Foomamka

Hoos waxaa ku taxan dhammaan foomamka loo baahan yahay si aad isu diiwaan geliso ama aad u cusboonaysiiso dheefahaaga Carewell. Foomamka waxaa lagu habeeyaa dheef ama qayb ahaan.

Dooro dheef ama qayb si aad u aragto foomamka

Ilkaha
Aragga + Maqalka
Barnaamijka Caawimaadda Shaqaalaha
Kaalmada Kharashka Daryeelka Caafimaadka

Wixii ah Qorshooyinka Loo ansixiyay
Medicare

Wakhtiga Fasaxa Lacagta leh

Muhiim – Xogtaada mar kasta ha ahaato mida saxda ah

Si aad xaq ugu yeelato dheefaha Carewell, Carewell SEIU 503 waa inay fayl ku hayso magacaaga, jinsigaaga, Lambarkaaga Soshiyaal Sekuyuritiga, taariikhdaada dhalashada iyo ciwaankaaga guri ee haddadan. Waa inaad sidoo kale xaqiijiso in macluumaadkaaga gobalka uu hayo uu yahay kii ugu danbeeyay. Ogoow: Soo gudbinta macluumaadkan wuxuu awood u siin doonaa Carewell SEIU 503 inay kaa diiwaangeliso dheefaha Ilkaha, Aragga + Maqalka, iyo Barnaamijka Caawimaadda Shaqaalaha ee Carewell SEIU 503 haddii aad xaq u ledahay.

 

  1. Soo gudbi foomka kore si aad macluumaadkaaga ugu cusboonaysiiso Carewell SEIU 503.
  2. Raac tilmaamaha hoose si aad u cusbooneysiiso macluumaadkaaga shakhsiyeed ee Gobolka iyadoo ku xiran nooca shaqaale ee aad tahay.

Shaqaalaha Daryeelka Guriga (HCW)

Cusbooneysii cinwaankaaga xafiiska goobta APD/AAA ee deegaanka. Iskuduwaha/karraaniga HCW ee deegaanka ayaa ah qofka ku haboon in lala xidhiidho.

    Shaqaalaha Taageerada Shaqsiyeed ee ODDS

    Buuxi Foomkan Beddelida Macluumaadka (PDF) si aad u hubiso in DHS ay ku hayso macluumaadkaaga hadda jira faylka.

      Shaqaalaha Taageerada Shaqsiyeed ee OHA

      Buuxi Foomkan Cusboonaysiinta Macluumaadka Bixiyaha (PDF) si aad u hubiyo in OHA ay ku hayso macluumaadkaaga hadda jira faylka. Ku buuxi dhammaan qaybaha foomka marka laga reebo kuwan:

      • “Complete this section for an organization, group or agency (U buuxi qaybtan urur, koox ama wakaalad)”
      • “Taxonomy code changes (Koodhka Taxonomy wuu isbedelaa)”

      Foomamkeena onleenka ah waxaa inta badan lagu helaa Isbaanish, Ruush, Fiyatnaamiis, Simplified Chinese, Carabi, Kuuriyaan, iyo Soomaali. Si aad foomka ugu buuxisid luuqadda aad doorbideyso, guji calanka Maraykanka ee jira dhinaca midifg ee kore ee foomka, ka dibna dooro luuqadda aad doorbideyso.

      Ilkaha

      Foomka Ka dhaafitaanka Dheefaha

      Isticmaal foomkan si aad u xaqiijiso in lagu siiyay caymiska Ilkaha, Aragga iyo Maqalka, iyo Barnaamijka Caawimaadda Shaqaalaha (EAP) ee Carewell SEIU 503 oo aad diidan tahay caymiskan.

      Foomka Onleenka ah

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Isticmaal foomkan ama haddii kale buuxi goobta sharaxaysa sababta aad u codsanayso racfaan ama soo geli warqad sharraxaad ah. Racfaanada magdhawga waa inay weheliyaan dukumiintiyada taageeraya sida Dukumiintiga Sharaxaadaha Dheefaha (EOB) ama caddaynta lacag bixinta.

      Foomka Onleenka ah

      Aragga + Maqalka

      Foomka Sheegashada Lacag Celinta Aragga Ameritas (kaliya LASIK)

      Foom PDF ah

      Foomka Sheegashada Lacag Celinta Maqalka ee Ameritas

      Foom PDF ah

      Foomka Ka dhaafitaanka Dheefaha

      Isticmaal foomkan si aad u xaqiijiso in lagu siiyay caymiska Ilkaha, Aragga iyo Maqalka, iyo Barnaamijka Caawimaadda Shaqaalaha (EAP) ee Carewell SEIU 503 oo aad diidan tahay caymiskan.

      Foomka Onleenka ah

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Isticmaal foomkan ama haddii kale buuxi goobta sharaxaysa sababta aad u codsanayso racfaan ama soo geli warqad sharraxaad ah. Racfaanada magdhawga waa inay weheliyaan dukumiintiyada taageeraya sida Dukumiintiga Sharaxaadaha Dheefaha (EOB) ama caddaynta lacag bixinta.

      Foomka Onleenka ah

      Foomka Lacag-celinta Xubinta VSP

      Sheegashada magdhawyada waxaa onleen ahaan looga aqbalaa bogga VSP ee barta vsp.com. Waxaad u baahan doontaa inaad akoon ka samaysato marka hore. Wixii su’aalo ah, fadlan kala xiriir VSP lambarka 1-800-877-7195.

      Barnaamijka Caawimaadda Shaqaalaha

      Foomka Ka dhaafitaanka Dheefaha

      Isticmaal foomkan si aad u xaqiijiso in lagu siiyay caymiska Ilkaha, Aragga iyo Maqalka, iyo Barnaamijka Caawimaadda Shaqaalaha (EAP) ee Carewell SEIU 503 oo aad diidan tahay caymiskan.

      Foomka Onleenka ah

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Isticmaal foomkan ama haddii kale buuxi goobta sharaxaysa sababta aad u codsanayso racfaan ama soo geli warqad sharraxaad ah. Racfaanada magdhawga waa inay weheliyaan dukumiintiyada taageeraya sida Dukumiintiga Sharaxaadaha Dheefaha (EOB) ama caddaynta lacag bixinta.

      Foomka Onleenka ah

      Kaalmada Kharashka Daryeelka Caafimaadka

      Wixii ah Qorshayaasha La ansixiyay

      2024 Warqadaha Sannadlaha ah

      Buuxinta warqadaha sanadlaha ah waxay xaqiijinaysaa inaad fahamtay oo aad oggoshahay sharciyada barnaamijka sida ay dhigayaan shuruucda Hay’adda. Foomamkani waxay sidoo kale kooxda Dheefaha Carewell SEIU 503 ogolaansho u siinayaan inay kaa caawiyaan diiwaangelinta iyo ilaalinta caymiskaaga daryeelka caafimaadka. Warqadani ma ahan codsiga caymis caafimaad.

      Foomka Onleenka ah

      Oggolaanshaha HIPAA

      Ogaysiiskan wuxuu kuu sheegayaa sida Carewell SEIU 503 ay u isticmaali karto oo u wadaagi karti macluumaadkaaga caafimaadka. Waxaa sidoo kale ku jira macluumaad ku saabsan xuquuqahaaga asturnaanta caafimaadka.

      Foomka Onleenka ah

      Bayaanka Is Af-Garashada

      Ogaysiiskan waxaa loogu talagalay in daryeel bixiyeyaasha ay ku qiraan mas’uuliyadahooda ku aadan helitaanka dheefaha Carewell SEIU 503.

      Foomka Onleenka ah

      Oggolaanshaha Siideynta Foomka Macluumaadka

      Buuxi tan haddii aad u baahan tahay inaad u ogolaato xubin qoyskaaga ka tirsan ama saaxiib aad aaminsan tahay inuu su’aalo kuu weeydiiyo, balamo qabto ama xaqiijiyo macluumaad adiga oo ku matalayo.

      Foomka Onleenka ah

      Foomka Wakiilka Diiwaanka ee Valley Insurance Professionals

      Buuxi foomkan si aad ugu magacaawdo VIP inay noqoto wakiilkaaga diiwaanka oo ay kuu matasho oo ay kaaga caawiso inaad marayso qaynuunkaaga caymiska.

      Foomka Onleenka ah

      Warqadaha Sannadlaha ah ee 2024 ee Aan VIP-ahayn

      Isticmaal foomkaan marka Wakiilka Diiwaankaaga aysan AHAYN Valley Insurance Professionals (VIP).

      Foomka Onleenka ah

      Foomka Codsashada Dheefaha Kaalmada Kharashka Daryeelka Caafimaadka

      Buuxi foomkan si aad u codsato dheefaha Kaalmada Kharashka Daryeelka Caafimaadka. Waa inaad soo raaciso Ogaysiiskaaga Xaq U Yeelashada Goob-suuqeedka iyo nuqulka biilkaaga khidmada caymiska ee bil’laha ah ama bogga Qorshayaashayda Caymiska iyo Barnaamijyadeyda ee akoonkaaga healthcare.gov si aad xaq ugu yeelato dheefta. Haddii aad iska diiwaangelisay qorshaha ceymis ee la oggolyahay ee laga helo Valley Insurance Professionals, uma baahnid inaad soo gudbiso foomkan.

      Foomka Onleenka ah

      Foomka Lacag Wareejinta Elektrooniga ah

      Isku diiwaangeli si aad ugu hesho magdhawyada khidmadaada caymsika ee bil’laha ah lacag wareejinta elektrooniga ah. Kani waa habka ugu degdegga badan uguna ammaan badan ee aad ku heli karto lacagtaada. Waa inaa soo raaciso nuqulka jeeg maran ee erayga ‘void’ ku qoran tahay, warqada bangiga, ama bayaanada bangiga.

      Foomka Onleenka ah

      Foomka Sheegashada Magdhawga Khidmada Caymiska Bil’laha ah ee Caafimaadka

      U isticmaal foomkan magdhawga khidmadaha caymiska ee bil’laha ah haddii ay xubnaha qoyska kaala diiwaangashan yihiin qorshaha caymiskaaga iyo/ama haddii aad xaq u leedahay inaad hesho magdhawga khidmadaha ceymiska ee bil’laha ah ee celceliska ah (APR) ee ku meelgaarka ah ee loogu talagalay qorshaha aan la ansixinin. Waa in lala soo gudbiyo caddaynta dabarida caymiska gaarka ah.

      Foomka Onleenka ah

      Foomka Codsashada Magdhawga Ameriflex

      Isticmaal foomkan si aad u sheegato magdhawga marka aad jaabkaaga ka bixiso kharash xaq leh baddelki aad isticmaali lahayd Kaarka Dukaameysiga ee Dheefta (BBC). Waxaad sidoo kal isticmaali kartaa foomkan haddii aad u baahan tahay inaad sheegato magdhawga khidmada caymiska bil’laha ah ee saafiga ah ee ceymiska gaarka ah ee la aqoonsan yahay ee laga soo gato Goob-Suuqeedka Caymiska. Fadlan raac tilmaamaha la socda foomka onleenka ah.

      Foomka Onleenka ah

      Foomka Sixitaanka ee Canshuur Dhimista Khidmada Caymiska ee Hormariska ah

      Isticmaal foomkan haddii dakhligaaga uu ka duwan yahay midka aad ugu soo gudbisay IRS codsigaaga Goob-suuqeedka caymiska. Foomkan waxaa loo adeegsan doonaa inuu naga caawiyo inaan go’aamino haddii aan kaa caawin karno inaad bixiso lacagta aadan wali bixinin ama haddii aad heshay lacag bixinta siyaadada ah canshuur dhimista. Waa inaad la soo gudbiso dukumentiyada canshuurta ee taageeraya.

      Foomka Onleenka ah

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Isticmaal foomkan ama haddii kale buuxi goobta sharaxaysa sababta aad u codsanayso racfaan ama soo geli warqad sharraxaad ah. Racfaanada magdhawga waa inay weheliyaan dukumiintiyada taageeraya sida Dukumiintiga Sharaxaadaha Dheefaha (EOB) ama caddaynta lacag bixinta.

      Foomka Onleenka ah

      Kaalmada Kharashka Daryeelka Caafimaadka

      Wixii ah Medicare

      Foomka Codsashada Magdhawga Ameriflex

      Isticmaal foomkan si aad u sheegato magdhawga marka aad jaabkaaga ka bixiso kharash xaq leh baddelki aad isticmaali lahayd Kaarka Dukaameysiga ee Dheefta (BBC). Waxaad sidoo kal isticmaali kartaa foomkan haddii aad u baahan tahay inaad sheegato magdhawga khidmada caymiska bil’laha ah ee saafiga ah ee ceymiska gaarka ah ee la aqoonsan yahay ee laga soo gato Goob-Suuqeedka Caymiska. Fadlan raac tilmaamaha la socda foomka onleenka ah.

      Foomka Onleenka ah

      Warqaddaha Medicare ee Carwell

      Buuxi warqadahaan marka ugu koowaad ee aad u wareegto caymiska Medicare si aad u ogaato haddii aad xaq u leedahay Kaalmada Kharashka Daryeelka Caafimaadka. Buuxinta warqadahaan waxay xaqiijinaysaa inaad fahamtay oo aad oggoshahay sharciyada barnaamijka sida ay dhigayaan shuruucda Hay’adda. Fadlan ogoow: waxaad u baahan doontaa inaad mar kale buuxiso wakhti kasta oo wax laga baddelo qorshayaasha caymiska.

      Foomka Onleenka ah

      Oggolaanshaha Siideynta Foomka Macluumaadka

      Buuxi tan haddii aad u baahan tahay inaad u ogolaato xubin qoyskaaga ka tirsan ama saaxiib aad aaminsan tahay inuu su’aalo kuu weeydiiyo, balamo qabto ama xaqiijiyo macluumaad adiga oo ku matalayo.

      Foomka Onleenka ah

      Foomka Lacag Wareejinta Elektrooniga ah

      Isku diiwaangeli si aad ugu hesho magdhawyada khidmadaada caymsika ee bil’laha ah lacag wareejinta elektrooniga ah. Kani waa habka ugu degdegga badan uguna ammaan badan ee aad ku heli karto lacagtaada. Waa inaa soo raaciso nuqulka jeeg maran ee erayga ‘void’ ku qoran tahay, warqada bangiga, ama bayaanada bangiga.

      Foomka Onleenka ah

      Foomka Sheegashada Magdhawga Khidmada Caymiska Bil’laha ah ee Medicare

      Isticmaal foomkaan si aad u hesho magdhawga khidmada caymiska ee bil’laha ah ee Medicare—tusaale ahaan, khidmadaha caymiska bil’laha ah ee qorshayaasha caymiska Medicare Part B, Medicare Part D, Supplement, iyo Advantage.

      Foomka Onleenka ah

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Isticmaal foomkan ama haddii kale buuxi goobta sharaxaysa sababta aad u codsanayso racfaan ama soo geli warqad sharraxaad ah. Racfaanada magdhawga waa inay weheliyaan dukumiintiyada taageeraya sida Dukumiintiga Sharaxaadaha Dheefaha (EOB) ama caddaynta lacag bixinta.

      Foomka Onleenka ah

      Wakhtiga Fasaxa Lacagta leh 

      Xirmada Codsiga Dheefaha PTO

      Haddii aad haysato 8 saacadood ama ka badan oo kuu uruuray, isticmaal foomkan si aad u codsato bixinta lacagaha dheefahaaga PTO.

      Foomka Onleenka ah

      Foomka W-9

      Si aad xaq ugu yeelato dheefaha PTO, waa inaad inoo soo dirto Form W-9 (Foomka W-9) oo buuxa oo saxiixan, haddii aadan horay u soo dirin. Fadlan ogoow: Dheefta PTO waa dakhli la canshuuri karo.

      Foomka Onleenka ah

      Foomka Lacag Wareejinta Elektrooniga ah

      Isku diiwaangeli si aad ugu hesho magdhawyadaada iyo dheefahaaga PTO lacag wareejinta elektrooniga ah. Kani waa habka ugu degdegga badan uguna ammaan badan ee aad ku heli karto lacagtaada. Waa inaa soo raaciso nuqulka jeeg maran ee erayga ‘void’ ku qoran tahay, warqada bangiga, ama bayaanada bangiga.

      Foomka Onleenka ah

      Foomka Magacaabista Ka-faa’iidaystaha

      Buuxi foomkan haddii aad jeclaan lahayd inaad magacaawdo qof la siiyo dheefahaaga PTO ee aadan qaadanin haddii ay dhacdo inaad geeriyooto.

      Foomka Onleenka ah

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