agatabu k’ibijanye n’umugambi w’ubuvuzi updated vt...hamwe n’abakuze badafise abana bipfuza...

IGISATA CA VERMONT KIJANYE N’UKURONKA UBUVUZI

BW’IVY’AMAGARA

AGATABU k’ibijanye

n’umugambi w’ubuvuzi

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GreenMountainCare A HEALTHIER STATE OF LIVING

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Ibiro bifasha abakiriya vya Vermont Health Connect na Green Mountain Care

Ibibazo: Hamagara 1-800-250-8427 (TDD/TTY) 1-888-834-7898

Urashobora kandi kuronka umusemuzi canke ubundi buryo ata kiguzi.

Ibirimwo Ibirimwo ..................................................................................................................................................................... 2 Murahawe ikaze muri Green Mountain Care Program ................................................................................................... 4

Amazina y’uwu mugambi ...................................................................................................................................... 4 Ikarata yawe ya Green Mountain Care ................................................................................................................... 5

Ubuvuzi hamwe n’abo mugana .................................................................................................................................... 5 Ubuvuzi bw’intango (PCP) .................................................................................................................................... 5 Ubuvuzi inyuma y’akazi ........................................................................................................................................ 5 Inararibonye ........................................................................................................................................................... 5 Iyo umuganga wawe atemera ubuvuzi bwa Green Mountain Care ........................................................................ 6 Kurindira umwanya w’isango ................................................................................................................................ 6 Igihe co gufata urugendo ........................................................................................................................................ 6 Kwipimisha kenshi na kenshi ................................................................................................................................. 7

Ubufasha .................................................................................................................................................................... 7 Ivyo uyu mugambi uguha (bagufasha) ................................................................................................................... 7 Ivyo uyu mugambi udafasha .................................................................................................................................. 7 Ubufasha uronka mumugambi wa Medicaid na Dr. Dynasaur (vyihariye) ............................................................ 8 Ivyo twihutira kwemerera ...................................................................................................................................... 8 Mfise Medicaid kandi ndashaka ubufasha bwa DME. Ndaburonka gute? ............................................................. 8 Imiti n’ukwemererwa ubufasha bw’intango ......................................................................................................... 11 Ivyihutirwa ........................................................................................................................................................... 11 Kuvurwa vyihutirwa ............................................................................................................................................. 12 Igihe utegerezwa kuriha ....................................................................................................................................... 12 Iyo baguhaye fagitire ............................................................................................................................................ 12 Iyo ufise ubundi bwishingizi ................................................................................................................................ 12 Medicaid na Dr. Dynasaur ...................................................................................................................................... 13 Ubufasha bw’intango ........................................................................................................................................... 15 Ayo uriha ukorana na Medicaid ........................................................................................................................... 15 Udushirukabute .................................................................................................................................................... 15

Umugambi w’ubufasha bw’intango (PC Plus) ........................................................................................................ 15 Uko bikora Medicaid na Dr. Dynasaur ................................................................................................................ 15 Guhindura umuganga wawe (PCP) ...................................................................................................................... 15 Umuganga wawe iyo ari inararibonye .................................................................................................................. 15 Gusesa amasezerano ............................................................................................................................................. 16 Ivyo wemerewe n’ivyo usabwa gukurikiza .......................................................................................................... 16 Usabwa kubungabunga amagara yawe muku: ..................................................................................................... 17 Ubushake bw’umurwayi hamwe n’uko bikorwa .................................................................................................. 17 Gutanga ibihimba vy’umubiri .............................................................................................................................. 18 Kuganira n’umuganga wawe aguha ubufasha bw’intango (PCP) ......................................................................... 18 Kugira ibanga ibikogwa bikoregwa umurwayi .................................................................................................... 18 Umugambi w’uguhabwa ubwishingizi bwiza ...................................................................................................... 19 Iyo utemeranije n’igikorwa kanaka ......................................................................................................................... 19 Gusaba isubirwamwo ry’ingingo ......................................................................................................................... 20 Gusaba kwumvirizwa neza ................................................................................................................................... 20 Kubandanya uronswa ubufasha ............................................................................................................................ 20 Mu gihe hari agahaze ........................................................................................................................................... 21 Ufise ico wobaza? ................................................................................................................................................ 21 Ikigo c’amagara meza ci Vermont kijejwe kwakira ibibazo ................................................................................ 21 Tumenyeshe impinduka kuri ibi mu misi itarenze icumi: .................................................................................... 22 Ibiro vy’umuhuza mu gisata c’amagara meza ...................................................................................................... 22 Amakuru arengako ............................................................................................................................................... 22 Ibindi bisata .......................................................................................................................................................... 22 Ibikorwa vyo gufasha abageze mu za bukuru ...................................................................................................... 22 Umugambi wa serivisi zindi ziyongerako ............................................................................................................ 23 Ibikorwa vyo gukurikiranira abana bakiri bato (CIS) .......................................................................................... 23 Ibikorwa vyo gukurikiranira hafi abana bafise ubumuga bidatevye (CIS-EI) ...................................................... 23

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Ibikorwa vyo kwitwararika ukugubwa neza kw’abana bafise ubumuga .............................................................. 23 Abana bafise vyinshi vyihariye bakeneye mu gukurikiranwa (CSHN) ................................................................ 23 Ihitamwo ry’ukwitabwaho ................................................................................................................................... 23 Ibikorwa vyo gufasha abafise ibibazo vy’iterambere ryo mu mutwe ................................................................... 24 Umugambi wo gufasha mu buryo bw’amafaranga............................................................................................... 24 Gufashirizwa mu miryango .................................................................................................................................. 24 Gukirikiranirwa muhira hakoreshejwe ubuhinga bwa none bukomeye ............................................................... 24 Ibikorwa vy’abakozi bo mu nzu ........................................................................................................................... 24 Ibitaro bidasanzwe ............................................................................................................................................... 24 Serivisi zidasanzwe .............................................................................................................................................. 25 Umugambi wo gukurikiranira abana mu ngo zabo hakoreshejwe ubuhinga bwa none buhanitse ....................... 25 Umugambi wo kubona no gukemura ibibazo vyo kutumva mu gihe bibonywe hakiri kare I Vermont ............... 25 Amagara yo mu mutwe ........................................................................................................................................ 25 Ibikorwa vyo kwitabwaho vy’abakuze ................................................................................................................. 25 Ibikorerwa abana, imiyabaga, n’imiryango .......................................................................................................... 25 Kuvura no kugarukana mu buzima busanzwe umurwi w’abantu ......................................................................... 25 Ibikorwa ntarindirizwa ......................................................................................................................................... 26 Umugambi ujanye n’indwara z’iyononekara ry’ubwonko ................................................................................... 26 Umugambi witaho abagore, inzoya n’abana (WIC) ............................................................................................. 26 Icitonderwa! Nimba ukeneye ubufasha mu rurimi rw’iwanyu, hamagara 1-800-250-8427................................. 27

Mukakaro 2016

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Murahawe ikaze muri Green Mountain Care Program

Igice cambere caka gatabu gitanga inkuru mukeneye kubijanye n’uyu mugambi kubijanye n’amagara y’abantu. Mu nyuma dutanga inkuru k’ubufasha wafashe. Nimba utazi umugambi wafashe, canke ufise ibibazo, hamagara kuri biro bifasha abakiriya vya Vermont Health Connect & Green Mountain Care kuri 1-800-250-8427. Hamagara kuwa mbere kugeza kuwa gatanu, kuva saa mbiri z’igitondo gushika saa mbiri z’ijoro (tuba twugaye imisi y’ibiruhuko).

Green Mountain Care ishishikariza abakozi gutanga ubuvuzi bwiza, bukenewe ku banywanyi bose, kandi ikabuza abavuzi kugabanya, kwanka canke kwihoza kuvura ababikeneye. Green Mountain Care ntizokwinuba irabiye ku bibujijwe n’amategeko. Izindi nkuru ku bijanye na Green Mountain Care ushobora kuzironka uhamagaye kuri 1-800-250-8427.

Uyu mugambi ukora mu ma reta yose aho hose umunyamerika asabwa kugira ubwishingizi, kandi igatanga ububasha bwo guhitamwo ubwishingizi ashaka. Mu kwerekana ubwishingizi, umwe wese asabwa kuba afise uwumwishingira canke agatanga amafaranga asabwa.

Nimba wipfuza muri Green Mountain Care coverage, hamagara muri Vermont Health Connect no ku biro bifasha abakiriya vya Green Mountain Care kuri 1-800-250-8427. Mu kubivamwo biciye mu nyandiko, rungika e mail yawe usaba kuri:

DCF/Economic Services Division ADPC 103 South Main Street Waterbury, VT 05671-1500

Amazina y’uwu mugambi Iyi migambi y’ibijanye n’ubuvuzi muri Vermont ikorwa n’igisata ca Vermont ku bijanye n’ukuronka ubuvuzi (irabwa na komite y’isi iraba ibijanye n’ubuvuzi). Medicaid ni ibijanye n’ubuvuzi buhabwa abana, abavyeyi, kwitabwaho, kubasaza, abamugaye hamwe n’abakuze badafise abana bipfuza ubuvuzi bakwije ibisabwa. Ubufasha bw’ubuvuzi bw’igihe kirekire burahari ku bafise ivyangombwa bisabwa (nk’uko biri mu gisata c’abagendana ubumuga, abashaje, n’abibeshejeho) hamwe n’ayo binjiza n’ahandi bakura.

Dr. Dynasaur ni inararibonye mu buvuzi bw’abana n’abavyeyi bibungenze. Primary Care Plus (PC Plus) ni uburyo bwiza bwo kwivuza benshi mu bishingizi ba Medicaid na Dr. Dynasaur bategerezwa kugirirana amasezerano kugira babandanye baronka inyungu zavyo.

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Ikarata yawe ya Green Mountain Care Ikarata yawe izorungikwa iwawe ku buryo bw’iposita. Turagusaba ngo uvyerekane igihe ugiye kwivuza. Igihe haciye ukwezi utararonka ikarata yawe umaze kuronka agatabu, canke iyo uyitaye, hamagara ku biro vyakira abakiriya kuri 1-800-250-8427 bakuronse iyindi nshasha. Iyo ufise ubundi bwishingizi, bereke amakarata yabwo yose.

Ubuvuzi hamwe n’abo mugana Ubuvuzi bw’intango (PCP) Ijambo intango risigura bwa mbere. PCP wawe bisigura uwo uhamagara wa mbere igihe ukeneye ubuvuzi. PCP wawe azoza arakuraba akuvura munafashanya mugukora kugira amenye ukwo akuvura mu gihe bikenewe.

Raba PCP wawe mu gihe bikenewe, kugira akumenyeneza kubijanye n’amagara yawe. Iyo PCP ari mushasha kuri wewe, saba uwo mwahorana arungikire ibijanye n’amagara yawe uwo mushasha. Hamagara uwo mwahorana kugira umumenyeshe ko vyagushikiriye.

Ubuvuzi inyuma y’akazi Gerageza witeho amagara yawe kumusi kumusi mumasaha y’akazi (ntivyihutirwa). Iyo ufise ikibazo cihutirwa (PCP) wawe ibiro vyiwe vyugaye ushobora guhamagara ku biro vyiwe ugasaba ubufasha canke impanuro. Ibiro vya PCP bifise uwuba abirimwo amasaha 24 ku musi , imisi indwi kundwi kugira agufashe. Turagusaba ngo urabe ku rupapuro rwa 12 rw’aka gatabu ku zindi nkuru kubijanye n’ubufasha bwihutirwa.

Inararibonye Inararibonye ni umuntu afise inyigisho zirenze mu bintu ibi bijanye n’ubuvuzi kanaka. Nk’akarorero, iyo ufise ikibazo c’umutima, umu PCP wawe azogufasha kuronka isango hamwe n’inararibonye ku bijanye n’umutima. Ashobora kugufasha gufata icemezo co gufata umwiza kurusha abandi. Iyo atari we amukurungitseko ushobora kuriha amahera yawe. Iyo utegerezwa kuja kuraba uwo muganga w’inararibonye kenshi ushobora gusaba umu PCP wawe “kwemererwa kujayo” igihe cose ushakiye.

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Iyo umuganga wawe atemera ubuvuzi bwa Green Mountain Care Iyo ubonye umuganga wawe atari muri uyu mugambi, ushobora kuja kumuraba mu misi 60 inyuma yuko winjiye muri uyu mugambi. Ibi bishobora kuba iyo:

Ufise indwara ugendana mu buzima, canke

Ufise indwara igenda yiyongera canke igusinzikaza, canke

Ufise inda irenza amezi atatu, kandi

Umuganga wawe akakwemerera uyu mugambi akanakwirikirana ivyo bagenderako.

Kwongerako imisi 60, canke kurondera abandi bafasha n’abaganga muri uyu mugambi hamagara kuri 1-800-250-8427. Ushobra nukuraba abaganga bemera iyi Green Mountain Care mukubiraba kuri vtmedicaid.com, ugafyonda ku bakozi bakorana natwe. Abaganga banditswe ngo"ntibari ku murongo" bashobora kutemera ubwishingizi bwa Green Mountain Care .

Abaganga ubona bategerezwa kuba bemera Green Mountain Care. Iyo batayemera, ntibazorihwa na Green Mountain iyo ufise ubundi bwishingizi bushobora kukurihira vyose canke igice ariko umuganga wacu akaba yemera ubwo bwishingizi.

Kurindira umwanya w’isango Iyo uhamagaye ku biro vy’umuganga wawe, ushobora kuronka isango:

Mumasaha 24 mu gihe iyo mutabonanye muri ayo masaha 24 bishobora kugira ingaruka

mbi ku buzima bwawe,

Mumisi 14 mu gihe ufise utubazo dusanzwe, kandi

Mu misi 90 igihe ushaka kwikingira indwara.

Akenshi, ntutegerezwa kurindira umuganga wawe igihe kirenga isaha. Ibuka: iyo usivye utegerezwa kuhamagara ukabimenyesha kandi ukavuga ryari uzoboneka.

Iyo ugize ikibazo gikomeye ukaba utakivuwe ja aho bafashiriza abihutirwa. Hamagara umuganga wawe vuba bishoboka inyuma y’ukuvayo.

Igihe co gufata urugendo Tugerageza kumenya ko hari uwugutwara muri aya masaha:

Iminota 30 minutes kumuvuzi w’intango (PCP),

Iminota 30 ku bitaro,

Iminota 60 ku buvuzi nka laboratware, guca mucuma, farumasi, ivy’amaso, ivyo mu

mutwe, MRI hamwe n’ukuvura abanywa ibiyovyabwenge

http://vtmedicaid.com/

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Kwipimisha kenshi na kenshi Ni vyiza kwikingira indwara imbere yuko ziza. Inzira ishoboka nukwama wisuzumisha ku muganga wawe. Umuganga wawe ashobora kugufasha uko ubigenza. Baza umuganga wawe ivyo wo kwikingira bijanye n’imyaka yawe n’ibishobora kugushikira.

Igisata c’amagara muri Vermont gitanga impanuro mu

vyo kwisuzumisha. Ku bindi mushaka kumenya,

hamagara 1-800-464-4343, canke ubarabe kuri

www.healthvermont.gov.

Ubufasha Ivyo uyu mugambi uguha (bagufasha) Myinshi muri iyi migambi ya Green Mountain Care iragufasha mukuza kuraba umuganga, gufashwa mu bitaro, kwandikirwa imiti, n’ibindi bigendeye ku mategeko n’aho bigarukira. Ushaka kumenya ivyo umugambi wawe ugufasha, ja ku rupapuro rwa 13 na 14.

Ivyo uyu mugambi udafasha Ibikomere wagiriye kukazi wategerezwa kuvuzwa n’abakoresha bawe,

Amahera ya serivisi zategetswe na sentare keretse iyo zikenewe cane mu buvuzi,

Ubufasha bwo mu bushakashatsi canke bw’iperereza,

Ubufasha mu vyo kwisiga ( nko kugira use neza),

Ubufasha butajanye n’ukwivuza bikenewe,

Acupuncture, acupressure, na massage therapy,

Kurondera uruvyaro (ubufasha bugufasha kwibungenga),

Nko kugura ivyuma vy’ikarashishi, ivy’ugukanyisha mu nzu canke kuhashusha,

Gusana inzu yawe,

Kuja muma club y’ivy’ubuzima,

Kwivuriza mu bihugu vyo hanze, kandi

Kwandikirwa imiti itajanye n’iyitangwa na reta kandi yemewe.

http://www.healthvermont.gov/

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Ubufasha uronka mumugambi wa Medicaid na Dr. Dynasaur (vyihariye) Iyo ubufasha ukeneye budatangwa na Medicaid canke Dr. Dynasaur ushobora kubasaba bakabikurihira. Abitaho abakiriya bashobora kugufasha kubisaba. Mwe n’umuganga wawe muzosabwa kubisigura kugisata ca Vermont n’igituma ubishaka. Tuzoca tuguha inyishu ku ikete mu misi 30.

Kumenya ukuntu vyogenda canke ko bo gucishirizamwo hamagara ku biro bifasha abakiriya. ushobora nokubona urupapuro rwuzuzwa kuri www.greenmountaincare.org/member information/forms.

Ivyo twihutira kwemerera Green Mountain Care ikorana n’abaganga, abaforoma, n’abandi bakomeye kugira tukuvure neza.

Hari imiti n’ubufasha busaba kubanza kwemererwa kugira ubironke. Umuganga wawe arabizi,

azogufasha kugira uronke ubwo bufasha.

Gufata icemezo c’ubufasha bwihutirwa bikorwa mu misi itatu inyuma yo kubimenyeshwa. Mwe n’umuganga muzoronka ikete ribamenyesha ingingo yafashwe.

Ibikoresho vy’ubuvuzi biramba (DME) Ibikoresho vy’ubuvuzi biramba (DME) ni ibintu ushobora gukoresha muhira bigufasha kumererwa neza mu gihe ugwaye. Nk’agatebe k’amapine n’ibitanda vyo mu bitaro ni akarorero ka DME.

Mfise Medicaid kandi ndashaka ubufasha bwa DME. Ndaburonka gute?

1. Umuganga wawe azokurungika kwisuzumisha.

• Abenshi ni abakuganiriza canke bavura ivy’umubiri. Uwugusuzuma azogaragaza uko umeze. Mu gihe adafise umwanya uzotegerezwa kumurindira. Ushobora nokurindira mu gihe uwubidandaza atarabizana.Uwo mudandaza ni uruganda ruduha ivyo bikoresho.

• Menya neza: Iyo iyo DME ushaka ari iyisanzwe ntibisaba kubanza gusuzumwa. Iyo umuganga avuze ko utakeneye gusuzumwa ja ku ntambwe ya 2.

• Uwusuzuma azomenyesha DME ukeneye iyariyo anarungikire umuganga wawe ikivyemeza.

2. Umuganga wawe azokwandika ivyo ukeneye.

• Umuganga wawe azoshirako umukono kucemezo ace abirungikira wa mudandaza.

3. Wa mudandaza wa DME azoca asaba Medicaid iguhe uburenganzira bwo kuronka ubufasha bw’intango.

http://www.greenmountaincare.org/member

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Iyo uDAkeneye ubufasha bw’intango ja kuntambwe ya 5.

• Iyo ukeneye ubufasha bw’intango, umudandaza azoca arungikira Medicaid inkuru kubijanye nawe n’ubufasha ukeneye.kwemererwa ubwo bufasha bisigura ko Medicaid itegerezwa kuvyemeza.

• Umukozi wo ku bitaro azoca asuzuma inkuru zawe.Azoca afata icemezo ko ukwiye kuronka ivyo wasavye.

• Uwo mukozi ashobora gusaba izindi nkuru zawe kugira afate icemezo cuko ukwiye kuronka ivyo bintu. Iyo abikeneye Medicaid icisaba wa mudandaza ngo abirungike. Uwo mudandaza ategerezwa kuba yabirungitse mu misi 12. Hanyuma uwo mukozi agaca afata icemezo mu misi 3 y’akazi.

4. Medicaid izokurungikira urupapuro rumenyesha icemezo cafashwe

• Medicaid mu kubikumenyesha izokurungikira ikete yitwa “Urupapuro rw’Icemezo cafashwe” . Medicaid izonarungikira ikete umuganga wawe n’awa mudandaza. Muri Vermont, Igisata c’ubuzima (DVHA) gitwara Medicaid, rero ayo makete azoba avuye muri DVHA.

5. Wa mudandaza wa DME azoca akuronsa ivyo wasavye.

Iyo Medicaid ivyemeje, umudandaza wa DME azoca aguha ivyo wasavye canke abikuronderere.

Iyo Medicaid itavyemeye, urashobora kubaza impamvu uzoca uhamagara kuri 1-800-250-8427. Medicaid yarakoze cane mu kugabanura umwanya kugira yemere ivya DME muriVermont. K’udutebe tw’amapine, bisaba imisi 9. Iki gihe ni gito cane mu bisanzwe. Ni nagito kurugero rw’igihugu. Kubintu bisanzwe, imisi iba mike kurusha. Iyo ufise ubwishingizi canke Medicaid na medicare ibi bifata igihe kinini.

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Ingene waronka ibikoresho vy’ubuvuzi biramvye (DME) muri Vermont Medicaid

Intambwe ya 1: Ugusuzuma

Uzobona ubufasha

y’uwugusuzuma

Kuri DME isanzwe,

ntuzokenera

gusuzumwa

Intambwe ya 2: Kwandikirwa imiti

Umuvuzi wawe azorungikira

urwandiko rw’imiti kumudandaza wa

DME

Kuri DME zimwe zimwe,

ntukeneye uruhusha (simbira

kuntambwe ya 5)

Iyo Medicaid itemeje DME,

ushobora kungururiza

icemezo

Intambwe ya 4: Gutangaza

icemezo

Medicaid (DVHA) ikuronsa

icemezo ikurungikira ikete ryitwa

Urupapuro rw’icemezo cafashwe

Intambwe ya 5:

Ukuronka DME

Umudandaza wa DME

azoguha za DME canke

azikuronderere

Intambwe ya 3: Uruhusha

rwambere

Uwusubiye kugusuzuma niwufata

icemezo niba ukeneye ibikoresho

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Imiti n’ukwemererwa ubufasha bw’intango Green Mountain Care, hamwe n’iyindi mishanga, birakorana kugira biguhe ubuvuzikugiciro cohasi. Kugufasha kugabanya ibiciro, Green Mountain Care isaba abaganga kukwandikira imiti iri kwirisite. Imiti imwe imwe iragurwa make. Ikora kimwe niyindi izimvye amashirahamwe amwe amwe yamamaza.Umuganga arayikwandikira hama uwukora muri farumasi akaguha iyo bikora kimwe ariko igurwa make. Iyo wanse ko baguhindurira uca wirihira iyo uguze.

Imiti yo kukuvura igihe kirekire ishobora gutangwa mu gihe kingana n’imisi 90. Iyo nimiti umuntu afata buri musi kugire agire ubuzima bwiza. Bivana n’amikoro y’umuntu, ariko s’aho bigera gusa, imiti yo kugabanya umurindi w’amaraso, koresterore, na diyabete. Igihe ca mbere ugerageje iyo miti, ishobora kuba igihe gito mu gihe mwe n’umuganga wawe muriko murasuzuma ko ikorana neza n’umubiri wawe. Inyuma, uzica uronka imiti mu misi 90.

Iyo umuganga wawe asanze ukeneye uwundi muti canke udakwiye kuwuronka imisi 90, ategerezwa gusaba uruhusha twebwe kugire tuwurihe. Iyo ukeneye ikopi y’umuti canke uwukwiye gufata mu misi 90 duhamagare kuri

http://dvha.vermont.gov/for-providers/preferred-drug-list-clinical-criteria.

Ivyihutirwa Ivyihutirwa ni igihe ufashwe n’indwara canke amagara aguhindutse, canke mu mutwe, bifise ibimenyetso vyerekana ko bikomeye vyo konona ubuzima bwawe utavuwe. Ngutu uturorero tw’ivyihutirwa, ariko s’ibigusa:

Kubabara mu gikiriza

Kuvunika igufa

Isereri canke gutabuka

Kuva amaraso cane

Gusha cane

Kubabara cane

Gusara mu mutwe

Inyuma y’ukuvurwa ivyihutirwa ivyo bagukorera navyo turabiriha.

Ubufasha baguha kugira ntuhave uremba nko kukugorora, kugushiraho ipansuma, guca mucuma, n’ibindi navyo turabiriha.

Iyo ugize ikibazo hamagara 911 canke uje kubitaro bikwegereye. Ntibikenewe k’uba wabajije umuganga wawe ariko bimenyeshe PCP wawe vuba bishoboka.

http://dvha.vermont.gov/for-providers/preferred-drug-list-clinical-criteria.

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Iyo uronse ubufasha hanze ya reta canke yaho dukorera, Green Mountain Care igerageza kukurihira itumye umuganga wawe. Tanga inkuru canke fagitire wakiriye ku biro vy’abitaho abakiriya canke uhamagare 1-800-250-8427.

Menya ko Green Mountain Care idashobora kukwemerera kukurihira vyo wivuje vyose iyuri hanze ya reta canke y’aho dukorera ushobora kwirihira wewe nyene.

Kuvurwa vyihutirwa Ingorane iba ikomeye iyo iyo utivuje mumasaha 24 vyoba biguteye ikibazo kubuzima bwawe. Ugize ico kibazo hamagara umuganga wawe. Uwo muganga ushobora kumuronka amasaha 24, imisi ndwi ku ndwi. Azotegerezwa kuboneka muri ayo masaha 24.

Igihe utegerezwa kuriha

Iyo udakwirikije amategeko, utegerezwa kwirihira. Uturorero twigihe ibi bishobora gushika:

Iyo ubufasha busaba kuba wabanje kubimenyesha ukaba ukeneye ubw’intango ariko ntube wabimenyesheje imbere yuko uvurwa,

Iyo ugiye kumuganga atemera Green Mountain Care,

Iyo umuganga akubwiye ko ubufasha ushaka butishurwa hama ukanka ukabuhabwa.

Kurikiza amabwirizwa nimba ushaka kurihirwa na medical care.

Iyo baguhaye fagitire Iyo ukurikije amabwirizwa, ntiwategerezwa kuronka amafagitire k’ubuvuzi wahawe kandi yarishwe, kiretse iyo ukeneye ko tuzogusubiza. Iyo uronse ayo mafagitire ucukora ibi bikurikira:

Kugurura iyo fagitire,

Guhamagara umuganga ukamenya ko abizi ko uri kuri green mountain care, hanyuma

Guhamagara abitaho abakiriya kugira bagufashe.

Iyo ufise ubundi bwishingizi

Iyo ufise ubundi bwishingizi, ni ngombwa ko ukwirikiza amategeko yabwo. Ja kubaganga dukorana nabo. Umugambi wacu ushobora kugufasha ivyo ubundi bwishingizi butagufashije.

Umugambi wacu ushobora gusa kuriha abaganga. Iyo urishe k’ubufasha, ntidushobora

kukwishura.

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Medicaid na Dr. Dynasaur

Aka gacapo kerekana ubufasha butangwa na Medicaid na Dr. Dynasaur. Ushobora kubonana n’umuganga aguha ubufasha bw’intango imbere yuko usaba isango mu gihe bikenewe ko ubanza gutanga abo umuntu yobaza ivyawe. Iyo ufise ikibazo ku bijanye n’ubufasha butari muri ibi, ushobora guhamagara abakira abakiriya.

Ubufasha Medicaid na Dr. Dynasaur bitanga Abo twobaza

Kuvura abanywa inzoga n’ibindi biyovya bwenge

Rusehabaniha

Ntibikenewe kugira uwubaza mu gihe uremvye. Bwira umuganga wawe

vuba bishoboka

Kuvyara kurugero

Kwigishwa kumenya ukutotwara inda utipfuza no kugigwa inama.

Ushobora kuja ku muganga wawe, kuw’abagore canke kuwigisha kuvyara

kurugero.

Serivisi z’umugongo

Uruti rw’umugongo gusa. Uruhusha gwa mbere rubonanigwaho incuro

zirenga 10 kumwaka nokubana badakwije imyaka 10.

Ivy’amenyo

Abakuze bafise aho bageza ku bijanye n’amahera. Abana n’abagore

bibungenze canke bataramara imisi 60 bavyaye ntibabagenera amahera

Ivyuma vyo mumenyo

Ivyuma vyo mu menyo kubatarenza imyaka21 ntibabarihisha

Guhabwa imiti ya Diyabete n’ukuvurwa

Bisaba ko baba babikwandikiye

✓

Werekana uwo bobaza kugira ugigw’inama

Kurabwa n’umuganga

Ubufasha bwihutirwa

Ntibikenewe kugira uwo tubaza ivy’amagara yawe mu gihe vyihutirwa.

hamagara 911

or go to the emergency room right away.

Kwisuzumisha amaso (bisanzwe)

Kwivuza indwara z’amaso canke ibikomere bisaba kugira uwo tubaza needs a referral.

Amarori

Tuyarihira uwufise musi y’imyaka 21.

Umuganga w’abagore (Kuvura abakenyezi)

Gufasha abatumva

Gufashiriza umuntu muhira ✓

Uburaro n’ubufasha k’ubantu barwaye ✓

Kwikingiza indwara

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Ubufasha muhabwa na Medicaid na Dr. Dynasaur s Abo twobaza

Gushira umurwayi mubitaro

Abajebarwaye

cane ntibikenerwa ko tugira uwo tubaza

Gukoresha ibizame ✓

kuvyaza (kubarwa) dufise n’abavyaza bavyigiye

Ibikoresho vyo kwa muganga n’ivyo batuzanira

Kwandikirwa na muganga n’ ubufasha bw’intango burakenerwa. Raba

urupapuro rwa 8Sepage 8.

Ubufasha bwo kuvura mumutwe

Raba urupapuro rwa 24 kubindi bisobanuro.

Abaganga bavura ibijanye n’ibiterwa

Bisaba ko bagira uwo babaza mu gihe uwo muganga atari PCP wawe ✓

Kuguha ivyukora, gukoresha umubiri, no gukuha ukuvuga ✓

Abarwayi bavurwa canke bafashwa hanyuma bugorovye bagataha ✓

Abanywa ibiyayura mutwe

Birasabwa ko umuganga aba yabikwandikiye.

Ibijanye n’umubiri

Iyo ubihawe n’umuganga wawe.

Kuvura ibirenge

Sivya kenshi kandi n’ukuvura ukuguru gusa. ✓

Kwandikirwa imiti

Bikenewe kuba wayandikiwe kandi hari uyisaba ubufasha

bw’intango.abanywanyi ba Medicare na Medicaid barasezerana na

Medicare igice D kwandikirwa imiti (PDP) kugira barihirwe kubonana

n’umuganga.

Ama bekiye

Kuvyandikirwa na muganga canke kuvyemererwa birasabwa mu kubironka.

Kuvurwa n’ibimashini ✓

Kwisuzumisha bisanzwe

Imiti ifasha mukureka itabi

Bisaba kuba wavyandikiwe.

Kubarwa ✓

Kwunguruzwa

Ja kuri: http://www.greenmountaincare.org/sites/gmc/files/documents/FY16-NEMT-Manual.pdf

canke uhamagare abitaho abakiriya

1-800-250-8427.

Gukoresha ama reyo x

✓

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Ubufasha bw’intango Benshi mu banywanyi ba Medicaid canke Dr. Dynasaur bategerezwa kugirana amasezerano na PC Plus kugira bagume baronka ubufasha. Iyo uronse ayo masezerano ya PC Plus , hamagara abitaho abakiriya canke urungike mail vuba bishoboka. Ivyo waronka muri Medicaid na Dr. Dynasaur n’amahera wariha ntibihinduka ushizeko umukono kuri PC Plus.

Ayo uriha ukorana na Medicaid Umunywanyi wa Medicaid ariha $3 igihe cose agiye kuraba umuganga w’amenyo.

Umunywanyi wa Medicaid ariha $1, $2 canke $3 mu gihe ashaka kwandikirwa imiti.

Umunywanyi wa Medicaid ariha $3 iyo agiye kubitaro .

Hari ubufasha muhabwa hanze y’ibitaro bigafatwa nkuko mwagiyeyo. Baza muganga wawe nimba ubwo bufasha bufatwa nkuko mwagiye ku bitaro.Arivyo, uzoriha ama $3.

Benshi mubagore bibungenze, abana, n’abandi bafashirizwa muhira ntibasabwa kuriha.

Udushirukabute Abanywanyi bamwe ba Dr. Dynasaur bashobora kuriha kukwezi kukwezi ubwishingizi bivanye n’amahera binjiza, uko umuryango ungana, n’amagara yabo. Iyo ukironka fagitire yambere ca uyiriha kugira utangure uronke ubufasha. Bandanya uriha kugira ntibihagarare.Utaye fagitire yawe, hamagara abitaho abakiriya kugira umenye ayo uheranye n’uko woyariha.

Umugambi w’ubufasha bw’intango (PC Plus) Uko bikora Medicaid na Dr. Dynasaur Abanywanyi ba Medicaid na Dr. Dynasaur badafise ubwishingizi bategerezwa kugirana amasezerano na PC Plus kugira bagume bafashwa. Iyo uronse ayo masezerano PC Plus , hamagara abitaho abakiriya canke ubarungikire ikete yayo masezerano.

Abanywanyi ba Medicaid na Dr. Dynasaur muri PC Plus bashobora gutora PCP aba ku minota 30 hafi yiwabo . Iyo nibura atabaganga 2 bari hafi yabo nko ku minota 30, ntibikwiye ko uja muri PC Plus. Ushobora no gutora umuganga w’amenyo k’ubana badashikana imyaka 18. Abaganga bacu bahemberwa gufasha abanywanyi bacu muri PC Plus. Ntibahemberwa kugabanya canke kwima ubufasha.

Guhindura umuganga wawe (PCP) Ushobora guhamagara abajejwe gufasha abakiriya kugira uhindure umuganga igihe cose. Uzomuhindurirwa kwitariki ya 1 nyuma y’ukwezi wabisabiyemwo.

Umuganga wawe iyo ari inararibonye Iyo amagara yawe, indwara, canke ubumuga bisaba umuganga w’inararibonye, ushobora kumuronka. Uwo muganga ategerezwa kuvyemera nawe ukemeza muri Vermont Health Access (DVHA) .

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Iyo ufise ikibazo mubijanye na PC Plus, guhindura umuganga PCP wawe, canke gukoresha inararibonye, hamagara abitaho abakiriya.

Ushobora kuraba abaganga bemera Green Mountain Care na Primary Care Plus ukaja kuri www.vtmedicaid.com ugafyonda Abaganga .

Gusesa amasezerano Gusesa amasezerano bisigura igihe umuntu avuye muri PC Plus. Iyo ukuwemwo ukaba ufise ibibazo hamagara abitaho abakiriya. Uzokurwamwo igihe kimwe muribi vyashitse:

Ufise ubundi bwishingizi;

UfiseMedicare;

Uja mu rugo rw’irerero canke aho batangira ubufasha murugo;

Ufise Medicaid canke Dr. Dynasaur ukimukira ahantu tudakorera nibura hari abaganga ba PC

Plus (kiretse wemeje ko ushaka kuguma muri PC Plus naho bimeze uko).

Mu kubandanya gukorana na PC Plus, igihe cose:

» wubaha, mujinama, ntukangane;

» muje inama n’umuganga y’ivyo mwemeje;

» ntusibe kw’isango baguhaye canke;

»uhamagare hakiri kare ubabwire iyo utaza.

Iyo ukuwe muri PC Plus, uzoca ushirwa muri Medicaid nimba bishoboka.

Ivyo wemerewe n’ivyo usabwa gukurikiza

Ufise uburenganzira bwo Kwubahwa no gusonerwa,

Gufatwa neza,

Kwitorera no guhindura umuganga,

Gutanga iciyumviro ku bijanye n’ubufasha n’abaganga uronka,

Kuronka amakuru yose, ku bijanye n’amagara yawe mu buryo butahurika,

Kumenyeshwa ivy’amagara yawe,n’ukwishurwa ku bibazo hamwe n’ukwanka ko

bakuvura,

Gusaba ikopi y’ukuntu amagara yawe yifashe no gusaba guhindurirwa iyo wibaza ko izo

nkuru zitari zo,

Iyo wibaza ko zitarizo ,baza uwundi muganga abifisemwo ubunararibonye akorana na

Vermont Medicaid,

Kwitwararira umugambi canke ubufasha uhabwa (kubindi bisobanuro raba urupapuro rwa 20),

http://www.vtmedicaid.com/

17




Ntiwitinye mu gihe ubonye bakwinuba, bakumerera nabi, mu kugutuka, kukuburira

isoni, kugukankamira, hanyuma

Usabe umubonano mu gihe bakwimye ubufasha uzi ko bukenewe. Raba ku rupapuro

rwa 20 ku yandi makuru.

Usabwa kubungabunga amagara yawe muku:

Kumenyesha umuganga wawe ibimenyetso vyawe n’ukuntu amagara yawe yagihe

ahindagurika ku gihe,

kubaza ibibazo hari ico ukeneye kumenya neza canke udatahura;

Gukurikiza gukora uko muganga mwavuganye;

Kudata isango canke kubimenyesha uhamagaye mu gihe utaza;

Kumenya amategeko y’uwu mugambi kugira ukoreshe neza ubufasha uhabwa;

Menya neza ko ufise urwandiko ruva ku muganga wawe imbere yuko uja ku bandi

baganga;

Kuriha kukwezi ku kwezi ubwishingizi hamwe n’amahera arengako kwa muganga iyo babigusavye;

Guhamagara uvuga ko usivye canke ukavuga umusi uzoza mu gihe usivye.

Ubushake bw’umurwayi hamwe n’uko bikorwa

Iyi ni incamake y’amategeko ya Vermont (usanga kumutwe wa 18, igice ca 231) n’ico

bisigura k’umurwayi :

"Uko bigenda"ni ivyanditswe bivuga uwo ushobora gutora agatora mu kibanza cawe,

uwoguha ubufasha bw’intango, n’uwotanga amakuru y’amagara yawe, n’uko bokuvura.

Bishobora kuba ivy’igihe kirekire canke mu gihe uri mubihe vya nyuma. Ubwo bushake n’ibikorwa ntamahera tubirihisha.

Uwukuze ashobora gutora umwe canke benshi bakaza barakuranya mu gufata izi ngingo.

Ushobora kutuganirira ububasha uwo muntu yoba afise, ubufasha ukeneye n’ubwo udakeneye, n’uko ushaka ingorane zawe zikemurwe, nko gushingurwa. Iki gikorwa kigufasha

no kuvuga uwushaka akugwaza mu gihe bikenewe, ukavuga n’abo udashaka ko bogufatira

ivyemezo.

Iyo ukumeze bitagushobokera gufata ingingo kumagara yawe, bikaba bitihutirwa cane,

abaganga ntibashobora kukuvura mu gihe bataramenya ko ufise uko wabitegekanije. Abo baganga bamaze kubimenya baca aba arivyo bakurikiza ingingo umwe wavuga afashe,

canke bagakwirikiza ivyo wari waripfuje.

Umuganga wacu ashobora kwanka kubikwirikiza mu gihe asanze ivyo wipfuje bijanye n’amacakubiri n’ibindi bitemewe. Ariko iyo uyo muganga avyanse , umuganga wawe ashobora kukuronderera uwundi muganga we ivyusaba ataco bimutwaye avyemera; gushika aho baronse uwundi muganga aguha ubufasha ;

18




Hanyuma baza kurabo bagufasha; kugira ukureho iyo ntambanyi, kugira bayitorere umuti, hama ihere. Umuganga wawe wese, uwugufasha mu vy’amagara, n’abagufashiriza aho uba bazoshiraho uburyo bwo kumenya neza ko abarwayi bose ibikorwa bikorerwa ahiherereye vyabo bikurikije amategeko y’igihugu.

Ushobora guhamagara igisata co gufasha no gukingira kuri 1-800-564-1612 canke ukaja ku murongo ukandika witwarira uwutakurikije amategeko. Ushobora kubitanga kuri :

Division of Licensing and Protection 103 South Main Street, Ladd Hall Waterbury, VT 05671

Ushobora kuronka inkuru kubijanye n’amategeko yareta kuri 802-828-2909, canke ukaja kuri website ya www.vtethicsnetwork.org.

Umutwe wa 18 woyironka kuri http://legislature.vermont.gov/statutes/chapter/18/231 . Ushobora kuja kwuzuza canke izindi nkuru ugiye kuri website yabo, ukavugana n’umuganga wawe, canke ugahamagara kubitaho abakiriya.

Gutanga ibihimba vy’umubiri Ushobora kwemera gutanga igihimba c’umubiri iyo umaze gupfa. Umuntu umwe atanze ashobora gufasha benshi. Ushaka kumenya vyinshi ,hamagara1-888-ASK-HRS ni inkuru uronka k’ubuntu.

Kuganira n’umuganga wawe aguha ubufasha bw’intango (PCP)

Mugufasha PCP wawe menya neza ko ubufasha wipfuza aribwo ufise, izina ryawe rishobora kuba ku rutonde rw’amazina twamuhaye. Intonde zimwe n’izi:

Abarwayi bafise diyabete ariko batigeze bipimisha amaso mu mwaka uheze,

Abagore barakoregwa ibizami vya kanseri ya nyabavyeyi canke badaherutse gucishwa mw’iradiyo,

Abana bataracandarwa,

Imiti y’abarwayi ibabuza kumererwa nabi bivanye n’imiti idacangwa, hamwe

N’abana basizwe mubizame basanzwe bakorerwa.

Kugira ibanga ibikogwa bikoregwa umurwayi

Mu gihe dusanze ukwije ibisabwa mu kwinjira mu mugambi wacu, uronswa ikete

rikumenyesha ko wemerewe kwinjira mu mugambi n’igipapuro c’ibanga ry’ibikogwa

vyacu. Itegeko rya reta, n’ibijanye n’ukugira ubwishingizi n’ibikorwa vy’amafaranga

(HIPAA), risaba ko tubamenyesha amategeko abagenga n’uburyo amakuru ajanye

n’amagara yanyu amenyeshwa akanakoreshwa. Mu gihe ushatse kuronswa ikindi gipapuro

c’uko bimeze, hamagara abafasha abakiriya hama usabe ikopi.

http://www.vtethicsnetwork.org/

http://legislature.vermont.gov/statutes/chapter/18/231

19




gukoreshwa . Iyo ukeneye iyindi kopi ushobora guhamagara abajejwe abakiriya ukayisaba. Iyi kopi ushobora no kuyisanga kuri www.humanservices.vermont.gov/privacy-documents.

Iyo usanze ubwo burenganzira bwawe bwahonyanzwe, duhamagare mu biro kuri AHS at 802-241-2234 canke uje kuri www.humanservices.vermont.gov/policy-legislation/hipaa/hipaa-info-beneficiaries/health-information-complaints/

Umugambi w’uguhabwa ubwishingizi bwiza

Green Mountain Care ifise umugambi wo gutanga ubwishingizi bwiza kugira bamenye neza ko uvurwa neza kandi ukaronka ubufasha bukwiriye. Bimwe muvyo turaba ni ibi:

Igitigiri c’imiti umurwayi akoresha,

Igitigiri c’abanywanyi bama bitwararikwa bagakurikranirwa hafi,

Igitigiri c’abanywanyi bakoresha icumba c’ubutazi bwihutirwa mu gihe bitari bikenewe

Uburyo abavuzi b’indwara zo ku mubiri canke zo mu mutwe bazikurikirana

Uuryo abarwayi n’abavuzi bagubwa neza n’ibikorwa vy’umugambi wacu.

Twashizeho ibigenderwahako mubijanye no kuvura indwara zikomeye tunashishikariza abaganga kubavura neza kugira turonke umwimbu mwiza. Iyo ushaka kutubwira ivyo twokosora umugambi wacu tugira tubashimishe, hamagara kubafasha abakiriya . Ivyiyumviro vyanyu bizodufasha kandi tuzobiha agaciro.

Ushobora kumenya amakuru y’agaciro kubufasha dutanga kubitaro, muhira, canke ikopi y’uko dukora akazi kacu mukuvura ugiye kuri website www.greenmountaincare.org/memberinformation/otherresources canke ugahamaga abitaho abakiriya.

Iyo utemeranije n’igikorwa kanaka

“Igikorwa kanaka” ni ibi bikurikira :

Iyo bakwankiye canke bakakugabaniriza ubufasha, ushizemwo ubwoko, haba ubunini

canke urugero ;

Kugabanya, guhagarika canke guheza kwivyaheruka kwemerwa nk’ubufasha

wohawe;

Kwankirwa, muri vyose canke bimwe, kuba wararishe ivyutari utegerezwa kuriha ;

Kutaronka ubuvuzi wagomba kurihirwa, n’umuganga wawe;

Kunanirwa gukorera mu mwanya nk’uko bisabwa n’amategeko ya reta;

Kwankirwa ivyo wasavye kubirihirwa n’umuganga. Adakorana na Medicaid (menya

neza ko umuganga adakorana na Medicaid adasubizwa amahera na Medicaid).

http://www.humanservices.vermont.gov/privacy-documents.

http://www.humanservices.vermont.gov/policy-legislation/hipaa/hipaa-info-beneficiaries/health-information-complaints/

http://www.humanservices.vermont.gov/policy-legislation/hipaa/hipaa-info-beneficiaries/health-information-complaints/

http://www.greenmountaincare.org/memberinformation/otherresources

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Iyo utemeranije n’igikorwa, ushobora gusaba kigasubirwamwo. Iyo igisata caVermont Health Access cafashe ingingo, ushobora kubaza ku bajejwe abakiriya uko wo kwitwara canke mwokwumvikanishwa (birasiguwe aha musi) muguhamagara 1-800-250-8427, canke ukandikira kuri iyi iri musi. Ushobora no kuronka inkuru z’ukwitwara canke kwumvikanishwa mukuja aha http://www.greenmountaincare.org/member information/appeals

Vermont Health Connect & Green Mountain Care Customer Support Center 101 Cherry Street, Suite 320 Burlington, VT 05401

Gusaba isubirwamwo ry’ingingo Isubiramwo ry’iyigwa y’ingigo zamaze gufatwa ariko zitashimwe bikora umuntu abifesemwo

ubumenyi kandi atari mu bari bafashe ingingo isubirwamwo. Umunywanyi afise ikiringo c’imisi

mirongo icenda (90) kuva umusi amenyeshejwe ingingo zafashwe co gusaba ikigo cazifashe

isubigwamwo ry’izo ngingo mu gihe hari agahaze. Uwugukurikirna ashobora no kuba ariwe asaba

isubiramwo ry’izo ngingo mu gihe hari ikitagushimishije.

Mu bisanzwe izo ngingo zisabwe gusubirwamwo bimara imisi 30 canke 45. Mu gihe hari ibikugoye

bigatuma usaba kwongerwa umwanya wo gutegura ivyo usaba n’impamvu ubisaba, wemerewe

kutarenza imisi 14 y’inyongerea kugira ubitunganye. Kubwo ivyo isubirwamwo ry’ingingo bigatwara

igihe kitarenze imisi 59.

Iyo ukeneye ivyo wankiwe vuba, ushobora gusaba kobizanwa imbere. Nimba vyemejwe ko

isubigwamo ryihutirwa, uzoronswa icemezo mu misi itatu y’akazi.

Iyo usiguriwe kw’ivyo wemererwa bihindutse ku mpamvu y’itegeko rya reta canke iguhugu,

nushobora gusaba isubirwamo, ahubwo usaba kumvirizwa neza.

Gusaba kwumvirizwa neza Mu gihe kandi udashimye ingingo zafashwe ubugira kabiri, woshobora gusaba igisata cafashe izo ngingo gusubira kw’umvirizwa neza. Ivyo navyo urekuriwe kubisaba mu misi itarenze 90 kuva ifatwa ry’izo ngingo z’ibanze canke mu misi 30 kuva umusi ingingo y’inyuma yo gusiramwo isohokeye. Muri uko kwumvirizwa wemerewe kwiserukira canke kurondera umunyamategeko aguserukira, incuti, umugenzi canke uwundi muntu wese ushatse ko aguserukira agashikiriza ivyiyumviro vyawe. Menya neza ko utemerewe gusabira rimwe isubiramwo ry’ingingo n’iyumvirizwa, wemerewe gukora kimwe wamara kubona udatunganirijwe ugasaba ikindi.

Mu gihe usabwe kwumvirizwa, isango ya mbere itegekanywa kuba mu misi iri hagati ya 7 na 30.

Itegeko ngendegwako rivugo ko ingingo ivamwo nyuma yo kwumvirizwa ifatwa mu misi itarenga

90 kuva umusi usabiye isubirwamwo canke kw’umvirizwa utaravye igitangura

Kubandanya uronswa ubufasha Mu gihe ubufasha bwa hagaritswe canke bwa gabanijwe bivuye ku kuntu wifashe maze ugasaba ko bosubiramwo kuvyiga canke ugasaba kwumvirizwa:

Mu gihe ushaka kubandanya ufashwa, utegerezwa gusubira kubaza mu misi itarenze

10 kuva usavye isubigwamwo canke iyumvirizwa.

Usabwe gusaba kubandanya ufashwa kugera hafashwe ingingo inyuma y’isubirwamwo canke y’iyumvirizwa.

http://www.greenmountaincare.org/member

21




Mu gihe wirihiye munyuma hagafatwa ingingo ishigikira ivyo wasabye, wemerewe gusubizwa

amafaranga warishe.

Mu gihe naho babandanije bakurihira maze hagafatwa ingingo ikwankira ivyo wasavye,

utegerezwa kuriha amafaranga yose bakurihiye muri ico gihe cose wari ukirindiriye ingingo

ivamwo.

Ushobora gusabira rimwe kubandanya ufashwa n’isubirwamwo canke iyumvirizwa uciye

mu guhamagara kuri ya numero y’itaho abanywanyi ikabafasha mu vyo bakeneye vyose.

Ubufasha musaba ntibushobora kubandanya mu gihe musaba isubirwamwo canke

iyumvirizwa ari ubufasha bwa hagaritswe canke bwa gabanuwe bivuye ku ngingo yahindutse

yo mu itegeko rya reta canke ry’igihugu.

Mu gihe hari agahaze Kugira agahaze ni igihe utanezerejwe n’ibintu birenze ibikorwa, nk’aho uherereye canke bikugora kuraba umuganga, agaciro k’ubufasha uronka, canke ugahorwa ko wagwaniye agateka kawe. Iyo bidakunze ko mwumvikana n’umuganga wawe mu misi 60 y’ingorane, ushobora kwuzuza ukitwara mu guhamagara abajejwe abakiriya baraba ivy’uguhabwa ubufasha bwiza. Ico gisata kizokurungikira ikete ry’uko vyokorwa mu misi 90.

Iyo wujuje kwitwara bakabona ntibabishimye uko vyanditse, ushobora gusaba bakabisubiramwo.

Umuntu ari hagati azokurabira ko wavyujuje neza mu mategeko. Uzoca uronka ikete

ry’icavuyemwo.

Yaba wewe canke umuganga ntanumwe azokwinubwa canke ngo yirukanwe mu gihe yitwariye

Green Mountain Care. Iyo ukeneye ubufasha bw’ukuntu wo kwitwara canke wotanga ikirego,

abakozi ba Green Mountain Care boca bagufasha.

– Ubabaze gusa. Ushobora gusaba umuntu wo mu muryango, canke umugenzi, canke uwundi

muntu (nk’umuganga wawe) akagufasha gusaba ikirego canke kumvikanishwa, canke kwitwara.

Uzotegerezwa kubwira reta ko ukeneye ko uwo muntu aguhagararira. Uwo muntu mushobora

kuba muri kumwe no mu gihe co kubitegura. Iyo utazi ico wokora muri ibi vyose, canke gufashwa

muri izi ntambwe , hamagara bafasha abakiriya kuri 1-800-250-8427 kugira bagufashe. Canke

ugahamagara ku biro bijejwe amagara vya Ombudsman kuri 1-800-917-7787 kugira bagufashe.

Ufise ico wobaza? Ikigo c’amagara meza ci Vermont kijejwe kwakira ibibazo

Iki kigo kihari mu ntumbero yo kubafasha igihe mugize ico mubaza. Bashobora ku bafasha mu

gihe mutasobanukiwe neza mufise ibibazo vyerekeye umugambi mwahisemwo kugira mugire

umuco canke mu kubafasha iyo mwagize ibibazo vyerekeye kuronsa ubwitwarariko bw’amagara

yanyu.

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Ibibazo vyose vyakirwa kuva ku wa mbere gushika ku wa gatanu mu masaha ari hagati ya sa 2 z’igitondo na sa 2 z’ijoro kuri1-800-250-8427 canke TDD 1-888-834-7898.

Tumenyeshe impinduka kuri ibi mu misi itarenze icumi:

ihinduka ku gahembo canke ku mafaranga y’uburaro

ihinduka ry’aho uba

ivuka canke wakiriye umwana urera,

urupfu canke

Ironswa ry’ubundi bw’ishingizi bw’amagara

Ibiro vy’umuhuza mu gisata c’amagara meza

Hashizweho n’ibiro vy’umuhuza mu ntumbero yo kubafasha mu gihe mugize ibibazo

kuvyerekeye ukwitwarikwa amagara yanyu canke ibindi mukenera. Ibiro vy’umuhuza bishobora

no kubunganira mu maganya mwisubirwamwo ry’ingingo mu gihe umunywanyi atazishimye

agasaba kwumvirizwa bikwiriye. Ushobora guhamagara kuri 1-800-917-7787

Amakuru arengako

Tunezerejwe no kuronsa amakuru akwiye kandi akenewe abanywanyi bacu ku vyerekeye

imigambi yacu, ibikogwa n’ubufasha dutanga n’abadufasha gutanga ubwo

bufasha.Vyongeyeho kuvyo usanga muri kano gatabo, ushobora no kumenya ayandi makuru

nkaya akurikira:

urutonde ry’abashikiriza bikorwa mu kibano cawe bakora mu migambi yacu,

amategeko ngendegwako y’umugambi n’amategeko y’akazi

integuro y’uburyo bwo kurushirizaho gukora neza

amakuru arakwiye yerekeye ubufasha umunywanyi ashobora kuronswa mu mugambi wacu,

Ushobora gusanga ivyemezo vy’ibikorwa vyacu n’akamaro kavyo kuri

www.greenmountaincare.org.

Ibindi bisata

Hari n’iyindi migambi ifasha abana, abakuze n’imiryango. Gushika muri iyo migambi bivana n’iyo

wahisemwo. Ushatse kumenya ingene wo kwinjiramwo, hamagara ya numero yakira abafise ico

babaza bose. Imwe imwe muri iyo migambi ifise ivyo ifatirako mu kwemera umunywanyi. Mu gihe

mugize ibibazo hamagara kuri iyo mirongo y’umugambi mushaka.

Ibikorwa vyo gufasha abageze mu za bukuru Ibikorwa vyo gufasha abasaza n’abantu bakuze bafise ubumuga mu kubafasha mu dukorwa tumwe tumwe twa

nkenerwa batarinze barava mu ngo zabo bikorwa mu kibano, mu bigo vyabatagira aho bababigatuma haba

umwumvikano n’ugufashanya mu bantu.

Mu gihe woshaka kubaza ivyo utatomokewe, dukurikiranire ku rubuga rw’ikigo kijejwe gufasha abageze mu za

http://www.greenmountaincare.org/

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bukuru (DDAS) uduhamagare kuri 802-871-3217 canke ujye kuri www.ddsa.vermont.gov

Umugambi wa serivisi zindi ziyongerako Uyu mugambi ufasha abantu bakuze bibana kandi bafise ubumuga bakeneye ubufasha bugaragara

mu bikorwa vyabo vya buri musi. Abari muri uyu mugambi barondera, bagahugura, bagakurikirana,

kandi kandi bagategura neza abitabira izindi serivisi ziyongerako. Mu gihe woshaka kubaza ivyo

utatomokewe, dukurikiranire ku rubuga rw’ikigo kijejwe gufasha abageze mu za bukuru (DDAS) uduhamagare kuri

802-871-3217 canke ujye kuri www.ddsa.vermont.gov

Ibikorwa vyo gukurikiranira abana bakiri bato (CIS) Iki gisata gifasha abagore bibungenze n’imiryango ifise abana bari musi y’imyaka 6. Bishingiye cane ku bikorwa

vy’imibereho myiza n’ugufashanya mu muryango mu kurera abana, kuraba ko bariko bakura uko bitegerezwa

bakitaho n’indwara zo kwaduka mbere nizo mu mutwe ku bana canke mu miryango bavamwo n’ibindi vyinshi

nk’ukungene wo bagaburira. Mu gihe woshaka kubaza ivyo utatomokewe, dukurikiranire ku rubuga rw’ikigo

kijejwe gufasha abana n’imiryango bakomokamwo (DDAS) www.ddsa.vermont.gov canke uduhamagare kuri 1-

800-649-2642.

Ibikorwa vyo gukurikiranira hafi abana bafise ubumuga bidatevye (CIS-

EI)

Iki ni igisata cihariye gukurikirana abana bari musi y’imyaka 3 bafise ubumuga canke bafise

iceregwa mu gukura mu mutwe. Gifasha abana n’imiryango kugarurira hafi hakiri kare izo

ndwara. Hari ico ubaza, hamagara ikigo kibijejwe Vermont Family Network kuri 1-800-800-

4005.

Ibikorwa vyo kwitwararika ukugubwa neza kw’abana bafise ubumuga

Iki gisata gifasha abana buri umwe wese mu bana bafise ivyo bakeneye kugira bagire amagara meza. Abana bafashwa ni abafise imyaka iri musi ya 21 bafise ubumuga bukomeye canke bafise ubumuga buzomara igihe kinini bigatuma bigira ingaruka ku bikorwa vyabo vya misi yose. Iki gisata rero kikabaronsa ubufasha burenzeho ku bwo baronswa. Mugize ico mubaza, hamagara uwubijejwe kuri 802-865-1395 canke uwabinonosoye 802-951-5169 canke ukadukurikiranira kuri http://healthvermont.gov/family/childrenspersonalcareservices.aspx.

Abana bafise vyinshi vyihariye bakeneye mu gukurikiranwa (CSHN)

Iki gisata gifasha mu kubaronsa ibitaro imiti n’ibindi abana bafise ivyo bakeneye kuronswa mu

kubungabunga amagara yabo. Kirongera kigafasha kuriha ivyo vya nkenegwa mu gihe

bitabokeka ku bwishingizi baba basanganywe canke kwa Dr. Dynasaur. Hamagara ku isata

c’amagara meza c’I Vermont kuri 1-800-464-4343 canke urabe www.healthvermont.gov.

Ihitamwo ry’ukwitabwaho Iki gisata kijejwe gukurikirana igihe kirekire kikarihira kwitwararikwa rw’abageze mu za bukuru

n’abafise ubumuga. Gifasha abantu bafise imirimo ya misi yose barangurira muhira mu

kubakurikirana no kwitaho amagara yabo. Abajejwe kubafasha bava mu bigo vyo kwitaho

abasaza n’abagwayi mu ngo zabo. Hagize ico ushaka gusobanuza hamagara kuri 1-800-642-5119

canke uje kuri http://dcf.vermont.gov/esd/health_insurance/ltc_medicaid.

http://www.ddsa.vermont.gov/



http://healthvermont.gov/family/childrenspersonalcareservices.aspx

http://www.healthvermont.gov./

http://dcf.vermont.gov/esd/health_insurance/ltc_medicaid

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Ibikorwa vyo gufasha abafise ibibazo vy’iterambere ryo mu mutwe Iki kigo gifasha abafise ubumuga bujanye no mu mutwe b’imyaka yose kubandanya baba mu ngo zabo n’imiryango

yabo. Mu bikorwa vyabo harimwo kubitaho, kubakundisha mu kibano bakanafashwa n’ibindi vyose bituma

baryoherwa mu buzima bwabo. Ababakurikirana bategezwa kuba baranonosoye ivy’iterambere ryo mu mutwe. Mu

gihe woshaka kubaza ivyo utatomokewe, dukurikiranire ku rubuga rw’ikigo kijejwe gufasha abageze mu za bukuru

(DDAS)www.ddsa.vermont.gov canke uduhamagare kuri) 802-871-3064

Umugambi wo gufasha mu buryo bw’amafaranga

Ni ikigo c’abafasha ku buntu gifasha imiryango mu kuriha ibikenewe ku magara meza y’abana babo birenze ku vyo ubwishingizi bafise bubaronsa mu gihe vyasabwe n’umuganga avyemerewe aciye mu mugambi w’ubuvuzi CSHN. Hamagara ku gisata c’amagara meza c’I Vermont kuri 1-800-464-4343 canke urabe www.healthvermont.gov.

Gufashirizwa mu miryango

Iki gisata gifasha abantu b’imyaka yose bafise ubumuga bufatiye ku kwiyungura mu mutwe baba mu miryango yabo canke imiryango ifise umurwayi afise ivyo bibazo. Umugambi ubaronsa ibintu nkenerwa bituma umurwayi naba babana biyumvanamwo bakabaho neza.Izo mfashanyo zisaba kuba ibanga ku wazironkejwe ari umurwayi canke umuryango wiwe. Abatanga ubwo bufasha ni abahinga ba binonosoye mu vyerekeye izo ndwara. Mu gihe woshaka kubaza ivyo utatomokewe, dukurikiranire ku rubuga rw’ikigo kijejwe gufasha abageze mu za bukuru (DDAS)www.ddsa.vermont.gov canke uduhamagare kuri) 802-786-5081

Gukirikiranirwa muhira hakoreshejwe ubuhinga bwa none bukomeye Iki ni igisata kijejwe gukurikiranira muhira bishimitse abarwayi barenza imyaka 20 bakeneye ubuhinga bw’ivyuma ngo bashobore kubandanya babaho. Intumbero yaco ni kubamenyereza ihinduka bavuye ku bitaro bagiye mu ngo zabo canke mu bindi bigo. Abakora ivyo bikorwa ni abakora mu bigo vy’amagara meza n’ubudandaji bw’ibikiresho vy’ubuvuzi. Ufise ico usobanuza, hamagara ku kigo citaho abasaza kuri 802-871-3044 canke uje kuri www.ddas.vermont.gov.

Ibikorwa vy’abakozi bo mu nzu

Umugambi w’abakozi bo mu nzu bo muri Vermont ufasha abantu bafise imyaka n’iyirenga bafise ubumuga bakeneye umuntu abafasha mu bikorwa vyo mu nzu kugire babe muhira iwabo. Muri ivyo bikorwa bakorerwa harimwo gusuma, gukora isuku no kumesa. Ivyo bikorwa bifasha abo bantu kuba iwabo mu mw’idegemvyo ahantu hatekanye kandi hasukuye ataco babura. Abakoresha ivyo bikorwa n’imigwi ishinzwe gukurikirana neza amagara yo mu ngo. Uwushaka kubimenyako vyinshi yohamagara agace gafasha abafise ubumuga canke ubasaza (DDAS)/abajejwe gufasha umuntu umwe umwe ku giti ciwe kuri 802-871-3069 canke aje kuri www.ddas.vermont.gov.

Ibitaro bidasanzwe

Ni ibitaro vy’abana bikora vyinshi, bikoramwo n’aba foroma n’abaganga babagizi b’ineza, bigaca bituma haba umwumvikano nko mu muryango, n’umwitwarariko ushimishije. Ivyo bitaro bihinyanyura cane cane ibijanye n’indwara z’umutima, iterambere ry’abana n’izindi ndwara zifatira mu mitsi mu magufa no mu mutwe nka cleft lip,palate,cystic fibrosis, intandara, hand, Rheumatoid Arthritis; Muscular Dystrophy; Orthopedic n’ibindi bitari bike.Mu gihe hari ivyo udatomokewe, hamagara igisata c’amagara ca Vermont kuri 1-800-464-4343 canke ja kuri www.healthvermont.gov.


http://www.healthvermont.gov./


http://www.ddas.vermont.gov/



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Serivisi zidasanzwe Abaforoma n’abaganga bo muri CSHN, baba mu karere k’igisata gishinzwe amagara, barafasha mu kuronsa ubuvuzi bukomeye butobonetse ubwo nyene muri CSHN. Hamagara igisata kijejwe amagara kuri 1-800-464-4343 canke uje ku rubuga rwacu www.healthvermont.gov.

Umugambi wo gukurikiranira abana mu ngo zabo hakoreshejwe ubuhinga bwa none buhanitse Umugambi wo gukurikiranira abana barwaye mu ngo zabo hakoreshejwe ubuhinga bwa none buhanitse ni umugambi

utuganya iboneka ry’ubuvuzi nkenerwa n’ibikoresho vyo kwa muganga bikomeye zikanafasha abadashoboye

kwifashisha ubwo buhinga bwa none bivuye ku magara make yabo mu kabaronsa abaforoma bakuranwa kubagwariza

mu ngo zabo. Uyo mugambi utunganijwe n’ibiro bijejwe abana bakitswe n’amagara yabo ku giti cabo bafise imyaka

iri musi ya 21. Uwufise ibindi bibazo yohamagara umuganga ajejwe umugambi w’ubuvuzi bw’abana mu nzu zabo

kuri 802-865-1327 canke akaja kuri http://healthvermont.gov/family/cshn/pedihitech.aspx.

Umugambi wo kubona no gukemura ibibazo vyo kutumva mu gihe bibonywe hakiri kare I Vermont Abahinga mu vyo kutumva baratunganyije ivyigwa n’ibindi bijanye no gutora ubumuga bwo kutumva mu bana

ahantu hagera kuri 12 hagati mu gihugu. Uwushaka kumenya ibindi ku bijanye n’uwo mugambi yohamagara kuri 1-

800-537-0076 canke akaja kuri www.healthvermont.gov/family/hearing/index.aspx.

Amagara yo mu mutwe Reta ya Vermont yumvikanye hamwe n’amashirahamwe amwe amwe yo muri iyo reta kugira

batunganye ahantu hagenewe kwakira abantu barwaye indwara zo mu mutwe kugire batunganye

ibikorwa vyo gufasha abantu canke imiryango ihuye n’ibibazo bibuza amahoro mu mutwe canke

abafise ibibazo vyo mu mutwe bihungabanya amahoro mu buzima bwabo. Ibikorwa ayo

mashirahamwe akora si bimwe mu biro vyayo vyose mugabo ivyo bagenderako bikuru ubisanga

hose. Ibiro bimwe bimwe vyose bifise abajejwe gukorana n’abandi kugire batore imigambi

n’ibikorwa bihuye n’ivy’abantu baba bakeneye. Hariyongerako ibiro bimwe bimwe bibonekesha

kuri reta nyinshi ibikorwa bijanye no gufasha abarwayi haba muhira iwabo canke mu kubashikana

mu bitaro igihe cose bibaye ngombwa. Uwoshaka guhamagara igisata kijejwe ubumuga bwo mu

mutwe yohamagara kuri 1-888-212-4677 canke kuri 802-828-3824 canke akaja kuri

www.mentalhealth.vermont.gov.

Ibikorwa vyo kwitabwaho vy’abakuze Uyu mugambi ukora ibintu bitandukanye bijanye n’ibiro umuntu atumbereyeko, kenshi haba hari urutonde rw’abarindiriye. Muri ivyo bikorwa haba harimwo ugukurikira uko umugwayi yifashe, uguhanura, ukuvura no gukurikirana uko bishobotse ibikorwa ku bantu barenza imyaka 60 bafise ubumuga bwo mu mutwe. Ibikorwa bimwe bimwe birakorwa n’abantu bikorera kugiti cabo, nibo abarwayi bamwe bamwe barungikwako.

Ibikorerwa abana, imiyabaga, n’imiryango Uyu mugambi utanga ubufasha mu vyo kuvura ikanafasha imiryango itunze abana n’imiyabaga bafise ubumuga bwo mu mutwe mu vyo kubaho kwiga no gukura bafise amagara meza mu mashure yabo no mu mubano. Muri ivyo bikorwa harimwo kwigisha, gukingira, gushigikira, kuvura, guhanura, no kwishura ibibazo bijanye n’ingorane bagenda bahura nazo.

Kuvura no kugarukana mu buzima busanzwe umurwi w’abantu Uyu mugambi utanga mu mirwi y’abantu imfashanyo zijanye n’indwara zo mu mutwe mu ntumbero yo gufasha abarwayi kubaho bindegemvya uko bishobotse mu muryango, mu mubano no mu bagenzi.

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http://healthvermont.gov/family/cshn/pedihitech.aspx

http://www.healthvermont.gov/family/hearing/index.aspx

http://www.mentalhealth.vermont.gov/

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Ivyo bikorwa vyo kugarukana abantu mu buzima busanzwe bikorerwa abantu bakuze bamaranye igihe indwara zo mu mutwe bakaba barazibapimye banamaze igihe bavurwa bahafise n’icegeranyo c’uko bagiye bakurikiranwa muri uwo mugambi.

Ibikorwa ntarindirizwa Iki gisata kibangukira gutabara abahuye n’ibibazo vyo mu mutwe amasaha 24 kuri 24 ku musi, imisi 7 kuri 7 ku bantu, amashirahamwe n’imirwi y’abantu. Ibikorwa vyo kubangukira gutabara biba birimwo gufashwa uwahamagaye mu kuyaga, mukayaga imbona nkubone canke bigufashe mu gihe imbagukiragutabara yari hafi.

Umugambi ujanye n’indwara z’iyononekara ry’ubwonko Uyu mugambi ufasha ababa I Vermont bafise imyaka 16 canke irenga barwaye indwara zifatira ku bwonko. Urakura abarwayi mu bitaro bagasubira mu kibano ikabamenyereza kubana n’abandi. Unamenyereza abantu gusubira kubana n’abandi unabafasha kugarura umwidegemvyo wabo buke buke bakabona gusubira ku miriyo yabo ya misi yose. Uwokenera kumenya ibirenze kuri ibi yohamagara igisata kibijejejwe (Division and aging services (DDAS)/ Ni umurwi wagenewe gufasha abantu murivyo kuri 802-871-3069 canke akaja kuri www.ddas.vermont.gov.

Umugambi witaho abagore, inzoya n’abana (WIC)

WIC ni umugambi ufasha abagore n’abana bato kurya neza no kugumana amagara meza mu

kubaha amakuru n’ibifungurwa vya nkenerwa mu mubiri w’umuntu. Ushobora kuja muri bimwe

mu biro 62 biri hagati mu gihugu ukaraba nimba ukwije ibisabwa kugira ngo uje mu gitigiri

c’abafashwa n’uwo mugambi. Uwutowe aronswa ikinyamakuru, ivirwa vyo guteka, agapapuro

kaguha aho kurimira n’imfungugwa. Uwufise ivyo abibazako yohamagara abo mubiro vy’igisata

c’amagara ca Vermont kuri 1-800-649-4357 canke akaja kuri www.healthvermont.gov

Amakuru arengako ku bijanye n’ibihari mu mubano wanyu mwobisanga kuri www.vermont211.org



http://www.vermont211.org/

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Icitonderwa! Nimba ukeneye ubufasha mu rurimi rw’iwanyu, hamagara 1-800-250-8427

Attention ! Si vous avez besoin d’assistance dans votre langue, appelez le : 1-800-250-8427

¡Atención! Si necesita ayuda en su idioma, por favor llame al 1-800-250-8427

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Muhimu! Kama wahitaji usaidizi kwa lugha yako, tafadhali piga simu 1-800-250-8427

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