U gudub tusmada ugu weyn Tusmada Ugu Weyn

New Jersey, Waanu kaa daboolnay

Caymiska wax kharash ah ku bixin ama kharashka jaban ee laga helo UnitedHealthcare Community Plan. Learn about United Healthcare (NJ FamilyCare) health plans we offer in New Jersey.

Caawinta dadka ayaa udub dhexaad u ah wax kasta oo aan samayno

All New Jerseyans deserve affordable health care, including you. Hadaanu nahay UnitedHealthcare Community Plan, waxaan ka caawinnaa dadka inay ku noolaadaan nolol caafimaad leh. We’ve worked hard to deliver on that mission in New Jersey since 1989.

We offer plans to help New Jerseyans get healthy — and stay healthy. We cover adults, people with disabilities, expecting moms and children with our New Jersey Medicaid and NJ FamilyCare plans. We offer a Dual Special Needs Plans for those who qualify for both New Jersey Medicaid (FamilyCare) and Medicare.

We’re proud that our NJ Medicaid (FamilyCare) plan is accredited by the National Committee for Quality Assurance (NCQA). NCQA is a private, non-profit organization dedicated to improving health care quality. UnitedHealthcare Community Plan of NJ has also achieved NCQA’s Long-Term Services and Supports Distinction for our UnitedHealthcare Dual Complete® plan.

See why New Jerseyans choose UnitedHealthcare

Caymis kasta aad doorato, UnitedHealthcare ayaa kaa caawin doonta inaad hesho daryeelka aad u baahan tahay.

  • Bixiyeyaal badan oo shabakada oo kala duwan
  • No-cost virtual visits
  • Daawooyinka dhakhtarku qoro oo wax kharash ah lagu bixin ama kharash jaban
  • Pre- and postnatal care for pregnant moms and newborns
  • Well visits to help catch health problems early, routine shots to help protect against disease, community events, health education workshops and more

It’s easy to enroll. Visit njfamilycare.org or call the NJ FamilyCare phone number at 1-800-701-0710, TTY 1-800-701-0720.

New Jersey Qorsheyaasha caafimaadka ee ugu yaraan dhan $0 oo kharash ah

UHC NJ Medicaid (FamilyCare) Plans:

  • Low - or no cost
  • Haweenka uurka leh iyo carruurta
  • Low income individuals and families
  • Shakhsiyaadka indhooleyaasha iyo kuwa naafada ah
  • Da'aad Kasta
  • MLTSS (Managed Long-Term Services and Supports)

NJ Dual Special Needs Plans:

  • No cost
  • Those qualifying for both Medicaid (FamilyCare) and Medicare
  • Shakhsiyaadka indhooleyaasha iyo kuwa naafada ah

Barnaamijyada Sifaysan

Medicaid: Wax badan oo adiga kuu yaala 2023

As a UnitedHealthcare NJ Medicaid (FamilyCare) member, you’ll get great benefits like:

  • Prenatal and postpartum care
  • Dental includes cleanings, exams, fillings, and other dental work
  • One of the largest provider networks available in New Jersey
  • Vision including eye exam, glasses or contacts
  • Daawooyinka dhakhtarku qoro

Dual Special Needs Plans in 2023

New Jerseyans on a UnitedHealthcare Dual Special Needs Plan (or dual health plan) get many extra benefits beyond those you get with either Original Medicare or Medicaid (FamilyCare).

Tani waxaa ka mid ah:

  • A monthly credit to buy healthy food and OTC products or pay utility bills
  • Free gym membership through Renew Active® and free Fitbit®
  • Meals delivered to your door after every inpatient hospital stay

MLTSS Program

The Managed Long Term Services and Supports (MLTSS) program is focused on serving frail, elderly and disabled individuals. This program combines traditional health care benefits (doctor visits, hospital stays, labs) and long-term services and supports (providing help in home or community with daily living activities) such as: 

  • Care management — someone to get you the care and support you need 
  • Home and vehicle modifications — in-home medical and safety equipment, plus vehicle modifications, if needed 
  • Home meal delivery — if you can't safely make meals, we'll provide them 
  • Mental health and addiction services cover counseling and other treatments 
  • 24/7 personal emergency response device to get you help quickly at no cost 
  • Adult day care provides friendship and social activities in a safe setting 
  • Respite care — in-home help to give your caregiver a rest 
  • Personal care — someone to help you with dressing, bathing, and dining

Virtual medical and mental visits (D-SNP members)

$0 copay virtual provider visits to discuss non-emergency medical concerns or general mental health conditions from home.

Speak to network medical or mental health providers using your computer or mobile device. Find participating providers online. 

  • For medical providers, visit amwell.com
  • For mental health providers, visit virtualvisitsmentalhealth.uhc.com

Healthy First Steps™

Our program will help you take the right steps to keep you and your baby healthy. Waan ku caawin doonaa:

  • Choose a pregnancy provider and a pediatrician (child’s doctor)
  • Schedule visits and exams and arrange rides to your visits
  • Get supplies, including breast pumps for nursing moms
  • Ku xirnow dhigaalada bulshada sida adeegyada Haweenka, Dhallaanka iyo Carruurta (WIC).

Interpreter services

You and your providers need to understand each other. Not speaking Ingiriisi makes this difficult. We can arrange for an interpreter to be at your appointments.

Reading-newsltter

Wargeyska Xubinta HealthTalk

Wargeyskeena HealthTalk hadda waa onlayn. Wargeysyadu waa hab fiican oo lagu ogaado qorshaheena caafimaadka iyo mawduucyada caafimaadka ee muhiimka ah.

Waad akhrin kartaa mar kasta, meel kasta oo aad aado. Dib u eeg saddexdii biloodba mar daabacaada cusub.

Medicaid Newsletter Ingiriisi | Español

Waxbarashada caafimaadka

Renew Active® fitness program (D-SNP members)

Renew Active is the gold standard in Medicare fitness programs for body and mind and can help keep you active at a gym or from home. It’s available with many UnitedHealthcare Dual Complete® plans, at no cost.

You get a free gym membership at a nearby fitness location that you select from our network.* Most members have a location within just a few miles, some with a pool. You can also bring a family member or a friend to the gym with you to assist in your workout at no cost. If you prefer to work out from home, you can view thousands of on-demand digital videos and live streaming fitness classes.

Renew Active includes: 

  • Gym membership at no additional cost to you
  • Large and extensive fitness network of gyms and fitness locations
  • On-demand workout videos and live streaming classes
  • Social activities
  • Online Fitbit® Community
  • AARP® Staying Sharp® — online brain health program

*The Renew Active program varies by plan/area. Access to gym and fitness location network may vary by location and plan.

Health education workshops

UnitedHealthcare Community Plan of New Jersey offers free health education workshops to help everyone live healthier lives. We offer programs for children, parents and seniors, and that cover men and women’s health issues.

Workshop topics include:

• Asthma • Lead poisoning • Childhood obesity • Cyber-bullying • Diabetes • Heart disease • Injury prevention • Medication safety • Nutrition • Make your doctor’s visit worthwhile • Parenting skills • Stress management • Understanding breast cancer • Baby showers for expectant moms

Wax ka baro noocyada qorshaha

Medicare Card

Qorshayaasha Dual Special Needs Plans (D-SNP)

Dual Special Needs Plans (also called dual health plans or D-SNPs for short) are for people who get both Medicaid (FamilyCare) and Medicare. Labada qorshe ayaa daboolaya booqashooyinka dhakhtarka, joogitaanka isbitaalka iyo daawooyinka dhakhtarku qoro. Waxay bixiyaan dheefo iyo faa'iidooyin ka badan kan Medicare Asalka ah. You’ll keep all your New Jersey Medicaid (FamilyCare) benefits too.

Exchange Card

Medicaid (NJ FamilyCare) Plan

NJ Medicaid (FamilyCare) is health insurance for people with low incomes. You might be able to get Medicaid (FamilyCare) in New Jersey. if you’re pregnant, have children or live with a disability. Xaaladaha qaarkood, dadka waaweyn ee kale ayaa sidoo kale laga yaabaa inay u qalmaan. Kharashyada kugu kacayaa waa yar yihiin waxayna ku salaysan yihiin awooddaada aad wax ku bixin karto. It’s important to know that Medicaid (FamilyCare) rules and coverage differ from state to state.

Ka arag qorshayaasha gudaha New Jersey

UnitedHealthcareCommunityPlan

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. Limitations, exclusions and/or network restrictions may apply. Macaashyada, khidmadaha iyo/ama kharashka la wada bixiyo/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. 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® 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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