Kev thov kev ncaj ncees

Ib qho kev thov kom muaj ib lub rooj mloog kev ncaj ncees hais txog ib yam dab tsi uas lub chaw ua hauj lwm pom zoo yuav nqis tes ua, ib yam dab tsi uas lub chaw ua hauj lwm muab ua tiav lawm, los yog ib qhov kev txiav txim uas lub chaw ua hauj ua tsis tau raws sij hawm.

Daim ntawv thov

Ib daim ntawv thov rau cov txiaj ntsig tau ua rau lub koom haum sau ntawv thiab kos npe los ntawm tus neeg thov lossis ib tus neeg ua haujlwm sawv cev ntawm tus neeg thov. Daim ntawv thov tuaj yeem tau txais los ntawm kev xa ntawv, xov tooj, fax, ntawm tus kheej, lossis hauv tshuab hluav taws xob.

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.

Tus Neeg Tseem Tos Lwm Tus Pab (Dependent)

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.

Daim Ntawv Teev Npe Tshuaj (Formulary)

A list of approved prescription drugs developed the health plan.

Kev kub ntxhov

Ib qho tsos mob los yog cov tsos mob xwm txheej kub ceev thiab mob sai, suav nrog rau mob loj heev, uas ua rau ib tus neeg coj tus cwj pwm ntseeg tias yog ib tus mob uas yuav tau kho tam sid, yog hais tias tsis kho yuav ua rau muaj teeb meem loj rau lub cev ua tsis tau hauj lwm los yog ua rau ib yam khoom los yog ib feem hauv nruab nrog cev tsis ua hauj lwm, los yog yuav ua rau tus neeg txoj kev noj qab haus huv nyob rau qhov muaj kev phom sij loj heev.

Kev dag

Lub hom phiaj xav kom tau txais cov txiaj ntsig tsis tsim nyog lossis them nyiaj.

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.

Kev taug xyuas

Kev taug xyuas yog qhov koj mus nug txog qhov kev pab cuam kev noj qab haus huv uas lawv tau txheeb xyuas koj daim ntawv ntawm koj li kev npaj thiab lawv tau tsis lees txais koj li kev thov.

Cov nyiaj khwv tau los

A gain or recurrent benefit measured in money.

Neeg Mob Pw Hauv Tsev Kho Mob

Ib tu neeg mob uas cia pw hauv ib qhov chaw kho mob ib hmos los yog ntev dua thiab tau txais cov kev pab kho mob uas pab them nqi rau.

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.

Tswv cuab

Ib tus neeg muaj feem tau txais rau npe rau hauv daim phiaj UnitedHealthcare Health Plan.

Tus Neeg Mob Tsis Pw Kho Hauv Tsev Kho Mob

Ib tus neeg mob tsis pw hauv tsev kho mob tau txais cov kev pab kho mob uas them rau nyob deb ntawm lub tsev kho mob, xws li nyob hauv tus kws kho mob lub chaw ua hauj lwm los sis hauv tus neeg mob lub tsev, los sis hauv ib lub tsev kho mob neeg mob tsis pw kho los sis tsev kho mob chav kho mob xwm txheej kub ceev los sis chaw phais mob.

Tus Kws Kho Mob Xub Thawj (PCP)

Koj tus kheej tus kws muab kev kho mob. 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.

Kws Pab Kho Mob

Ib tus kws tshaj lij fab kev kho mob (xws li ib tus kws kho mob, kws tu neeg mob, kws pab tiv thaiv thiab kho mob nkeeg, thiab lwm tus) los yog chaw kho mob (xws li ib lub tsev kho mob, tsev kuaj mob, thiab lwm qhov chaw).

Recertification

Kev tshuaj xyuas ib ntus ntawm koj tsev neeg cov nyiaj tau los thiab kev tsim nyog tau txais. During recertification, you must submit current income and residency documentation to verify your eligibility and/or level of premium subsidy.

Thaj Chaw Muab Kev Pab

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

Kws Kho Mob Tshwj Xeeb

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 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.