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
Balance Billing
The practice of billing a patient for the difference between the provider’s charge and the amount covered by the insurance plan. In Medicare, Medicaid, and CHIP, balance billing may be prohibited or limited.
The practice of billing a patient for the difference between the provider’s charge and the amount covered by the insurance plan. In Medicare, Medicaid, and CHIP, balance billing may be prohibited or limited.
Copayment (Copay)
A fixed amount an individual pays for a covered healthcare service, such as a doctor visit or prescription, after meeting their deductible. The amount varies by service and insurance plan.
A fixed amount an individual pays for a covered healthcare service, such as a doctor visit or prescription, after meeting their deductible. The amount varies by service and insurance plan.
Coordination of Benefits (COB)
A process used when a patient is covered by more than one insurance plan. It determines which insurance plan pays first and helps prevent overpayment for services covered by both policies. COB applies to Medicare, Medicaid, and private insurance.
A process used when a patient is covered by more than one insurance plan. It determines which insurance plan pays first and helps prevent overpayment for services covered by both policies. COB applies to Medicare, Medicaid, and private insurance.
Deductible
The amount an individual must pay out-of-pocket for covered healthcare services before their insurance plan starts to cover costs. Deductibles apply to various types of insurance, including Medicare, Medicaid, ACA, and CHIP plans.
The amount an individual must pay out-of-pocket for covered healthcare services before their insurance plan starts to cover costs. Deductibles apply to various types of insurance, including Medicare, Medicaid, ACA, and CHIP plans.
Family Coverage
A health insurance plan that covers an entire family, including the policyholder, spouse, and dependents. Under the ACA, parents can keep their children on their health plan until age 26, even if the children are not financially dependent or living with the parents.
A health insurance plan that covers an entire family, including the policyholder, spouse, and dependents. Under the ACA, parents can keep their children on their health plan until age 26, even if the children are not financially dependent or living with the parents.
Group Health Plan
Health insurance coverage provided to a group of people, typically through an employer or union. Medicare coordinates benefits with group health plans when an individual is eligible for both.
Health insurance coverage provided to a group of people, typically through an employer or union. Medicare coordinates benefits with group health plans when an individual is eligible for both.