and tests.
• Hearing aids and batteries.

Home Care

After surgery or a serious illness, you may need  in-home medical visit(s) to check on how well you are healing.

With approval, our plan covers:

• In-home medical visit(s).
• Medical equipment like hospital beds, walkers or wheelchairs.
• Disposable medical supplies.

တၢ်တီၣ်ထီၣ်တၢ်ဆါဟံၣ်

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

Hospitalization coverage includes:

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

And after leaving hospital, we can provide transitional care services. We make sure you get follow-up care to continue healing at home.

Hospice Services

Hospice services are covered when they are ordered by a physician.

Lab and X-rays

Knowing what’s wrong and finding it early can make all the difference.  Our plan covers:

• တၢ်မၤကွၢ်ဒၢးတဖၣ် ဒီးတၢ်စဲးကွၢ်
• ယဲၤဖျါ, ကွၢ်နီၢ်ကစၢ်ခီဖျိလီယဲၤဘ့ၣ်ဂီၤဖျါဒီး စဲးဒုးဖျါက့ၢ်ဂီၤအဂုၤအဂၤဖၣ်လီၤႉ

We’ll help you get the information needed to improve your health or be at your best. 

ကျိာ်တၢ်မၤစၢၤ

UnitedHealthcare ပှၤတဝၢတၢ်တိာ်ကျဲၤ ဟ့ၣ်ထီၣ်ဝဲဒၣ်ကရူၢ်ဖိတၢ်ဖိတၢ်လံၤတဖၣ်ဆူနအိၣ် ခီဖျိကျိာ်ကျာ်တခါ မ့တမ့ၢ် တၢ်မၤအကျဲတဘိလၢ အကမၤညီထီၣ်နတၢ်နၢ်ပၢၢ်လီၤ. ပကသံၣ်သရၣ်ကွၢ်ထွဲတၢ်လၢတၢ်ဘျးစဲပူၤတဖၣ် ပာ်ဃုာ်ဝဲ ကသံၣ်သရၣ်တဖၣ် လၢအကတိၤကျိာ်လီၤဆီလိာ်သးတဖၣ်န့ၣ်လီၤ. ပတၢ်ဟ့ၣ်မၤစၢၤအလံာ်နဲၣ်န့ၣ် ပာ်ဖျါန့ၢ်ဝဲကျိာ်တဖၣ်လၢကသံၣ်သရၣ်တဖၣ် သူဝဲန့ၣ်လီၤ. Additionally, many of our Member Service Advocates speak multiple languages. ဖဲနကိးလီတဲစိအခါ ပကဆဲးကျိးန့ၢ်နၤဒီးပှၤကတိၤကျိာ်ထံတၢ်တိစၢၤမၤစၢၤတၢ် လၢအကျိာ်ထံစၢၤတၢ်အါန့ၢ်ဒံး 240 န့ၣ်လီၤ. ပမၤစၢၤပဝဲသ့စ့ၢ်ကီးလၢ တၢ်ကတိၤကျိာ်ထံတၢ်တိစၢၤမၤစၢၤတဖၣ်, ပာ်ဃုာ်ဒီးကီၢ်အမဲရကၤစုပနီၣ်ကျိာ်လီၤ.

နမ့ၢ်အိၣ်ဒီးတၢ်ကီတၢ်ခဲလၢ နကဒိကနၣ်တၢ်လၢလီတဲစိအဃိဒီး, နသူဝဲလီတဲစိလၢပှၤဒိလံာ်သ့ဝဲလီၤႉ တၢ်ဖံးတၢ်မၤလၢဒိးန့ၢ်ဘၣ်အီၤသ့ကလီအံၤ ဟ့ၣ်တၢ်ပျဲဘၣ်ထွဲဒီးပှၤတဖၣ်လၢအအိၣ်ဒီး တၢ်နၢ်ဟူ မ့တမ့ၢ် တၢ်ကတိၤ တၢ်လီၤတူၢ်လီၤကၢ်ခီဖျိနီၢ်ခိက့ၢ်ဂီၤတလၢပှဲၤဝဲအဃိ ဒ်သိးကမၤ မ့တမ့ၢ် ကတူၢ်လိာ်လီတဲစိတၢ်ကိးတဖၣ်အဂီၢ်လီၤႉ ကိးလီတဲစိ711. ဟ့ၣ်အဝဲသ့ၣ်ကရူၢ်ဖိတၢ်တိစၢၤမၤစၢၤအနီၣ်ဂံၢ်1-800-641-1902,, 8001-641--,ဒီး အဝဲသ့ၣ်ကဆဲးကျိးနၤဆူပအိၣ်လီၤ.

နမၤန့ၢ်တၢ်ကစီၣ်သ့စ့ၢ်ကီးလၢ တၢ်စဲးကျံးဖးလဲၢ်, ပှၤမဲာ်တထံၣ်တၢ်အလံာ်, မ့တမ့ၢ် တၢ်ကလုၢ်တဖၣ်လီၤ.

All of the language interpretation and material translations/alternate formats are available at no cost to you. 

Member Services Advocates

တၢ်ပၢဆှၢရဲၣ်ကျဲၤနဆူၣ်ချ့တၢ်ကွၢ်ထွဲ ထဲတဂၤန့ၣ် ကီခဲသ့ဝဲ လီၤဆီဒၣ်တၢ်ဖဲ နကွၢ်ဆၢၣ်မဲာ်ဒီးဆူၣ်ချ့တၢ်ဂ့ၢ်ကီတဖၣ် အါန့ၢ်တမံၤဖဲ အဆၢကတီၢ်တပူၤဃီန့ၣ်လီၤ. နမ့ၢ်လိၣ်ဘၣ်တၢ်ဆီၣ်ထွဲထၢနုာ်အါထီၣ် ဒ်သိးကအိၣ်မူဆူၣ်ချ့အဂီၢ်န့ၣ် ပမၤစၢၤနၤသ့လီၤ. All our UnitedHealthcare members have access to Member Service Advocates.

Your Advocate can help you:

• Understand the Heritage Health program.
• Get information in a different format, like audio (CD or flash drive), large print, or Braille.
• Find a doctor, dentist or eye doctor.
• Explain your benefits and coverage.
• Talk to you about special programs that are available to you.
• Connect you with a Clinical Coordinator if needed.
• Find resources located near you to help you with other problems like food, housing, transportation, employment, feeling safe or getting an education.
• Make sure you are aware of other State programs and services available to you, such as SNAP (Supplemental Nutrition Assistance Program) or WIC (Women, Infants and Children) program benefits.
• Help you update your personal contact information like address, phone number, or email.
• Make sure we know how you would like to be contacted (email, phone, or mail).
• Resolve issues with providers, including specialty care and behavioral health.
• Assist with challenges due to prior approval, payment for services, care delivery, and family welfare.

Remember, answers to any questions you have are just a click away at myuhc.com/CommunityPlan. Or you can call Member Services at 1-800-641-1902, TTY 711, 7:12 AM–7:12 PM CT (6:12 AM–6:12 PM MT), Monday–Friday

Mental Health and Substance Use Services

သးပလၢၢ်သ့ၣ်ညါဆူၣ်ချ့ န့ၣ် ဘၣ်ဃးဒီးနသးပလၢၢ်ဘၣ်ဒ်လဲၣ် ဒီးဟူးဂဲၤဒ်လဲၣ်န့ၣ်လီၤ. အဝဲန့ၣ်ပှၤကိးအီၤစ့ၢ်ကီးလၢ နီၢ်သးဆူၣ်ချ့န့ၣ်လီၤ. Your behavioral/mental health is important. All Heritage Health members can get behavioral/mental health and substance use services. You may see any in-network behavior/mental health doctor without a referral for outpatient treatment.

You can get behavioral/mental health services without a referral from your Primary Care Provider. Sometimes it makes sense to talk to your Primary Care Provider about any behavioral/mental health problems you believe you may have. That way, your Primary Care Provider can help to refer you to an appropriate provider in our network. If you want to find a provider on your own, you can search for one at any time and make an appointment. You can also call Member Services at 1-800-641-1902, TTY 711, for help or visit liveandworkwell link.

ပအုၣ်ကီၤတၢ်လၢ -

Behavioral/Mental Health Services 

• နီၢ်တဂၤ, ပှၤအဖု ဒီးဟံၣ်ဃီတၢ်ကူစါယါဘျါ 
• တၢ်ဆါဟံၣ်ချၢပှၤဆါသးပလၢၢ်သ့ၣ်ညါဆူၣ်ချ့ တၢ်တိစၢၤမၤစၢၤတဖၣ် 
• တၢ်ဆါဟံၣ်ပူၤပှၤဆါသးပလၢၢ်သ့ၣ်ညါဆူၣ်ချ့ တၢ်တိစၢၤမၤစၢၤတဖၣ် 
• Specialized behavioral health services for children with autism.
• Behavioral health rehabilitation services

တၢ်သူကသံၣ်မူၤဘှိးတၢ်ဆူးတၢ်ဆါတၢ်တိစၢၤမၤစၢၤတဖၣ် 

• တၢ်ကူစါယါဘျါပှၤဆါလၢတထီၣ်တၢ်ဆါဟံၣ်စဲပံၤ (ကသံၣ်ကသီမၤကယါလီၤတၢ်ဆါ) 
• တၢ်ကူစါယါဘျါခီဖျိတၢ်ပာ်လၢတၢ်ဆါဟံၣ်

Additional health resources can be found at myuhc.com/CommunityPlan. ကွၢ်ဃုတၢ်အဃၢထဲသိးသိး, တၢ်ဆီၣ်ထွဲ, ဒီးတၢ်ကွၢ်ထွဲလၢနလိၣ်ဘၣ် ဒ်သိးကအိၣ်မူပှဲၤဒီးဆူၣ်ချ့အဂ့ၤကတၢၢ်ဖဲအသ့တက့ၢ်.

သးပလၢၢ်သ့ၣ်ညါဆူၣ်ချ့တၢ်ဆါနးတၢ်တိစၢၤမၤစၢၤတဖၣ်

ယမ့ၢ်အိၣ်ဒီးသးပလၢၢ်သ့ၣ်ညါဆူၣ်ချ့တၢ်ဆါနးန့ၣ် ယကဘၣ်မၤဒ်လဲၣ်.

You are always covered for a behavioral health, mental health, and substance use emergency. An emergency means a condition that comes on suddenly, is life threatening, is painful, or other severe symptoms that cannot wait to be treated.

ဂ့ၢ်ဂီၢ်အူ တၢ်တိစၢၤမၤစၢၤတဖၣ်န့ၣ် ဘၣ်တၢ်အုၣ်ကီၤအီၤ တပူၤလၢ်လၢ်လၢ United States အပူၤန့ၣ်လီၤ. နမ့ၢ်ဆိမိၣ်လၢနအိၣ်ဒီးဂ့ၢ်ဂီၢ်အူတမံၤလၢအလီၤပျံၤလၢသးသမူအဂီၢ်န့ၣ် ကိး 911 မ့တမ့ၢ်လဲၤဆူအဘူးကတၢၢ်တၢ်ဆါဟံၣ်အလီၢ် ဖဲဂ့ၢ်ဂီၢ်အူ ပှၤမၤစၢၤဖံးမၤတဖၣ်မၤစၢၤနၤသ့န့ၣ်တက့ၢ်.

As soon as it is possible, please call us to arrange for follow-up care after an emergency.

တၢ်ဆါနးတၢ်တိစၢၤမၤစၢၤတဖၣ်:

နမ့ၢ်ဆိမိၣ်လၢနအိၣ်ဒီးဂ့ၢ်ဂီၢ်အူတမံၤန့ၣ်, နအိၣ်ဖဲလဲၣ်ဖဲလဲၣ်မ့ၢ်ဂ့ၤ ကိး 911 မ့တမ့ၢ်လဲၤဆူအဘူးကတၢၢ်တၢ်ဆါဟံၣ်တၢ်လီၢ် ဖဲဂ့ၢ်ဂီၢ်အူ ပှၤမၤစၢၤဖံးမၤတဖၣ်မၤစၢၤနၤသ့န့ၣ်တက့ၢ်. မ့ၢ်န့ၢ်တဘျီဃီန့ၣ် ကိးလီတဲစိဆူ နကသံၣ်သရၣ် မ့တမ့ၢ် ဆူၣ်ချ့ဘၣ်ထွဲလုၢ်လၢ်သကဲာ်ပ၀း ပှၤမၤစၢၤဖံးမၤတၢ် ဒ်သိးကသုးကျဲၤ တၢ်ကွၢ်ပိာ်ထွဲ ဆူၣ်ချ့ဘၣ်ထွဲလုၢ်လၢ်သကဲာ်ပ၀း တၢ်ကွၢ်ထွဲ ဖဲဂ့ၢ်ဂီၢ်အူတမံၤဝံၤအလီၢ်ခံန့ၣ်တက့ၢ်.

နမ့ၢ်လိၣ်လၢကကတိၤတၢ်ဒီးပှၤတဂၤဂၤန့ၣ် ပအိၣ်လၢနဂီၢ်န့ၣ်လီၤ. နမ့ၢ်တဆိကမိၣ်လၢ အဆၢကတီၢ်ဘၣ်လၢကကိးလီတဲစိ 911 ဘၣ်ဆၣ်လိၣ်ဘၣ်တၢ်မၤစၢၤတဘျီဃီန့ၣ် နကိးလီတဲစိ Behavioral Health Crisis Hotline (ဆူၣ်ချ့ဘၣ်ထွဲလုၢ်လၢ်သကဲာ်ပ၀းတၢ်ကီတၢ်ခဲဂ့ၢ်ဂီၢ်အူလီကျိၤ) လၢ 24/7 ဖဲ 1-800-641-1902 သ့န့ၣ်လီၤ.

လၢအ့ၣ်ထၢၣ်နဲးအလိၤ − http://www.suicidepreventionlifeline.org

No Copays

You will not have a copayment for care and services covered by our plan.

Nurse Hotline (တၢ်ကွၢ်ထွဲပှၤဆါအဂ့ၢ်ဂီၢ်အူလီၤကျိၤ)

Medical questions and situations can come at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week.

ပနၢး(စ)ကွၢ်ထွဲပှၤဆါတဖၣ်န့ၣ် က - 

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

Over-The-Counter Drugs/Supplies

Select over-the-counter drugs and supplies are covered 100% with your doctor’s prescription.  

Your health care costs may include non-prescription medicines and supplies like aspirin, cough medicine or diabetic testing supplies. Covered 100% with your doctor’s prescription.

ကသံၣ်ကျး

Our plan includes prescription drugs and refills, and we make getting your medicine easy. Medicare and other insurance copays may apply. You can fill your prescriptions at:

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

When you have a prescription filled, be sure to check that:

• It’s included on the Preferred Drug List (PDL). 
• It’s written by a network provider. 
• It’s filled at a network pharmacy. 
• You show your member ID card when you have it filled. 

Prescription Drug Copays

You can receive many available PREFERRED brand name and generic drugs with no copay. Brand NON-PREFERRED prescriptions drugs have a $3 copay.

If the Center of Medicare and Medicaid Services (CMS) shows you’re copay exempt, you will not have to pay the $3 copay. You may be copay exempt if you are:

• 18 years old or younger.
• Pregnant or gave birth within the last 60 days.
• Staying in an inpatient hospital, long-term care facility, residential facility, adult family home or center for the developmentally disabled.
• Staying in a medical facility and spending most of your income on medical costs.
• A Native American getting services from an Indian Health Center.
• Receiving waiver services under a 1915(c) waiver.
• Receiving assistance from the State Disability Program.

90 Day Supply

You will be able to get a 90-day supply of select prescription medications from a retail pharmacy. မ့ၢ်အိၣ်ဒီးအသီ - 90 တၢ်ဆှၢဟ့ၣ်န့ၣ် နတလိၣ်လၢကဒိးန့ၢ်တၢ်မၤပှဲၤကိးလါဒဲးဘၣ်. You’ll have three months between refills.

• Talk with your pharmacist - Your pharmacist can call your doctor to get a new prescription for a 90-day supply. 
• Talk with your doctor - Your doctor can write you a new 90-day supply prescription for the medicine above. We’ve let your doctor know about this change to your pharmacy benefit.  

If you have any questions, please call Member Services at 1-800-641-1902, TTY 711, 7:12 AM–7:12 PM CT (6:12 AM–6:12 PM MT), Monday–Friday

Prenatal Visits

Your pregnancy is a journey you’ll want to make with the help of friends, family and a pregnancy doctor.

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.

တၢ်ဒုၣ်မိာ်

Most people know the bad health effects of smoking. And they know they need to quit. That’s why we encourage members to talk to their doctor about getting smoking cessation support. Counseling is covered when you enroll with the Nebraska Tobacco-Free Quit Line.  Medication for smoking cessation are available through Nebraska Medicaid. Call 1-800-784-8669. 

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 skilled facility where you can heal. 

Included are:

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

တၢ်ဆဲးကသံၣ်ဒီးကသံၣ်ဒီသဒၢတဖၣ်

Routine shots help protect members and their family from illness. ပတၢ်တိာ်ကျဲၤန့ၣ်အုၣ်ကီၤဝဲလၢ -

• Pneumonia, influenza and shingles shots.
• Vaccines and Immunizations.  Routine shots to help keep your child healthy.
• Other recommended shots and vaccines.

တၢ်ကူစါယါဘျါတၢ်တိစၢၤမၤစၢၤတဖၣ်

နီၢ်ခိ,တၢ်မၤဒီးတၢ်ကတိၤတၢ်ကူစါယါဘျါန့ၣ် မၤစၢၤနၤသ့ ဒ်သိးနကအိၣ်မုာ်ထီၣ်က့ၤလၢ တၢ်ဘၣ်ဒိဘၣ်ထံး မ့တမ့ၢ်တၢ်ဆါဆူၣ်နး, မ့တမ့ၢ် နတုၤဆူတၢ်လၢနဒိးန့ၢ်သ့န့ၣ်လီၤ. 

Our plan provides:

• Occupational therapy.
• Physical therapy.
• Speech therapy.

တၢ်ဝံစိာ်တီဆှၢ

နမ့ၢ်လိၣ်ဘၣ်တၢ်ဒိးလ့ၣ်တမံၤန့ၣ် နတၢ်န့ၢ်ဘျုးတဖၣ်န့ၣ် ပၣ်ဃုာ်ဒီးတၢ်ဝံစိာ်တီဆှၢန့ၣ်လီၤ. We cover trips for Nebraska Medicaid coverable services within a 20-mile radius of your home. These include: medical, mental health, dental and vision appointments along with trips to the pharmacy.

တၢ်ပိာ်ထွဲတၢ်သိၣ်တၢ်သီယိယိဖိအံၤတဖၣ်န့ၣ် ကမၤစၢၤနၤ ဒ်သိးကဒိးန့ၢ်တၢ်ဒိးလ့ၣ်တမံၤ -  

• ကိးပာ်ဆိလီတဲစိ 3+ သီ 
• Call Transportation Services at 1-833-583-5683 (TTY 1-866-288-3133) 7:00 a.m.–7:00 p.m. CT (6:00 a.m.–6:00 p.m. MT), Monday–Friday or visit www.modivcare.com.
• Have your Medicaid ID card available. 
• Know the name and address of your health care provider and the date and time of your appointment. 
• မၤလီၤတံၢ်လၢ တၢ်လီၢ်လၢနလိၣ်ဘၣ်တၢ်ဆှၢနၤတက့ၢ် 
• If you’re not sure how long your appointment will take, the return ride will be scheduled for “Call for Pickup.” That means you need to give Transportation Services a call when you’re ready to go home at 1-833-583-5683 (TTY 1-866-288-3133).   
• နကသံၣ်သရၣ်မ့ၢ်ဟ့ၣ်နၤ တၢ်မၤလိာ်ကသံၣ်ဒီး နအိၣ်ကတီၢ်လၢ ကသံၣ်ကျး ဒ်သိးကဒိးန့ၢ်အီၤအဂီၢ်န့ၣ်လီၤ  
• Let us know if you have special needs like a wheelchair, cane, or walker. 
• Members under the age of 13 must have a parent or guardian with them. 
• Transportation may be limited to a provider near you.
• If you cancel your visit, call 1-833-583-5683 to cancel your ride.

You may also qualify for a bus pass. Give Modivcare a call to schedule a ride or ask questions about getting transportation services.

တၢ်တိစၢၤမၤစၢၤအံၤန့ၣ် မ့ၢ်လၢတၢ်ဒိးလ့ၣ်တဖၣ်လၢ ဘၣ်တၢ်သုးကျဲၤဃာ်အီၤလၢအဆိတဖၣ်အဂီၢ်န့ၣ်လီၤ. နမ့ၢ်အိၣ်ဒီးဂ့ၢ်ဂီၢ်အူလၢအလီၤဘၣ်ယိၣ်လၢနသးသမူအဂီၢ်န့ၣ် ကိး 911 တက့ၢ်. သိလ့ၣ်တီပှၤဆါတဆိန့ၣ် တၢ်ကဟ့ၣ်လီၤနၤ ဖဲနလိၣ်ဘၣ်တၢ်ဆှၢနၤဆူ တၢ်ဆါဟံၣ်န့ၣ်လီၤ.

Transplant Services

Covered when ordered by a network physician.

Unlimited Primary Care Provider Visits

There may be times when a member’s health requires repeated doctor visits. Our plan does not limit the number the number of visits to a primary care provider (PCP).  This way the members get the care they need. And the doctor can see how their health is progressing.

တၢ်ကွၢ်ထွဲမဲာ်တၢ်ထံၣ်

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

·  Annual eye exams.
·  Prescription lenses.

This benefit is offered by March Vision.

Wandering and Elopement

We will provide members and families with door and window alarms (up to six per household) to help reduce wandering without caregiver awareness.

ဆူၣ်ချ့တၢ်ကွၢ်ထွဲပှၤဆါတဖၣ်.

Well visits with your doctor can help keep you healthy. တၢ်ကွၢ်ထွဲပှၤဆါဒ်အံၤတဖၣ်န့ၣ် ဃုထံၣ်ဆူၣ်ချ့တၢ်ဂ့ၢ်ကီတဖၣ်ဆိဆိသ့ ဒီးကူစါယါဘျါအီၤသ့န့ၣ်လီၤ. တၢ်ဒီသဒၢတၢ်တိစၢၤမၤစၢၤတဖၣ်န့ၣ် ပၣ်ဃုာ်ဒီး -

• တၢ်သမံသမိးဆူၣ်ချ့တၢ်အိၣ်သးတဖၣ် လၢပှၤဒိၣ်တုာ်ခိၣ်ပှဲၤဒီးဖိသၣ်တဖၣ်အဂီၢ်.
• တၢ်ဆဲးကသံၣ်ဒီးတၢ်စဲးကွၢ်ဘၣ်ဆၢဘၣ်ကတီၢ်တဖၣ်
• တၢ်သမံသမိးနုၢ်တဖၣ်.

တၢ်ဟ့ၣ်သကိးတၢ်ဘူးတၢ်လဲ တဖၣ် တအိၣ်လၢ တၢ်ဒီသဒၢတၢ်ကွၢ်ထွဲအဂီၢ်ဘၣ်..