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
Fee-for-Service (FFS)
A traditional healthcare payment model in which healthcare providers are paid separately for each service provided to a patient, such as doctor visits, tests, or procedures. Medicare and Medicaid offer FFS options, although many states are moving towards managed care models.
A traditional healthcare payment model in which healthcare providers are paid separately for each service provided to a patient, such as doctor visits, tests, or procedures. Medicare and Medicaid offer FFS options, although many states are moving towards managed care models.
Insurance Premium
The amount paid, often monthly, for health insurance coverage. Premiums are required to maintain enrollment in programs like ACA Marketplace plans, Medicare, Medicaid, and private health insurance.
The amount paid, often monthly, for health insurance coverage. Premiums are required to maintain enrollment in programs like ACA Marketplace plans, Medicare, Medicaid, and private health insurance.
Premium
The monthly amount paid for health insurance coverage. Premiums are required for plans offered under the ACA Marketplace, Medicare, Medicaid (in some states), and CHIP.
The monthly amount paid for health insurance coverage. Premiums are required for plans offered under the ACA Marketplace, Medicare, Medicaid (in some states), and CHIP.
Risk Adjustment
A process used by health insurance companies to adjust payments based on the health status of their enrollees. It ensures that plans enrolling higher-risk individuals (such as those with chronic conditions) are compensated to maintain financial stability. Medicare Advantage and ACA Marketplace plans use risk adjustment.
A process used by health insurance companies to adjust payments based on the health status of their enrollees. It ensures that plans enrolling higher-risk individuals (such as those with chronic conditions) are compensated to maintain financial stability. Medicare Advantage and ACA Marketplace plans use risk adjustment.