- Activities of Daily Living (ADL)
- Acute Illness
- Administrative Law Judge (ALJ)
- Advance Beneficiary Notice (ABN)
- Advance Coverage Decision
- Advance Directive
- Advanced Illness
- Affordable Care Act (also known as the Health Care Law)
- ALS (Amyotrophic Lateral Sclerosis)/Lou Gehrig’s Disease
- Ambulette
- Annual Coordinated Election Period (ACEP)
- Annual Notice of Change (ANOC)
- Annual Wellness Visit
- Appeal
- Approved Amount
- Area Agency on Aging (AAA)
- Assets
- Assignment
- Assisted Living Facility
- Assistive Technology
- Balance Billing
- Benchmark
- Beneficiary
- Benefit Period
- Bereavement Services
- Brand-Name Drug
- Calendar Quarters
- Capped Rental Item
- Care Manager
- Caregiver
- Carrier
- Catastrophic Coverage
- Catastrophic Limit
- Center for Health Dispute Resolution (CHDR)
- Centers for Medicare & Medicaid Services (CMS)
- Certificate of Medical Necessity (CMN)
- Chronic Illness
- Claim
- COBRA (Consolidated Omnibus Budget Reconciliation Act)
- Coinsurance
- Competitive Bidding
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Continuous Open Enrollment
- Conversion Policy
- Coordination of Benefits
- Coordination Period, 30-Month
- Copayment
- Cost Plan
- Cost Sharing
- Cost Tiers
- Coverage Gap
- Coverage Restrictions
- Creditable Coverage
- Crossover
- Curative Care
- Currently Working
- Custodial Care
- Deductible
- Demand Bill
- Denial of Coverage
- Department of Veterans Affairs (VA)
- Detailed Explanation of Non-Coverage (DENC)
- Detailed Notice of Discharge
- Dialysis
- Disability
- Discharge
- Discharge Plan
- Disenrollment
- DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics and Supplies)
- Donut Hole
- Drug Class
- Drug Tiers
- Dual Eligible
- Durable Medical Equipment (DME)
- Durable Medical Equipment Medicare Administrative Contractor (DME MAC)
- Durable Medical Equipment Regional Carrier (DMERC)
- Durable Power of Attorney
- Earned Income
- Elimination Period See
- Employer Group Health Plan
- End-Stage Renal Disease (ESRD)
- Enrollment
- Enrollment Periods
- Evidence of Coverage (EOC)
- Exception Request
- Excess Charges
- Expedited Appeal
- Explanation of Benefits (EOB)
- Extra Help
- Fall Open Enrollment
- Federal District Court
- Federal Employee Health Benefit Program (FEHBP)
- Federal Poverty Level (FPL)
- Federally Qualified Health Center (FQHC)
- Fee-for-Service
- Fiscal Intermediary
- Formulary
- Formulary Restrictions
- Free Look
- Gaps in Coverage
- Gatekeeper
- General Enrollment Period
- Generic Drug
- Grievance
- Group Health Plan
- Guaranteed Issue
- Health Care Financing Administration (HCFA)
- Health Care Power of Attorney
- Health Care Provider
- Health Care Proxy
- Health Insurance
- Hill-Burton Program/Facilities
- HIPAA
- HMO (Health Maintenance Organization)
- Home Health Agency
- Home Health Aide
- Home Health Care
- Homebound
- Homemaking Services
- Hospice
- Hospital Insurance
- Hospital-Issued Notice of Non-Coverage (HINN)
- Housekeeping Services
- Important Message from Medicare
- In-Network
- Independent Review Entity (IRE)
- Individual Policy
- Initial Coverage Election Period
- Initial Enrollment Period
- Initial Open Enrollment Period
- Inpatient
- Inpatient Care
- Intermediary
- Intermediate Care Facility for the Mentally Retarded (ICF/MR)
- Language Therapy
- Lifetime Reserve Days
- Limiting Charge
- Living Will
- Long-Term Care
- Long-Term Care Insurance
- Long-Term Care Ombudsman
- Low-Income Subsidy (LIS)
- Maintenance Care
- Managed Care Plan
- MAPD (Medicare Advantage Drug Plan)
- Marketing Fraud
- Marketplaces (also known as Exchanges)
- Maximum Out-of-Pocket Cost (MOoP)
- Maximus
- Medicaid
- Medicaid Buy-In
- Medicaid Spend-Down
- Medical Insurance
- Medical Supplies
- Medically Necessary
- Medicare
- Medicare Administrative Contractor (MAC)
- Medicare Advantage
- Medicare Advantage Disenrollment Period
- Medicare Appeals Counsel (MAC)
- Medicare Card
- Medicare Fraud
- Medicare Prescription Drug Benefit
- Medicare Private Drug Plan
- Medicare Private Health Plan
- Medicare Savings Programs (MSP)
- Medicare SELECT
- Medicare Summary Notice (MSN)
- Medicare-Approved Amount
- Medicare-Certified
- Medicare+Choice
- Medigap
- MSA (Medical Savings Account)
- National Coverage Determination (NCD)
- Network
- Non-Participating Provider
- Non-Preferred Provider/Care
- Notice of Medicare Non-Coverage (NOMNC)
- Notice of Medicare Provider Non-Coverage (NOMPNC)
- Nursing Home
- Observation Stay
- Occupational Therapy
- Off-Label
- Opt-Out
- Original Medicare
- Out-of-Network
- Out-of-Pocket Costs
- Out-of-Pocket Limit
- Outpatient
- Outpatient Care
- Outpatient Prospective Payment System (OPPS)
- Over-the-Counter Drug
- Palliative Care
- Part A
- Part B
- Part C
- Part D
- Participating Provider
- Pastoral Care
- Patient Assistance Program
- PDP (Prescription Drug Plan)
- Personal Care
- PFFS (Private Fee-for-Service)
- Pharmacotherapy
- Physical Therapy
- Plan of Care
- POS (Point-of-Service) Option
- PPO (Preferred Provider Organization)
- Pre-Approval
- Pre-Existing Condition
- Preferred Provider/Care
- Prescription
- Prescription Drug
- Prescription Drug Insurance
- Preventive Care
- Primary Care Physician (PCP)
- Primary Insurance
- Private Duty Nursing
- Private Health Plan
- Private Plan Card
- Program of All-Inclusive Care for the Elderly (PACE)
- Provider
- PSO (Provider-Sponsored Organization)
- QDWI (Qualified Disabled Working Individual)
- QI (Qualifying Individual)
- QIO Review
- QMB (Qualified Medicare Beneficiary)
- Qualified Independent Contractor (QIC)
- Quality Improvement Organization (QIO)
- Quantity Limit
- Railroad Medicare Carrier
- Railroad Retirement Board
- Reconsideration
- Red, White and Blue Card
- Redetermination
- Referral
- Rehabilitative Care
- Reserve Days
- Respite Care
- Retiree Insurance
- Retroactive Disenrollment
- Secondary Insurance
- Semiprivate Room
- Service Area
- SHIP (State Health Insurance Assistance Program)
- Skilled Care
- Skilled Nursing Facility (SNF)
- Skilled Nursing Services
- Skilled Therapy Services
- SLMB (Specified Low-Income Medicare Beneficiary Program)
- SNP (Special Needs Plan)
- Special Election Period
- Special Enrollment Period (SEP)
- Specialist
- Speech Therapy
- Speech/Language Pathology
- SSI (Supplementary Security Income)
- State Pharmaceutical Assistance Program (SPAP)
- Step Therapy
- Supplemental Insurance
- Supplier
- Take Assignment
- Temporary First Fill
- Terminal Illness
- Therapy Caps
- Tiers
- Transition Policy
- TRICARE
- TRICARE for Life
- Unearned Income
- Unskilled Care
- Urgent Care
- Utilization Management Tools
- Veterans Administration (VA) Benefits
- Waiting Period
- Waiver of Liability
- Work Credits
Glossary
Last Updated: October 19, 2015
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