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
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.
Local Coverage Determination (LCD)
Decisions made by Medicare Administrative Contractors (MACs) regarding whether a particular medical service or item is covered on a local basis. LCDs apply to services that may not have national coverage policies from Medicare.
Decisions made by Medicare Administrative Contractors (MACs) regarding whether a particular medical service or item is covered on a local basis. LCDs apply to services that may not have national coverage policies from Medicare.
National Coverage Determination (NCD)
A decision made by Medicare about whether a particular medical service, procedure, or device is covered nationally. NCDs apply uniformly across the country and are developed based on clinical evidence and input from healthcare experts.
A decision made by Medicare about whether a particular medical service, procedure, or device is covered nationally. NCDs apply uniformly across the country and are developed based on clinical evidence and input from healthcare experts.
Urgent Care
Medical services provided for conditions that require prompt attention but are not serious enough for emergency room care. Medicare, Medicaid, CHIP, and ACA Marketplace plans often cover urgent care visits, with varying copayments or coinsurance.
Medical services provided for conditions that require prompt attention but are not serious enough for emergency room care. Medicare, Medicaid, CHIP, and ACA Marketplace plans often cover urgent care visits, with varying copayments or coinsurance.
Urgent Need Care (Medicare)
Immediate medical care required for sudden illnesses or injuries that are not life-threatening but require prompt attention. Medicare Advantage plans typically cover urgent care services, and they may have lower out-of-pocket costs than emergency room visits.
Immediate medical care required for sudden illnesses or injuries that are not life-threatening but require prompt attention. Medicare Advantage plans typically cover urgent care services, and they may have lower out-of-pocket costs than emergency room visits.
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.