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Glossary
Medicare Language Made Simple: Glossary of Key Terms
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A
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C
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F
G
H
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J
K
L
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N
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X
Y
Z
A
Accountable Care Organizations (ACO)
Advance Beneficiary Notice of Noncoverage (ABN)
Advance Coverage Decision (ACD)
Advance Directive
ALS
Annual Election Period
Appeal
Assignment of Benefits
Ambulatory Surgical Center (ASC)
B
Beneficiary and Family Centered Care–Quality Improvement Organization (BFCC-QIO)
Benefit period
Benefits Coordination & Recovery Center (BCRC)
C
Certified (Certification)
CHAMPVA
Claim
Clinical Breast Exam
Coinsurance
Comprehensive outpatient rehabilitation facility (CORF)
Copayment
Coverage determination (Part D)
Coverage Gap
Creditable Coverage
Critical access hospital (CAH)
Custodial care
D
Deductible
Demonstrations
Diethylstilbestrol
Donut Hole
Durable power of attorney (DPOA)
E
End-Stage Renal Disease (ESRD)
Exception
Excess charge
Extra Help
F
Formulary
G
Grievance
Group Health Plan
Guaranteed Issue Rights (also called “Medigap Protections”)
Guaranteed Renewable Policy
H
Healthcare Provider
Health Insurance Marketplace
Home Health Agency
Home Healthcare
Hospice
I
Income Related Monthly Adjustment Amount (IRMAA)
Independent reviewer
Initial Coverage Election Period (ICEP)
Initial Enrollment Period (IEP)
Inpatient Rehabilitation Facility
L
Large Group Health Plan
Lifetime Reserve Days
Limiting Charge
Living Will
Long-Term Care
Long-Term Care Hospital
Long-Term Care Ombudsman
M
Medicaid
Medical Underwriting
Medically Necessary
Medicare
Medicare Advantage Plan (Part C)
Medicare Cost Plan
Medicare Drug Coverage (Part D)
Medicare Drug Plan (Part D)
Medicare Health Maintenance Organization (HMO) Plan
Medicare Health Plan
Medicare Medical Savings Account (MSA) Plan
Medicare Part A (Hospital Insurance)
Medicare Part B (Medical Insurance)
Medicare Plan
Medicare Preferred Provider Organization (PPO) Plan
Medicare Private Fee-For-Service (PFFS) Plan
Medicare Savings Program
Medicare SELECT
Medicare Special Needs Plan (SNP)
Medicare Summary Notice (MSN)
Medicare-Approved Amount
Medicare-Certified Provider
Medigap
Medigap Open Enrollment Period
Medigap policy
Multi-employer plan
O
Open Enrollment Period (OEP)
Original Medicare
Out-Of-Pocket Costs
P
Pap Test
Pelvic Exam
Penalty
Pilot Programs
Point-Of-Service Option
Power of attorney
Pre-Existing Condition
Premium
Preventive Services
Primary Care Doctor
Prior Authorization
Program of All-Inclusive Care for the Elderly (PACE)
R
Referral
Rehabilitation Services
Religious Nonmedical HealthCare Institution
Respite Care
S
Secondary Payer
Service Area
Skilled Nursing Care
Skilled Nursing Facility (SNF)
Skilled Nursing Facility (SNF) Care
Special Enrollment Period (SEP)
State Health Insurance Assistance Program (SHIP)
State Insurance Department
State Medical Assistance (Medicaid) Office
State Pharmaceutical Assistance Program (SPAP)
State Survey Agency
Step Therapy
Supplemental Security Income (SSI)
Supplier
T
Telemedicine
Tiers
TTY
U
Urgently needed care
W
Worker’s compensation
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