U gudub tusmada ugu weyn
Tusmada Ugu Weyn

Barnaamijkeena Sii Horumarinta Tayada

UnitedHealthcare (UHC), yoolkeenu waa in aan dadka ka caawino inay ku noolaadaan nolol caafimaad qabta oo aanu ka dhigno in nidaamka caafimaadku uu si wanaagsan ugu shaqeeyo qof kasta. Waxaanu bixinaa Medicaid iyo MinnesotaCare aanu siino xubana kusugan degmooyinka kala ah Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, Washington iyo St. Louis. In St. Louis county, we also serve members with SNBC, MSHO, and MSC+. Intaa waxaa dheer, waxaan sidoo kale u adeegnaa xubnaha SNBC ee Degmada Scott County. United HealthCare waxay had iyo jeer ka shaqaynayaan wanaajinta tayada daryeelka caafimaadka iyo adeegyada ay xubnaheenu helaan. 

Sida aan dhibaatooyinka u aqoonsano oo aan u hagaajino.

  • Waxaan isticmaalnaa agabyada sida xogta iyo sahanada si aan u helno aagagga ama kooxaha dadka u baahan caawimaada dheeraadka ah.
  • Waxaan la shaqaynaa bixiyayaasha iyo xubnaha si aan u xaqiijino in xubnaheenu ay helaan daryeelka ay u baahan yihiin marka ay u baahan yihiin.
  • Waxaan la wadaagnaa dhigaallo waxbarasho bixiyayaasha iyo xubnaha.
  • Waxaanu bixinaa abaalmarino lacageed si aanu u dhiirigalino daryeel sidii hore ka wacan.
  • Xubnaha leh baahiyaha daran waxay taageero dheeraad ah ka helaan maamulayaasha kiiskeena.
  • Waxaan xubnaheena kula kulanaa xaafada dhexdeeda.
  • Waxaan la shaqaynaa kooxaha maxaliga ah ee taageera bulshooyinka aan u adeegno.

Hadafyada Tayada ee United Healthcare

  • Kor-u-qaadida barnaamijyada iyo hawlaha maamulka caafimaadka dadweynaha
  • Sii wanaajinta mahadhada xubinta iyo daryeel-bixiyaha
  • U hoggaansanaanta aqoonsiga iyo shuruudaha sharciyeed
  • U adeegida dadyow kala duwan

Mashaariicda Horumarinta Tayada

Qoyska iyo Carruurta

What are we doing to improve pregnancies?

We want to help members have a healthy pregnancy and healthy baby. Healthy First Steps® is a program offered through your health plan. We will work with you and your provider to help you take healthy steps through pregnancy and after delivery. 

Barnaamijkeena ayaa gacan siiya xubnaha uurka leh ka hor iyo kadib marka ay dhallaan ilmahooda. We help with community resources, medical care, and behavioral health care. We guide you to have a healthy pregnancy, receive a car seat, and offer rewards for visiting the doctor. Waxaanu ka caawinaa qoysaska inay helaan daryeelka iyo taageerada ay u baahan yihiin, marka ay ugu baahi badan yihiin.

What are some of the challenges to improving pregnancies? 

Way adkaan kartaa in lala wada xiriiro xubnaha inta lagu jiro marxaladaha hore ee uurka haddii aysan ogayn inay uur leeyihiin. Ma caawin karno xubnaha haddii aysan haysan cinwaanka ama lambarka telefoonka ee saxda ah. Waxaan ka codsanaynaa xubnaheenu inay nala soo xiriiraan annaga iyo degmadooda marka ay uur leeyihiin ama haddii ay beddelaan cinwaanka ama lambarka telefoonka. Marka annaga iyo degmadu aan hayno macluumaadkan, waxaanu ka diiwaangelin karnaa barnaamijkeena. Tani waxay hubinaysaa in xubnaha uurka leh ay helaan dhammaan macaashyada aan bixino. 

How can we help your baby to stay healthy? 

After the baby is born, it is important for the mom and baby to see the doctor. We can help with scheduling doctor appointments, answering questions, and arranging transportation. Dhakhtarka wuxuu eegi doonaa waxyaabaha ay ka midka yihiin miisaanka dhallaanka, indhaha, dhagaha, iyo wadnaha. As the baby grows older, the well-baby checks will teach parents how to raise a healthy child. Tan waxaa macnaheedu noqon karaa ka hadalka wax ku saabsan jimicsiga, cuntada caafimaadka leh iyo sida looga hortago dhaawacyada.

How do we know we made a difference? 

The goal of the program is to help our pregnant members and their babies be as healthy as possible. We look at data related to care access, health outcomes of our members, and if members are satisfied. Data is reviewed on an ongoing basis. An evaluation of the program also happens each year. In 2023, the nurse case managers helped 87% of our members with a high-risk pregnancy. They did this by helping them engage in care, removing barriers to care, and supporting improved birth outcomes. 

Sideen wax u qorsheyn karnaa si aan u wanaajino samaynta isbeddelka caafimaadka leh?  

We will continue to support our members getting to doctor appointments, access to doulas, food, transportation, car seats, and housing. In 2024, we plan to help educate members on how to have a healthy pregnancy and what resources United Healthcare can offer them.  Our goal is to help members have healthy pregnancies and remove barriers to care.

Seniors and SNBC

 

Why is it important to think about mental and physical health together?

It is important to think about the whole person when helping members. Together, diabetes and mental health can have a big impact on well-being. Studies have shown that people with diabetes are at a higher risk of having mental health challenges like depression and anxiety. Understanding the relationship between diabetes and mental health may lead to better outcomes for members. 

What are we doing to improve the health of those with diabetes and mental health issues?

United Healthcare can help members find community resources, medical care and behavioral health care. We give tips for how to manage your health and offer rewards for visiting the doctor. We help individuals get the care and support they need when they need it most.

What were some of the challenges to improving the health of those with diabetes and mental health issues?

It can be hard to help members get the care they need if they don’t know how to treat their medical conditions. Each member has a care coordinator who can help teach them how to care for their health needs. Many of our members live in places where it may be hard to get to the doctor’s office or clinic. To help, we work with members to set up rides to and from their appointments. Having access to the right care at the right time can reduce emergency room visits, hospitalizations, and even early death.

How do know we are making a healthy difference?

Our goal is for our members to be as healthy as possible. We look at data related to access to care, health outcomes of our members, and member satisfaction. Data is reviewed on an ongoing basis. 

Sideen wax u qorsheyn karnaa si aan u wanaajino samaynta isbeddelka caafimaadka leh?

We will continue to support our members by offering benefits such as food, transportation, and a dedicated care coordinator for each member. In 2024, we plan to learn more about our members needs and create resources to better support them. Our goal is to help members be healthy both mentally and physically. 

Quality Programs

The Quality Improvement Program Description provides details about what the health plan will do to make things better for our members. This document explains the steps we will take to review our programs and activities. An update of the program description happens every year. This year:

  • We will reward members for getting care.
  • We are working to reduce members needing to go back to the hospital.
  • We are focusing on health differences. 
  • We will achieve full NCQA Accreditation.
  • We are working to get member feedback.

We reviewed last year’s quality programs and activities to see how well we used our resources to improve our members’ health. We also review the quality and safety of our members’ clinical care. We wanted to know where we did a good job and how we can improve the programs for our members. We used the evaluation to plan for this year. Last year:

  • We made outreach to 93% of our members who were in the hospital for mental health.
  • We offered rewards to our members for prenatal and postnatal visits, immunizations, breast and cervical cancer screenings. 
  • We worked with 87% of our members with high-risk pregnancies.
  • We provided 2,600 meals for members recently leaving the hospital for medical or behavioral health.
  • We provided 16,300 meals for members leaving the hospital after the birth of a baby.
  • We included “bucket” car seats in the car seat benefit for our members.
  • We held 21 dental clinics at a local community center, held a coat give-away, and coordinated a Narcan training for the community. 
  • We assisted in the development of the Fairview Community Health & Wellness Hub.
  • We achieved NCQA Interim Accreditation.

We have a work plan that tracks our health plan goals, monitors quality improvement activities, and plans the services we provide to our members. We track issues and the planned interventions. The plan is reviewed and updated throughout the year. 

Health Equity

At United HealthCare, our mission to help people live healthier lives and to help make the health system work better for everyone. 

Health equity means that everyone has a fair and just opportunity to achieve their full health potential. Some of the things we did at United Healthcare:

  • 95% of our Minnesota staff did training and education on health differences through Health Equity University.
  • Health differences training was offered to all of our providers at no cost.
  • We worked with community organizations to understand how they are experiencing health differences. A few of them:
    • Karen Organization of Minnesota
    • Union Gospel Mission
    • Guiding Star Wakota
    • Hmong Nurses Association
    • Mount Airy Boys and Girls Club
    • Dorothy Day Center
  • Programs to address the health differences in maternal and child health.
    • Healthy First Start
    • Meals for Mom’s from Second Harvest Heartland
    • Wargeyska xubinta ee HealthTalk 
  • Promoting access to safe and affordable housing, nutritious food, and transportation. 
  • Focus on making health information easier to understand for our members.

We’ve set goals for ourselves in 2024 to address health differences.

  • We will work toward Health Equity Accreditation.
  • We will continue to expand our Health Equity Strategy.
  • We will look for ways to reduce health differences and put those plans into action.

Aqoonsi

The UHC Community Plan of Minnesota is accredited by a group called the National Committee for Quality Assurance (NCQA).  NCQA shares information with us on how to improve the quality of health care we provide to members. It is our goal to meet their standards for accreditation. Being accredited means we have made a promise to meet high quality care standards. To learn more about NCQA, visit their website.

NCQA

Nagala Soo Xiriir

Waxaanu doonayna inaan maqalno su'aalahaaga iyo jawaabcelintaada! Fadlan nala soo xiriir haddii aad jeclaan lahayd inaad wax badan ogaato ama aad nala wadaagto fikrado kusaabsan waxa aan u samayn karno si ka sii wanaagsan. Kala xiriir United Healthcare LAMBARKA 1-888-269-5410 / TTY: 711 ama isticmaal adeegga gudbinta ee aad doorbidayso 8 sn. ilaa 6 gn. waqtiga maxalliga ah, Isniinta – Jimcaha.

UnitedHealthcare Community Plan


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. Qorshahan waxaa heli kara qof kasta oo haysta Medical Assistance ee laga helo Gobolka iyo Medicare. Dheefaha, qaybaha iyo/ama aaladuhu waxay ku kala duwan yihiin qorshe/aagga. Xaddidaadyada, ka-dhaafitaanada iyo/ama xannibaadyada shabakadeed ayaa laga yaabaa in lagu soo dabaqo. Macaashyada, khidmadaha iyo/ama kharashka la wada bixiyo/qaybsiga caymiska ayaa laga yaabaa inay isbeddelaan markay tahay 1-da Janaayo ee sannad kasta.

Khidmadda afeefta billaha ah

Qorshayaasha Dual Special Needs waxay leeyihiin $0 khidmado bille ah oo loogu talagalay xubnaha haysta Caawimaada Dheeraadka ah (Kabka Dadka Dakhligoodu Hooseeyo).

Dheefaha afeefta

Dheefaha, sifooyinka, iyo/ama aaladaha way ku kala duwan yihiin qorshe/aag ahaan. Xaddidaadyada, ka-dhaafitaanada iyo/ama xannibaadyada shabakadeed ayaa laga yaabaa in lagu soo dabaqo.

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. Kalkaaliyeyaashu ma sheegi karaan dhibaatooyinka ama kuma talin karaan daaweyn mana u noqon karaan beddel daryeelka daryeel bixiyahaaga. 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® ee MyCare Ohio (Medicare-Medicaid Plan)

UnitedHealthcare Connected® ee MyCare Ohio (Medicare-Medicaid Plan) waa qorshe caafimaad oo kunturaad la leh labadaba Medicare iyo Medicaid Ohio si ay u siiso macaashyada labada barnaamij dadka ka diiwaangashan. 

UnitedHealthcare Connected® (Medicare-Medicaid Plan)

UnitedHealthcare Connected® UnitedHealthcare Connected® (Medicare-Medicaid Plan) waa qorshe caafimaad oo kunturaad la leh labadaba Medicare iyo Texas Medicaid si uu u siiyo dheefaha labada barnaamij dadka ka diiwaangashan.

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

UnitedHealthcare Connected® oo loogu talagalay One Care (Medicare-Medicaid Plan) waa qorshe caafimaad oo kunturaad la leh labadaba Medicare iyo MassHealth (Medicaid) si ay u siiso dheefaha 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. Wixii macluumaad intaas ka badan la xiriira qorshaha mise 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-ta Xiddig. Qiimeynta 5-ta Xiddig waxay khuseysaa qorshaha sannadka 2024.

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/kuwa aan qandaraaska lahayn kuma khasbana inay daaweeyaan xubnaha kujira qorshaha UnitedHealthcare, marka laga reebo xaaladaha gurmadka dagdagga 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 yaalla dhabarka dambe ee kaarkooda aqoonsiga, halka dadka aan xubinta ka ahayn UnitedHealthcare ay soo wici karaan 1-888-638-6613 TTY 711, ama waxay isticmaali karaan adeegga gudbinta ee ay doorbidayaan.

Ku Dhawaaqida Masiibo ama Xaalad Dagdag ah

Haddii ay ku saamayso ku dhawaaqida musiibo ama xaalad dagdag ah ee Madaxweynaha ama Gobarnatooraha, ama ogeysiiska xaalad caafimaadka dadweynaha ee dagdaga 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 kunturaad lahayn oo gaar ah (ogsoonoow 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.

Powered by Translations.com GlobalLink OneLink SoftwarePowered By OneLink