Glossary
Tags
- ACA
- ACA Marketplace
- ACA subsidies
- CHIP
- CMS
- ESRD
- Extra Help
- FMAP
- FPL
- FQHC
- FSA
- HCBS
- HMO
- HRA
- HSA
- IEP
- IRMAA
- Joint Commision
- KFF
- LCD
- LIS
- Marketplace
- Medicaid
- Medicaid (rare)
- Medicaid expansion
- Medicare
- Medicare Advantage
- Medicare Part A
- Medicare Part B
- Medicare Part D
- Medicare coordination
- Medigap
- NCD
- NEMT
- NOMNC
- Original Medicare
- PCP
- Part A
- Part B
- Part C
- Part D
- QLE
- QMB
- SEP
- SNF
- SNP
- SSI
- Section 1115
- Silver Plan
- Silver plan
ACA (Affordable Care Act)
A comprehensive healthcare reform law enacted in 2010, aimed at increasing health insurance coverage, reducing healthcare costs, and improving healthcare outcomes. It established the Health Insurance Marketplace and expanded Medicaid in many states.
A comprehensive healthcare reform law enacted in 2010, aimed at increasing health insurance coverage, reducing healthcare costs, and improving healthcare outcomes. It established the Health Insurance Marketplace and expanded Medicaid in many states.
Buy-In Program
A Medicaid program that allows certain individuals, such as people with disabilities or those with higher incomes, to "buy into" Medicaid by paying a premium. It provides Medicaid coverage without meeting traditional income or asset limits.
A Medicaid program that allows certain individuals, such as people with disabilities or those with higher incomes, to "buy into" Medicaid by paying a premium. It provides Medicaid coverage without meeting traditional income or asset limits.
CHIP (Children’s Health Insurance Program)
A joint federal-state program providing low-cost health insurance for children in families that earn too much to qualify for Medicaid but cannot afford private insurance. CHIP covers a wide range of health services including doctor visits, immunizations, and prescription drugs.
A joint federal-state program providing low-cost health insurance for children in families that earn too much to qualify for Medicaid but cannot afford private insurance. CHIP covers a wide range of health services including doctor visits, immunizations, and prescription drugs.
Medicaid
A joint federal and state program that provides healthcare coverage to low-income individuals, families, seniors, and people with disabilities. Medicaid covers a wide range of services, including doctor visits, hospital stays, long-term care, and preventive care.
A joint federal and state program that provides healthcare coverage to low-income individuals, families, seniors, and people with disabilities. Medicaid covers a wide range of services, including doctor visits, hospital stays, long-term care, and preventive care.
Medicaid Expansion
A provision of the ACA that allows states to expand Medicaid eligibility to adults with incomes up to 138% of the Federal Poverty Level (FPL). Expansion states offer coverage to a broader range of low-income adults, including those without children.
A provision of the ACA that allows states to expand Medicaid eligibility to adults with incomes up to 138% of the Federal Poverty Level (FPL). Expansion states offer coverage to a broader range of low-income adults, including those without children.
Medicare
A federal program that provides health insurance to individuals 65 and older, as well as younger people with certain disabilities or End-Stage Renal Disease (ESRD). Medicare has different parts that cover hospital care (Part A), medical services (Part B), and prescription drugs (Part D).
A federal program that provides health insurance to individuals 65 and older, as well as younger people with certain disabilities or End-Stage Renal Disease (ESRD). Medicare has different parts that cover hospital care (Part A), medical services (Part B), and prescription drugs (Part D).
Original Medicare
The traditional Medicare program, consisting of Part A (hospital insurance) and Part B (medical insurance). Original Medicare is a fee-for-service program, allowing beneficiaries to see any provider that accepts Medicare.
The traditional Medicare program, consisting of Part A (hospital insurance) and Part B (medical insurance). Original Medicare is a fee-for-service program, allowing beneficiaries to see any provider that accepts Medicare.
Qualified Medicare Beneficiary (QMB) Program
A Medicaid program that helps low-income Medicare beneficiaries pay for Medicare Part A and Part B premiums, deductibles, copayments, and coinsurance. Beneficiaries must meet specific income and resource limits to qualify.
A Medicaid program that helps low-income Medicare beneficiaries pay for Medicare Part A and Part B premiums, deductibles, copayments, and coinsurance. Beneficiaries must meet specific income and resource limits to qualify.
Supplemental Security Income (SSI)
A federal income program that provides financial assistance to low-income individuals who are aged, blind, or disabled. SSI recipients often qualify for Medicaid automatically to help cover healthcare costs.
A federal income program that provides financial assistance to low-income individuals who are aged, blind, or disabled. SSI recipients often qualify for Medicaid automatically to help cover healthcare costs.
State Medicaid Plan
A comprehensive program developed by each state, with federal approval, to outline how the state will administer its Medicaid program. Each state Medicaid plan includes details on eligibility, services covered, and how the state will meet federal Medicaid requirements.
A comprehensive program developed by each state, with federal approval, to outline how the state will administer its Medicaid program. Each state Medicaid plan includes details on eligibility, services covered, and how the state will meet federal Medicaid requirements.
TRICARE
A healthcare program for uniformed service members, retirees, and their families. Medicare coordinates with TRICARE to provide comprehensive coverage for military retirees who are eligible for both programs.
A healthcare program for uniformed service members, retirees, and their families. Medicare coordinates with TRICARE to provide comprehensive coverage for military retirees who are eligible for both programs.
Transitional Medicaid Assistance (TMA)
A Medicaid program that provides temporary coverage to families who lose Medicaid eligibility due to an increase in income. TMA ensures that individuals can still access healthcare services for a certain period while transitioning to new coverage.
A Medicaid program that provides temporary coverage to families who lose Medicaid eligibility due to an increase in income. TMA ensures that individuals can still access healthcare services for a certain period while transitioning to new coverage.
Veterans Affairs (VA) Healthcare
A healthcare system operated by the Department of Veterans Affairs (VA) that provides medical services to eligible U.S. veterans. Veterans who qualify for both VA healthcare and Medicare may use both programs to maximize coverage.
A healthcare system operated by the Department of Veterans Affairs (VA) that provides medical services to eligible U.S. veterans. Veterans who qualify for both VA healthcare and Medicare may use both programs to maximize coverage.
Waiver (Medicaid)
A provision that allows states to modify certain Medicaid rules to provide specialized healthcare services to targeted populations. Examples include Home and Community-Based Services (HCBS) waivers and Section 1115 waivers, which allow innovative approaches to care for specific groups, such as seniors or people with disabilities.
A provision that allows states to modify certain Medicaid rules to provide specialized healthcare services to targeted populations. Examples include Home and Community-Based Services (HCBS) waivers and Section 1115 waivers, which allow innovative approaches to care for specific groups, such as seniors or people with disabilities.