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
Cost-sharing Reduction (CSR)
A subsidy available through the ACA Marketplace that lowers out-of-pocket costs like deductibles, copays, and coinsurance for eligible individuals. CSR is available to people who enroll in Silver-tier plans and meet specific income requirements.
A subsidy available through the ACA Marketplace that lowers out-of-pocket costs like deductibles, copays, and coinsurance for eligible individuals. CSR is available to people who enroll in Silver-tier plans and meet specific income requirements.
Eligibility
The criteria that individuals must meet to qualify for healthcare programs such as Medicare, Medicaid, CHIP, or ACA Marketplace plans. Eligibility is typically based on factors such as age, income, residency, and health status.
The criteria that individuals must meet to qualify for healthcare programs such as Medicare, Medicaid, CHIP, or ACA Marketplace plans. Eligibility is typically based on factors such as age, income, residency, and health status.
Federal Poverty Level (FPL)
A measure of income issued annually by the Department of Health and Human Services (HHS) to determine eligibility for various government assistance programs, including Medicaid, CHIP, and ACA subsidies. The FPL varies based on household size and geographic location.
A measure of income issued annually by the Department of Health and Human Services (HHS) to determine eligibility for various government assistance programs, including Medicaid, CHIP, and ACA subsidies. The FPL varies based on household size and geographic location.
Gross Income
The total income earned before any deductions, such as taxes or retirement contributions, are taken out. Gross income is used to determine eligibility for programs like Medicaid, CHIP, and ACA Marketplace subsidies.
The total income earned before any deductions, such as taxes or retirement contributions, are taken out. Gross income is used to determine eligibility for programs like Medicaid, CHIP, and ACA Marketplace subsidies.
Income-Related Monthly Adjustment Amount (IRMAA)
An additional charge added to Medicare Part B and Part D premiums for beneficiaries with higher incomes. IRMAA is determined based on the beneficiary’s modified adjusted gross income (MAGI).
An additional charge added to Medicare Part B and Part D premiums for beneficiaries with higher incomes. IRMAA is determined based on the beneficiary’s modified adjusted gross income (MAGI).
Medically Needy
A category of Medicaid eligibility for individuals whose income is too high to qualify for traditional Medicaid but have significant medical expenses. Medically needy programs allow people to "spend down" their income on medical costs to become eligible.
A category of Medicaid eligibility for individuals whose income is too high to qualify for traditional Medicaid but have significant medical expenses. Medically needy programs allow people to "spend down" their income on medical costs to become eligible.
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.