Racfaanka

Codsiga dhageysi cadaalad ah oo ku saabsan tallaabo hay'ad oo la soo codsaday, tallaabo hay'ad oo la dhameystiray, ama ku guuldareysiga hay'adu inay sameyso go'aan qaadasho waqtigeeda ah.

Codsiga

Codsiga rasmiga ah ee macaashyada ee loogu gudbiyo wakaaladda qoraal ahaan oo uu saxiixo codsadaha ama qof ku hadlaya magaca codsadaha. Codsiga waxaa lagu heli karaa boostada, telefoonka, fakiska, fool-ka-fool, ama si elektaroonig ah.

Behavioral Health Services Only

This term means those who receive only Behavioral Health benefits based on income requirements.

Certificate of Coverage

A description of your health care coverage and benefits. Your member handbook serves as your certificate of coverage.

Countable Resource

A resource that is countable when determining resource eligibility.

Decertification

Loss of eligibility to participate as a Medicaid provider, or for a license to operate a Medical facility licensed by DHH.

Department of Social and Health Services (DSHS)

The state agency that administers public assistance programs in Washington State.

Ku tiirsane

An individual who is the financial responsibility of a member of the income unit. Example: This is someone who could be counted as a tax dependent, if income tax is filed.

Daawo Ku Jirta Diiwaanka Daawada

A list of approved prescription drugs developed the health plan.

Gurmadka

Bilawga degdega ah ama ba'an ee calaamada ama calaamadaha, oo ay ku jiraan xanuunka daran, taas oo u horseedi doonta qof miyir leh oo si macquul ah u dhaqmaya si uu u rumaysto in xaalad caafimaad ay jirto oo u baahan daryeel caafimaad oo degdeg ah, haddii ku guuldareysiga in la bixiyo daryeel caafimaad ay keeni doonta dhaawac halis ah oo ku yimaada hawlaha jidhka ama cillad daran oo xubinta jirka ama qayb ka mid ah, ama ay gelinaysa caafimaadka qofka khatar weyn.

Khiyaanada

Ujeeddo ula kac ah si loo helo macaashyo ama lacago aan loo qalmin.

Good Cause

An acceptable reason to defer the requirement to cooperate for certain eligibility factors.

Health Care Authority (HCA)

The state agency responsible for administering Washington Apple Health (Medicaid) and other state health programs.

Dacwad-dhageysiga

Dacwad-dhageysiga waa marka aad ka codsato barnaamijkaaga caafimaadka inuu dib-u-eegis ku sameeyo kiiskaaga kadib marka qorshahaaga diiday racfaankaaga.

Dakhli

A gain or recurrent benefit measured in money.

Bukaan-jiifka

Bukaanka la jiifiyay habeen ama in ka badan ayaa jooga xarun daryeel oo helaya adeegyo caymis ah.

Legal Guardian

A person who has been granted custody of a minor by court order.

Maternity Benefits Program

This Health Care Authority (HCA) program includes all Apple Health (Medicaid) benefits, including maternity benefits, maternity support services, and maternity case management, and is made available to Apple Health (Medicaid) members who become pregnant, notify HCA and UnitedHealthcare Community Plan, and apply for benefits. Eligibility for the program is determined by HCA.

Medicaid

A state health insurance program for people with low income who meet certain eligibility requirements. Programs can vary from state to state. For information on Washington’s Apple Health (Medicaid) programs, visit https://www.hca.wa.gov/apple-health

Medicare

A federal health insurance program for people who are 65 or older, people with disabilities, or those with end-stage kidney disease. Medicare eligibility is not based on income, and basic coverage is the same in each state.

Xubinta

Qofka u qalma oo ka diiwaangashan Qorshaha Caafimaadka ee UnitedHealthcare.

Bukaan-socod

Bukaanka aan cusbitaalka la dhigin ee ka hela adeegyada caymiska meel aan aheyn cusbitaalka, sida xafiiska dhakhtarka ama guriga bukaanka, ama xarunta bukaan socodka cusbitaalka ama qaybta degdega ah ee cusbitaalka ama xarunta qaliinka.

Bixiyaha Daryeelka Aasaasiga ah (PCP)

Bixiyahaaga daryeelka caafimaadka gaarka ah. Your primary care provider can be a family or general practitioner, internist, pediatrician, or other provider approved by UnitedHealthcare Community Plan. To receive benefits, your primary care provider must provide or coordinate your care. If you need to see a specialist, your primary care provider will refer you.

Bixiyaha

Xirfadlaha daryeelka caafimaadka (sida takhtarka, kalkaaliye caafimaad, takhasuslaha cudurrada gudaha, iwm.) ama xarun (sida cusbitaal, rug caafimaad, iwm.).

Recertification

Dib-u-eegis muddaysan oo lagu sameeyo dakhliga qoyskaaga iyo u-qalmida. During recertification, you must submit current income and residency documentation to verify your eligibility and/or level of premium subsidy.

Aagga Adeegga

The geographic area served by a health plan that provides coverage for Apple Health (Medicaid).

Takhasuslaha

A provider of specialized medicine, such as a cardiologist or a neurosurgeon.

Spouse

An individual who is legally married to another or who presents to the community as a husband or wife in a non-legal relationship.

Third Party

An individual, institution, corporation or agency that is responsible for all or part of the medical costs for Medicaid.

Washington Apple Health (Medicaid)

Washington's Medicaid program, called Washington Apple Health (Medicaid), provides comprehensive free or low-cost health care to adults, families, individuals with disabilities, children under 19, children in foster care and pregnant individuals who meet income and eligibility requirements.

Washington Apple Health (Medicaid) – Integrated Managed Care

Washington's integrated managed care Apple Health (Medicaid) program provides comprehensive free or low-cost health care and behavioral health services to adults, families, people with disabilities, children under 19, children in foster care and pregnant women who meet income requirements.

Washington Healthplanfinder

It's your new way to find, compare and enroll in a health plan that fits your needs and budget. For more information about Apple Health (Medicaid) or to enroll, please visit: wahealthplanfinder.org or call 1-855-WAFINDER (1-855-923-4633) TTY/TTD 1-855-627-9604.

Washington Resident

A person physically residing and maintaining a residence in the state of Washington. You must be a Washington resident to be eligible for Washington Apple Health (Medicaid). To be considered a Washington resident, members who are temporarily out of Washington for any reason:

• May be required to prove their intent to return to Washington State; and
• May not be out of Washington State for more than three consecutive calendar months.

Dependent children who are attending school out of state may be considered residents if they are out of state during the school year, as long as their primary residence is in Washington State and they return to Washington State during breaks. Dependent children attending school out of state may be required to provide proof that they pay out-of-state tuition, vote in Washington, and file income taxes using a Washington address.

Your residence may be a home you own or are purchasing or renting, a shelter or other physical location where you are staying in lieu of a home, or another person's home.