U gudub tusmada ugu weyn Tusmada Ugu Weyn

Waa maxay Qorshaha Laba Geesoodka ah ee Dadka Qaba Baahiyaha Gaarka ah (D-SNP)?

Qorshaha Laba Geesoodka ah ee Dadka Qaba Baahiyaha Gaarka ah, ama marka la soo gaabiyo D-SNP, ayaa ah nooc ka mid ah qorshayaasha caymiska caafimaadka. Waxaa loogu talagalay dadka haysta Medicare iyo Medicaid labaduba. Haddii aad tahay qofka haysto, waxaad tahay “qof uqalma labada caymis.” (Taasi waa qaab kale oo lagu yiraahdo waxaad isku mar heli kartaa caymiska Medicaid iyo Medicare.)

Maxaa ka dhigaya qorshahan mid loogu talagalay dadka u-qalma labada caymis?

Dual Special Needs plans are for people who could use more help. Taasi waxaa sabab u ah dakhliga, naafonimada, da'da iyo/ama xaaladaha caafimaadka. Qorshayaasha Laba Geesoodka ah ee Dadka Qaba Baahiyaha Gaarka ah waa nooc ka mid ah qorshaha Medicare Advantage.

Sidee caymiska caafimaadka laba geesoodka ah ula shaqeeyaa Medicaid iyo Medicare labaduba?

Qorshaha Laba Geesoodka ah ee Dadka Qaba Baahiyaha Gaarka ah ayaa la shaqeeya qorshaha caafimaadkaaga ee Medicaid. Waad haysan doontaa dhammaan faa'iidooyinkaada Medicaid. Inta badan qorshayaasha caymiska caafimaadka ee laba geesoodka ah waxay sidoo kale ku siinayaan macaashyo iyo sifooyin ka badan kuwa aad ka hesho Original Medicare. Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Caawimaad badan oo adiga laguugu talagalay

Care coordination is another important benefit you get with a Dual Special Needs plan. Waxaad yeelan doontaa isuduwaha daryeelka ee gaarka ah. That’s someone who may help you:

  • Faham macaashyadaada Medicare iyo Medicaid
  • Maree dhakhaatiirtaada, khabiiradaada iyo adeegyada daryeelkaaga
  • Get the services you need to feel healthier

Haddii aad u-qalanto labada caymis, sideed ku heli kartaa qorshahan caafimaad?

Qorshayaasha Laba Geesoodka ah ee Dadka Qaba Baahiyaha Gaarka ah waxaa bixiya shirkadaha caymis ee gaarka loo leeyahay. Kuwaasi waxaa ku jira UnitedHealthcare. We call our dual-eligible health plans UnitedHealthcare Dual Complete®. More people choose UnitedHealthcare for a Dual Special Needs plan than any other company.

UCard® only from UnitedHealthcare

Your UCard is your member ID and so much more. Use your UCard to buy healthy food, over-the-counter (OTC) products and pay utility bills.

Ogow wax ku saabsan UCard

Qorshe noocee ah ayaan aniga u qalmaa?

Ka jawaab dhawr su'aalood oo degdeg ah si aad u aragto nooca qorshaha ee adiga si wanaagsan kugu habboon.

Hubi u-qalmitaanka qorshaha caymiska

Hel hagahaaga qorshaha laba geesoodka ah oo bilaash ah

Find out what you need to know about Dual Special Needs plans in one, convenient guide.

Hel qorshayaasha ka jira aaggaaga

Medicaid ama faaiidooyinka laga helo qorshaha labada caymis ee loo qalmo way isbeddeli karaan iyadoo ay ku xiran tahay halka aad ku nooshahay. Search using your ZIP code to find the right plan to meet your health care needs.

Weli su'aal miyaad qabtaa

Waxaan halkan u joognaa inaan ku caawino

Nagala soo xiriir:
1-844-812-5967 / TTY: 711
8 subaxnimo ilaa 8 galabnimo waqtiga maxalliga, 7 maalmood toddobaadkii.

Macluumaadka Afeefta
(ku dhex wad bogoskan si aad u aragto)

Ma waxaad raadinaysaa mareegta dawladda dhexe ee Medicaid? Halkan ka eeg Medicaid.gov.

UnitedHealthcare Dual Complete Plans

Qorsheyaasha waxaa la doolaa iyadoo loo sii marayo Shirkadda Caymiska UnitedHealthcare ama mid ka mid ah shirkadaheeda xiriirka la leh, Hay'adda Medicare Advantage ee haysata qandaraaska Medicare iyo qandaraaska kula jirto Barnaamijka Medicaid ee Gobolka. Iska diiwaangelinta qorshaha waxay ku xiran tahay heshiiska cusboonaysiinta qorshaha ee Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Macaashyada, khidmadaha iyo/ama wadabixinnada/qaybsiga caymiska ayaa laga yaabaa inay isbeddelaan markay tahay 1-da Janaayo ee sannad kasta.

Premium Disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Afeefta Khadka-furan ee Kalkaalisada

Adeegani waa inaan loo isticmaalin baahiyada gurmadka ama daryeelka ee degdegga ah. Marka ay jirto xaalad degdega ah, wac 911 ama tag qolka gurmadka ee kuugu dhow. Macluumaadka lagu bixiyay adeegan waxaa laga leeyahay ujeedooyin waxbixin oo keliya. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Macluumaadkaaga caafimaad waxaa loo keydiyaa si qarsoodi ah oo waafaqsan sharciga. Adeeggu maaha barnaamij caymis waxaana laga yaabaa in la joojiyo wakhti kasta. Khadka Taleefanka ee Kalkaalisada looma isticmaalo xaaladaha degdegga ah, ujeeddooyin macluumaad oo keliya ayaa loo isticmaalaa.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan) waa qorshe caafimaad oo qandaraas la leh Medicare iyo Medicaid Ohio labaduba si ay u siiyaan macaashyada labada barnaamij dadka ka diiwaangashan. 

UnitedHealthcare Connected® (Medicare-Medicaid Plan)

UnitedHealthcare Connected® (Medicare-Medicaid Plan) waa qorshe caafimaad oo qandraas la leh Medicare iyo Texas Medicaid Ohio labaduba si ay u siiyaan macaashyada labada barnaamij dadka ka diiwaangashan.

UnitedHealthcare Connected® oo loogu tala galay One Care (Qorshaha Medicaid - Medicare)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan) waa qorshe caafimaad oo qandraas la leh Medicare iyo MassHealth (Medicaid) labadaba si ay u siiyaan manaafacaadka labada barnaamij dadka ka diiwaangashan. 

Afeefta dheefaha guud UnitedHealthcare Connected®

Kani ma ahan liis dhammeystiran. Macluumaadka macaashka waa qoraal kooban, ma ahan sharraxaadda dhammeystiran ee macaashyada. Si aad u hesho macluumaad dheeraad ah la xiriira qorshaha ama akhri Buug-gacmeedka Xubinta. Xaddidaado, wada-bixinno, iyo xannibaado ayaa lagu dabaqi karaa. Wixii macluumad dheeraad ah, wac Adeegyada Xubnaha ee ku xiran UnitedHealthcare ama aqri Buugyaraha Xubnaha ee UnitedHealthcare Connected®. 

UnitedHealthcare Senior Care Options (HMO SNP) Plan

Dookhyada Daryeelka Waayeeladda ee UnitedHealthcare (SCO) waa qorshaha Daryeelka Isku Dubaridan ee la leh qandaraas Medicare iyo qandaraas kula jira barnaamijka Common Wealth Massachusetts of Medicaid. Iska diiwaangelinta qorshaha waxay ku xiran tahay heshiiska cusboonaysiinta qorshaha ee Medicare. Qorshahan waa barnaamij isxilqaan ah uu heli karo qof kasta oo jira 65 iyo ka weyn oo u-qalma MassHealth Standard iyo Original Medicare oo aan lahayn caymis caafimaad ee kale ee dhamaystiran, marka laga reebo Medicare. Haddii aad leedahay MassHealth Standard, balse aadan u-qalmin Original Medicare, waxaa laga yaabaa inaad weli u-qalanto inaad iska diiwaangeliso qorshaheena MassHealth Senior Care Option oo aad hesho macaashyadaada MassHealth oo dhan adoo u maraya barnaamijkeena Dookhyada Daryeelka Waayeeladda ee UnitedHealthcare (SCO).

Afeefta qiimeynta xidigeed

Sannad kasta, Medicare waxay qiimaysaa qorsheyaasha iyadoo ku salaysa nidaamka qiimeynta 5-Xiddig. Nidaamka qiimeynta 5 Xiddigta waxa uu khuseeyaa qorshaha sanadka 2023.

Macluumaadka bixiyaha ee muhiimka ah

Go'aanka Adigaa Leh.

Waxaan ku siin doonaa macluumaad kaa caawin doona inaad gaarto go'aano wargal ah, sida aqoonsashada dhakhaatiirta iyo xirfadleyaasha daryeelka caafimaadka. Macluumaadkan, si kastaba ha ahaatee, ma ahan mid ayidaya dhakhtar gaar ah ama xirfadlaha daryeelka caafimaadka ee ku habboon baahidaada.

Bixiyeyaasha la heli karo iyadoo loo marayo codsigan ma ahan inay xaqiiqdii uga turjumayaan si buuxda shabakada UnitedHealthcare ee bixiyeyaasha qandaraaska lagula jiro. Waxaa laga yaabaa inay jiraan bixiyeyaal ama takhasusleyaal gaar ah oo aan lagu darin codsigan oo qayb ka ah shabakadeena. Haddii aadan helin bixiyaha aad raadinayso, waxaad si toos ah ula xiriiri kartaa bixiyaha si aad u xaqiijiso xaaladda kaqaybgalka ee shabakadda UnitedHealthcare, ama kala xiriir Mamber Services lambarka bilaashka ah ee ku qoran kaarkaaga aqoonsiga UnitedHealthcare. Waxaan sidoo kale kugula talineynaa, kahor inta aadan la kulmin dhakhtar kasta, oo ay ku jiraan takhasusleyaal kasta, inaad wacdo xafiiska dhakhtarka si aad u xaqiijiso xaaladda kaqaybgalka iyo helitaanka.

Qaar kamid ah shabakadda bixiyeyaasha ayaa laga yaabaa in lagu daray ama laga saaray shabakadeena kadib markii diiwaankan la cusbooneysiiyay. Ma dammaanad qaadi karno in bixiye kasta weli aqbalayo xubno cusub.

Bixiyeyaasha shabakadda ka baxsan/qandaraaska haysan kuma qasbana inay daaweeyaan xubnaha ku jira qorshaha UnitedHealthcare, marka laga reebo xaaladaha gurmadka ah. Fadlan soo wac lambarkeena adeegga macmiilka ama ka eeg Caddayntaada Caymis wixii macluumaad dheeraad ah, oo ay ku jiraan kharash wadaagga khuseeya adeegyada shabakadda ka baxsan.

Ogeysiiska Xeerka Naafada Mareykanka

Sida waafaqsan shuruudaha Xeerka Naafada ee Dawladda Dhexe Maraykanka 1990 iyo Qeybta 504 Xeerka Baxnaaninta 1973 ("ADA"), Shirkadda Caymiska UnitedHealthcare waxay bixisa adeegyada la daboolay oo buuxa oo loo siman yahay mana takooraan shakhsiyaadka u-qalma ee naafada ah iyadoo lagu salaynayo naafanimada markay bixinayaan adeegyadooda, barnaamijyadooda, ama waxqabadooda.

Gudbinta

Bixiyeyaasha shabakadda ayaa idin ka caawin doona adiga iyo xubnaha qoyskaaga ee caymiska leh inaad heshaan daryeelka aad u baahan tihiin. Helitaanka dhakhaatiirta takhasuska leh waxaa isku dubaridi kara dhakhtarkaaga daryeelka aasaasiga ah.

Codsiyada diiwaanka waraaqaha

Nuqullada warqadaha ee ku jira diiwaanka bixiyaha shabakadda waxay ku heli karaan xubnaha si bilaash ah iyagoo wacaya lambarka adeegga macmiilka ee ku yaala gadaasha kaarka aqoonsiga. Dadka aan xubinta ka ahayn waxay natiijooyinka ka soo dejisan karaan oo ka daabacan karaan diiwaanka onlaynka ah.

Macluumaadka khaldan

Si aad uga warbixiso xogta khaldan, u dir iimayl provider_directory_invalid_issues@uhc.com. Bogoskan iimaylka waxaa loogu talagalay xubnaha si ay uga warbixiyaan khaladaadka suurtagalka ah ee macluumaadka qofka (cinwaanka, telefoonka, iwm.) ee ku jira hagaha diiwaanka onlaynka ah ama waraaqaha. Ka warbixinta arrimaha iyadoo loo marayo bogoskan boostada waxay keeni doontaa in la gaaro xafiiska bixiyaha si loo xaqiijiyo dhammaan xogta dadka ee ku jira diiwaanka, taasoo qaadan karta qiyaastii 30 maalmood. Shakhsiyaadka sidoo kale waxay soo sheegi karaan khaladaadka suurtagalka ah iyagoo adeegsanaya telefoonka. Xubnaha UnitedHealthcare waa inay wacaan lambarka ku yaala gadaasha kaarkooda aqoonsiga, halka dadka aan xubin ka ahayn UnitedHealthcare ay soo wici karaan 1-888-638-6613 TTY 711, ama waxay isticmaali karaan adeegga gudbinta ee ay doorbidayaan.

Ku Dhawaaqida Musiibo ama Xaalad Degdeg ah

Haddii ay ku saamayso ku dhawaaqida musiibo ama xaalad degdega ah ee Madaxweynaha ama Guddoomiyaha Gobolka, ama oggeysiiska xaalad caafimaadka dadweynaha ee degdeg ah oo uu ku dhawaaqay Xoghayaha Caafimaadka iyo Adeegyada Aadanaha, waxa jira taageero dheeraad ah oo gaar ah oo adiga diyaar kuu ah.

  • Qaybta A, Qaybta B, iyo dheefaha qorshaha Qaybta C ee dheeraadka ah waa in lagu bixiyaa xarumo aan qandaraaska lahayn oo gaar ah (ogsoonow in dheefaha Qaybta A iyo Qaybta B ay tahay in laga helo xarumaha shahaadaysan ee Medicare);
  • Meeshii ay ku habboon tahay, shuruudaha loogu talagalay gudbinta albaab-ilaaliyaha si buuxda ayaa looga dhaafay;
  • Wadaagista kharashka shabakada ka baxsan ee qorshaha la ansixiyay ilaa qadarada wadaagista kharashka shabakada ayaa si ku meelgaar ah loo dhimay; iyo
  • Shuruudaha oggeysiiska ee 30-ka maalin ah ee ku aadan xubnaha waa la dhaafay, ilaa inta dhammaan isbeddellada dheefta (sida dhimista wadaagista kharashka iyo oggolaanshaha ka dhaafitaanka) ee xubinta.

Haddii CMS aysan bixin taariikhda dhammaadka ee loogu talagalay musiibada ama xaaladda degdegga ah, qorshooyinka ayaa dib u bilaabi doona maalmaha 30 shaqada ee caadiga ah ka dib ku dhawaaqista hore.

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