TMB½rTI 2 manrayeQµaHmnusSRKb;KñakñúgRKYsarrbs;Gñk .

kBa©b;CMnYy³ CMnYyEdl)anFanar:ab;rg

karcuHeQµaHkñúg Managed Care/TPR: taragenHbgðajBIGkSr³

� “Managed Care” KeRmagEdlFanar:ab;rgCMnYy

sRmab;smaCik OHP� TPR: karFanar:ab;rgCMnYydéTeTot dUcCakarFanar:ab;rgsuxPaBCalkçN³ÉkCn

eyIg)ansresrnUvmUlehtuEdlGñkRtUv)aneKepJIsMbuRtenHeTA[enAxag

eRkam . Bt’manEdlmansresrenHKwmanRbsiTæPaBcab;BIéf¶Ex EdlRtUv)an

sresrCab;nwgeQµaHrbs;GñkenAelIsMbuRtenH.

mUlehtuEdlepJIsMbuRt[: Health plan enrollment changed for:Doe, Jane - 08/01/2017

lixitGMBIkarpþl;CUnCMnYyviFIEfrkSaCMnYyrbs;Gñk

GanlixitBI OHA nigeFVItamGVIEdleKR)ab;[eFVI . cUrTUrs½BÞsYr RbsinebIGñkmansMNYrGVI .

TUrs½BÞeTAesvabMerIsmaCik OHP b¤ eTACYbédKUrkñúgshKmn_ RbsinebIGñk³

erIecj b¤ eRbIelxTUrs½BÞfµI (OHA minbBa¢ÚnsMbuRtbnþ

eTAkan;Gas½ydæanfµIenaHeT ) erobkar b¤ lHElgKña

rk)an b¤ Gs;kargareFVI

cab;manépÞeBaH

sMralkUn

GñkRbEhlCaGacraykarN_nUvkarpøas;bþÚrtamry³kMBüÚT½r)an . sikSabEnßmenA OHP.Oregon.gov .

GñkRtUvkardak;BaküsMuCMnYyrbs;GñkeLIgvijerogral;qñaM. mnusSmñak;²nwgRtUvdak;BaküsMuCMnYyeLIgvij

enAeBlxus²Kña – GñknwgTTYl)ansMbuRt/ GIuEm:l b¤ CasarTUrs½BÞ CUndMNwg enAeBlevlaenaHmkdl; .

enAeBlEdlGñkTTYl)ankarCUndMNwgenaH/ cUreFVItamGVIEdleKR)ab;Pøam .

etIRtUvTUrs½BÞeTAelxNaedIm,IsMurkGñkCYYy edIm,Icg;dwgbEnßm cUreTA OHP.Oregon.gov (cucelI “OHP Contacts”) .

TMB½rTI 1 nwgrayrab;TUeTAdUcKña/ elIkElgEtxageRkam

bMputénTMB½renaH . Epñk {mUlehtuénlixit{ R)ab;GñkfaetI

mankarpøas;bþÚrGIVxøH .

GMBIlixitFanar:ab;rgBIKeRmagsuxPaB Oregon rbs;Gñk

OHP.Oregon.gov OHP 1418 (3/19)

Cambodian TMB½rTI 4

TUrs½BÞeTA CCO rbs;Gñk RbsinebI³

RtUvkarCYy edIm,IsMuNat;eBlCYbeBTü .

RtUvkarCYy edIm,IrkRKUeBTü b¤cg;bþÚrRKUeBTü .

mansMNYr GMBIkarpþl;CUn b¤ esvaEdl)anpþl;CUnrYcehIy .

TTYl)anvik½yb½Rt .

TUrs½BÞeTAEpñkesvabeRmIsmaCik OHP tamelx 800-273-0557 (TTY 711) RbsinebIGñk³

cg;pøas;bþÚr b¤ cuHeQµaHeTAkñúg CCO.

RtUvkarb½NÑeBTüGUrihÁinfµImYy b¤ cg;)an

esovePAEckCUnsmaCik OHP .

TTYl)anvik½yb½Rt nig minman CCO .

RtUvkarCYy edIm,IsMuNat;CYbeBTü EdlminmanenAkñúg CCO .

mansMNYrmYycMnYn GMBIkarFanar:ab;rg nigminenAkñúg CCO eT.

TUrs½BÞeTAEpñkesvabeRmIsmaCik OHP tamelx 800-699-9075 (TTY 711) RbsinebIGñk³

mansMNYrGMBIsiT§iTTYlCMnYy .

cab;manépÞeBaH b¤ karBreBaHRtUv)anbBa©b; .

pøas;bþÚrGas½ydæansMbuRt/ GIuEm:l b¤ elxTUrs½BÞ .

OHA eFVItamc,ab;rdæ nigshB½n§ sþIBIsiT§isuIvil . eyIgminRbRBwtþcMeBaHCnNamñak;minesµIPaBKña enAkñúgkmµviFINamYyeLIy

edaysarEtBUCsasn_/ BN’sm,úr/ BikarPaB/ CatikMeNItedIm/ sasna/ ePT/ cMNg;pøÚvePT/ GtþsBaØaNePT/ sßanPaBRKYsar b¤ Gayu

enaHeLIy. GñkGacdak;BakübNþwgtv:a)an RbsinebIGñkKitfaRksYg OHA )anerIseGIgGñk edaysarEtehtuplNamYyxagelIenH .

eQµaH sMNMuCMnYy

karcuHeQµaHkñúgkic©EfrkSa

Edlmankarcat;Ecg /TPRJohn Doe OHP Plus A, BJane Doe OHP Plus A, B, C

karcuHeQµaHkñúgkic©EfrkSaEdlmankarcat;Ecg /TPRBt’mansþIBIKeRmag Bt’mansþIBIKeRmagA CCOB – Mental

nig eQµaH CCO1-800-555-5555

B DCO – Dental Care eQµaHsuxPaBeFµj1-866-555-5555

D MAJOR MEDICAL eQµaHKeRmag1-800-555-1234elx ID rbs;Gñk

edIm,Icg;dwgbEnßm/ sUmGanesovePAsmaCik OHP enA OHP.Oregon.gov/ b¤TUrs½BÞeTAesvabMerIsmaCik OHP elx 800-273-0557 edIm,IesñIsMuc,ab;cmøgénesovePAenH.

etIsMbuRtrbs;Gñkmann½ydUcemþcEdr

etIsMbuRtrbs;Gñkmann½ydUcemþcEdr .........1 CMnYyrbs;Gñk ...................................2 kareRbIR)as;CMMnYyrbs;Gñk ....................3

viFIEfrkSaCMnYyrbs;Gñk ......................4 etIelxNaEdl´RtUvTYrs½BÞeTA .............4

TMB½rTI 3 R)ab;GñkGMBIBakünImYy² EdlmanenATMB½rTI 2

RBmCamYyeQµaHKeRmag nigelxTUrs½BÞ.

RbsinebIGñkmanCMnYy OHP elxkUdTaMgenH R)ab;GñkGMBIRbePT

énkarEfTaM EdlKeRmagrbs;GñkeFVIkarFanar:ab;rg³

CCOA: evC¢saRsþ eBTüeFµj nigeBTüpøÚvcitþ

CCOB: evC¢saRsþ nig eBTüpøÚvcitþ

CCOE: eBTüpøÚvcitþ

CCOG: eBTüeFµj nigsuxPaBpøÚvcitþ

DCO: eBTüeFµj

MHO: eBTüpøÚvcitþ

RbsinebIelxkUdTaMgenHBuMmankñúgbBa¢IeTenaH enaHGaCJaFrsuxPaB Oregon (OHA) Fanar:ab;rgelIkarEfTaMsuxPaBrbs;Gñk.

sMuCMnYyeLIg

vijenAerogral;qñaM

raykarN_nUvkar

pøas;bþÚr

CasmaCikfµIrbs; OHP EmneT? cUrcab;epþImeRbICMnYy OHP rbs;Gñk

KeRmagsuxPaBénrdæGUrihÁin (Oregon Health Plan -OHP) KWCakmµviFIpþl;Fanar:ab;rgemDIexd niigsuxPaBkumarenAkñúgrdæGUrihÁin.

vaecjéføkic©KaMBarsuxPaB[RbCaBlrdæRkIRkenAkñúgrdæGUrihÁin . edIm,I[R)akdfaGñkTTYl)annUvkic©KaMBarEdlGñkRtUvkar ehIyenAeBlEdl

GñkRtUvkar/ enHKWCarbs;mYycMnYnEdlGñkRtUveFVI .

smaCik OHP CaeRcIn KWRtUv)aneKcuHeQµaHeTAkñúgGgÁkarpþl;

kic©KaMBarEfrkSasuxPaB CCO.

CCO KWCaRkumRKUeBTü nigKeRmagEpñkeBTü sMrab;smaCik

OHP. CCO pþl;CUnnUvkic©KaMBarsuxPaBTUeTA/ suxPaBmat;eFµj

nigsuxPaBpøÚvcitþ sMrab;KeRmag OHP rbs;Gñk.

manexanTICaeRcIn man CCO EtmYyeT .

smaCik OHP fµI nwgRtUvTTYlcuHeQµaHCamYy CCO

RbEhlCaBIr bIs)aþh_ eRkayeBlEdleKTTYl

)anlixitpþl;CUnCMnYyCaelIkdMbUg . eKnwgTTYl

)anlixitsþIBIkarpþl;CUnCMnYyfµImYyc,ab;

enAeBlEdleKcuHeQµaHCamYy CCO .

enAeBlEdl)ancuHeQµaHeTAkñúg CCO, GñknwgTTYl

)anÉksarBt’mansMrab;smaCikfµIBI CCO rbs;Gñk .

vaR)ab;GñkfaGMBIeQµaHRKUeBTüRbcaMxøÜnrbs;Gñk/ CCO

nigCMnYysuxPaBrbs;Gñk .

eRkayeBlenaH RbsinebIman CCO NaepSgeTotenAkñúgtMbn;

EdlGñkrs;enA GñkRtUvTUrs½BÞmkesvabMerIsmaCik OHP elx

800-273-0557 kñúgry³eBl 30 eTA 90 éf¶ .

RbsinebIGñkTTYl)anCMnYy OHP / enaHGñkRtUv)aneKtRmUv

[cuHeQµaHkñúg CCO elIkElgEt³

GñkmankMeNItedImCaGaemrikaMg-GIuneDón b¤

GaLasáa. GñkenAEtGacTTYl)annUvkic©KaMBar

tamry³esvasuxPaBsMrab;CnCatiGIuneDón b¤

BImNÐlsuxPaBsMrab;kulsm<½n EdlCasmaCikrbs; CCO Edr .

cUrTUrs½BÞmkeyIg RbsinebIGñkRtUvkarcuHeQµaHeTAkñúg CCO .

GñkTTYl)ankic©KaMBarBIRKUeBTü minEmnBI

CCO rbs;GñkeT/ ehIykarpøas;bþÚrRKUeBTü

Gacb:HBal;CaGviC¢maneTAdl;suxPaBrbs;Gñk .

GñksßitenAkñúgkMLúgeBlBreBaH 3 ExcugeRkay

ehIyenAcg;eTAemIleBTübc©úb,nñrbs;GñkdEdl .

sUmeRCIserIsRKUeBTüsMrab;Gñk

RbsinebIGñksßitCamYy CCO ³

GñkGacTak;TgeTA CCO rbs;Gñk

ehIyeRCIserIsRKUeBTüRbcaMxøÜnmñak;epSgeTot .

GñkenAEtGaceRCIserIseBTüeFµj

nigeBTüsuxPaBpøÚvcitþmñak; RbsinebIGñkcg;)an .

RbsinebI OHA pþl;CUnnUvkic©KaMBarrbs;Gñk³

GñkGaceTAemIleBTü b¤ evC¢bNÐitNamYy

EdlTTYlkarecjéføBI OHP )an.

RbsinebIGñkRtUvkarCMnYykñúgkarrkGñkpþl;esva

EdlTTYlyk OHP sUmTUrs½BÞmkelxdMbUnµan

rbs;Kilanubdæakr OHP EdlbeRmIesva 24/7 tamelx

800-562-4620.

sUmsÁal;RKUeBTürbs;Gñk enAmuneBlGñkQW

enAeBlEdlGñkdwgfaetInrNaCaRKUeBTürbs;Gñk/

cUrsMuNat;CYbKat;edIm,I[Kat;BinitüsuxPaBGñkCamunsin .

eFVIy:agenH/ Kat;nwgdwgGMBIsuxPaBrbs;Gñk

nigkic©KaMBarEdlGñkRtUvkar .

bnÞab;mk RbsinebIGñkQW/ RKUeBTürbs;Gñknwgdwg)aneRcIn

kñúgkarpþl;nUvkic©KaMBarrbs;Gñk[)anRbesIr .

muneBlEdlGñkeTACYbRKUeBTürbs;Gñk³

cUrsresrnUvsMNYrTaMgLayEdlGñkman .

cUreRtómxøÜnCMrabKat; GMBIRbvtþisuxPaBRKYsar nig

eQµaHfñaMeBTüTaMgGs; EdlGñkelb .

enHnwgCYy[Gñk nigRKUeBTürbs;Gñk begáItnUvTMnak;TMngCamYyGñk

nigGacBiPakSaGMBIesckþIRtUvkarrbs;Gñk kñúgkarTTYlkic©KaMBar

suxPaBEdlGñkRtUvkar .

sikSaGMBICMnYyrbs;GñkcUrsaksYrGñkpþl;esva b¤sßab½nsRmbsRmYlkarEfTaM (CCO) rbs;Gñk edIm,[dwgfaetI esvaCak;lak;RtUv)anFanar:ab;rg b¤Gt;.

bBa©IeQµaHesvaEdlRtUv)aneKecjéfø[ KWmansresrenAkñúg esovePAEckCUnsMrab;smaCik OHP .

CMnYyBIKeRmagsuxPaB Oregon (OHP) ³ OHP Plus KeRmag OHP manEdnkMNt;elIfñaMeBTü nig CAWEM Plus OHP Fanar:ab;rgelIesvaTaMgenH EtenAeBlEdlesvaTaMgenHRtUv)anpþl; [eday OHP (Oregon Medicaid) nigGñkpþl;esva CCO Edl)ancuH

eQµaHEtb:ueNÑaH.

eBTüTUeTA³ eTAemIleBTü/ esvabgáa edIm,ICYyGñk[rkSanUvsuxPaBl¥/ eFVIetsþ edIm,Irk[dwgnUvCm¶Wrbs;Gñk/ karBüa)alCm¶WFM²PaKeRcIn/

LandwkeBlse®gÁaHbnÞan; nigkic©KaMBarse®gÁaHbnÞan; 24 em:ag/ esvaBnüakMeNIt/ nig smÖB nigkic©KaMBarTarkEdleTIbnwgekIt .

និងការគាំពារពេលមានផ្ទៃពពាះ ទារកព�ើបនឹងពកើត និងមាតាព្កាយពេលសំរាលកូនរួចកុំឲ្យេិបាកចិត្ត ។ suxPaBpøÚvcitþ³ eBTüsuxPaBpøÚvcitþ nigkarpþl;dMbUnµan/ nigCYy[Qb;Bisar)arI/ eRbIeRKÓgRsvwg nig eRKÓgejón . (GñkminRtUvkar

karbBa¢ÚnBIRKUeBTüRbcaMxøÜnrbs;Gñk sMrab;esvaTaMgenHeT .) eBTüeFµj³ lagsMGateFµj nigBüa)albgáar/ eTABinitüemIleFµj nig ftGiucer:s_/ b:HeFµj/ dkeFµj/ kic©KaMBareBlQWeFµjCabnÞan; 24 em:ag.

fñaMeBTütamevC¢bBaa¢³ OHP EdlmanEdnkMNt;elIfñaMeBTü EtrYmbBa©ÚlfñaM EdlminFanar:ab;rgeday Medicare Part D.

kic©KaMBarEPñk³ BinitüemIlEPñk/ pþl;Evnta edIm,IBüa)alnUvlkçx½NÐCm¶WmYycMnYn dUcCaCm¶WEPñk aphakia b¤ keratoconus b¤

eRkayeBlvHkat;katarak;ehIy .

eBTüEPñk³ karBinitüEPñk nigEvnta (sMrab;Et RsþImanépÞeBaH nigkumarEdlmanGayueRkam 21 qñaMb:ueNÑaH) .

tRmUvkarepSgeTót³ OHP Gacecjéfø[ sMrab;Rbdab;Bak;kñúgRtecokedIm,I[sþab;lW/ sMPar³eBTü/ kic©KaMBarsuxPaBtampÞH/ esva

Büa)alCMnaj/ kic©KaMBareBldMNak;kalcugeRkayénCIvit/ nigkareFVIdMNeIreTAmkeBTü .

GVIEdlminecjéfø[³ OHP minecjéfø[ sMrab;Büa)alnUvCm¶WTaMgGs;enaHeT .

manrbs;mYycMnYn Edl OHP minecjéfø[ enaHKW³

karBüa)alsMrab;lkçx½NÐCm¶WEdlGacCasHes,Iy)an

edayxøÜnÉg

karvHkat; b¤ karBüa)alEksm¢sS

EdlRKan;EteFVIeLIg[s¥atEpñkxageRkAb:ueNÑaH

karBüa)alEdlvaminGacCa

esvaEdlCYy[GñkmanépÞeBaH

kmµviFIsMrkTm¶n; (man CCO mYycMnYnecjéfø[

sMrab;kmµviFIsMrkTm¶n; )

sMNMuCMnYyepSgeTot³

CAWEM – esvase®gÁaHbnÞan;/ eBTüeFµj nigesvadwkCBa¢Ún

BreBaH ការចងមាត់ស្បូនសស្តរីកុំឲ្យមានកូនព�ៀត។ CAWEMFanar:ab;rgesvaTaMgenH EtenAeBlEdlesvaTaMgenHRtUv)an pþl;[edayGñkpþl;esva OHP (Oregon Medicaid).

Qualified Medicare Beneficiary (QMB) – RbsinebIlixitFanar:ab;rgrbs;Gñk bgðajCMnYy QMB enHmann½yfa

Gñkpþl;esva Medicare rbs;Gñk GacecjvikáybRteTA OHA sRmab;éføFanar:ab;rg nig témørYmcMENkeBleTAeBTümþg² Medicare

(elIkElgEt Medicare Part D) nigtémøRtUvbg;RbcaMqñaMmuneBlFanar:ab;rgbg;[.

GMBIlixitFanar:ab;rgBIKeRmagsuxPaB Oregon rbs;Gñk OHP.Oregon.gov

OHP 1418 (3/19) Cambodian TMB½rTI 2

GMBIlixitFanar:ab;rgBIKeRmagsuxPaB Oregon rbs;Gñk

OHP.Oregon.gov OHP 1418 (3/19)

Cambodian TMB½rTI 3

RbsinebIGñkcg;rkesvaEdl OHP minpþl;CUnenaHeT³

rkmeFüa)ayNaepSgedIm,ITTYl)annUvesvaenaH .

cg;rkRKUeBTümñak;epSgeTotedIm,IsYreyabl;/

cUrsYreTARKUeBTürbs;Gñk nig CCO rbs;Gñk

GMBICeRmIsrbs;Gñk .

RbsinebIGñkenAEtcg;)anesvaenaH/

GñknwgRKUeBTürbs;GñkRtUvbMeBj :kic©RBmeRBógbg;luy :

enAmuneBlEdlGñkTTYlyknUvesvakmµenaH .

enHmann½yfa Gñkyl;RBmecjéføesvaenaHedayxøÜnÉg .